Exemption of certain systems of records under the Privacy Act. Final rule.

PubMed

2008-09-26

This final rule exempts four systems of records (SORs) from subsections (c)(3), (d)(1) through (d)(4), (e)(4)(G) and (H), and (f) of the Privacy Act pursuant to 5 U.S.C. 552a(k)(2): The Automated Survey Processing Environment (ASPEN) Complaint/ Incidents Tracking System (ACTS), HHS/CMS, System No. 09-70-0565; the Health Insurance Portability and Accountability Act (HIPAA) Information Tracking System (HITS), HHS/CMS, System No. 09-70-0544; the Organ Procurement Organizations System (OPOS), HHS/CMS, System No. 09-70- 0575; and the Fraud Investigation Database (FID), HHS/CMS, System No. 09-70-0527.

Track propagation methods for the correlation of charged tracks with clusters in the calorimeter of the bar PANDA experiment

NASA Astrophysics Data System (ADS)

Nasawasd, T.; Simantathammakul, T.; Herold, C.; Stockmanns, T.; Ritman, J.; Kobdaj, C.

2018-02-01

To classify clusters of hits in the electromagnetic calorimeter (EMC) of bar PANDA (antiProton ANnihilation at DArmstadt), one has to match these EMC clusters with tracks of charged particles reconstructed from hits in the tracking system. Therefore the tracks are propagated to the surface of the EMC and associated with EMC clusters which are nearby and below a cut parameter. In this work, we propose a helix propagator to extrapolate the track from the Straw Tube Tracker (STT) to the inner surface of the EMC instead of the GEANE propagator which is already embedded within the PandaRoot computational framework. The results for both propagation methods show a similar quality, with a 30% gain in CPU time when using the helix propagator. We use Monte-Carlo truth information to compare the particle ID of the EMC clusters with the ID of the extrapolated points, thus deciding upon the correctness of the matches. By varying the cut parameter as a function of transverse momentum and particle type, our simulations show that the purity can be increased by 3-5% compared to the default value which is a constant cut in the bar PANDA simulation framework PandaRoot.

Health information technology and physicians' perceptions of healthcare quality.

PubMed

Fang, Hai; Peifer, Karen L; Chen, Jie; Rizzo, John A

2011-03-01

To investigate the relationship between the use of health information technology (HIT) and physician perceptions of providing high-quality care and to determine whether this relationship has changed over time. We used 2 waves of longitudinal data from the Community Tracking Study Physician Surveys, 2000-2001 and 2004-2005. Three measures of HIT were examined: a binary variable measuring the use of at least 1 type of HIT, a continuous variable measuring the total number of HIT types, and a binary variable measuring use of all 5 HIT types related to "meaningful use" of HIT as defined by Centers for Medicare and Medicaid Services. Three multivariate models were estimated to study the effect of each HIT measure on physicians' perception of providing high-quality care. Individual fixed-effects estimation also was used to control for individual time-invariant factors. Using at least 1 type of HIT significantly enhanced physicians' perception of providing high-quality care in 2000-2001, but not in 2004-2005. The marginal effect of adding 1 extra HIT type was positive and statistically significant in both periods. The association between using all 5 HIT types related to meaningful use and perceived quality was statistically significant in 2000-2001, but not in 2004-2005. Health information technology has become a multifunctional system and appears to have enhanced physicians' perception of providing high-quality care. Physicians' perceptions of medical care quality improved as the number of HIT types used increased. This study supports more extensive use of HIT in physician practices.

Deployment and Evaluation of the Helicopter In-Flight Tracking System (HITS)

DOT National Transportation Integrated Search

2004-12-30

The Gulf of Mexico airspace has two major operating regions: low altitude offshore (below 7,000 ft) and high altitude oceanic (above 18,000 ft). Both regions suffer significant inefficiencies due to the lack of continuous surveillance during Instrume...

Deployment and evaluation of the Helicopter In-flight Tracking System (HITS)

DOT National Transportation Integrated Search

2004-12-31

The Gulf of Mexico airspace has two major operating regions: low altitude offshore (below 7,000 ft) and high altitude oceanic (above 18,000 ft). Both regions suffer significant inefficiencies due to the lack of continuous surveillance during Instrume...

An analysis of particle track effects on solid mammalian tissues

NASA Technical Reports Server (NTRS)

Todd, P.; Clarkson, T. W. (Principal Investigator)

1992-01-01

Relative biological effectiveness (RBE) and quality factor (Q) at extreme values of linear energy transfer (LET) have been determined on the basis of experiments with single-cell systems and specific tissue responses. In typical single-cell systems, each heavy particle (Ar or Fe) passes through a single cell or no cell. In experiments on animal tissues, however, each heavy particle passes through several cells, and the LET can exceed 200 keV micrometers-1 in every cell. In most laboratory animal tissue systems, however, only a small portion of the hit cells are capable of expressing the end-point being measured, such as cell killing, mutation or carcinogenesis. The following question was therefore addressed: do RBEs and Q factors derived from single-cell experiments properly account for the damage at high LET when multiple cells are hit by HZE tracks? A review is offered in which measured radiation effects and known tissue properties are combined to estimate on the one hand, the number of cells at risk, p3n, per track, where n is the number of cells per track based on tissue and organ geometry, and p3 is the probability that a cell in the track is capable of expressing the experimental end-point. On the other hand, the tissue and single-cell responses are compared by determining the ratio RBE in tissue/RBE in corresponding single cells. Experimental data from the literature indicate that tissue RBEs at very high LET (Fe and Ar ions) are higher than corresponding single-cell RBEs, especially in tissues in which p3n is high.

The Israel DNA database--the establishment of a rapid, semi-automated analysis system.

PubMed

Zamir, Ashira; Dell'Ariccia-Carmon, Aviva; Zaken, Neomi; Oz, Carla

2012-03-01

The Israel Police DNA database, also known as IPDIS (Israel Police DNA Index System), has been operating since February 2007. During that time more than 135,000 reference samples have been uploaded and more than 2000 hits reported. We have developed an effective semi-automated system that includes two automated punchers, three liquid handler robots and four genetic analyzers. An inhouse LIMS program enables full tracking of every sample through the entire process of registration, pre-PCR handling, analysis of profiles, uploading to the database, hit reports and ultimately storage. The LIMS is also responsible for the future tracking of samples and their profiles to be expunged from the database according to the Israeli DNA legislation. The database is administered by an in-house developed software program, where reference and evidentiary profiles are uploaded, stored, searched and matched. The DNA database has proven to be an effective investigative tool which has gained the confidence of the Israeli public and on which the Israel National Police force has grown to rely. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Dosimetry in radiobiological studies with the heavy ion beam of the Warsaw cyclotron

NASA Astrophysics Data System (ADS)

Kaźmierczak, U.; Banaś, D.; Braziewicz, J.; Czub, J.; Jaskóła, M.; Korman, A.; Kruszewski, M.; Lankoff, A.; Lisowska, H.; Malinowska, A.; Stępkowski, T.; Szefliński, Z.; Wojewódzka, M.

2015-12-01

The aim of this study was to verify various dosimetry methods in the irradiation of biological materials with a 12C ion beam at the Heavy Ion Laboratory of the University of Warsaw. To this end the number of ions hitting the cell nucleus, calculated on the basis of the Si-detector system used in the set-up, was compared with the number of ion tracks counted in irradiated Solid State Nuclear Track Detectors and with the number of ion tracks detected in irradiated Chinese Hamster Ovary cells processed for the γ-H2AX assay. Tests results were self-consistent and confirmed that the system serves its dosimetric purpose.

Optimization of the microcable and detector parameters towards low noise in the STS readout system

NASA Astrophysics Data System (ADS)

Kasinski, Krzysztof; Kleczek, Rafal; Schmidt, Christian J.

2015-09-01

Successful operation of the Silicon Tracking System requires charge measurement of each hit with equivalent noise charge lower than 1000 e- rms. Detector channels will not be identical, they will be constructed accordingly to the estimated occupancy, therefore for the readout electronics, detector system will exhibit various parameters. This paper presents the simulation-based study on the required microcable (trace width, dielectric material), detector (aluminum strip resistance) and external passives' (decoupling capacitors) parameters in the Silicon Tracking System. Studies will be performed using a front-end electronics (charge sensitive amplifier with shaper) designed for the power budget of 10 mA/channel.

Tracking down quirks at the Large Hadron Collider

NASA Astrophysics Data System (ADS)

Knapen, Simon; Lou, Hou Keong; Papucci, Michele; Setford, Jack

2017-12-01

Nonhelical tracks are the smoking gun signature of charged and/or colored quirks, which are pairs of particles bound by a new, long-range confining force. We propose a method to efficiently search for these nonhelical tracks at the LHC, without the need to fit their trajectories. We show that the hits corresponding to quirky trajectories can be selected efficiently by searching for coplanar hits in the inner layers of the ATLAS and CMS trackers, even in the presence of on average 50 pile-up vertices. We further argue that backgrounds from photon conversions and unassociated pile-up hits can be removed almost entirely, while maintaining a signal reconstruction efficiency as high as ˜70 % . With the 300 fb-1 dataset, this implies a discovery potential for string tension between 100 eV and 30 keV, and colored (electroweak charged) quirks as heavy as 1600 (650) GeV may be discovered.

Back-end and interface implementation of the STS-XYTER2 prototype ASIC for the CBM experiment

NASA Astrophysics Data System (ADS)

Kasinski, K.; Szczygiel, R.; Zabolotny, W.

2016-11-01

Each front-end readout ASIC for the High-Energy Physics experiments requires robust and effective hit data streaming and control mechanism. A new STS-XYTER2 full-size prototype chip for the Silicon Tracking System and Muon Chamber detectors in the Compressed Baryonic Matter experiment at Facility for Antiproton and Ion Research (FAIR, Germany) is a 128-channel time and amplitude measuring solution for silicon microstrip and gas detectors. It operates at 250 kHit/s/channel hit rate, each hit producing 27 bits of information (5-bit amplitude, 14-bit timestamp, position and diagnostics data). The chip back-end implements fast front-end channel read-out, timestamp-wise hit sorting, and data streaming via a scalable interface implementing the dedicated protocol (STS-HCTSP) for chip control and hit transfer with data bandwidth from 9.7 MHit/s up to 47 MHit/s. It also includes multiple options for link diagnostics, failure detection, and throttling features. The back-end is designed to operate with the data acquisition architecture based on the CERN GBTx transceivers. This paper presents the details of the back-end and interface design and its implementation in the UMC 180 nm CMOS process.

Integration of a vision-based tracking platform, visual instruction, and error analysis models for an efficient billiard training system

NASA Astrophysics Data System (ADS)

Shih, Chihhsiong; Hsiung, Pao-Ann; Wan, Chieh-Hao; Koong, Chorng-Shiuh; Liu, Tang-Kun; Yang, Yuanfan; Lin, Chu-Hsing; Chu, William Cheng-Chung

2009-02-01

A billiard ball tracking system is designed to combine with a visual guide interface to instruct users for a reliable strike. The integrated system runs on a PC platform. The system makes use of a vision system for cue ball, object ball and cue stick tracking. A least-squares error calibration process correlates the real-world and the virtual-world pool ball coordinates for a precise guidance line calculation. Users are able to adjust the cue stick on the pool table according to a visual guidance line instruction displayed on a PC monitor. The ideal visual guidance line extended from the cue ball is calculated based on a collision motion analysis. In addition to calculating the ideal visual guide, the factors influencing selection of the best shot among different object balls and pockets are explored. It is found that a tolerance angle around the ideal line for the object ball to roll into a pocket determines the difficulty of a strike. This angle depends in turn on the distance from the pocket to the object, the distance from the object to the cue ball, and the angle between these two vectors. Simulation results for tolerance angles as a function of these quantities are given. A selected object ball was tested extensively with respect to various geometrical parameters with and without using our integrated system. Players with different proficiency levels were selected for the experiment. The results indicate that all players benefit from our proposed visual guidance system in enhancing their skills, while low-skill players show the maximum enhancement in skill with the help of our system. All exhibit enhanced maximum and average hit-in rates. Experimental results on hit-in rates have shown a pattern consistent with that of the analysis. The hit-in rate is thus tightly connected with the analyzed tolerance angles for sinking object balls into a target pocket. These results prove the efficiency of our system, and the analysis results can be used to attain an efficient game-playing strategy.

A novel 3-dimensional electromagnetic guidance system increases intraoperative microwave antenna placement accuracy.

PubMed

Sastry, Amit V; Swet, Jacob H; Murphy, Keith J; Baker, Erin H; Vrochides, Dionisios; Martinie, John B; McKillop, Iain H; Iannitti, David A

2017-12-01

Failure to locate lesions and accurately place microwave antennas can lead to incomplete tumor ablation. The Emprint™ SX Ablation Platform employs real-time 3D-electromagnetic spatial antenna tracking to generate intraoperative laparoscopic antenna guidance. We sought to determine whether Emprint™ SX affected time/accuracy of antenna-placement in a laparoscopic training model. Targets (7-10 mm) were set in agar within a laparoscopic training device. Novices (no surgical experience), intermediates (surgical residents), and experts (HPB-surgeons) were asked to locate and hit targets using a MWA antenna (10-ultrasound only, 10-Emprint™ SX). Time to locate target, number of attempts to hit the target, first-time hit rate, and time from initiating antenna advance to hitting the target were measured. Participants located 100% of targets using ultrasound, with experts taking significantly less time than novices and intermediates. Using ultrasound only, successful hit-rates were 70% for novices and 90% for intermediates and experts. Using Emprint™ SX, successful hit rates for all 3-groups were 100%, with significantly increased first-time hit-rates and reduced time required to hit targets compared to ultrasound only. Emprint™ SX significantly improved accuracy and speed of antenna-placement independent of experience, and was particularly beneficial for novice users. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

L1 track triggers for ATLAS in the HL-LHC

DOE PAGES

Lipeles, E.

2012-01-01

The HL-LHC, the planned high luminosity upgrade for the LHC, will increase the collision rate in the ATLAS detector approximately a factor of 5 beyond the luminosity for which the detectors were designed, while also increasing the number of pile-up collisions in each event by a similar factor. This means that the level-1 trigger must achieve a higher rejection factor in a more difficult environment. This presentation discusses the challenges that arise in this environment and strategies being considered by ATLAS to include information from the tracking systems in the level-1 decision. The main challenges involve reducing the data volumemore » exported from the tracking system for which two options are under consideration: a region of interest based system and an intelligent sensor method which filters on hits likely to come from higher transverse momentum tracks.« less

The design and performance of the ZEUS Central Tracking Detector z-by-timing system

NASA Astrophysics Data System (ADS)

Bailey, D. S.; Foster, B.; Heath, G. P.; Morgado, C. J. S.; Harnew, N.; Khatri, T.; Lancaster, M.; McArthur, I. C.; McFall, J. D.; Nash, J.; Shield, P. D.; Topp-Jorgensen, S.; Wilson, F. F.; Carter, R. C.; Jeffs, M. D.; Milborrow, R.; Morrissey, M. C.; Phillips, D. A.; Quinton, S. P. H.; Westlake, G.; White, D. J.; Lane, J. B.; Nixon, G.; Postranecky, M.

1997-02-01

The ZEUS Central Tracking Detector utilizes a time difference measurement to provide a fast determination of the z coordinate of each hit. The z-by-timing measurement is achieved by using a Time-to-Amplitude Converter which has an intrinsic timing resolution of 36 ps, has pipelined readout, and has a multihit capability of 48 ns. In order to maintain the required sub-nanosecond timing accuracy, the technique incorporates an automated self-calibration system. The readout of the z-by-timing data utilizes a fully customized timing control system which runs synchronously with the HERA beam-crossing clock, and a data acquisition system implemented on a network of Transputers. Three dimensional space-points provided by the z-by-timing system are used as input to all three levels of the ZEUS trigger and for offline track reconstruction. The average z resolution is determined to be 4.4 cm for multi-track events from positron-proton collisions in the ZEUS detector.

Commercial associative memory performance for applications in track-based triggers at the Large Hadron Collider

NASA Astrophysics Data System (ADS)

Webster, Jordan

2017-01-01

Dense track environments in pp collisions at the Large Hadron Collider (LHC) motivate the use of triggers with dedicated hardware for fast track reconstruction. The ATLAS Collaboration is in the process of implementing a Fast Tracker (FTK) trigger upgrade, in which Content Addressable Memories (CAMs) will be used to rapidly match hit patterns with large banks of simulated tracks. The FTK CAMs are produced primarily at the University of Pisa. However, commercial CAM technology is rapidly developing due to applications in computer networking devices. This poster presents new studies comparing FTK CAMs to cutting-edge ternary CAMs developed by Cavium. The comparison is intended to guide the design of future track-based trigger systems for the next Phase at the LHC.

Readout, first- and second-level triggers of the new Belle silicon vertex detector

NASA Astrophysics Data System (ADS)

Friedl, M.; Abe, R.; Abe, T.; Aihara, H.; Asano, Y.; Aso, T.; Bakich, A.; Browder, T.; Chang, M. C.; Chao, Y.; Chen, K. F.; Chidzik, S.; Dalseno, J.; Dowd, R.; Dragic, J.; Everton, C. W.; Fernholz, R.; Fujii, H.; Gao, Z. W.; Gordon, A.; Guo, Y. N.; Haba, J.; Hara, K.; Hara, T.; Harada, Y.; Haruyama, T.; Hasuko, K.; Hayashi, K.; Hazumi, M.; Heenan, E. M.; Higuchi, T.; Hirai, H.; Hitomi, N.; Igarashi, A.; Igarashi, Y.; Ikeda, H.; Ishino, H.; Itoh, K.; Iwaida, S.; Kaneko, J.; Kapusta, P.; Karawatzki, R.; Kasami, K.; Kawai, H.; Kawasaki, T.; Kibayashi, A.; Koike, S.; Korpar, S.; Križan, P.; Kurashiro, H.; Kusaka, A.; Lesiak, T.; Limosani, A.; Lin, W. C.; Marlow, D.; Matsumoto, H.; Mikami, Y.; Miyake, H.; Moloney, G. R.; Mori, T.; Nakadaira, T.; Nakano, Y.; Natkaniec, Z.; Nozaki, S.; Ohkubo, R.; Ohno, F.; Okuno, S.; Onuki, Y.; Ostrowicz, W.; Ozaki, H.; Peak, L.; Pernicka, M.; Rosen, M.; Rozanska, M.; Sato, N.; Schmid, S.; Shibata, T.; Stamen, R.; Stanič, S.; Steininger, H.; Sumisawa, K.; Suzuki, J.; Tajima, H.; Tajima, O.; Takahashi, K.; Takasaki, F.; Tamura, N.; Tanaka, M.; Taylor, G. N.; Terazaki, H.; Tomura, T.; Trabelsi, K.; Trischuk, W.; Tsuboyama, T.; Uchida, K.; Ueno, K.; Ueno, K.; Uozaki, N.; Ushiroda, Y.; Vahsen, S.; Varner, G.; Varvell, K.; Velikzhanin, Y. S.; Wang, C. C.; Wang, M. Z.; Watanabe, M.; Watanabe, Y.; Yamada, Y.; Yamamoto, H.; Yamashita, Y.; Yamashita, Y.; Yamauchi, M.; Yanai, H.; Yang, R.; Yasu, Y.; Yokoyama, M.; Ziegler, T.; Žontar, D.

2004-12-01

A major upgrade of the Silicon Vertex Detector (SVD 2.0) of the Belle experiment at the KEKB factory was installed along with new front-end and back-end electronics systems during the summer shutdown period in 2003 to cope with higher particle rates, improve the track resolution and meet the increasing requirements of radiation tolerance. The SVD 2.0 detector modules are read out by VA1TA chips which provide "fast or" (hit) signals that are combined by the back-end FADCTF modules to coarse, but immediate level 0 track trigger signals at rates of several tens of a kHz. Moreover, the digitized detector signals are compared to threshold lookup tables in the FADCTFs to pass on hit information on a single strip basis to the subsequent level 1.5 trigger system, which reduces the rate below the kHz range. Both FADCTF and level 1.5 electronics make use of parallel real-time processing in Field Programmable Gate Arrays (FPGAs), while further data acquisition and event building is done by PC farms running Linux. The new readout system hardware is described and the first results obtained with cosmics are shown.

The Impact of the Geometrical Structure of the DNA on Parameters of the Track-Event Theory for Radiation Induced Cell Kill.

PubMed

Schneider, Uwe; Vasi, Fabiano; Besserer, Jürgen

2016-01-01

When fractionation schemes for hypofractionation and stereotactic body radiotherapy are considered, a reliable cell survival model at high dose is needed for calculating doses of similar biological effectiveness. An alternative to the LQ-model is the track-event theory which is based on the probabilities for one- and two two-track events. A one-track-event (OTE) is always represented by at least two simultaneous double strand breaks. A two-track-event (TTE) results in one double strand break. Therefore at least two two-track-events on the same or different chromosomes are necessary to produce an event which leads to cell sterilization. It is obvious that the probabilities of OTEs and TTEs must somehow depend on the geometrical structure of the chromatin. In terms of the track-event theory the ratio ε of the probabilities of OTEs and TTEs includes the geometrical dependence and is obtained in this work by simple Monte Carlo simulations. For this work it was assumed that the anchors of loop forming chromatin are most sensitive to radiation induced cell deaths. Therefore two adjacent tetranucleosomes representing the loop anchors were digitized. The probability ratio ε of OTEs and TTEs was factorized into a radiation quality dependent part and a geometrical part: ε = εion ∙ εgeo. εgeo was obtained for two situations, by applying Monte Carlo simulation for DNA on the tetranucleosomes itself and for linker DNA. Low energy electrons were represented by randomly distributed ionizations and high energy electrons by ionizations which were simulated on rays. εion was determined for electrons by using results from nanodosimetric measurements. The calculated ε was compared to the ε obtained from fits of the track event model to 42 sets of experimental human cell survival data. When the two tetranucleosomes are in direct contact and the hits are randomly distributed εgeo and ε are 0.12 and 0.85, respectively. When the hits are simulated on rays εgeo and ε are 0.10 and 0.71. For the linker-DNA εgeo and ε for randomly distributed hits are 0.010 and 0.073, and for hits on rays 0.0058 and 0.041, respectively. The calculated ε fits the experimentally obtained ε = 0.64±0.32 best for hits on the tetranucleosome when they are close to each other both, for high and low energy electrons. The parameter εgeo of the track event model was obtained by pure geometrical considerations of the chromatin structure and is 0.095 ± 0.022. It can be used as a fixed parameter in the track-event theory.

Using task dynamics to quantify the affordances of throwing for long distance and accuracy.

PubMed

Wilson, Andrew D; Weightman, Andrew; Bingham, Geoffrey P; Zhu, Qin

2016-07-01

In 2 experiments, the current study explored how affordances structure throwing for long distance and accuracy. In Experiment 1, 10 expert throwers (from baseball, softball, and cricket) threw regulation tennis balls to hit a vertically oriented 4 ft × 4 ft target placed at each of 9 locations (3 distances × 3 heights). We measured their release parameters (angle, speed, and height) and showed that they scaled their throws in response to changes in the target's location. We then simulated the projectile motion of the ball and identified a continuous subspace of release parameters that produce hits to each target location. Each subspace describes the affordance of our target to be hit by a tennis ball moving in a projectile motion to the relevant location. The simulated affordance spaces showed how the release parameter combinations required for hits changed with changes in the target location. The experts tracked these changes in their performance and were successful in hitting the targets. We next tested unusual (horizontal) targets that generated correspondingly different affordance subspaces to determine whether the experts would track the affordance to generate successful hits. Do the experts perceive the affordance? They do. In Experiment 2, 5 cricketers threw to hit either vertically or horizontally oriented targets and successfully hit both, exhibiting release parameters located within the requisite affordance subspaces. We advocate a task dynamical approach to the study of affordances as properties of objects and events in the context of tasks as the future of research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Transverse-momentum and pseudorapidity distributions of charged hadrons in pp collisions at square root of s = 7 TeV.

PubMed

Khachatryan, V; Sirunyan, A M; Tumasyan, A; Adam, W; Bergauer, T; Dragicevic, M; Erö, J; Fabjan, C; Friedl, M; Frühwirth, R; Ghete, V M; Hammer, J; Hänsel, S; Hoch, M; Hörmann, N; Hrubec, J; Jeitler, M; Kasieczka, G; Kiesenhofer, W; Krammer, M; Liko, D; Mikulec, I; Pernicka, M; Rohringer, H; Schöfbeck, R; Strauss, J; Taurok, A; Teischinger, F; Waltenberger, W; Walzel, G; Widl, E; Wulz, C-E; Mossolov, V; Shumeiko, N; Suarez Gonzalez, J; Benucci, L; Ceard, L; De Wolf, E A; Hashemi, M; Janssen, X; Maes, T; Mucibello, L; Ochesanu, S; Roland, B; Rougny, R; Selvaggi, M; Van Haevermaet, H; Van Mechelen, P; Van Remortel, N; Adler, V; Beauceron, S; Blyweert, S; D'Hondt, J; Devroede, O; Kalogeropoulos, A; Maes, J; Maes, M; Tavernier, S; Van Doninck, W; Van Mulders, P; Villella, I; Chabert, E C; Charaf, O; Clerbaux, B; De Lentdecker, G; Dero, V; Gay, A P R; Hammad, G H; Marage, P E; Vander Velde, C; Vanlaer, P; Wickens, J; Costantini, S; Grunewald, M; Klein, B; Marinov, A; Ryckbosch, D; Thyssen, F; 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Chou, J P; Cutts, D; Esen, S; Heintz, U; Jabeen, S; Kukartsev, G; Landsberg, G; Narain, M; Nguyen, D; Speer, T; Tsang, K V; Borgia, M A; Breedon, R; Calderon De La Barca Sanchez, M; Cebra, D; Chertok, M; Conway, J; Cox, P T; Dolen, J; Erbacher, R; Friis, E; Ko, W; Kopecky, A; Lander, R; Liu, H; Maruyama, S; Miceli, T; Nikolic, M; Pellett, D; Robles, J; Schwarz, T; Searle, M; Smith, J; Squires, M; Tripathi, M; Vasquez Sierra, R; Veelken, C; Andreev, V; Arisaka, K; Cline, D; Cousins, R; Deisher, A; Erhan, S; Farrell, C; Felcini, M; Hauser, J; Ignatenko, M; Jarvis, C; Plager, C; Rakness, G; Schlein, P; Tucker, J; Valuev, V; Wallny, R; Babb, J; Clare, R; Ellison, J; Gary, J W; Hanson, G; Jeng, G Y; Kao, S C; Liu, F; Liu, H; Luthra, A; Nguyen, H; Pasztor, G; Satpathy, A; Shen, B C; Stringer, R; Sturdy, J; Sumowidagdo, S; Wilken, R; Wimpenny, S; Andrews, W; Branson, J G; Dusinberre, E; Evans, D; Golf, F; Holzner, A; Kelley, R; Lebourgeois, M; Letts, J; Mangano, B; Muelmenstaedt, J; Padhi, S; Palmer, C; Petrucciani, G; Pi, H; Pieri, M; Ranieri, R; Sani, M; Sharma, V; Simon, S; Tu, Y; Vartak, A; Würthwein, F; Yagil, A; Barge, D; Blume, M; Campagnari, C; D'Alfonso, M; Danielson, T; Garberson, J; Incandela, J; Justus, C; Kalavase, P; Koay, S A; Kovalskyi, D; Krutelyov, V; Lamb, J; Lowette, S; Pavlunin, V; Rebassoo, F; Ribnik, J; Richman, J; Rossin, R; Stuart, D; To, W; Vlimant, J R; Witherell, M; Bornheim, A; Bunn, J; Gataullin, M; Kcira, D; Litvine, V; Ma, Y; Newman, H B; Rogan, C; Shin, K; Timciuc, V; Veverka, J; Wilkinson, R; Yang, Y; Zhu, R Y; Akgun, B; Carroll, R; Ferguson, T; Jang, D W; Jun, S Y; Paulini, M; Russ, J; Terentyev, N; Vogel, H; Vorobiev, I; Cumalat, J P; Dinardo, M E; Drell, B R; Ford, W T; Heyburn, B; Luiggi Lopez, E; Nauenberg, U; Smith, J G; Stenson, K; Ulmer, K A; Wagner, S R; Zang, S L; Agostino, L; Alexander, J; Blekman, F; Chatterjee, A; Das, S; Eggert, N; Fields, L J; Gibbons, L K; Heltsley, B; Hopkins, W; Khukhunaishvili, A; Kreis, B; Kuznetsov, V; Kaufman, G Nicolas; Patterson, J R; Puigh, D; Riley, D; Ryd, A; Shi, X; Sun, W; Teo, W D; Thom, J; Thompson, J; Vaughan, J; Weng, Y; Wittich, P; Biselli, A; Cirino, G; Winn, D; Abdullin, S; Albrow, M; Anderson, J; Apollinari, G; Atac, M; Bakken, J A; Banerjee, S; Bauerdick, L A T; Beretvas, A; Berryhill, J; Bhat, P C; Bloch, I; Borcherding, F; Burkett, K; Butler, J N; Chetluru, V; Cheung, H W K; Chlebana, F; Cihangir, S; Demarteau, M; Eartly, D P; Elvira, V D; Fisk, I; Freeman, J; Gao, Y; Gottschalk, E; Green, D; Gutsche, O; Hahn, A; Hanlon, J; Harris, R M; James, E; Jensen, H; Johnson, M; Joshi, U; Khatiwada, R; Kilminster, B; Klima, B; Kousouris, K; Kunori, S; Kwan, S; Limon, P; Lipton, R; Lykken, J; Maeshima, K; Marraffino, J M; Mason, D; McBride, P; McCauley, T; Miao, T; Mishra, K; Mrenna, S; Musienko, Y; Newman-Holmes, C; O'Dell, V; Popescu, S; Pordes, R; Prokofyev, O; Saoulidou, N; Sexton-Kennedy, E; Sharma, S; Smith, R P; Soha, A; Spalding, W J; Spiegel, L; Tan, P; Taylor, L; Tkaczyk, S; Uplegger, L; Vaandering, E W; Vidal, R; Whitmore, J; Wu, W; Yumiceva, F; Yun, J C; Acosta, D; Avery, P; Bourilkov, D; Chen, M; Di Giovanni, G P; Dobur, D; Drozdetskiy, A; Field, R D; Fu, Y; Furic, I K; Gartner, J; Kim, B; Klimenko, S; Konigsberg, J; Korytov, A; Kotov, K; Kropivnitskaya, A; Kypreos, T; Matchev, K; Mitselmakher, G; Pakhotin, Y; Piedra Gomez, J; Prescott, C; Remington, R; Schmitt, M; Scurlock, B; Sellers, P; Wang, D; Yelton, J; Zakaria, M; Ceron, C; Gaultney, V; Kramer, L; Lebolo, L M; Linn, S; Markowitz, P; Martinez, G; Mesa, D; Rodriguez, J L; Adams, T; Askew, A; Chen, J; Diamond, B; Gleyzer, S V; Haas, J; Hagopian, S; Hagopian, V; Jenkins, M; Johnson, K F; Prosper, H; Sekmen, S; Veeraraghavan, V; Baarmand, M M; Guragain, S; Hohlmann, M; Kalakhety, H; Mermerkaya, H; Ralich, R; Vodopiyanov, I; Adams, M R; Anghel, I M; Apanasevich, L; Bazterra, V E; Betts, R R; Callner, J; Cavanaugh, R; Dragoiu, C; Garcia-Solis, E J; Gerber, C E; Hofman, D J; Khalatian, S; Lacroix, F; Shabalina, E; Smoron, A; Strom, D; Varelas, N; Akgun, U; Albayrak, E A; Bilki, B; Cankocak, K; Clarida, W; Duru, F; Lae, C K; McCliment, E; Merlo, J-P; Mestvirishvili, A; Moeller, A; Nachtman, J; Newsom, C R; Norbeck, E; Olson, J; Onel, Y; Ozok, F; Sen, S; Wetzel, J; Yetkin, T; Yi, K; Barnett, B A; Blumenfeld, B; Bonato, A; Eskew, C; Fehling, D; Giurgiu, G; Gritsan, A V; Guo, Z J; Hu, G; Maksimovic, P; Rappoccio, S; Swartz, M; Tran, N V; Whitbeck, A; Baringer, P; Bean, A; Benelli, G; Grachov, O; Murray, M; Radicci, V; Sanders, S; Wood, J S; Zhukova, V; Bandurin, D; Bolton, T; Chakaberia, I; Ivanov, A; Kaadze, K; Maravin, Y; Shrestha, S; Svintradze, I; Wan, Z; Gronberg, J; Lange, D; Wright, D; Baden, D; Boutemeur, M; Eno, S C; Ferencek, D; Hadley, N J; Kellogg, R G; Kirn, M; Mignerey, A; Rossato, K; Rumerio, P; Santanastasio, F; Skuja, A; Temple, J; Tonjes, M B; Tonwar, S C; Twedt, E; Alver, B; Bauer, G; Bendavid, J; Busza, W; Butz, E; Cali, I A; Chan, M; D'Enterria, D; Everaerts, P; Gomez Ceballos, G; Goncharov, M; Hahn, K A; Harris, P; Kim, Y; Klute, M; Lee, Y-J; Li, W; Loizides, C; Luckey, P D; Ma, T; Nahn, S; Paus, C; Roland, C; Roland, G; Rudolph, M; Stephans, G S F; Sumorok, K; Sung, K; Wenger, E A; Wyslouch, B; Xie, S; Yilmaz, Y; Yoon, A S; Zanetti, M; Cole, P; Cooper, S I; Cushman, P; Dahmes, B; De Benedetti, A; Dudero, P R; Franzoni, G; Haupt, J; Klapoetke, K; Kubota, Y; Mans, J; Petyt, D; Rekovic, V; Rusack, R; Sasseville, M; Singovsky, A; Cremaldi, L M; Godang, R; Kroeger, R; Perera, L; Rahmat, R; Sanders, D A; Sonnek, P; Summers, D; Bloom, K; Bose, S; Butt, J; Claes, D R; Dominguez, A; Eads, M; Keller, J; Kelly, T; Kravchenko, I; Lazo-Flores, J; Lundstedt, C; Malbouisson, H; Malik, S; Snow, G R; Baur, U; Iashvili, I; Kharchilava, A; Kumar, A; Smith, K; Strang, M; Zennamo, J; Alverson, G; Barberis, E; Baumgartel, D; Boeriu, O; Reucroft, S; Swain, J; Wood, D; Zhang, J; Anastassov, A; Kubik, A; Ofierzynski, R A; Pozdnyakov, A; Schmitt, M; Stoynev, S; Velasco, M; Won, S; Antonelli, L; Berry, D; Hildreth, M; Jessop, C; Karmgard, D J; Kolb, J; Kolberg, T; Lannon, K; Lynch, S; Marinelli, N; Morse, D M; Ruchti, R; Slaunwhite, J; Valls, N; Warchol, J; Wayne, M; Ziegler, J; Bylsma, B; Durkin, L S; Gu, J; Killewald, P; Ling, T Y; Williams, G; Adam, N; Berry, E; Elmer, P; Gerbaudo, D; Halyo, V; Hunt, A; Jones, J; Laird, E; Lopes Pegna, D; Marlow, D; Medvedeva, T; Mooney, M; Olsen, J; Piroué, P; Stickland, D; Tully, C; Werner, J S; Zuranski, A; Acosta, J G; Huang, X T; Lopez, A; Mendez, H; Oliveros, S; Ramirez Vargas, J E; Zatzerklyaniy, A; Alagoz, E; Barnes, V E; Bolla, G; Borrello, L; Bortoletto, D; Everett, A; Garfinkel, A F; Gecse, Z; Gutay, L; Jones, M; Koybasi, O; Laasanen, A T; Leonardo, N; Liu, C; Maroussov, V; Merkel, P; Miller, D H; Neumeister, N; Potamianos, K; Shipsey, I; Silvers, D; Yoo, H D; Zablocki, J; Zheng, Y; Jindal, P; Parashar, N; Cuplov, V; Ecklund, K M; Geurts, F J M; Liu, J H; Morales, J; Padley, B P; Redjimi, R; Roberts, J; Betchart, B; Bodek, A; Chung, Y S; de Barbaro, P; Demina, R; Flacher, H; Garcia-Bellido, A; Gotra, Y; Han, J; Harel, A; Miner, D C; Orbaker, D; Petrillo, G; Vishnevskiy, D; Zielinski, M; Bhatti, A; Demortier, L; Goulianos, K; Hatakeyama, K; Lungu, G; Mesropian, C; Yan, M; Atramentov, O; Gershtein, Y; Gray, R; Halkiadakis, E; Hidas, D; Hits, D; Lath, A; Rose, K; Schnetzer, S; Somalwar, S; Stone, R; Thomas, S; Cerizza, G; Hollingsworth, M; Spanier, S; Yang, Z C; York, A; Asaadi, J; Eusebi, R; Gilmore, J; Gurrola, A; Kamon, T; Khotilovich, V; Montalvo, R; Nguyen, C N; Pivarski, J; Safonov, A; Sengupta, S; Toback, D; Weinberger, M; Akchurin, N; Bardak, C; Damgov, J; Jeong, C; Kovitanggoon, K; Lee, S W; Mane, P; Roh, Y; Sill, A; Volobouev, I; Wigmans, R; Yazgan, E; Appelt, E; Brownson, E; Engh, D; Florez, C; Gabella, W; Johns, W; Kurt, P; Maguire, C; Melo, A; Sheldon, P; Velkovska, J; Arenton, M W; Balazs, M; Buehler, M; Conetti, S; Cox, B; Hirosky, R; Ledovskoy, A; Neu, C; Yohay, R; Gollapinni, S; Gunthoti, K; Harr, R; Karchin, P E; Mattson, M; Milstène, C; Sakharov, A; Anderson, M; Bachtis, M; Bellinger, J N; Carlsmith, D; Dasu, S; Dutta, S; Efron, J; Gray, L; Grogg, K S; Grothe, M; Hall-Wilton, R; Herndon, M; Klabbers, P; Klukas, J; Lanaro, A; Lazaridis, C; Leonard, J; Lomidze, D; Loveless, R; Mohapatra, A; Polese, G; Reeder, D; Savin, A; Smith, W H; Swanson, J; Weinberg, M

2010-07-09

Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at square root of s = 7  TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dN(ch)/dη|(|η|<0.5) = 5.78 ± 0.01(stat) ± 0.23(syst) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from square root of s = 0.9 to 7 TeV is [66.1 ± 1.0(stat) ± 4.2(syst)]%. The mean transverse momentum is measured to be 0.545 ± 0.005(stat) ± 0.015(syst)  GeV/c. The results are compared with similar measurements at lower energies.

Single ion hit detection set-up for the Zagreb ion microprobe

NASA Astrophysics Data System (ADS)

Smith, R. W.; Karlušić, M.; Jakšić, M.

2012-04-01

Irradiation of materials by heavy ions accelerated in MV tandem accelerators may lead to the production of latent ion tracks in many insulators and semiconductors. If irradiation is performed in a high resolution microprobe facility, ion tracks can be ordered by submicrometer positioning precision. However, full control of the ion track positioning can only be achieved by a reliable ion hit detection system that should provide a trigger signal irrespectively of the type and thickness of the material being irradiated. The most useful process that can be utilised for this purpose is emission of secondary electrons from the sample surface that follows the ion impact. The status report of the set-up presented here is based on the use of a channel electron multiplier (CEM) detector mounted on an interchangable sample holder that is inserted into the chamber in a close geometry along with the sample to be irradiated. The set-up has been tested at the Zagreb ion microprobe for different ions and energies, as well as different geometrical arrangements. For energies of heavy ions below 1 MeV/amu, results show that efficient (100%) control of ion impact can be achieved only for ions heavier than silicon. The successful use of the set-up is demonstrated by production of ordered single ion tracks in a polycarbonate film and by monitoring fluence during ion microbeam patterning of Foturan glass.

Simulations in the Analysis of Experimental Data Measured by BM@N Drift Chambers

NASA Astrophysics Data System (ADS)

Fedorišin, Ján

2018-02-01

The drift chambers (DCH's) are an important part of the tracking system of the BM@N experiment designed to study the production of baryonic matter at the Nuclotron energies. The method of particle hit and track reconstruction in the drift chambers has been already proposed and tested on the BM@N deuteron beam data. In this study the DCH's are first locally and globally aligned, and subsequently the consistency of the track reconstruction chain is tested by two methods. The first one is based on the backward extrapolation of the DCH reconstructed deuteron beam to a position where its deflection in the BM@N magnetic field begins. The second method reconstructs the deuteron beam momentum through its deflection angle. Both methods confirm correctness of the track reconstruction algorithm.

Single track effects, Biostack and risk assessment

NASA Technical Reports Server (NTRS)

Curtis, S. B.; Chatterjee, A. (Principal Investigator)

1994-01-01

The scientific career of Prof. Bucker has spanned a very exciting period in the fledgling science of Space Radiation Biology. The capability for placing biological objects in space was developed, and the methods for properly packaging, retrieving and analyzing them were worked out. Meaningful results on the effects of radiation were obtained for the first time. In fact, many of the successful techniques and methodologies for handling biological samples were developed in Prof. Bucker's laboratories, as attested by the extensive Biostack program. He was the first to suggest and successfully carry out experiments in space directly aimed at measuring effects of single tracks of high-energy heavy galactic cosmic rays by specifically identifying whether or not the object had been hit by a heavy particle track. Because the "hit" frequencies of heavy galactic cosmic rays to cell nuclei in the bodies of space travelers will be low, it is expected that any effects to humans on the cellular level will be dominated by single-track cell traversals. This includes the most important generally recognized late effect of space radiation exposure: radiation-induced cancer. This paper addresses the single-track nature of the space radiation environment, and points out the importance of single "hits" in the evaluation of radiation risk for long-term missions occurring outside the earth's magnetic field. A short review is made of biological objects found to show increased effects when "hit" by a single heavy charged-particle in space. A brief discussion is given of the most provocative results from the bacterial spore Bacillus subtilis: experimental evidence that tracks can affect biological systems at much larger distances from the trajectory than previously suspected, and that the resultant inactivation cross section in space calculated for this system is very large. When taken at face value, the implication of these results, when compared to those from experiments performed at ground-based accelerators with beams at low energies in the same LET range, is that high-energy particles can exert their influence a surprising distance from their trajectory and the inactivation cross sections are some 20 times larger than expected. Clearly, beams from high-energy heavy-ion accelerators should be used to confirm these results. For those end points that can also be caused by low-LET beams such as high-energy protons, it is important to measure their action cross sections as well. The ratio of the cross sections for a high-LET beam to that of a low-LET beam is an interesting experimental ratio and, we suggest, of more intrinsic interest than the RBE (Relative Biological Effectiveness). It is a measure of the "biological" importance of one particle type relative to another particle type. This ratio will be introduced and given the name RPPE (Relative Per Particle Effectiveness). Values of RPPE have appeared in the literature and will be discussed. A rather well-known value of this quantity (13,520) has been suggested for the RPPE of high-energy iron ions to high-energy protons. This value was suggested by Letaw et al. Nature 330, 709-710 (1987)] we will call it the Letaw limit. It will be discussed in terms of the importance of the heavy-ion component vs light-ion component of the galactic cosmic rays. It is also pointed out, however, that there may be unique effects from single tracks of heavy ions that do not occur from light-ion tracks. For such effects, the concepts of both RBE and RPPE lose their meaning.

A five states survivability model for missions with ground-to-air threats

NASA Astrophysics Data System (ADS)

Erlandsson, Tina; Niklasson, Lars

2013-05-01

Fighter pilots are exposed to the risk of getting hit by enemy fire when flying missions with ground-to-air threats. A tactical support system including a survivability model could aid the pilot to assess and handle this risk. The survivability model presented here is a Markov model with five states; Undetected, Detected, Tracked, Engaged and Hit. The output from the model is the probabilities that the aircraft is in these states during the mission. The enemy's threat systems are represented with sensor and weapon areas and the transitions between the states depend on whether or not the aircraft is within any of these areas. Contrary to previous work, the model can capture the behaviors that the enemy's sensor systems communicate and that the risk of getting hit depends on the enemy's knowledge regarding the aircraft's kinematics. The paper includes a discussion regarding the interpretation of the states and the factors that influence the transitions between the states. Further developments are also identified for using the model to aid fighter pilots and operators of unmanned aerial vehicles with planning and evaluating missions as well as analyzing the situation during flight.

Hit rates and radiation doses to nuclei of bone lining cells from alpha-particle-emitting radionuclides

NASA Technical Reports Server (NTRS)

Polig, E.; Jee, W. S.; Kruglikov, I. L.

1992-01-01

Factors relating the local concentration of a bone-seeking alpha-particle emitter to the mean hit rate have been determined for nuclei of bone lining cells using a Monte Carlo procedure. Cell nuclei were approximated by oblate spheroids with dimensions and location taken from a previous histomorphometric study. The Monte Carlo simulation is applicable for planar and diffuse labels at plane or cylindrical bone surfaces. Additionally, the mean nuclear dose per hit, the dose mean per hit, the mean track segment length and its second moment, the percentage of stoppers, and the frequency distribution of the dose have been determined. Some basic features of the hit statistics for bone lining cells have been outlined, and the consequences of existing standards of radiation protection with regard to the hit frequency to cell nuclei are discussed.

Probability of cell hits in selected organs and tissues by high-LET particles at the ISS orbit

NASA Technical Reports Server (NTRS)

Yasuda, H.; Komiyama, T.; Fujitaka, K.; Badhwar, G. D. (Principal Investigator)

2002-01-01

The fluence of high-LET particles (HLP) with LET infinity H2O greater than 15 keV micrometers-1 in selected organs and tissues were measured with plastic nuclear track detectors using a life-size human phantom on the 9th Shuttle-Mir Mission (STS-91). The planar-track fluence of HLP during the 9.8-day mission ranged from 1.9 x 10(3) n cm-2 (bladder) to 5.1 x 10(3) n cm-2 (brain) by a factor of 2.7. Based on these data, a probability of HLP hits to a matured cell of each organ or tissue was roughly estimated for a 90-day ISS mission. In the calculation, all cells were assumed to be spheres with a geometric cross-sectional area of 500 micrometers2 and the cell-hit frequency from isotropic space radiation can be described by the Poisson-distribution function. As results, the probability of one or more than 1 hit to a single cell by HLP for 90 days ranged from 17% to 38%; that of two or more than 2 hits was estimated to be 1.3-8.2%. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

Comparison of two hardware-based hit filtering methods for trackers in high-pileup environments

NASA Astrophysics Data System (ADS)

Gradin, J.; Mårtensson, M.; Brenner, R.

2018-04-01

As experiments in high energy physics aim to measure increasingly rare processes, the experiments continually strive to increase the expected signal yields. In the case of the High Luminosity upgrade of the LHC, the luminosity is raised by increasing the number of simultaneous proton-proton interactions, so-called pile-up. This increases the expected yields of signal and background processes alike. The signal is embedded in a large background of processes that mimic that of signal events. It is therefore imperative for the experiments to develop new triggering methods to effectively distinguish the interesting events from the background. We present a comparison of two methods for filtering detector hits to be used for triggering on particle tracks: one based on a pattern matching technique using Associative Memory (AM) chips and the other based on the Hough transform. Their efficiency and hit rejection are evaluated for proton-proton collisions with varying amounts of pile-up using a simulation of a generic silicon tracking detector. It is found that, while both methods are feasible options for a track trigger with single muon efficiencies around 98–99%, the AM based pattern matching produces a lower number of hit combinations with respect to the Hough transform whilst keeping more of the true signal hits. We also present the effect on the two methods of increasing the amount of support material in the detector and of introducing inefficiencies by deactivating detector modules. The increased support material has negligable effects on the efficiency for both methods, while dropping 5% (10%) of the available modules decreases the efficiency to about 95% (87%) for both methods, irrespective of the amount of pile-up.

A neural network z-vertex trigger for Belle II

NASA Astrophysics Data System (ADS)

Neuhaus, S.; Skambraks, S.; Abudinen, F.; Chen, Y.; Feindt, M.; Frühwirth, R.; Heck, M.; Kiesling, C.; Knoll, A.; Paul, S.; Schieck, J.

2015-05-01

We present the concept of a track trigger for the Belle II experiment, based on a neural network approach, that is able to reconstruct the z (longitudinal) position of the event vertex within the latency of the first level trigger. The trigger will thus be able to suppress a large fraction of the dominating background from events outside of the interaction region. The trigger uses the drift time information of the hits from the Central Drift Chamber (CDC) of Belle II within narrow cones in polar and azimuthal angle as well as in transverse momentum (sectors), and estimates the z-vertex without explicit track reconstruction. The preprocessing for the track trigger is based on the track information provided by the standard CDC trigger. It takes input from the 2D (r — φ) track finder, adds information from the stereo wires of the CDC, and finds the appropriate sectors in the CDC for each track in a given event. Within each sector, the z-vertex of the associated track is estimated by a specialized neural network, with a continuous output corresponding to the scaled z-vertex. The input values for the neural network are calculated from the wire hits of the CDC.

Iterative Track Fitting Using Cluster Classification in Multi Wire Proportional Chamber

NASA Astrophysics Data System (ADS)

Primor, David; Mikenberg, Giora; Etzion, Erez; Messer, Hagit

2007-10-01

This paper addresses the problem of track fitting of a charged particle in a multi wire proportional chamber (MWPC) using cathode readout strips. When a charged particle crosses a MWPC, a positive charge is induced on a cluster of adjacent strips. In the presence of high radiation background, the cluster charge measurements may be contaminated due to background particles, leading to less accurate hit position estimation. The least squares method for track fitting assumes the same position error distribution for all hits and thus loses its optimal properties on contaminated data. For this reason, a new robust algorithm is proposed. The algorithm first uses the known spatial charge distribution caused by a single charged particle over the strips, and classifies the clusters into ldquocleanrdquo and ldquodirtyrdquo clusters. Then, using the classification results, it performs an iterative weighted least squares fitting procedure, updating its optimal weights each iteration. The performance of the suggested algorithm is compared to other track fitting techniques using a simulation of tracks with radiation background. It is shown that the algorithm improves the track fitting performance significantly. A practical implementation of the algorithm is presented for muon track fitting in the cathode strip chamber (CSC) of the ATLAS experiment.

Effects of combat training on visuomotor performance in children aged 9 to 12 years - an eye-tracking study.

PubMed

Ju, Yan-Ying; Liu, Yen-Hsiu; Cheng, Chih-Hsiu; Lee, Yu-Lung; Chang, Shih-Tsung; Sun, Chi-Chin; Cheng, Hsin-Yi Kathy

2018-02-07

Data on visuomotor performance in combat training and the effects of combat training on visuomotor performance are limited. This study aimed to investigate the effects of a specially designed combat sports (CS) training program on the visuomotor performance levels of children. A pre-post comparative design was implemented. A total of 26 students aged 9-12 years underwent 40-min CS training sessions twice a week for 8 weeks during their physical education classes. The CS training program was designed by a karate coach and a motor control specialist. The other 30 students continued their regular activities and were considered as a control group. Each student's eye movement was monitored using an eye tracker, whereas the motor performance was measured using a target hitting system with a program-controlled microprocessor. The measurements were taken 8 weeks before (baseline), 1 day before (pretest), and 1 week after (posttest) the designated training program. The task used for evaluating these students was hitting or tracking random illuminated targets as rapidly as possible. A two-way analysis of variance [group(2) × time(3)] with repeated measures of time was performed for statistical analysis. For the children who received combat training, although the eye response improvement was not significant, both the primary and secondary saccade onset latencies were significantly earlier compared to the children without combat training. Both groups of students exhibited improvement in their hit response times during the target hitting tasks. The current finding supported the notion that sports training efforts essentially enhance visuomotor function in children aged 9-12 years, and combat training facilitates an earlier secondary saccade onset.

First results of the silicon telescope using an 'artificial retina' for fast track finding

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

Neri, N.; Abba, A.; Caponio, F.

We present the first results of the prototype of a silicon tracker with trigger capabilities based on a novel approach for fast track finding. The working principle of the 'artificial retina' is inspired by the processing of visual images by the brain and it is based on extensive parallelization of data distribution and pattern recognition. The algorithm has been implemented in commercial FPGAs in three main logic modules: a switch for the routing of the detector hits, a pool of engines for the digital processing of the hits, and a block for the calculation of the track parameters. The architecturemore » is fully pipelined and allows the reconstruction of real-time tracks with a latency less then 100 clock cycles, corresponding to 0.25 microsecond at 400 MHz clock. The silicon telescope consists of 8 layers of single-sided silicon strip detectors with 512 strips each. The detector size is about 10 cm x 10 cm and the strip pitch is 183 μm. The detectors are read out by the Beetle chip, a custom ASICs developed for LHCb, which provides the measurement of the hit position and pulse height of 128 channels. The 'artificial retina' algorithm has been implemented on custom data acquisition boards based on FPGAs Xilinx Kintex 7 lx160. The parameters of the tracks detected are finally transferred to host PC via USB 3.0. The boards manage the read-out ASICs and the sampling of the analog channels. The read-out is performed at 40 MHz on 4 channels for each ASIC that corresponds to a decoding of the telescope information at 1.1 MHz. We report on the first results of the fast tracking device and compare with simulations. (authors)« less

Interpretation of mutation induction by accelerated heavy ions in bacteria

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

Kozubek, S.; Ryznar, L.; Horneck, G.

In this report, a quantitative interpretation of mutation induction cross sections by heavy charged particles in bacterial cells is presented. The approach is based on the calculation of the fraction of energy deposited by indirect hits in the sensitive structure. In these events the particle does not pass through the sensitive volume, but this region is hit by {delta} rays. Four track structure models, developed by Katz, Chatterjee et al, Kiefer and Straaten and Kudryashov et al., respectively, were used for the calculations. With the latter two models, very good agreement of the calculations with experimental results on mutagenesis inmore » bacteria was obtained. Depending on the linear energy transfer (LET{infinity}) of the particles, two different modes of mutagenic action of heavy ions are distinguished: {open_quotes}{delta}-ray mutagenesis,{close_quotes} which is related to those radiation qualities that preferentially kill the cells in direct hits (LET{infinity} {ge} 100 keV/{mu}m), and {open_quotes}track core mutagenesis,{close_quotes} which arises from direct hits and is observed for lighter ions or ions with high energy (LET{infinity} {le} 100 keV/{mu}m). 37 refs., 6 figs., 1 tab.« less

FPGA-based Trigger System for the Fermilab SeaQuest Experimentz

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

Shiu, Shiuan-Hal; Wu, Jinyuan; McClellan, Randall Evan

The SeaQuest experiment (Fermilab E906) detects pairs of energetic μ + and μ -produced in 120 GeV/c proton–nucleon interactions in a high rate environment. The trigger system we used consists of several arrays of scintillator hodoscopes and a set of field-programmable gate array (FPGA) based VMEbus modules. Signals from up to 96 channels of hodoscope are digitized by each FPGA with a 1-ns resolution using the time-to-digital convertor (TDC) firmware. The delay of the TDC output can be adjusted channel-by-channel in 1-ns step and then re-aligned with the beam RF clock. The hit pattern on the hodoscope planes is thenmore » examined against pre-determined trigger matrices to identify candidate muon tracks. Finally, information on the candidate tracks is sent to the 2nd-level FPGA-based track correlator to find candidate di-muon events. The design and implementation of the FPGA-based trigger system for SeaQuest experiment are presented.« less

FPGA-based trigger system for the Fermilab SeaQuest experimentz

NASA Astrophysics Data System (ADS)

Shiu, Shiuan-Hal; Wu, Jinyuan; McClellan, Randall Evan; Chang, Ting-Hua; Chang, Wen-Chen; Chen, Yen-Chu; Gilman, Ron; Nakano, Kenichi; Peng, Jen-Chieh; Wang, Su-Yin

2015-12-01

The SeaQuest experiment (Fermilab E906) detects pairs of energetic μ+ and μ- produced in 120 GeV/c proton-nucleon interactions in a high rate environment. The trigger system consists of several arrays of scintillator hodoscopes and a set of field-programmable gate array (FPGA) based VMEbus modules. Signals from up to 96 channels of hodoscope are digitized by each FPGA with a 1-ns resolution using the time-to-digital convertor (TDC) firmware. The delay of the TDC output can be adjusted channel-by-channel in 1-ns step and then re-aligned with the beam RF clock. The hit pattern on the hodoscope planes is then examined against pre-determined trigger matrices to identify candidate muon tracks. Information on the candidate tracks is sent to the 2nd-level FPGA-based track correlator to find candidate di-muon events. The design and implementation of the FPGA-based trigger system for SeaQuest experiment are presented.

FPGA-based Trigger System for the Fermilab SeaQuest Experimentz

DOE PAGES

Shiu, Shiuan-Hal; Wu, Jinyuan; McClellan, Randall Evan; ...

2015-09-10

The SeaQuest experiment (Fermilab E906) detects pairs of energetic μ + and μ -produced in 120 GeV/c proton–nucleon interactions in a high rate environment. The trigger system we used consists of several arrays of scintillator hodoscopes and a set of field-programmable gate array (FPGA) based VMEbus modules. Signals from up to 96 channels of hodoscope are digitized by each FPGA with a 1-ns resolution using the time-to-digital convertor (TDC) firmware. The delay of the TDC output can be adjusted channel-by-channel in 1-ns step and then re-aligned with the beam RF clock. The hit pattern on the hodoscope planes is thenmore » examined against pre-determined trigger matrices to identify candidate muon tracks. Finally, information on the candidate tracks is sent to the 2nd-level FPGA-based track correlator to find candidate di-muon events. The design and implementation of the FPGA-based trigger system for SeaQuest experiment are presented.« less

The performance of the ZEUS central tracking detector z-by-timing electronics in a transputer based data acquisition system

NASA Astrophysics Data System (ADS)

Foster, B.; Heath, G. P.; Llewellyn, T. J.; Gingrich, D. M.; Harnew, N.; Hallam-Baker, P. M.; Khatri, T.; McArthur, I. C.; Morawitz, P.; Nash, J.; Shield, P. D.; Topp-Jorgensen, S.; Wilson, F. F.; Allen, D. B.; Carter, R. C.; Jeffs, M. D.; Morrissey, M. C.; Quinton, S. P. H.; Lane, J. B.; Postranecky, M.

1993-05-01

The Central Tracking Detector of the ZEUS experiment employs a time difference technique to measure the z coordinate of each hit. The method provides fast, three-dimensional space point measurements which are used as input to all levels of the ZEUS trigger. Such a tracking trigger is essential in order to discriminate against events with vertices lying outside the nominal electron-proton interaction region. Since the beam crossing interval of the HERA collider is 96 ns, all data must be pipelined through the front-end readout electronics. Subsequent data aquisition employs a novel technique which utilizes a network of approximately 120 INMOS transputers to process the data in parallel. The z-by-timing method and its data aquisition have been employed successfully in recording and reconstructing tracks from electron-proton interactions in ZEUS.

Real-time track-less Cherenkov ring fitting trigger system based on Graphics Processing Units

NASA Astrophysics Data System (ADS)

Ammendola, R.; Biagioni, A.; Chiozzi, S.; Cretaro, P.; Cotta Ramusino, A.; Di Lorenzo, S.; Fantechi, R.; Fiorini, M.; Frezza, O.; Gianoli, A.; Lamanna, G.; Lo Cicero, F.; Lonardo, A.; Martinelli, M.; Neri, I.; Paolucci, P. S.; Pastorelli, E.; Piandani, R.; Piccini, M.; Pontisso, L.; Rossetti, D.; Simula, F.; Sozzi, M.; Vicini, P.

2017-12-01

The parallel computing power of commercial Graphics Processing Units (GPUs) is exploited to perform real-time ring fitting at the lowest trigger level using information coming from the Ring Imaging Cherenkov (RICH) detector of the NA62 experiment at CERN. To this purpose, direct GPU communication with a custom FPGA-based board has been used to reduce the data transmission latency. The GPU-based trigger system is currently integrated in the experimental setup of the RICH detector of the NA62 experiment, in order to reconstruct ring-shaped hit patterns. The ring-fitting algorithm running on GPU is fed with raw RICH data only, with no information coming from other detectors, and is able to provide more complex trigger primitives with respect to the simple photodetector hit multiplicity, resulting in a higher selection efficiency. The performance of the system for multi-ring Cherenkov online reconstruction obtained during the NA62 physics run is presented.

Time Course of Visual Extrapolation Accuracy

DTIC Science & Technology

1995-09-01

The pond and duckweed problem: Three experiments on the misperception of exponential growth . Acta Psychologica 43, 239-251. Wiener, E.L., 1962...random variation in tracker velocity. Both models predicted changes in hit and false alarm rates well, except in a condition where response asymmetries...systematic velocity error in tracking, only random variation in tracker velocity. Both models predicted changes in hit and false alarm rates well

Multiple-hit parameter estimation in monolithic detectors.

PubMed

Hunter, William C J; Barrett, Harrison H; Lewellen, Tom K; Miyaoka, Robert S

2013-02-01

We examine a maximum-a-posteriori method for estimating the primary interaction position of gamma rays with multiple interaction sites (hits) in a monolithic detector. In assessing the performance of a multiple-hit estimator over that of a conventional one-hit estimator, we consider a few different detector and readout configurations of a 50-mm-wide square cerium-doped lutetium oxyorthosilicate block. For this study, we use simulated data from SCOUT, a Monte-Carlo tool for photon tracking and modeling scintillation- camera output. With this tool, we determine estimate bias and variance for a multiple-hit estimator and compare these with similar metrics for a one-hit maximum-likelihood estimator, which assumes full energy deposition in one hit. We also examine the effect of event filtering on these metrics; for this purpose, we use a likelihood threshold to reject signals that are not likely to have been produced under the assumed likelihood model. Depending on detector design, we observe a 1%-12% improvement of intrinsic resolution for a 1-or-2-hit estimator as compared with a 1-hit estimator. We also observe improved differentiation of photopeak events using a 1-or-2-hit estimator as compared with the 1-hit estimator; more than 6% of photopeak events that were rejected by likelihood filtering for the 1-hit estimator were accurately identified as photopeak events and positioned without loss of resolution by a 1-or-2-hit estimator; for PET, this equates to at least a 12% improvement in coincidence-detection efficiency with likelihood filtering applied.

Optical Indoor Positioning System Based on TFT Technology.

PubMed

Gőzse, István

2015-12-24

A novel indoor positioning system is presented in the paper. Similarly to the camera-based solutions, it is based on visual detection, but it conceptually differs from the classical approaches. First, the objects are marked by LEDs, and second, a special sensing unit is applied, instead of a camera, to track the motion of the markers. This sensing unit realizes a modified pinhole camera model, where the light-sensing area is fixed and consists of a small number of sensing elements (photodiodes), and it is the hole that can be moved. The markers are tracked by controlling the motion of the hole, such that the light of the LEDs always hits the photodiodes. The proposed concept has several advantages: Apart from its low computational demands, it is insensitive to the disturbing ambient light. Moreover, as every component of the system can be realized by simple and inexpensive elements, the overall cost of the system can be kept low.

Implications of social media use on health information technology engagement: Data from HINTS 4 cycle 3.

PubMed

Jackson, Devlon N; Chou, Wen-Ying Sylvia; Coa, Kisha I; Oh, April; Hesse, Bradford

2016-12-01

Little is known about the association between Internet/social media use and health information technology (HIT) engagement. This study examines patterns of social media use and HIT engagement in the U.S.A. using data from the 2013 Health Information National Trends Survey (N = 3,164). Specifically, predictors of two HIT activities (i.e., communicating with a healthcare provider using the Internet or email and tracking personal health information electronically) are examined. Persons who were females, higher education, non-Hispanic others, having a regular healthcare provider, and ages 35-44 were more likely to participate in HIT activities. After controlling for sociodemographics and health correlates, social media use was significantly associated with HIT engagement. To our knowledge, this is one of the first studies to systematically examine the use and relationships across multiple types of health-related online media.

What Websites Are Patients Using: Results of a Tracking Study Exploring Patients Use of Websites at a Multi-Media Patient Education Center

PubMed Central

Ravitch, Stephanie; Fleisher, Linda; Torres, Stephen

2005-01-01

An exploratory study utilized computer tracking software at a hospital based patient education center was conducted to access use of the Web. During six months, 625 hits were tracked with 1/3 to www.cancer.gov one of the recommended websites, while over half of the sites were not on the recommended list. Here we report the challenges and results of this tracking study. PMID:16779379

Multiple-Hit Parameter Estimation in Monolithic Detectors

PubMed Central

Barrett, Harrison H.; Lewellen, Tom K.; Miyaoka, Robert S.

2014-01-01

We examine a maximum-a-posteriori method for estimating the primary interaction position of gamma rays with multiple interaction sites (hits) in a monolithic detector. In assessing the performance of a multiple-hit estimator over that of a conventional one-hit estimator, we consider a few different detector and readout configurations of a 50-mm-wide square cerium-doped lutetium oxyorthosilicate block. For this study, we use simulated data from SCOUT, a Monte-Carlo tool for photon tracking and modeling scintillation- camera output. With this tool, we determine estimate bias and variance for a multiple-hit estimator and compare these with similar metrics for a one-hit maximum-likelihood estimator, which assumes full energy deposition in one hit. We also examine the effect of event filtering on these metrics; for this purpose, we use a likelihood threshold to reject signals that are not likely to have been produced under the assumed likelihood model. Depending on detector design, we observe a 1%–12% improvement of intrinsic resolution for a 1-or-2-hit estimator as compared with a 1-hit estimator. We also observe improved differentiation of photopeak events using a 1-or-2-hit estimator as compared with the 1-hit estimator; more than 6% of photopeak events that were rejected by likelihood filtering for the 1-hit estimator were accurately identified as photopeak events and positioned without loss of resolution by a 1-or-2-hit estimator; for PET, this equates to at least a 12% improvement in coincidence-detection efficiency with likelihood filtering applied. PMID:23193231

Representing Misalignments of the STAR Geometry Model using AgML

NASA Astrophysics Data System (ADS)

Webb, Jason C.; Lauret, Jérôme; Perevotchikov, Victor; Smirnov, Dmitri; Van Buren, Gene

2017-10-01

The STAR Heavy Flavor Tracker (HFT) was designed to provide high-precision tracking for the identification of charmed hadron decays in heavy-ion collisions at RHIC. It consists of three independently mounted subsystems, providing four precision measurements along the track trajectory, with the goal of pointing decay daughters back to vertices displaced by less than 100 microns from the primary event vertex. The ultimate efficiency and resolution of the physics analysis will be driven by the quality of the simulation and reconstruction of events in heavy-ion collisions. In particular, it is important that the geometry model properly accounts for the relative misalignments of the HFT subsystems, along with the alignment of the HFT relative to STARs primary tracking detector, the Time Projection Chamber (TPC). The Abstract Geometry Modeling Language (AgML) provides a single description of the STAR geometry, generating both our simulation (GEANT 3) and reconstruction geometries (ROOT). AgML implements an ideal detector model, while misalignments are stored separately in database tables. These have historically been applied at the hit level. Simulated detector hits are projected from their ideal position along the track’s trajectory, until they intersect the misaligned detector volume, where the struck detector element is calculated for hit digitization. This scheme has worked well as hit errors have been negligible compared with the size of sensitive volumes. The precision and complexity of the HFT detector require us to apply misalignments to the detector volumes themselves. In this paper we summarize the extension of the AgML language and support libraries to enable the static misalignment of our reconstruction and simulation geometries, discussing the design goals, limitations and path to full misalignment support in ROOT/VMC-based simulation.

Intelligent complementary sliding-mode control for LUSMS-based X-Y-theta motion control stage.

PubMed

Lin, Faa-Jeng; Chen, Syuan-Yi; Shyu, Kuo-Kai; Liu, Yen-Hung

2010-07-01

An intelligent complementary sliding-mode control (ICSMC) system using a recurrent wavelet-based Elman neural network (RWENN) estimator is proposed in this study to control the mover position of a linear ultrasonic motors (LUSMs)-based X-Y-theta motion control stage for the tracking of various contours. By the addition of a complementary generalized error transformation, the complementary sliding-mode control (CSMC) can efficiently reduce the guaranteed ultimate bound of the tracking error by half compared with the slidingmode control (SMC) while using the saturation function. To estimate a lumped uncertainty on-line and replace the hitting control of the CSMC directly, the RWENN estimator is adopted in the proposed ICSMC system. In the RWENN, each hidden neuron employs a different wavelet function as an activation function to improve both the convergent precision and the convergent time compared with the conventional Elman neural network (ENN). The estimation laws of the RWENN are derived using the Lyapunov stability theorem to train the network parameters on-line. A robust compensator is also proposed to confront the uncertainties including approximation error, optimal parameter vectors, and higher-order terms in Taylor series. Finally, some experimental results of various contours tracking show that the tracking performance of the ICSMC system is significantly improved compared with the SMC and CSMC systems.

Use of HIT for adverse event reporting in nursing homes: barriers and facilitators.

PubMed

Wagner, Laura M; Castle, Nicholas G; Handler, Steven M

2013-01-01

Approximately 8 million adverse events occur annually in nursing homes (NHs). The focus of this research is to determine barriers and health information technology (HIT)-related facilitators to adverse event reporting among U.S. NHs. Surveys were returned by 399 nursing home administrators using a mailed survey approach. Respondents were asked to report on their adverse event reporting processes focusing on barriers and role of HIT facilitators. About 15% of NHs had computerized entry by the nurse on the unit and almost 18% used no computer technology to track, monitor, or maintain adverse event data. One-third of nursing directors conducted data analysis "by-hand." NHs without HIT were more likely to not be accredited (p = 0.04) and not part of a chain/corporation (p = 0.03). Two of the top three barriers focused on fears of reporting as a barrier. This study found numerous barriers and few HIT-related facilitators to assist with adverse event reporting. Improvements in facilitating adverse event reporting through the use of HIT approaches may be warranted. Copyright © 2013 Mosby, Inc. All rights reserved.

“You Get Reminded You’re a Sick Person”: Personal Data Tracking and Patients With Multiple Chronic Conditions

PubMed Central

Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

2015-01-01

Background Consumer health information technologies (HIT) that encourage self-tracking, such as diet and fitness tracking apps and disease journals, are attracting widespread interest among technology-oriented consumers (such as “quantified self” advocates), entrepreneurs, and the health care industry. Such electronic technologies could potentially benefit the growing population of patients with multiple chronic conditions (MCC). However, MCC is predominantly a condition of the elderly and disproportionately affects the less affluent, so it also seems possible that the barriers to use of consumer HIT would be particularly severe for this patient population. Objective Our aim was to explore the perspectives of individuals with MCC using a semistructured interview study. Our research questions were (1) How do individuals with MCC track their own health and medical data? and (2) How do patients and providers perceive and use patient-tracked data? Methods We used semistructured interviews with patients with multiple chronic diseases and providers with experience caring for such patients, as well as participation in a diabetes education group to triangulate emerging themes. Data were analyzed using grounded theory and thematic analysis. Recruitment and analysis took place iteratively until thematic saturation was reached. Results Interviews were conducted with 22 patients and 7 health care providers. The patients had an average of 3.5 chronic conditions, including type 2 diabetes, heart disease, chronic pain, and depression, and had regular relationships with an average of 5 providers. Four major themes arose from the interviews: (1) tracking this data feels like work for many patients, (2) personal medical data for individuals with chronic conditions are not simply objective facts, but instead provoke strong positive and negative emotions, value judgments, and diverse interpretations, (3) patients track for different purposes, ranging from sense-making to self-management to reporting to the doctor, and (4) patients often notice that physicians trust technologically measured data such as lab reports over patients’ self-tracked data. Conclusions Developers of consumer health information technologies for data tracking (such as diet and exercise apps or blood glucose logs) often assume patients have unlimited enthusiasm for tracking their own health data via technology. However, our findings potentially explain relatively low adoption of consumer HIT, as they suggest that patients with multiple chronic illnesses consider it work to track their own data, that the data can be emotionally charged, and that they may perceive that providers do not welcome it. Similar themes have been found in some individual chronic diseases but appeared more complex because patients often encountered “illness work” connected to multiple diseases simultaneously and frequently faced additional challenges from aging or difficult comorbidities such as chronic pain, depression, and anxiety. We suggest that to make a public health impact, consumer HIT developers should engage creatively with these pragmatic and emotional issues to reach an audience that is broader than technologically sophisticated early adopters. Novel technologies are likely to be successful only if they clearly reduce patient inconvenience and burden, helping them to accomplish their “illness work” more efficiently and effectively. PMID:26290186

"You Get Reminded You're a Sick Person": Personal Data Tracking and Patients With Multiple Chronic Conditions.

PubMed

Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

2015-08-19

Consumer health information technologies (HIT) that encourage self-tracking, such as diet and fitness tracking apps and disease journals, are attracting widespread interest among technology-oriented consumers (such as "quantified self" advocates), entrepreneurs, and the health care industry. Such electronic technologies could potentially benefit the growing population of patients with multiple chronic conditions (MCC). However, MCC is predominantly a condition of the elderly and disproportionately affects the less affluent, so it also seems possible that the barriers to use of consumer HIT would be particularly severe for this patient population. Our aim was to explore the perspectives of individuals with MCC using a semistructured interview study. Our research questions were (1) How do individuals with MCC track their own health and medical data? and (2) How do patients and providers perceive and use patient-tracked data? We used semistructured interviews with patients with multiple chronic diseases and providers with experience caring for such patients, as well as participation in a diabetes education group to triangulate emerging themes. Data were analyzed using grounded theory and thematic analysis. Recruitment and analysis took place iteratively until thematic saturation was reached. Interviews were conducted with 22 patients and 7 health care providers. The patients had an average of 3.5 chronic conditions, including type 2 diabetes, heart disease, chronic pain, and depression, and had regular relationships with an average of 5 providers. Four major themes arose from the interviews: (1) tracking this data feels like work for many patients, (2) personal medical data for individuals with chronic conditions are not simply objective facts, but instead provoke strong positive and negative emotions, value judgments, and diverse interpretations, (3) patients track for different purposes, ranging from sense-making to self-management to reporting to the doctor, and (4) patients often notice that physicians trust technologically measured data such as lab reports over patients' self-tracked data. Developers of consumer health information technologies for data tracking (such as diet and exercise apps or blood glucose logs) often assume patients have unlimited enthusiasm for tracking their own health data via technology. However, our findings potentially explain relatively low adoption of consumer HIT, as they suggest that patients with multiple chronic illnesses consider it work to track their own data, that the data can be emotionally charged, and that they may perceive that providers do not welcome it. Similar themes have been found in some individual chronic diseases but appeared more complex because patients often encountered "illness work" connected to multiple diseases simultaneously and frequently faced additional challenges from aging or difficult comorbidities such as chronic pain, depression, and anxiety. We suggest that to make a public health impact, consumer HIT developers should engage creatively with these pragmatic and emotional issues to reach an audience that is broader than technologically sophisticated early adopters. Novel technologies are likely to be successful only if they clearly reduce patient inconvenience and burden, helping them to accomplish their "illness work" more efficiently and effectively.

The Head Tracks and Gaze Predicts: How the World’s Best Batters Hit a Ball

PubMed Central

Mann, David L.; Spratford, Wayne; Abernethy, Bruce

2013-01-01

Hitters in fast ball-sports do not align their gaze with the ball throughout ball-flight; rather, they use predictive eye movement strategies that contribute towards their level of interceptive skill. Existing studies claim that (i) baseball and cricket batters cannot track the ball because it moves too quickly to be tracked by the eyes, and that consequently (ii) batters do not – and possibly cannot – watch the ball at the moment they hit it. However, to date no studies have examined the gaze of truly elite batters. We examined the eye and head movements of two of the world’s best cricket batters and found both claims do not apply to these batters. Remarkably, the batters coupled the rotation of their head to the movement of the ball, ensuring the ball remained in a consistent direction relative to their head. To this end, the ball could be followed if the batters simply moved their head and kept their eyes still. Instead of doing so, we show the elite batters used distinctive eye movement strategies, usually relying on two predictive saccades to anticipate (i) the location of ball-bounce, and (ii) the location of bat-ball contact, ensuring they could direct their gaze towards the ball as they hit it. These specific head and eye movement strategies play important functional roles in contributing towards interceptive expertise. PMID:23516460

Monitoring the Gas Composition of the NIFFTE Time Projection Chamber

NASA Astrophysics Data System (ADS)

Towell, Travis; Travis Towell Collaboration

2017-09-01

The Neutron Induced Fission Fragment Tracking Experiment (NIFFTE) at Los Alamos National Laboratory(LANL) is using a Time Projection Chamber (TPC) to measure with high precision the cross section ratio of U238 to P239. When the neutron beam hits a target, it may emit fission fragments. As the fission fragments travels through the chamber, it ionizes the gas it passes through. Based on the time it takes for the ions to drift to the pad planes and the hit location of the ions, the path of fission fragments can be determined. Knowing the composition of the gas mixture is vital to accurately reconstruct the data. A Binary Gas Analyzer (BGA) is used to measure the gas composition. To confirm the accuracy of the BGA, varying amounts of nitrogen and carbon dioxide were flowed through a test gas system. Several tests were performed to validate that the BGA for our gas system is working properly. This poster will describe the test gas system setup, tests of the BGA, and elaborate on the main goals of the NIFFTE experiment.

The ATLAS Inner Detector commissioning and calibration

DOE PAGES

Aad, G.; Abbott, B.; Abdallah, J.; ...

2010-08-20

The ATLAS Inner Detector is a composite tracking system consisting of silicon pixels, silicon strips and straw tubes in a 2 T magnetic field. Its installation was completed in August 2008 and the detector took part in data-taking with single LHC beams and cosmic rays. The initial detector operation, hardware commissioning and in-situ calibrations are described. Tracking performance has been measured with 7. 6 million cosmic-ray events, collected using a tracking trigger and reconstructed with modular pattern-recognition and fitting software. The intrinsic hit efficiency and tracking trigger efficiencies are close to 100%. Lorentz angle measurements for both electrons and holes,more » specific energy-loss calibration and transition radiation turn-on measurements have been performed. Different alignment techniques have been used to reconstruct the detector geometry. After the initial alignment, a transverse impact parameter resolution of 22.1±0.9 μm and a relative momentum resolution σ p/p=(4. 83 ± 0.16)×10 -4 GeV -1×p T have been measured for high momentum tracks.« less

Optical Indoor Positioning System Based on TFT Technology

PubMed Central

Gőzse, István

2015-01-01

A novel indoor positioning system is presented in the paper. Similarly to the camera-based solutions, it is based on visual detection, but it conceptually differs from the classical approaches. First, the objects are marked by LEDs, and second, a special sensing unit is applied, instead of a camera, to track the motion of the markers. This sensing unit realizes a modified pinhole camera model, where the light-sensing area is fixed and consists of a small number of sensing elements (photodiodes), and it is the hole that can be moved. The markers are tracked by controlling the motion of the hole, such that the light of the LEDs always hits the photodiodes. The proposed concept has several advantages: Apart from its low computational demands, it is insensitive to the disturbing ambient light. Moreover, as every component of the system can be realized by simple and inexpensive elements, the overall cost of the system can be kept low. PMID:26712753

Hough transform method for track finding in center drift chamber

NASA Astrophysics Data System (ADS)

Azmi, K. A. Mohammad Kamal; Wan Abdullah, W. A. T.; Ibrahim, Zainol Abidin

2016-01-01

Hough transform is a global tracking method used which had been expected to be faster approach for tracking the circular pattern of electron moving in Center Drift Chamber (CDC), by transforming the point of hit into a circular curve. This paper present the implementation of hough transform method for the reconstruction of tracks in Center Drift Chamber (CDC) which have been generated by random number in C language programming. Result from implementation of this method shows higher peak of circle parameter value (xc,yc,rc) that indicate the similarity value of the parameter needed for circular track in CDC for charged particles in the region of CDC.

Remote vs. head-mounted eye-tracking: a comparison using radiologists reading mammograms

NASA Astrophysics Data System (ADS)

Mello-Thoms, Claudia; Gur, David

2007-03-01

Eye position monitoring has been used for decades in Radiology in order to determine how radiologists interpret medical images. Using these devices several discoveries about the perception/decision making process have been made, such as the importance of comparisons of perceived abnormalities with selected areas of the background, the likelihood that a true lesion will attract visual attention early in the reading process, and the finding that most misses attract prolonged visual dwell, often comparable to dwell in the location of reported lesions. However, eye position tracking is a cumbersome process, which often requires the observer to wear a helmet gear which contains the eye tracker per se and a magnetic head tracker, which allows for the computation of head position. Observers tend to complain of fatigue after wearing the gear for a prolonged time. Recently, with the advances made to remote eye-tracking, the use of head-mounted systems seemed destined to become a thing of the past. In this study we evaluated a remote eye tracking system, and compared it to a head-mounted system, as radiologists read a case set of one-view mammograms on a high-resolution display. We compared visual search parameters between the two systems, such as time to hit the location of the lesion for the first time, amount of dwell time in the location of the lesion, total time analyzing the image, etc. We also evaluated the observers' impressions of both systems, and what their perceptions were of the restrictions of each system.

Search for disappearing tracks as a signature of new long-lived particles in proton-proton collisions at $$\\sqrt{s} =$$ 13 TeV

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

Sirunyan, Albert M; et al.

A search is presented for long-lived charged particles that decay within the CMS detector and produce the signature of a disappearing track. A disappearing track is an isolated track with missing hits in the outer layers of the silicon tracker, little or no energy in associated calorimeter deposits, and no associated hits in the muon detectors. This search uses data collected with the CMS detector in 2015 and 2016 from proton-proton collisions at a center-of-mass energy of 13 TeV at the LHC, corresponding to an integrated luminosity of 38.4 fbmore » $$^{-1}$$. The results of the search are interpreted in the context of the anomaly-mediated supersymmetry breaking model. The data are consistent with the background-only hypothesis. Limits are set on the product of the cross section for direct production of charginos and their branching fraction to a neutralino and a pion, as a function of the chargino mass and lifetime. At 95% confidence level, charginos with masses below 715 (695) GeV are excluded for a lifetime of 3 (7) ns, as are charginos with lifetimes from 0.5 to 60 ns for a mass of 505 GeV. These are the most stringent limits using a disappearing track signature on this signal model for chargino lifetimes above $$\\approx$$0.7 ns.« less

Track vertex reconstruction with neural networks at the first level trigger of Belle II

NASA Astrophysics Data System (ADS)

Neuhaus, Sara; Skambraks, Sebastian; Kiesling, Christian

2017-08-01

The track trigger is one of the main components of the Belle II first level trigger, taking input from the Central Drift Chamber (CDC). It consists of several stages, first combining hits to track segments, followed by a 2D track finding in the transverse plane and finally a 3D track reconstruction. The results of the track trigger are the track multiplicity, the momentum vector of each track and the longitudinal displacement of the origin or production vertex of each track ("z-vertex"). The latter allows to reject background tracks from outside of the interaction region and thus to suppress a large fraction of the machine background. This contribution focuses on the track finding stage using Hough transforms and on the z-vertex reconstruction with neural networks. We describe the algorithms and show performance studies on simulated events.

Results from the First Beam-Induced Reconstructed Tracks in the LHCb Vertex Locator

NASA Astrophysics Data System (ADS)

Rodrigues, E.

2010-04-01

LHCb is a dedicated experiment at the LHC to study CP violation and rare b decays. The vertex locator (VELO) is a silicon strip detector designed to measure precisely the production and decay vertices of B-mesons. The detector is positioned at 8 mm of the LHC beams and will operate in an extremely harsh radiation environment. The VELO consists of two retractable detector halves with 21 silicon micro-strip tracking modules each. A module is composed of two n+-on-n 300 μm thick half disc sensors with R and Φ micro-strip geometry. The detectors are operated in vacuum and a bi-phase CO2 cooling system is used. The full system has been operated since June 2008 and its commissioning experience will be reported. During the LHC synchronization tests in August and September 2008, and June 2009 the LHCb detectors measured secondary particles produced by the interaction of the LHC primary beam on a beam dump. About 50,000 tracks were reconstructed in the VELO and they were used to derive the relative timing alignment between the sensors and for the first evaluation of the spatial alignment. Using this track sample the VELO has been aligned to an accuracy of 5 μm. A single hit resolution of 10 μm was obtained at the smallest pitch for tracks of perpendicular incidence. The design and the main components of the detector system are introduced. The commissioning of the detector is reported and the talk will focus on the results obtained using the first beam-induced reconstructed tracks.

Hough transform method for track finding in center drift chamber

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

Azmi, K. A. Mohammad Kamal, E-mail: khasmidatul@siswa.um.edu.my; Wan Abdullah, W. A. T., E-mail: wat@um.edu.my; Ibrahim, Zainol Abidin

Hough transform is a global tracking method used which had been expected to be faster approach for tracking the circular pattern of electron moving in Center Drift Chamber (CDC), by transforming the point of hit into a circular curve. This paper present the implementation of hough transform method for the reconstruction of tracks in Center Drift Chamber (CDC) which have been generated by random number in C language programming. Result from implementation of this method shows higher peak of circle parameter value (xc,yc,rc) that indicate the similarity value of the parameter needed for circular track in CDC for charged particlesmore » in the region of CDC.« less

Search for anomaly-mediated supersymmetry breaking with the ATLAS detector based on a disappearing-track signature in pp collisions at $$\\sqrt{s} = 7~\\mathrm{TeV}$$

DOE PAGES

Aad, G.; Abbott, B.; Abdallah, J.; ...

2012-04-27

In models of anomaly-mediated supersymmetry breaking (AMSB), the lightest chargino is predicted to have a lifetime long enough to be detected in collider experiments. This letter explores AMSB scenarios in pp collisions at (Formula Presented) = 7 TeV by attempting to identify decaying charginos which result in tracks that appear to have few associated hits in the outer region of the tracking system. The search was based on data corresponding to an integrated luminosity of 1.02 fb -1 collected with the ATLAS detector in 2011. The p T spectrum of candidate tracks is found to be consistent with the expectationmore » from Standard Model background processes and constraints on the lifetime and the production cross section were obtained. In the minimal AMSB framework with m 3/2 < 32 TeV, m 0 < 1.5 TeV, tan β = 5 and μ > 0, a chargino having mass below 92 GeV and a lifetime between 0.5 ns and 2 ns is excluded at 95 % confidence level.« less

Tracking, aiming, and hitting the UAV with ordinary assault rifle

NASA Astrophysics Data System (ADS)

Racek, František; Baláž, Teodor; Krejčí, Jaroslav; Procházka, Stanislav; Macko, Martin

2017-10-01

The usage small-unmanned aerial vehicles (UAVs) is significantly increasing nowadays. They are being used as a carrier of military spy and reconnaissance devices (taking photos, live video streaming and so on), or as a carrier of potentially dangerous cargo (intended for destruction and killing). Both ways of utilizing the UAV cause the necessity to disable it. From the military point of view, to disable the UAV means to bring it down by a weapon of an ordinary soldier that is the assault rifle. This task can be challenging for the soldier because he needs visually detect and identify the target, track the target visually and aim on the target. The final success of the soldier's mission depends not only on the said visual tasks, but also on the properties of the weapon and ammunition. The paper deals with possible methods of prediction of probability of hitting the UAV targets.

The readout chain for the bar PANDA MVD strip detector

NASA Astrophysics Data System (ADS)

Schnell, R.; Brinkmann, K.-Th.; Di Pietro, V.; Kleines, H.; Goerres, A.; Riccardi, A.; Rivetti, A.; Rolo, M. D.; Sohlbach, H.; Zaunick, H.-G.

2015-02-01

The bar PANDA (antiProton ANnihilation at DArmstadt) experiment will study the strong interaction in annihilation reactions between an antiproton beam and a stationary gas jet target. The detector will comprise different sub-detectors for tracking, particle identification and calorimetry. The Micro-Vertex Detector (MVD) as the innermost part of the tracking system will allow precise tracking and detection of secondary vertices. For the readout of the double-sided silicon strip sensors a custom-made ASIC is being developed, employing the Time-over-Threshold (ToT) technique for digitization and utilize time-to-digital converters (TDC) to provide a high-precision time stamp of the hit. A custom-made Module Data Concentrator ASIC (MDC) will multiplex the data of all front-ends of one sensor towards the CERN-developed GBT chip set (GigaBit Transceiver). The MicroTCA-based MVD Multiplexer Board (MMB) at the off-detector site will receive and concentrate the data from the GBT links and transfer it to FPGA-based compute nodes for global event building.

Transfer, loss and physical processing of water in hit-and-run collisions of planetary embryos

NASA Astrophysics Data System (ADS)

Burger, C.; Maindl, T. I.; Schäfer, C. M.

2018-01-01

Collisions between large, similar-sized bodies are believed to shape the final characteristics and composition of terrestrial planets. Their inventories of volatiles such as water are either delivered or at least significantly modified by such events. Besides the transition from accretion to erosion with increasing impact velocity, similar-sized collisions can also result in hit-and-run outcomes for sufficiently oblique impact angles and large enough projectile-to-target mass ratios. We study volatile transfer and loss focusing on hit-and-run encounters by means of smooth particle hydrodynamics simulations, including all main parameters: impact velocity, impact angle, mass ratio and also the total colliding mass. We find a broad range of overall water losses, up to 75% in the most energetic hit-and-run events, and confirm the much more severe consequences for the smaller body also for stripping of volatile layers. Transfer of water between projectile and target inventories is found to be mostly rather inefficient, and final water contents are dominated by pre-collision inventories reduced by impact losses, for similar pre-collision water mass fractions. Comparison with our numerical results shows that current collision outcome models are not accurate enough to reliably predict these composition changes in hit-and-run events. To also account for non-mechanical losses, we estimate the amount of collisionally vaporized water over a broad range of masses and find that these contributions are particularly important in collisions of ˜ Mars-sized bodies, with sufficiently high impact energies, but still relatively low gravity. Our results clearly indicate that the cumulative effect of several (hit-and-run) collisions can efficiently strip protoplanets of their volatile layers, especially the smaller body, as it might be common, e.g., for Earth-mass planets in systems with Super-Earths. An accurate model for stripping of volatiles that can be included in future planet formation simulations has to account for the peculiarities of hit-and-run events and track compositional changes in both large post-collision fragments.

Strategic Defense Initiative Organization adaptive structures program overview

NASA Astrophysics Data System (ADS)

Obal, Michael; Sater, Janet M.

In the currently envisioned architecture none of the Strategic Defense System (SDS) elements to be deployed will receive scheduled maintenance. Assessments of performance capability due to changes caused by the uncertain effects of environments will be difficult, at best. In addition, the system will have limited ability to adjust in order to maintain its required performance levels. The Materials and Structures Office of the Strategic Defense Initiative Organization (SDIO) has begun to address solutions to these potential difficulties via an adaptive structures technology program that combines health and environment monitoring with static and dynamic structural control. Conceivable system benefits include improved target tracking and hit-to-kill performance, on-orbit system health monitoring and reporting, and threat attack warning and assessment.

Identifying and Synchronizing Health Information Technology (HIT) Events from FDA Medical Device Reports.

PubMed

Kang, Hong; Wang, Frank; Zhou, Sicheng; Miao, Qi; Gong, Yang

2017-01-01

Health information technology (HIT) events, a subtype of patient safety events, pose a major threat and barrier toward a safer healthcare system. It is crucial to gain a better understanding of the nature of the errors and adverse events caused by current HIT systems. The scarcity of HIT event-exclusive databases and event reporting systems indicates the challenge of identifying the HIT events from existing resources. FDA Manufacturer and User Facility Device Experience (MAUDE) database is a potential resource for HIT events. However, the low proportion and the rapid evolvement of HIT-related events present challenges for distinguishing them from other equipment failures and hazards. We proposed a strategy to identify and synchronize HIT events from MAUDE by using a filter based on structured features and classifiers based on unstructured features. The strategy will help us develop and grow an HIT event-exclusive database, keeping pace with updates to MAUDE toward shared learning.

Developing a Health Information Technology Systems Matrix: A Qualitative Participatory Approach

PubMed Central

Chavez, Margeaux; Nazi, Kim M; Antinori, Nicole

2016-01-01

Background The US Department of Veterans Affairs (VA) has developed various health information technology (HIT) resources to provide accessible veteran-centered health care. Currently, the VA is undergoing a major reorganization of VA HIT to develop a fully integrated system to meet consumer needs. Although extensive system documentation exists for various VA HIT systems, a more centralized and integrated perspective with clear documentation is needed in order to support effective analysis, strategy, planning, and use. Such a tool would enable a novel view of what is currently available and support identifying and effectively capturing the consumer’s vision for the future. Objective The objective of this study was to develop the VA HIT Systems Matrix, a novel tool designed to describe the existing VA HIT system and identify consumers’ vision for the future of an integrated VA HIT system. Methods This study utilized an expert panel and veteran informant focus groups with self-administered surveys. The study employed participatory research methods to define the current system and understand how stakeholders and veterans envision the future of VA HIT and interface design (eg, look, feel, and function). Directed content analysis was used to analyze focus group data. Results The HIT Systems Matrix was developed with input from 47 veterans, an informal caregiver, and an expert panel to provide a descriptive inventory of existing and emerging VA HIT in four worksheets: (1) access and function, (2) benefits and barriers, (3) system preferences, and (4) tasks. Within each worksheet is a two-axis inventory. The VA’s existing and emerging HIT platforms (eg, My HealtheVet, Mobile Health, VetLink Kiosks, Telehealth), My HealtheVet features (eg, Blue Button, secure messaging, appointment reminders, prescription refill, vet library, spotlight, vitals tracker), and non-VA platforms (eg, phone/mobile phone, texting, non-VA mobile apps, non-VA mobile electronic devices, non-VA websites) are organized by row. Columns are titled with thematic and functional domains (eg, access, function, benefits, barriers, authentication, delegation, user tasks). Cells for each sheet include descriptions and details that reflect factors relevant to domains and the topic of each worksheet. Conclusions This study provides documentation of the current VA HIT system and efforts for consumers’ vision of an integrated system redesign. The HIT Systems Matrix provides a consumer preference blueprint to inform the current VA HIT system and the vision for future development to integrate electronic resources within VA and beyond with non-VA resources. The data presented in the HIT Systems Matrix are relevant for VA administrators and developers as well as other large health care organizations seeking to document and organize their consumer-facing HIT resources. PMID:27713112

Developing a Health Information Technology Systems Matrix: A Qualitative Participatory Approach.

PubMed

Haun, Jolie N; Chavez, Margeaux; Nazi, Kim M; Antinori, Nicole

2016-10-06

The US Department of Veterans Affairs (VA) has developed various health information technology (HIT) resources to provide accessible veteran-centered health care. Currently, the VA is undergoing a major reorganization of VA HIT to develop a fully integrated system to meet consumer needs. Although extensive system documentation exists for various VA HIT systems, a more centralized and integrated perspective with clear documentation is needed in order to support effective analysis, strategy, planning, and use. Such a tool would enable a novel view of what is currently available and support identifying and effectively capturing the consumer's vision for the future. The objective of this study was to develop the VA HIT Systems Matrix, a novel tool designed to describe the existing VA HIT system and identify consumers' vision for the future of an integrated VA HIT system. This study utilized an expert panel and veteran informant focus groups with self-administered surveys. The study employed participatory research methods to define the current system and understand how stakeholders and veterans envision the future of VA HIT and interface design (eg, look, feel, and function). Directed content analysis was used to analyze focus group data. The HIT Systems Matrix was developed with input from 47 veterans, an informal caregiver, and an expert panel to provide a descriptive inventory of existing and emerging VA HIT in four worksheets: (1) access and function, (2) benefits and barriers, (3) system preferences, and (4) tasks. Within each worksheet is a two-axis inventory. The VA's existing and emerging HIT platforms (eg, My HealtheVet, Mobile Health, VetLink Kiosks, Telehealth), My HealtheVet features (eg, Blue Button, secure messaging, appointment reminders, prescription refill, vet library, spotlight, vitals tracker), and non-VA platforms (eg, phone/mobile phone, texting, non-VA mobile apps, non-VA mobile electronic devices, non-VA websites) are organized by row. Columns are titled with thematic and functional domains (eg, access, function, benefits, barriers, authentication, delegation, user tasks). Cells for each sheet include descriptions and details that reflect factors relevant to domains and the topic of each worksheet. This study provides documentation of the current VA HIT system and efforts for consumers' vision of an integrated system redesign. The HIT Systems Matrix provides a consumer preference blueprint to inform the current VA HIT system and the vision for future development to integrate electronic resources within VA and beyond with non-VA resources. The data presented in the HIT Systems Matrix are relevant for VA administrators and developers as well as other large health care organizations seeking to document and organize their consumer-facing HIT resources.

VIPRAM_L1CMS: a 2-Tier 3D Architecture for Pattern Recognition for Track Finding

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

Hoff, J. R.; Joshi, Joshi,S.; Liu, Liu,

In HEP tracking trigger applications, flagging an individual detector hit is not important. Rather, the path of a charged particle through many detector layers is what must be found. Moreover, given the increased luminosity projected for future LHC experiments, this type of track finding will be required within the Level 1 Trigger system. This means that future LHC experiments require not just a chip capable of high-speed track finding but also one with a high-speed readout architecture. VIPRAM_L1CMS is 2-Tier Vertically Integrated chip designed to fulfill these requirements. It is a complete pipelined Pattern Recognition Associative Memory (PRAM) architecture includingmore » pattern recognition, result sparsification, and readout for Level 1 trigger applications in CMS with 15-bit wide detector addresses and eight detector layers included in the track finding. Pattern recognition is based on classic Content Addressable Memories with a Current Race Scheme to reduce timing complexity and a 4-bit Selective Precharge to minimize power consumption. VIPRAM_L1CMS uses a pipelined set of priority-encoded binary readout structures to sparsify and readout active road flags at frequencies of at least 100MHz. VIPRAM_L1CMS is designed to work directly with the Pulsar2b Architecture.« less

EEG and Eye Tracking Signatures of Target Encoding during Structured Visual Search

PubMed Central

Brouwer, Anne-Marie; Hogervorst, Maarten A.; Oudejans, Bob; Ries, Anthony J.; Touryan, Jonathan

2017-01-01

EEG and eye tracking variables are potential sources of information about the underlying processes of target detection and storage during visual search. Fixation duration, pupil size and event related potentials (ERPs) locked to the onset of fixation or saccade (saccade-related potentials, SRPs) have been reported to differ dependent on whether a target or a non-target is currently fixated. Here we focus on the question of whether these variables also differ between targets that are subsequently reported (hits) and targets that are not (misses). Observers were asked to scan 15 locations that were consecutively highlighted for 1 s in pseudo-random order. Highlighted locations displayed either a target or a non-target stimulus with two, three or four targets per trial. After scanning, participants indicated which locations had displayed a target. To induce memory encoding failures, participants concurrently performed an aurally presented math task (high load condition). In a low load condition, participants ignored the math task. As expected, more targets were missed in the high compared with the low load condition. For both conditions, eye tracking features distinguished better between hits and misses than between targets and non-targets (with larger pupil size and shorter fixations for missed compared with correctly encoded targets). In contrast, SRP features distinguished better between targets and non-targets than between hits and misses (with average SRPs showing larger P300 waveforms for targets than for non-targets). Single trial classification results were consistent with these averages. This work suggests complementary contributions of eye and EEG measures in potential applications to support search and detect tasks. SRPs may be useful to monitor what objects are relevant to an observer, and eye variables may indicate whether the observer should be reminded of them later. PMID:28559807

Object tracking via background subtraction for monitoring illegal activity in crossroad

NASA Astrophysics Data System (ADS)

Ghimire, Deepak; Jeong, Sunghwan; Park, Sang Hyun; Lee, Joonwhoan

2016-07-01

In the field of intelligent transportation system a great number of vision-based techniques have been proposed to prevent pedestrians from being hit by vehicles. This paper presents a system that can perform pedestrian and vehicle detection and monitoring of illegal activity in zebra crossings. In zebra crossing, according to the traffic light status, to fully avoid a collision, a driver or pedestrian should be warned earlier if they possess any illegal moves. In this research, at first, we detect the traffic light status of pedestrian and monitor the crossroad for vehicle pedestrian moves. The background subtraction based object detection and tracking is performed to detect pedestrian and vehicles in crossroads. Shadow removal, blob segmentation, trajectory analysis etc. are used to improve the object detection and classification performance. We demonstrate the experiment in several video sequences which are recorded in different time and environment such as day time and night time, sunny and raining environment. Our experimental results show that such simple and efficient technique can be used successfully as a traffic surveillance system to prevent accidents in zebra crossings.

Health Information Technologies-Academic and Commercial Evaluation (HIT-ACE) methodology: description and application to clinical feedback systems.

PubMed

Lyon, Aaron R; Lewis, Cara C; Melvin, Abigail; Boyd, Meredith; Nicodimos, Semret; Liu, Freda F; Jungbluth, Nathaniel

2016-09-22

Health information technologies (HIT) have become nearly ubiquitous in the contemporary healthcare landscape, but information about HIT development, functionality, and implementation readiness is frequently siloed. Theory-driven methods of compiling, evaluating, and integrating information from the academic and commercial sectors are necessary to guide stakeholder decision-making surrounding HIT adoption and to develop pragmatic HIT research agendas. This article presents the Health Information Technologies-Academic and Commercial Evaluation (HIT-ACE) methodology, a structured, theory-driven method for compiling and evaluating information from multiple sectors. As an example demonstration of the methodology, we apply HIT-ACE to mental and behavioral health measurement feedback systems (MFS). MFS are a specific class of HIT that support the implementation of routine outcome monitoring, an evidence-based practice. HIT-ACE is guided by theories and frameworks related to user-centered design and implementation science. The methodology involves four phases: (1) coding academic and commercial materials, (2) developer/purveyor interviews, (3) linking putative implementation mechanisms to hit capabilities, and (4) experimental testing of capabilities and mechanisms. In the current demonstration, phase 1 included a systematic process to identify MFS in mental and behavioral health using academic literature and commercial websites. Using user-centered design, implementation science, and feedback frameworks, the HIT-ACE coding system was developed, piloted, and used to review each identified system for the presence of 38 capabilities and 18 additional characteristics via a consensus coding process. Bibliometic data were also collected to examine the representation of the systems in the scientific literature. As an example, results are presented for the application of HIT-ACE phase 1 to MFS wherein 49 separate MFS were identified, reflecting a diverse array of characteristics and capabilities. Preliminary findings demonstrate the utility of HIT-ACE to represent the scope and diversity of a given class of HIT beyond what can be identified in the academic literature. Phase 2 data collection is expected to confirm and expand the information presented and phases 3 and 4 will provide more nuanced information about the impact of specific HIT capabilities. In all, HIT-ACE is expected to support adoption decisions and additional HIT development and implementation research.

Effects of Methamphetamine on Vigilance and Tracking during Extended Wakefulness.

DTIC Science & Technology

1993-09-01

the log likelihood ratio (log(p); Green & Swets, 1966; Macmillan & Creelman , 1990), was also derived from hit and false-alarm probabilities...vigilance task. Canadian Journal of Psychology, 19, 104-110. Macmillan, N.E., & Creelman , C.D. (1990). Response bias: Characteristics of detection

Active and passive surveillance of enoxaparin generics: a case study relevant to biosimilars.

PubMed

Grampp, Gustavo; Bonafede, Machaon; Felix, Thomas; Li, Edward; Malecki, Michael; Sprafka, J Michael

2015-03-01

This retrospective analysis assessed the capability of active and passive safety surveillance systems to track product-specific safety events in the USA for branded and generic enoxaparin, a complex injectable subject to immune-related and other adverse events (AEs). Analysis of heparin-induced thrombocytopenia (HIT) incidence was performed on benefit claims for commercial and Medicare supplemental-insured individuals newly treated with enoxaparin under pharmacy benefit (1 January 2009 - 30 June 2012). Additionally, spontaneous reports from the FDA AE Reporting System were reviewed to identify incidence and attribution of enoxaparin-related reports to specific manufacturers. Specific, dispensed products were identifiable from National Drug Codes only in pharmacy-benefit databases, permitting sensitive comparison of HIT incidence in nearly a third of patients treated with brand or generic enoxaparin. After originator medicine's loss of exclusivity, only 5% of spontaneous reports were processed by generic manufacturers; reports attributable to specific generics were approximately ninefold lower than expected based on market share. Claims data were useful for active surveillance of enoxaparin generics dispensed under pharmacy benefits but not for products administered under medical benefits. These findings suggest that the current spontaneous reporting system will not distinguish product-specific safety signals for products distributed by multiple manufacturers, including biosimilars.

A qualitative study of health information technology in the Canadian public health system.

PubMed

Zinszer, Kate; Tamblyn, Robyn; Bates, David W; Buckeridge, David L

2013-05-25

Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technology (HIT) policy related to public health in Canada that have succeeded, to identify remaining challenges, and to suggest future directions to improve the adoption and use of HIT in the public health system. A qualitative case study was performed with 24 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Identified benefits of HIT in public health included improved communication among jurisdictions, increased awareness of the need for interoperable systems, and improvement in data standardization. Identified barriers included a lack of national vision and leadership, insufficient investment, and poor conceptualization of the priority areas for implementing HIT in public health. The application of HIT in public health should focus on automating core processes and identifying innovative applications of HIT to advance public health outcomes. The Public Health Agency of Canada should develop the expertise to lead public health HIT policy and should establish a mechanism for coordinating public health stakeholder input on HIT policy.

A study of the feasibility of Internet administration of a computerized health survey: the headache impact test (HIT).

PubMed

Bayliss, M S; Dewey, J E; Dunlap, I; Batenhorst, A S; Cady, R; Diamond, M L; Sheftell, F

2003-12-01

Headache impact test (HIT) is a precise, practical tool that quantifies the impact of headache on respondents' lives. It is the first widely-available dynamic health assessment (DynHA). Applications of this brief, precise survey include population based screening for disabling headaches, tracking of individual patient scores over time, disease management programs and others. We use data from Internet HIT assessments during the fall of 2000 to (1) evaluate characteristics of respondents and assessments, (2) assess the utility of joint administration of HIT and the SF-8 Health Survey (SF-8) to screen for migraine and depression, and (3) explore associations between HIT scores and subsequent healthcare-related attitudes and behaviors. We analyzed Internet HIT surveys completed between 9/1 and 11/30/2000 (n = 19,195). Subsamples include respondents who also completed (1) a 12-item Internet survey assessing severity, frequency, cause and management of headaches; (2) an e-mail survey measuring healthcare-related behaviors; (3) the SF-8; or (4) the website registration process, providing age and gender data. We used analysis of variance (ANOVA) to evaluate HIT score differences associated with age, gender, headache severity or frequency, and healthcare-related behaviors and attitudes and chi2 tests to assess the prevalence and comorbidity of migraine and depression. Three-quarters of respondents achieved a precise HIT score in < or = 5 items. Most had moderate/severe headaches; 65% had headaches at least monthly. HIT scores were directly related to headache severity and frequency. Most respondents were females, with significantly higher HIT scores than males. Most HIT respondents were between ages 25 and 54 (HIT scores were higher for younger respondents). Sixty four percent screened positive for migraine; 20% for depression. Both conditions were more prevalent among females than males. Comorbid migraine and depression was 50% more prevalent among females and increased with age until age 50. Patients with worse headache impact were more likely to seek care, discuss headaches with their providers and find HIT useful. It is feasible to use Internet-based dynamic assessments to measure health status. These data complement previous results showing that HIT differentiates respondents according to headache characteristics (severity and frequency). HIT plus SF-8 yields a practical screen for migraine and depression in headache patients and may lead to more effective treatment for patients with these conditions. Preliminary findings suggest that the experience of taking HIT on the Internet may motivate headache patients to seek care and discuss headaches with their providers.

A practical approach to tramway track condition monitoring: vertical track defects detection and identification using time-frequency processing technique

NASA Astrophysics Data System (ADS)

Bocz, Péter; Vinkó, Ákos; Posgay, Zoltán

2018-03-01

This paper presents an automatic method for detecting vertical track irregularities on tramway operation using acceleration measurements on trams. For monitoring of tramway tracks, an unconventional measurement setup is developed, which records the data of 3-axes wireless accelerometers mounted on wheel discs. Accelerations are processed to obtain the vertical track irregularities to determine whether the track needs to be repaired. The automatic detection algorithm is based on time-frequency distribution analysis and determines the defect locations. Admissible limits (thresholds) are given for detecting moderate and severe defects using statistical analysis. The method was validated on frequented tram lines in Budapest and accurately detected severe defects with a hit rate of 100%, with no false alarms. The methodology is also sensitive to moderate and small rail surface defects at the low operational speed.

The muon pretrigger system of the HERA-B experiment

NASA Astrophysics Data System (ADS)

Bocker, M.; Adams, M.; Bechtle, P.; Buchholz, P.; Cruse, C.; Husemann, U.; Klaus, E.; Koch, N.; Kolander, M.; Kolotaev, I.; Riege, H.; Schutt, J.; Schwenninger, B.; van Staa, R.; Wegener, D.

2001-08-01

One of the main goals of the HERA-B experiment at DESY in Hamburg, Germany, is to study the properties of B-mesons with the emphasis on CP violation. B-mesons are produced in hadronic interactions of a 920-GeV proton beam with an internal wire target. An effective bunch crossing rate of about 8.5 MHz leads to about 200 charged tracks per event. Therefore, a highly selective and efficient trigger system providing high suppression of background events is required. The HERA-B trigger system consists of four levels. A rate reduction factor of 200 is aimed at by the first-level trigger (FLT). The muon pretrigger system, as a part of the FLT, is a modular system consisting of about 100 large-size VME modules of three different types: the pretrigger link board (PLB), the pretrigger coincidence unit (PCU), and the pretrigger message generator (PMG). The data rate processed by the pretrigger system is about 19.5 GByte/s. The PLBs process digitized hit information in eight independent electronic channels in parallel. Every electronic channel handles 32 bits of hit information received from the front-end driver buffer system. Optical links operating at 800 Mb/s transmit the data after serialization to PCUs, which calculate coincidences using complex programmable logic devices. The PMGs transform this coincidence information into messages for the FLT processors. The concept and design as well as results of the muon pretrigger running at HERA-B are presented.

Evaluation of GPUs as a level-1 track trigger for the High-Luminosity LHC

NASA Astrophysics Data System (ADS)

Mohr, H.; Dritschler, T.; Ardila, L. E.; Balzer, M.; Caselle, M.; Chilingaryan, S.; Kopmann, A.; Rota, L.; Schuh, T.; Vogelgesang, M.; Weber, M.

2017-04-01

In this work, we investigate the use of GPUs as a way of realizing a low-latency, high-throughput track trigger, using CMS as a showcase example. The CMS detector at the Large Hadron Collider (LHC) will undergo a major upgrade after the long shutdown from 2024 to 2026 when it will enter the high luminosity era. During this upgrade, the silicon tracker will have to be completely replaced. In the High Luminosity operation mode, luminosities of 5-7 × 1034 cm-2s-1 and pileups averaging at 140 events, with a maximum of up to 200 events, will be reached. These changes will require a major update of the triggering system. The demonstrated systems rely on dedicated hardware such as associative memory ASICs and FPGAs. We investigate the use of GPUs as an alternative way of realizing the requirements of the L1 track trigger. To this end we implemeted a Hough transformation track finding step on GPUs and established a low-latency RDMA connection using the PCIe bus. To showcase the benefits of floating point operations, made possible by the use of GPUs, we present a modified algorithm. It uses hexagonal bins for the parameter space and leads to a more truthful representation of the possible track parameters of the individual hits in Hough space. This leads to fewer duplicate candidates and reduces fake track candidates compared to the regular approach. With data-transfer latencies of 2 μs and processing times for the Hough transformation as low as 3.6 μs, we can show that latencies are not as critical as expected. However, computing throughput proves to be challenging due to hardware limitations.

The Ultimate Private Observatory

NASA Astrophysics Data System (ADS)

Aymond, J.

2009-03-01

An amateur astronomer from Washington Parish, Southeast Louisiana, USA has designed and built an amazing observatory. It is not only an astronomical observatory, but a home theater, and tornado shelter designed to take a direct hit from an F5 tornado. The facility is fully equipped and automated, with a hydraulically driven roof that weighs 20,571 lbs., which lifts up, then rolls away to the end of the tracks. This leaves the user sitting inside of four 14-foot high walls open to the night sky. It has two premium quality telescopes for viewing deep space and objects inside the solar system. The chair that the observer sits on is also hydraulically driven.

Technological iatrogenesis: the manifestation of inadequate organizational planning and the integration of health information technology.

PubMed

Palmieri, Patrick Albert; Peterson, Lori T; Corazzo, Luciano Bedoya

2011-01-01

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost-effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational-technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern. Recognizing the technology-organizational misalignments that result from HIT adoption is important for leaders seeking to eliminate sources of system instability. The Health Information Technology Iatrogenesis Model (HITIM) provides leaders with a conceptual framework from which to consider HIT as an instrument for organizational development. Complexity and Diffusion of Innovation theories support the framework that suggests each HIT adoption functions as a technological change agent. As such, leaders need to provide operational oversight to managers undertaking system change via HIT implementation. Traditional risk management tools, such as Failure Mode Effect Analysis and Root Cause Analysis, provide proactive pre- and post-implementation appraisals to verify system stability and to enhance system reliability. Reconsidering the use of these tools within the context of a new framework offers leaders guidance when adopting HIT to achieve performance improvement and better outcomes.

Isolated orbital mass as the primary presentation of a triple-hit lymphoma transformed from a systemic follicular lymphoma.

PubMed

Zhou, Xiao Yi; Lu, Xinyan; Raparia, Kirtee; Chen, Yi-Hua

2018-06-01

Triple-hit lymphoma is a highly aggressive B-cell lymphoma. We report a case of triple-hit lymphoma transformed from systemic follicular lymphoma (FL) after 9-year remission and presented primarily as an isolated orbital mass without systemic symptoms or lymphadenopathy. A 58-year-old female presented with intermittent vertical binocular diplopia, left upper eyelid swelling and pain and was found to have a 2.9 cm orbital mass. Histological section revealed a CD10-positive large B-cell lymphoma, consistent with transformation of FL. Fluorescent in situ hybridization (FISH) analysis demonstrated rearrangements involving C-MYC, BCL-2 and BCL-6 genes, indicating a high grade, triple-hit lymphoma. Triple-hit lymphoma transformed from a low-grade lymphoma may initially present as an isolated orbital mass without systemic evidence of transformation. Early recognition of double or triple-hit lymphomas is important since these patients require aggressive chemotherapy.

Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

PubMed

Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

2015-09-01

Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.

PubMed

Cifuentes, Maribel; Davis, Melinda; Fernald, Doug; Gunn, Rose; Dickinson, Perry; Cohen, Deborah J

2015-01-01

This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with clinicians, should intentionally design EHR products that support integrated care delivery functions, such as data documentation and reporting to support tracking patients with emotional and behavioral problems over time and settings, integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions such as depression, and improved registry functionality and interoperability. This work will require financial support and cooperative efforts among clinicians, EHR vendors, practice assistance organizations, regulators, standards setters, and workforce educators. © Copyright 2015 by the American Board of Family Medicine.

Novel particle tracking algorithm based on the Random Sample Consensus Model for the Active Target Time Projection Chamber (AT-TPC)

NASA Astrophysics Data System (ADS)

Ayyad, Yassid; Mittig, Wolfgang; Bazin, Daniel; Beceiro-Novo, Saul; Cortesi, Marco

2018-02-01

The three-dimensional reconstruction of particle tracks in a time projection chamber is a challenging task that requires advanced classification and fitting algorithms. In this work, we have developed and implemented a novel algorithm based on the Random Sample Consensus Model (RANSAC). The RANSAC is used to classify tracks including pile-up, to remove uncorrelated noise hits, as well as to reconstruct the vertex of the reaction. The algorithm, developed within the Active Target Time Projection Chamber (AT-TPC) framework, was tested and validated by analyzing the 4He+4He reaction. Results, performance and quality of the proposed algorithm are presented and discussed in detail.

Health Information Technology Systems profoundly impact users: a case study in a dental school.

PubMed

Hill, Heather K; Stewart, Denice C L; Ash, Joan S

2010-04-01

The purpose of this study was to increase our understanding of the impact of Health Information Technology Systems (HITS) on dental school users when the systems are integrated into chair-side patient care. We used qualitative research methods, including interviews, focus groups, and observations, to capture the experiences of HITS users at a single institution. Users included administrators, clinical faculty members, predoctoral students, support staff, and residents. The data were analyzed using a grounded theory approach, and nine themes emerged: 1) HITS benefits were disproportionate among users; 2) communicating about the HITS was challenging; 3) users experienced a range of strong emotions; 4) the instructor persona diminished; 5) there were shifts in the school's power structure; 6) allocation of end-users' time shifted; 7) the training and support needs of end-users were significant; 8) perceived lack of HITS usability made documentation cumbersome for clinicians; and 9) clinicians' workflow was disrupted. HITS integration into patient care impacts the work of all system users, especially end-users. The themes highlight areas of potential concern for implementers and users in integrating a HITS into patient care.

Two-fluid (plasma-neutral) Extended-MHD simulations of spheromak configurations in the HIT-SI experiment with PSI-Tet

NASA Astrophysics Data System (ADS)

Sutherland, D. A.; Hansen, C. J.; Jarboe, T. R.

2017-10-01

A self-consistent, two-fluid (plasma-neutral) dynamic neutral model has been implemented into the 3-D, Extended-MHD code PSI-Tet. A monatomic, hydrogenic neutral fluid reacts with a plasma fluid through elastic scattering collisions and three inelastic collision reactions: electron-impact ionization, radiative recombination, and resonant charge-exchange. Density, momentum, and energy are evolved for both the plasma and neutral species. The implemented plasma-neutral model in PSI-Tet is being used to simulate decaying spheromak configurations in the HIT-SI experimental geometry, which is being compare to two-photon absorption laser induced fluorescence measurements (TALIF) made on the HIT-SI3 experiment. TALIF is used to measure the absolute density and temperature of monatomic deuterium atoms. Neutral densities on the order of 1015 m-3 and neutral temperatures between 0.6-1.7 eV were measured towards the end of decay of spheromak configurations with initial toroidal currents between 10-12 kA. Validation results between TALIF measurements and PSI-Tet simulations with the implemented dynamic neutral model will be presented. Additionally, preliminary dynamic neutral simulations of the HIT-SI/HIT-SI3 spheromak plasmas sustained with inductive helicity injection will be presented. Lastly, potential benefits of an expansion of the two-fluid model into a multi-fluid model that includes multiple neutral species and tracking of charge states will be discussed.

Studying the HIT-Complexity Interchange.

PubMed

Kuziemsky, Craig E; Borycki, Elizabeth M; Kushniruk, Andre W

2016-01-01

The design and implementation of health information technology (HIT) is challenging, particularly when it is being introduced into complex settings. While complex adaptive system (CASs) can be a valuable means of understanding relationships between users, HIT and tasks, much of the existing work using CASs is descriptive in nature. This paper addresses that issue by integrating a model for analyzing task complexity with approaches for HIT evaluation and systems analysis. The resulting framework classifies HIT-user tasks and issues as simple, complicated or complex, and provides insight on how to study them.

A complex adaptive systems perspective of health information technology implementation.

PubMed

Keshavjee, Karim; Kuziemsky, Craig; Vassanji, Karim; Ghany, Ahmad

2013-01-01

Implementing health information technology (HIT) is a challenge because of the complexity and multiple interactions that define HIT implementation. Much of the research on HIT implementation is descriptive in nature and has focused on distinct processes such as order entry or decision support. These studies fail to take into account the underlying complexity of the processes, people and settings that are typical of HIT implementations. Complex adaptive systems (CAS) is a promising field that could elucidate the complexity and non-linear interacting issues that are typical in HIT implementation. Initially we sought new models that would enable us to better understand the complex nature of HIT implementation, to proactively identify problem issues that could be a precursor to unintended consequences and to develop new models and new approaches to successful HIT implementations. Our investigation demonstrates that CAS does not provide prediction, but forces us to rethink our HIT implementation paradigms and question what we think we know. CAS provides new ways to conceptualize HIT implementation and suggests new approaches to increasing HIT implementation successes.

An investigation of the 'von Restorff' phenomenon in post-test workload ratings

NASA Technical Reports Server (NTRS)

Thornton, D. C.

1985-01-01

The von Restorff effect in post-task ratings of task difficulty is examined. Nine subjects performed a hovercraft simulation task which combined elements of skill-based tracking and rule- and knowledge-based process control for five days of one hour sessions. The effects of isolated increases in workload on rating of task performance, and on the number of command errors and river band hits are analyzed. It is observed that the position of the workload increase affects the number of bank hits and command errors. The data reveal that factors not directly related to the task performance influence subjective rating, and post-task ratings of workload are biased.

Identifying the location of a concealed object through unintentional eye movements

PubMed Central

Neuman, Yair; Assaf, Dan; Israeli, Navot

2015-01-01

In some investigative and interrogative contexts, the investigator is seeking to identify the location of an object (e.g., implanted bomb) which is known to a given subject (e.g., a terrorist). In this paper, we present a non-intrusive methodology for uncovering the loci of a concealed object by analyzing the subject's eye movements. Using a combination of eye tracking, psychological manipulation and a search algorithm, we have performed two experiments. In the first experiment, we have gained 58% hit rate in identifying the location of the concealed object and in the second experiment 56% hit rate. The pros and cons of the methodology for forensic investigation are discussed. PMID:25904879

Citizen Science: A Gateway for Innovation in Disease-Carrying Mosquito Management?

PubMed

Bartumeus, Frederic; Oltra, Aitana; Palmer, John R B

2018-05-21

Traditional methods for tracking disease-carrying mosquitoes are hitting budget constraints as the scales over which they must be implemented grow exponentially. Citizen science offers a novel solution to this problem but requires new models of innovation in the public health sector. Copyright © 2018 Elsevier Ltd. All rights reserved.

The effect of obesity on the rate of heparin-induced thrombocytopenia.

PubMed

Marler, Jacob L; Jones, G Morgan; Wheeler, Brian J; Alshaya, Abdulrahman; Hartmann, Jonathan L; Oliphant, Carrie S

2018-06-01

: Heparin-induced thrombocytopenia (HIT) occurs in patients receiving heparin-containing products due to the formation of platelet-activating antibodies to heparin and platelet factor 4. Diagnosis includes utilization of a scoring system known as the 4-T score, and HIT laboratory assays. Recently, obesity was identified as a potential factor associated with the development of HIT. The objective of this study was to evaluate the association of HIT with obesity in ICU and general medicine patients. We performed a chart review of adult patients within the Methodist Healthcare System, and included patients who had an ELISA and serotonin release assay laboratory tests reported within same hospital admission in which they also had documented receipt of heparin. Obese patients were compared with nonobese patients (BMI < 30) for the primary outcome of HIT occurrence, and secondary outcomes including rate of thrombosis, 4-T scores, and ELISA optical density values. We also generated a 5-T score by including one additional point for those with a BMI of 30 or more to determine the predictive value of this score in identifying HIT. Obesity was confirmed to be a risk factor for HIT, and the 5-T score model was also predictive of the development of HIT. However, the 5-T score was not statistically more predictive of HIT than the 4-T score. Predicting HIT remains challenging and novel markers of HIT are needed to improve HIT recognition. Although obesity did not improve the 4-T score, it may improve the predictability of other scoring systems, and further investigation is warranted.

Assessing health information technology in a national health care system--an example from Taiwan.

PubMed

Chi, Chunhuei; Lee, Jwo-Leun; Schoon, Rebecca

2012-01-01

The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context? We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal. to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services, (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy. The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT. There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system. The lack of such research motivated this study. The major contributions of this study are (i) to develop a framework that follows systems thinking principles and (ii) propose a process through which a nation can identify its objectives for HIT and systematically assess its national HIT system. Using Taiwan's national health care system as a case study, this paper demonstrated how it can be done.

Developing Health Information Technology (HIT) Programs and HIT Curriculum: The Southern Polytechnic State University Experience

ERIC Educational Resources Information Center

Zhang, Chi; Reichgelt, Han; Rutherfoord, Rebecca H.; Wang, Andy Ju An

2014-01-01

Health Information Technology (HIT) professionals are in increasing demand as healthcare providers need help in the adoption and meaningful use of Electronic Health Record (EHR) systems while the HIT industry needs workforce skilled in HIT and EHR development. To respond to this increasing demand, the School of Computing and Software Engineering…

Novel 3-D laparoscopic magnetic ultrasound image guidance for lesion targeting

PubMed Central

Sindram, David; McKillop, Iain H; Martinie, John B; Iannitti, David A

2010-01-01

Objectives: Accurate laparoscopic liver lesion targeting for biopsy or ablation depends on the ability to merge laparoscopic and ultrasound images with proprioceptive instrument positioning, a skill that can be acquired only through extensive experience. The aim of this study was to determine whether using magnetic positional tracking to provide three-dimensional, real-time guidance improves accuracy during laparoscopic needle placement. Methods: Magnetic sensors were embedded into a needle and laparoscopic ultrasound transducer. These sensors interrupted the magnetic fields produced by an electromagnetic field generator, allowing for real-time, 3-D guidance on a stereoscopic monitor. Targets measuring 5 mm were embedded 3–5 cm deep in agar and placed inside a laparoscopic trainer box. Two novices (a college student and an intern) and two experts (hepatopancreatobiliary surgeons) targeted the lesions out of the ultrasound plane using either traditional or 3-D guidance. Results: Each subject targeted 22 lesions, 11 with traditional and 11 with the novel guidance (n = 88). Hit rates of 32% (14/44) and 100% (44/44) were observed with the traditional approach and the 3-D magnetic guidance approach, respectively. The novices were essentially unable to hit the targets using the traditional approach, but did not miss using the novel system. The hit rate of experts improved from 59% (13/22) to 100% (22/22) (P < 0.0001). Conclusions: The novel magnetic 3-D laparoscopic ultrasound guidance results in perfect targeting of 5-mm lesions, even by surgical novices. PMID:21083797

Patient-Centred Coordinated Care in Times of Emerging Diseases and Epidemics. Contribution of the IMIA Working Group on Patient Safety.

PubMed

Borycki, E; Cummings, E; Dexheimer, J W; Gong, Y; Kennebeck, S; Kushniruk, A; Kuziemsky, C; Saranto, K; Weber, J; Takeda, H

2015-08-13

In this paper the researchers describe how existing health information technologies (HIT) can be repurposed and new technologies can be innovated to provide patient-centered care to individuals affected by new and emerging diseases. The researchers conducted a focused review of the published literature describing how HIT can be used to support safe, patient-centred, coordinated care to patients who are affected by Ebola (an emerging disease). New and emerging diseases present opportunities for repurposing existing technologies and for stimulating the development of new HIT innovation. Innovative technologies may be developed such as new software used for tracking patients during new or emerging disease outbreaks or by repurposing and extending existing technologies so they can be used to support patients, families and health professionals who may have been exposed to a disease. The paper describes the development of new technologies and the repurposing and extension of existing ones (such as electronic health records) using the most recent outbreak of Ebola as an example.

Performance of Multiplexed XY Resistive Micromegas detectors in a high intensity beam

NASA Astrophysics Data System (ADS)

Banerjee, D.; Burtsev, V.; Chumakov, A.; Cooke, D.; Depero, E.; Dermenev, A. V.; Donskov, S. V.; Dubinin, F.; Dusaev, R. R.; Emmenegger, S.; Fabich, A.; Frolov, V. N.; Gardikiotis, A.; Gninenko, S. N.; Hösgen, M.; Karneyeu, A. E.; Ketzer, B.; Kirsanov, M. M.; Konorov, I. V.; Kramarenko, V. A.; Kuleshov, S. V.; Levchenko, E.; Lyubovitskij, V. E.; Lysan, V.; Mamon, S.; Matveev, V. A.; Mikhailov, Yu. V.; Myalkovskiy, V. V.; Peshekhonov, V. D.; Peshekhonov, D. V.; Polyakov, V. A.; Radics, B.; Rubbia, A.; Samoylenko, V. D.; Tikhomirov, V. O.; Tlisov, D. A.; Toropin, A. N.; Vasilishin, B.; Arenas, G. Vasquez; Ulloa, P.; Crivelli, P.

2018-02-01

We present the performance of multiplexed XY resistive Micromegas detectors tested in the CERN SPS 100 GeV/c electron beam at intensities up to 3 . 3 × 105e- /(s ṡcm2) . So far, all studies with multiplexed Micromegas have only been reported for tests with radioactive sources and cosmic rays. The use of multiplexed modules in high intensity environments was not explored due to the effect of ambiguities in the reconstruction of the hit point caused by the multiplexing feature. For the specific mapping and beam intensities analyzed in this work with a multiplexing factor of five, more than 50% level of ambiguity is introduced due to particle pile-up as well as fake clusters due to the mapping feature. Our results prove that by using the additional information of cluster size and integrated charge from the signal clusters induced on the XY strips, the ambiguities can be reduced to a level below 2%. The tested detectors are used in the CERN NA64 experiment for tracking the incoming particles bending in a magnetic field in order to reconstruct their momentum. The average hit detection efficiency of each module was found to be ∼96% at the highest beam intensities. By using four modules a tracking resolution of 1.1% was obtained with ∼85% combined tracking efficiency.

Patient safety goals for the proposed Federal Health Information Technology Safety Center.

PubMed

Sittig, Dean F; Classen, David C; Singh, Hardeep

2015-03-01

The Office of the National Coordinator for Health Information Technology is expected to oversee creation of a Health Information Technology (HIT) Safety Center. While its functions are still being defined, the center is envisioned as a public-private entity focusing on promotion of HIT related patient safety. We propose that the HIT Safety Center leverages its unique position to work with key administrative and policy stakeholders, healthcare organizations (HCOs), and HIT vendors to achieve four goals: (1) facilitate creation of a nationwide 'post-marketing' surveillance system to monitor HIT related safety events; (2) develop methods and governance structures to support investigation of major HIT related safety events; (3) create the infrastructure and methods needed to carry out random assessments of HIT related safety in complex HCOs; and (4) advocate for HIT safety with government and private entities. The convening ability of a federally supported HIT Safety Center could be critically important to our transformation to a safe and effective HIT enabled healthcare system. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Safe use of electronic health records and health information technology systems: trust but verify.

PubMed

Denham, Charles R; Classen, David C; Swenson, Stephen J; Henderson, Michael J; Zeltner, Thomas; Bates, David W

2013-12-01

We will provide a context to health information technology systems (HIT) safety hazards discussions, describe how electronic health record-computer prescriber order entry (EHR-CPOE) simulation has already identified unrecognized hazards in HIT on a national scale, helping make EHR-CPOE systems safer, and we make the case for all stakeholders to leverage proven methods and teams in HIT performance verification. A national poll of safety, quality improvement, and health-care administrative leaders identified health information technology safety as the hazard of greatest concern for 2013. Quality, HIT, and safety leaders are very concerned about technology performance risks as addressed in the Health Information Technology and Patient Safety report of the Institute of Medicine; and these are being addressed by the Office of the National Coordinator of HIT of the U.S. Dept. of Human Services in their proposed plans. We describe the evolution of postdeployment testing of HIT performance, including the results of national deployment of Texas Medical Institute of Technology's electronic health record computer prescriber order entry (TMIT EHR-CPOE) Flight Simulator verification test that is addressed in these 2 reports, and the safety hazards of concern to leaders. A global webinar for health-care leaders addressed the top patient safety hazards in the areas of leadership, practices, and technologies. A poll of 76 of the 221 organizations participating in the webinar revealed that HIT hazards were the participants' greatest concern of all 30 hazards presented. Of those polled, 89% rated HIT patient/data mismatches in EHRs and HIT systems as a 9 or 10 on a scale of 1 to 10 as a hazard of great concern. Review of a key study of postdeployment testing of the safety performance of operational EHR systems with CPOE implemented in 62 hospitals, using the TMIT EHR-CPOE simulation tool, showed that only 53% of the medication orders that could have resulted in fatalities were detected. The study also showed significant variability in the performance of specific EHR vendor systems, with the same vendor product scoring as high as a 75% detection score in one health-care organization, and the same vendor system scoring below 10% in another health-care organization. HIT safety hazards should be taken very seriously, and the need for proven, robust, and regular postdeployment performance verification measurement of EHR system operations in every health-care organization is critical to ensure that these systems are safe for every patient. The TMIT EHR-CPOE flight simulator is a well-tested and scalable tool that can be used to identify performance gaps in EHR and other HIT systems. It is critical that suppliers, providers, and purchasers of health-care partner with HIT stakeholders and leverage the existing body of work, as well as expert teams and collaborative networks to make care safer; and public-private partnerships to accelerate safety in HIT. A global collaborative is already underway incorporating a "trust but verify" philosophy.

ALPIDE: the Monolithic Active Pixel Sensor for the ALICE ITS upgrade

NASA Astrophysics Data System (ADS)

Šuljić, M.

2016-11-01

The upgrade of the ALICE vertex detector, the Inner Tracking System (ITS), is scheduled to be installed during the next long shutdown period (2019-2020) of the CERN Large Hadron Collider (LHC) . The current ITS will be replaced by seven concentric layers of Monolithic Active Pixel Sensors (MAPS) with total active surface of ~10 m2, thus making ALICE the first LHC experiment implementing MAPS detector technology on a large scale. The ALPIDE chip, based on TowerJazz 180 nm CMOS Imaging Process, is being developed for this purpose. A particular process feature, the deep p-well, is exploited so the full CMOS logic can be implemented over the active sensor area without impinging on the deposited charge collection. ALPIDE is implemented on silicon wafers with a high resistivity epitaxial layer. A single chip measures 15 mm by 30 mm and contains half a million pixels distributed in 512 rows and 1024 columns. In-pixel circuitry features amplification, shaping, discrimination and multi-event buffering. The readout is hit driven i.e. only addresses of hit pixels are sent to the periphery. The upgrade of the ITS presents two different sets of requirements for sensors of the inner and of the outer layers due to the significantly different track density, radiation level and active detector surface. The ALPIDE chip fulfils the stringent requirements in both cases. The detection efficiency is higher than 99%, fake-hit probability is orders of magnitude lower than the required 10-6 and spatial resolution within the required 5 μm. This performance is to be maintained even after a total ionising does (TID) of 2.7 Mrad and a non-ionising energy loss (NIEL) fluence of 1.7 × 1013 1 MeV neq/cm2, which is above what is expected during the detector lifetime. Readout rate of 100 kHz is provided and the power density of ALPIDE is less than 40 mW/cm2. This contribution will provide a summary of the ALPIDE features and main test results.

Evolving health information technology and the timely availability of visit diagnoses from ambulatory visits: a natural experiment in an integrated delivery system.

PubMed

Bardach, Naomi S; Huang, Jie; Brand, Richard; Hsu, John

2009-07-17

Health information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner. However, there are few studies documenting the changes in timely availability of data with the use of a sophisticated electronic medical record (EMR), nor a description of how the timely availability of data might differ with different types of EMRs. We hypothesized that timely availability of data would improve with use of increasingly sophisticated forms of HIT. We used an historical observation design (2004-2006) using electronic data from office visits in an integrated delivery system with three types of HIT: Basic, Intermediate, and Advanced. We calculated the monthly percentage of visits using the various types of HIT for entry of visit diagnoses into the delivery system's electronic database, and the time between the visit and the availability of the visit diagnoses in the database. In January 2004, when only Basic HIT was available, 10% of office visits had diagnoses entered on the same day as the visit and 90% within a week; 85% of office visits used paper forms for recording visit diagnoses, 16% used Basic at that time. By December 2006, 95% of all office visits had diagnoses available on the same day as the visit, when 98% of office visits used some form of HIT for entry of visit diagnoses (Advanced HIT for 67% of visits). Use of HIT systems is associated with dramatic increases in the timely availability of diagnostic information, though the effects may vary by sophistication of HIT system. Timely clinical data are critical for real-time population surveillance, and valuable for routine clinical care.

Hitting the Maternal Wall

ERIC Educational Resources Information Center

Williams, Joan C.

2004-01-01

Women's lack of progress in academe is well documented: in its 1999-2000 report, the AAUP's Committee on the Economic Status of the Profession found "striking evidence of a distorted gender distribution by rank." Women are more likely than men to end up in low-paid, non tenure-track positions that are often a dead end. Women who do manage to…

Two year performance of a 10 kW CPV system installed in two areas of Saudi Arabia

NASA Astrophysics Data System (ADS)

Khonkar, Hussam; Alowais, Abdullah; Sheikho, Ayman; Alyahya, Abdulaziz; Alghamdi, Ahmed; Alsaedan, Abdullah; Eugenio, Nunilo N.; Alalweet, Fahad; Halawani, Mohammad; Alsaferan, Abdulrahman

2014-09-01

The three year KACST/IBM collaboration in solar technology research led to the design and development of a 10kW CPV system. The system is comprised of 81 PV modules, inverters and a tracking system and is grid connected. A primary and secondary optics were employed to reach 1600x concentration on multijunction solar cells. Two CPV trackers were installed in the city of Riyadh and one in the eastern coastal city of Al Khafji. These two areas differ in climatic conditions. Riyadh is mostly dry and very often hit by very strong sand storms while Al Khafji is very humid with sand storms. Very fine dusts and dirt carried by the storms hits the surface of the primary optics, Fresnel lens, of the system. In Riyadh, the particles stick to the lenses but accumulation in the surface is not much since it is blown away by wind. However, the humid condition of the coastal areas wets the dusts and makes it sticky, cumulating more dusts and dirt. This paper discusses in details the parts of the 10kW CPV system. It presents a comprehensive analysis of the system's performance since the time they were installed and operated. CPV systems are operated with the least number of personnel and supervision. However, dust and dirt lessens the amount of sunlight passing through the primary optics. It requires periodic cleaning of the Fresnel lens. Different methods of cleaning were tried to identify the efficient way to clean the system that results to a higher power generation. Corrections and modifications of the system to further increase power production are presented.

"Hit-and-Run" transcription: de novo transcription initiated by a transient bZIP1 "hit" persists after the "run".

PubMed

Doidy, Joan; Li, Ying; Neymotin, Benjamin; Edwards, Molly B; Varala, Kranthi; Gresham, David; Coruzzi, Gloria M

2016-02-03

Dynamic transcriptional regulation is critical for an organism's response to environmental signals and yet remains elusive to capture. Such transcriptional regulation is mediated by master transcription factors (TF) that control large gene regulatory networks. Recently, we described a dynamic mode of TF regulation named "hit-and-run". This model proposes that master TF can interact transiently with a set of targets, but the transcription of these transient targets continues after the TF dissociation from the target promoter. However, experimental evidence validating active transcription of the transient TF-targets is still lacking. Here, we show that active transcription continues after transient TF-target interactions by tracking de novo synthesis of RNAs made in response to TF nuclear import. To do this, we introduced an affinity-labeled 4-thiouracil (4tU) nucleobase to specifically isolate newly synthesized transcripts following conditional TF nuclear import. Thus, we extended the TARGET system (Transient Assay Reporting Genome-wide Effects of Transcription factors) to include 4tU-labeling and named this new technology TARGET-tU. Our proof-of-principle example is the master TF Basic Leucine Zipper 1 (bZIP1), a central integrator of metabolic signaling in plants. Using TARGET-tU, we captured newly synthesized mRNAs made in response to bZIP1 nuclear import at a time when bZIP1 is no longer detectably bound to its target. Thus, the analysis of de novo transcripomics demonstrates that bZIP1 may act as a catalyst TF to initiate a transcriptional complex ("hit"), after which active transcription by RNA polymerase continues without the TF being bound to the gene promoter ("run"). Our findings provide experimental proof for active transcription of transient TF-targets supporting a "hit-and-run" mode of action. This dynamic regulatory model allows a master TF to catalytically propagate rapid and broad transcriptional responses to changes in environment. Thus, the functional read-out of de novo transcripts produced by transient TF-target interactions allowed us to capture new models for genome-wide transcriptional control.

Monitoring Seawall Deformation With Repeat-Track Space-Borne SAR Images

NASA Astrophysics Data System (ADS)

Pei, Yuanyuan; Wan, Qing; Wei, Lianhuan; Fang, Zhilei; Liao, Mingsheng

2010-10-01

Seawalls are constructed to protect coastal cities from typhoon, flood and sea tide. It is necessary to monitor the deformation of seawalls in real time. Repeat-track space-borne SAR images are useful for environment monitoring, especially ground deformation monitoring. Shanghai sits on the Yangtze River Delta on China's eastern coast. Each year, the city is hit by typhoons from Pacific Ocean and threatened by the flood of the Yangtze River. PS-InSAR technique is carried out to monitor the deformation of the seawalls. Experiment exhibits that the seawalls around Pudong airport and Lingang town suffered serious deformation.

Evaluating health information technology: provider satisfaction with an HIV-specific, electronic clinical management and reporting system.

PubMed

Magnus, Manya; Herwehe, Jane; Andrews, Laura; Gibson, Laura; Daigrepont, Nathan; De Leon, Jordana M; Hyslop, Newton E; Styron, Steven; Wilcox, Ronald; Kaiser, Michael; Butler, Michael K

2009-02-01

Health information technology (HIT) offers the potential to improve care for persons living with HIV. Provider satisfaction with HIT is essential to realize benefits, yet its evaluation presents challenges. An HIV-specific, electronic clinical management and reporting system was implemented in Louisiana's eight HIV clinics, serving over 7500. A serial cross-sectional survey was administered at three points between April 2002 and July 2005; qualitative methods were used to augment quantitative. Multivariable methods were used to characterize provider satisfaction. The majority of the sample (n = 196; T1 = 105; T2 = 46; T3 = 45) was female (80.0%), between ages of 25 and 50 years (68.3%), frequent providers at that clinic (53.7% more than 4 days per week), and had been at the same clinic for a year or more (85.0%). Improvements in satisfaction were observed in patient tracking ( p < 0.05), distribution of educational materials ( p < 0.04), and belief that electronic systems improve care ( p < 0.05). Provider self-reports of time to complete critical functions decreased for all tasks, two significantly so. Time (in minutes) to find current CD4 count decreased at each time point (mean 3.9 [standard deviation {SD} 5.8], 2.9 [2.3], 2.1 [2.6], p>0.05), current viral load decreased at each time point (mean 4.0 [SD 5.6], 2.9 [2.5], 1.8 [2.6], p = 0.08], current antiretroviral status decreased at each time point (mean 3.9 [SD 4.7], 2.9 [3.7], 1.5 [1.1], p < 0.04), history of antiretroviral use decreased at each time point (mean 15.1 [SD 21.9], 6.0 [5.4], 5.4 [7.2], p < 0.04]. Time savings were realized, averaging 16.1 minutes per visit ( p < 0.04). Providers were satisfied with HIT in multiple domains, and significant time savings were realized.

Factors influencing nurses' attitudes towards healthcare information technology.

PubMed

Huryk, Laurie A

2010-07-01

This literature review examines the current trend in nurses' attitudes toward healthcare information technology (HIT). HIT implementation and expansion are at the core of global efforts to improve healthcare quality and patient safety. As a large portion of the healthcare workforce, nurses' attitudes towards HIT are likely to have a major impact on the electronic health record (EHR) implementation process. A search of PubMed, CINAHL and Medline databases produced 1930 combined hits. Returned articles were scanned for relevancy and applicability. Thirteen articles met all criteria and were subsequently reviewed in their entirety. In accordance with two change theories, if HIT implementation projects are to be successful, nurses must recognize that incorporating EHRs into their daily practice is beneficial to patient outcomes. Overall, the attitudes of nurses toward HIT are positive. Increased computer experience is the main demographic indicator for positive attitudes. The most common detractors are poor system design, system slowdown and system downtime. Nurses are also fearful that the use of technology will dehumanize patient care. Involving nurses in system design is likely to improve post-implementation satisfaction. Creating a positive, supportive atmosphere appears to be instrumental to sustainability.

Implementation of Health Insurance Support Tools in Community Health Centers.

PubMed

Huguet, Nathalie; Hatch, Brigit; Sumic, Aleksandra; Tillotson, Carrie; Hicks, Elizabeth; Nelson, Joan; DeVoe, Jennifer E

2018-01-01

Health information technology (HIT) provides new opportunities for primary care clinics to support patients with health insurance enrollment and maintenance. We present strategies, early findings, and clinic reflections on the development and implementation of HIT tools designed to streamline and improve health insurance tracking at community health centers. We are conducting a hybrid implementation-effectiveness trial to assess novel health insurance enrollment and support tools in primary care clinics. Twenty-three clinics in 7 health centers from the OCHIN practice-based research network are participating in the implementation component of the trial. Participating health centers were randomized to 1 of 2 levels of implementation support, including arm 1 (n = 4 health centers, 11 clinic sites) that received HIT tools and educational materials and arm 2 (n = 3 health centers, 12 clinic sites) that received HIT tools, educational materials, and individualized implementation support with a practice coach. We used mixed-methods (qualitative and quantitative) to assess tool use rates and facilitators and barriers to implementation in the first 6 months. Clinics reported favorable attitudes toward the HIT tools, which replace less efficient and more cumbersome processes, and reflect on the importance of clinic engagement in tool development and refinement. Five of 7 health centers are now regularly using the tools and are actively working to increase tool use. Six months after formal implementation, arm 2 clinics demonstrated higher rates of tool use, compared with arm 1. These results highlight the value of early clinic input in tool development, the potential benefit of practice coaching during HIT tool development and implementation, and a novel method for coupling a hybrid implementation-effectiveness design with principles of improvement science in primary care research. © Copyright 2018 by the American Board of Family Medicine.

Effective implementation of health information technologies in U.S. hospitals.

PubMed

Khatri, Naresh; Gupta, Vishal

2016-01-01

Two issues pertaining to the effective implementation of health information technologies (HITs) in U.S. hospitals are examined. First, which information technology (IT) system is better--a homegrown or an outsourced one? In the second issue, the critical role of in-house IT expertise/capabilities in the effective implementation of HITs is investigated. The data on type of HIT system and IT expertise/capabilities were collected from a national sample of senior executives of U.S. hospitals. The data on quality of patient care were gathered from the Hospital Compare Web site. The quality of patient care was significantly higher in hospitals deploying a homegrown HIT system than hospitals deploying an outsourced HIT system. Furthermore, the professional competence and compelling vision of the chief information officer was found to be a major driver of another key IT capability of hospitals-professionalism of IT staff. The positive relationship of professionalism of IT staff with quality of patient care was mediated by proactive employee behavior. A homegrown HIT system achieves better quality of patient care than an outsourced one. The chief information officer's IT vision and the professional expertise and professionalism of IT staff are important IT capabilities in U.S. hospitals.

Integration of the enterprise electronic health record and anesthesia information management systems.

PubMed

Springman, Scott R

2011-09-01

Fewer than 5% of anesthesia departments use an electronic medical record (EMR) that is anesthesia specific. Many anesthesia information management systems (AIMS) have been developed with a focus only on the unique needs of anesthesia providers, without being fully integrated into other electronic health record components of the entire enterprise medical system. To understand why anesthesia providers should embrace health information technology (HIT) on a health system-wide basis, this article reviews recent HIT history and reviews HIT concepts. The author explores current developments in efforts to expand enterprise HIT, and the pros and cons of full enterprise integration with an AIMS. Copyright © 2011 Elsevier Inc. All rights reserved.

PageRank without hyperlinks: Reranking with PubMed related article networks for biomedical text retrieval

PubMed Central

Lin, Jimmy

2008-01-01

Background Graph analysis algorithms such as PageRank and HITS have been successful in Web environments because they are able to extract important inter-document relationships from manually-created hyperlinks. We consider the application of these techniques to biomedical text retrieval. In the current PubMed® search interface, a MEDLINE® citation is connected to a number of related citations, which are in turn connected to other citations. Thus, a MEDLINE record represents a node in a vast content-similarity network. This article explores the hypothesis that these networks can be exploited for text retrieval, in the same manner as hyperlink graphs on the Web. Results We conducted a number of reranking experiments using the TREC 2005 genomics track test collection in which scores extracted from PageRank and HITS analysis were combined with scores returned by an off-the-shelf retrieval engine. Experiments demonstrate that incorporating PageRank scores yields significant improvements in terms of standard ranked-retrieval metrics. Conclusion The link structure of content-similarity networks can be exploited to improve the effectiveness of information retrieval systems. These results generalize the applicability of graph analysis algorithms to text retrieval in the biomedical domain. PMID:18538027

Acceptance of health information technology in health professionals: an application of the revised technology acceptance model.

PubMed

Ketikidis, Panayiotis; Dimitrovski, Tomislav; Lazuras, Lambros; Bath, Peter A

2012-06-01

The response of health professionals to the use of health information technology (HIT) is an important research topic that can partly explain the success or failure of any HIT application. The present study applied a modified version of the revised technology acceptance model (TAM) to assess the relevant beliefs and acceptance of HIT systems in a sample of health professionals (n = 133). Structured anonymous questionnaires were used and a cross-sectional design was employed. The main outcome measure was the intention to use HIT systems. ANOVA was employed to examine differences in TAM-related variables between nurses and medical doctors, and no significant differences were found. Multiple linear regression analysis was used to assess the predictors of HIT usage intentions. The findings showed that perceived ease of use, but not usefulness, relevance and subjective norms directly predicted HIT usage intentions. The present findings suggest that a modification of the original TAM approach is needed to better understand health professionals' support and endorsement of HIT. Perceived ease of use, relevance of HIT to the medical and nursing professions, as well as social influences, should be tapped by information campaigns aiming to enhance support for HIT in healthcare settings.

A plastic scintillator-based muon tomography system with an integrated muon spectrometer

NASA Astrophysics Data System (ADS)

Anghel, V.; Armitage, J.; Baig, F.; Boniface, K.; Boudjemline, K.; Bueno, J.; Charles, E.; Drouin, P.-L.; Erlandson, A.; Gallant, G.; Gazit, R.; Godin, D.; Golovko, V. V.; Howard, C.; Hydomako, R.; Jewett, C.; Jonkmans, G.; Liu, Z.; Robichaud, A.; Stocki, T. J.; Thompson, M.; Waller, D.

2015-10-01

A muon scattering tomography system which uses extruded plastic scintillator bars for muon tracking and a dedicated muon spectrometer that measures scattering through steel slabs has been constructed and successfully tested. The atmospheric muon detection efficiency is measured to be 97% per plane on average and the average intrinsic hit resolution is 2.5 mm. In addition to creating a variety of three-dimensional images of objects of interest, a quantitative study has been carried out to investigate the impact of including muon momentum measurements when attempting to detect high-density, high-Z material. As expected, the addition of momentum information improves the performance of the system. For a fixed data-taking time of 60 s and a fixed false positive fraction, the probability to detect a target increases when momentum information is used. This is the first demonstration of the use of muon momentum information from dedicated spectrometer measurements in muon scattering tomography.

A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

PubMed

Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

2010-01-01

We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

Laser dazzling impacts on car driver performance

NASA Astrophysics Data System (ADS)

Steinvall, Ove; Sandberg, Stig; Hörberg, Ulf; Persson, Rolf; Berglund, Folke; Karslsson, Kjell; Öhgren, Johan; Yu, Zhaohua; Söderberg, Per

2013-10-01

A growing problem for the Police and Security Forces has been to prevent potentially hostile individuals to pass a checkpoint, without using lethatl violence. Therefore the question has been if there is a laser or any other strong light source that could be used as a warning and dazzling device, without lethal or long term effects. To investigate the possibilities a field trial has been performed at a motor-racing track. A green CW laser with an irradiance on the eye of maximum 0.5 MPE, as defined by ICNIRP [1] and the ANZI standard [2], was used as a dazzle source. Ten drivers have been driving with dipped headlights through a course of three lines with orange cones. In every line there has been only one gate wide enough to pass without hitting the cones. The time through the course, the choice of gates and the number of cones hit have been measured. For every second trial drive through the track, the driver was exposed to the laser dazzler. The background illuminances ranged from a thousand lux in daylight to about ten millilux in darkness. The protective effect of the sun-visor of the car was investigated. The drives visual system was carefully examined before and after experimental driving and a few weeks after the experimental driving to verify that no pathological effects, that could potentially be induced by the laser exposure, pre-existed or occurred after the laser exposure. An analysis of variance for a within subjects design has been used for evaluation. It was found that green laser light can have an obvious warning effect in daylight. Dazzling does reduce the drivers ability to make judgments and manouver the car in twilight and darkness. A sun-visor can reduce the glare and give the driver an improved control, but that perception can be unjustified. No damage to the visual system was observed.

Monolithic active pixel sensor development for the upgrade of the ALICE inner tracking system

NASA Astrophysics Data System (ADS)

Aglieri, G.; Cavicchioli, C.; Chalmet, P. L.; Chanlek, N.; Collu, A.; Giubilato, P.; Hillemanns, H.; Junique, A.; Keil, M.; Kim, D.; Kim, J.; Kugathasan, T.; Lattuca, A.; Mager, M.; Marin Tobon, C. A.; Marras, D.; Martinengo, P.; Mattiazzo, S.; Mazza, G.; Mugnier, H.; Musa, L.; Pantano, D.; Puggioni, C.; Rousset, J.; Reidt, F.; Riedler, P.; Siddhanta, S.; Snoeys, W.; Usai, G.; van Hoorne, J. W.; Yang, P.; Yi, J.

2013-12-01

ALICE plans an upgrade of its Inner Tracking System for 2018. The development of a monolithic active pixel sensor for this upgrade is described. The TowerJazz 180 nm CMOS imaging sensor process has been chosen as it is possible to use full CMOS in the pixel due to the offering of a deep pwell and also to use different starting materials. The ALPIDE development is an alternative to approaches based on a rolling shutter architecture, and aims to reduce power consumption and integration time by an order of magnitude below the ALICE specifications, which would be quite beneficial in terms of material budget and background. The approach is based on an in-pixel binary front-end combined with a hit-driven architecture. Several prototypes have already been designed, submitted for fabrication and some of them tested with X-ray sources and particles in a beam. Analog power consumption has been limited by optimizing the Q/C of the sensor using Explorer chips. Promising but preliminary first results have also been obtained with a prototype ALPIDE. Radiation tolerance up to the ALICE requirements has also been verified.

Winning Attitude & Dedication to Physical Therapy Keep Sam Schmidt on Track

ERIC Educational Resources Information Center

Bosley, Nikki Prevenslik

2006-01-01

This article relates how Sam Schmidt returned to living a productive life after an accident left him with spinal cord injury. Schmidt was a former Indy Racing League driver who founded Sam Schmidt Motorsports after his accident in 2000. Schmidt's car hit the wall as he exited turn two during a practice session at Walt Disney World Speedway in…

Study of the material of the ATLAS inner detector for Run 2 of the LHC

DOE PAGES

Aaboud, M.; Aad, G.; Abbott, B.; ...

2017-12-07

The ATLAS inner detector comprises three different sub-detectors: the pixel detector, the silicon strip tracker, and the transition-radiation drift-tube tracker. The Insertable B-Layer, a new innermost pixel layer, was installed during the shutdown period in 2014, together with modifications to the layout of the cables and support structures of the existing pixel detector. The material in the inner detector is studied with several methods, using a low-luminosity √s=13 TeV pp collision sample corresponding to around 2.0 nb -1 collected in 2015 with the ATLAS experiment at the LHC. In this paper, the material within the innermost barrel region is studiedmore » using reconstructed hadronic interaction and photon conversion vertices. For the forward rapidity region, the material is probed by a measurement of the efficiency with which single tracks reconstructed from pixel detector hits alone can be extended with hits on the track in the strip layers. The results of these studies have been taken into account in an improved description of the material in the ATLAS inner detector simulation, resulting in a reduction in the uncertainties associated with the charged-particle reconstruction efficiency determined from simulation.« less

Study of the material of the ATLAS inner detector for Run 2 of the LHC

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

Aaboud, M.; Aad, G.; Abbott, B.

The ATLAS inner detector comprises three different sub-detectors: the pixel detector, the silicon strip tracker, and the transition-radiation drift-tube tracker. The Insertable B-Layer, a new innermost pixel layer, was installed during the shutdown period in 2014, together with modifications to the layout of the cables and support structures of the existing pixel detector. The material in the inner detector is studied with several methods, using a low-luminosity √s=13 TeV pp collision sample corresponding to around 2.0 nb -1 collected in 2015 with the ATLAS experiment at the LHC. In this paper, the material within the innermost barrel region is studiedmore » using reconstructed hadronic interaction and photon conversion vertices. For the forward rapidity region, the material is probed by a measurement of the efficiency with which single tracks reconstructed from pixel detector hits alone can be extended with hits on the track in the strip layers. The results of these studies have been taken into account in an improved description of the material in the ATLAS inner detector simulation, resulting in a reduction in the uncertainties associated with the charged-particle reconstruction efficiency determined from simulation.« less

Study of the material of the ATLAS inner detector for Run 2 of the LHC

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

Aaboud, M.; Aad, G.; Abbott, B.

The ATLAS inner detector comprises three different sub-detectors: the pixel detector, the silicon strip tracker, and the transition-radiation drift-tube tracker. The Insertable B-Layer, a new innermost pixel layer, was installed during the shutdown period in 2014, together with modifications to the layout of the cables and support structures of the existing pixel detector. The material in the inner detector is studied with several methods, using a low-luminosity √s = 13 TeV pp collision sample corresponding to around 2.0 nb -1 collected in 2015 with the ATLAS experiment at the LHC. In this paper, the material within the innermost barrel regionmore » is studied using reconstructed hadronic interaction and photon conversion vertices. For the forward rapidity region, the material is probed by a measurement of the efficiency with which single tracks reconstructed from pixel detector hits alone can be extended with hits on the track in the strip layers. The results of these studies have been taken into account in an improved description of the material in the ATLAS inner detector simulation, resulting in a reduction in the uncertainties associated with the charged-particle reconstruction efficiency determined from simulation.« less

Study of the material of the ATLAS inner detector for Run 2 of the LHC

NASA Astrophysics Data System (ADS)

Aaboud, M.; Aad, G.; Abbott, B.; Abdallah, J.; Abdinov, O.; Abeloos, B.; Abidi, S. H.; AbouZeid, O. S.; Abraham, N. L.; Abramowicz, H.; Abreu, H.; Abreu, R.; Abulaiti, Y.; Acharya, B. S.; Adachi, S.; Adamczyk, L.; Adelman, J.; Adersberger, M.; Adye, T.; Affolder, A. A.; Agatonovic-Jovin, T.; Agheorghiesei, C.; Aguilar-Saavedra, J. A.; Ahlen, S. P.; Ahmadov, F.; Aielli, G.; Akatsuka, S.; Akerstedt, H.; Åkesson, T. P. A.; Akilli, E.; Akimov, A. V.; Alberghi, G. L.; Albert, J.; Albicocco, P.; Alconada Verzini, M. J.; Aleksa, M.; Aleksandrov, I. N.; Alexa, C.; Alexander, G.; Alexopoulos, T.; Alhroob, M.; Ali, B.; Aliev, M.; Alimonti, G.; Alison, J.; Alkire, S. P.; Allbrooke, B. M. M.; Allen, B. W.; Allport, P. P.; Aloisio, A.; Alonso, A.; Alonso, F.; Alpigiani, C.; Alshehri, A. A.; Alstaty, M.; Alvarez Gonzalez, B.; Álvarez Piqueras, D.; Alviggi, M. G.; Amadio, B. T.; Amaral Coutinho, Y.; Amelung, C.; Amidei, D.; Amor Dos Santos, S. P.; Amorim, A.; Amoroso, S.; Amundsen, G.; Anastopoulos, C.; Ancu, L. S.; Andari, N.; Andeen, T.; Anders, C. F.; Anders, J. K.; Anderson, K. J.; Andreazza, A.; Andrei, V.; Angelidakis, S.; Angelozzi, I.; Angerami, A.; Anisenkov, A. V.; Anjos, N.; Annovi, A.; Antel, C.; Antonelli, M.; Antonov, A.; Antrim, D. J.; Anulli, F.; Aoki, M.; Aperio Bella, L.; Arabidze, G.; Arai, Y.; Araque, J. P.; Araujo Ferraz, V.; Arce, A. T. H.; Ardell, R. E.; Arduh, F. A.; Arguin, J.-F.; Argyropoulos, S.; Arik, M.; Armbruster, A. J.; Armitage, L. J.; Arnaez, O.; Arnold, H.; Arratia, M.; Arslan, O.; Artamonov, A.; Artoni, G.; Artz, S.; Asai, S.; Asbah, N.; Ashkenazi, A.; Asquith, L.; Assamagan, K.; Astalos, R.; Atkinson, M.; Atlay, N. B.; Augsten, K.; Avolio, G.; Axen, B.; Ayoub, M. K.; Azuelos, G.; Baas, A. E.; Baca, M. J.; Bachacou, H.; Bachas, K.; Backes, M.; Backhaus, M.; Bagnaia, P.; Bahrasemani, H.; Baines, J. T.; Bajic, M.; Baker, O. K.; Baldin, E. M.; Balek, P.; Balli, F.; Balunas, W. K.; Banas, E.; Banerjee, Sw.; Bannoura, A. A. E.; Barak, L.; Barberio, E. L.; Barberis, D.; Barbero, M.; Barillari, T.; Barisits, M.-S.; Barkeloo, J. T.; Barklow, T.; Barlow, N.; Barnes, S. L.; Barnett, B. M.; Barnett, R. M.; Barnovska-Blenessy, Z.; Baroncelli, A.; Barone, G.; Barr, A. J.; Barranco Navarro, L.; Barreiro, F.; Barreiro Guimarães da Costa, J.; Bartoldus, R.; Barton, A. E.; Bartos, P.; Basalaev, A.; Bassalat, A.; Bates, R. L.; Batista, S. J.; Batley, J. R.; Battaglia, M.; Bauce, M.; Bauer, F.; Bawa, H. S.; Beacham, J. B.; Beattie, M. D.; Beau, T.; Beauchemin, P. H.; Bechtle, P.; Beck, H. P.; Becker, K.; Becker, M.; Beckingham, M.; Becot, C.; Beddall, A. J.; Beddall, A.; Bednyakov, V. A.; Bedognetti, M.; Bee, C. P.; Beermann, T. A.; Begalli, M.; Begel, M.; Behr, J. K.; Bell, A. S.; Bella, G.; Bellagamba, L.; Bellerive, A.; Bellomo, M.; Belotskiy, K.; Beltramello, O.; Belyaev, N. L.; Benary, O.; Benchekroun, D.; Bender, M.; Bendtz, K.; Benekos, N.; Benhammou, Y.; Benhar Noccioli, E.; Benitez, J.; Benjamin, D. P.; Benoit, M.; Bensinger, J. R.; Bentvelsen, S.; Beresford, L.; Beretta, M.; Berge, D.; Bergeaas Kuutmann, E.; Berger, N.; Beringer, J.; Berlendis, S.; Bernard, N. R.; Bernardi, G.; Bernius, C.; Bernlochner, F. U.; Berry, T.; Berta, P.; Bertella, C.; Bertoli, G.; Bertolucci, F.; Bertram, I. A.; Bertsche, C.; Bertsche, D.; Besjes, G. J.; Bessidskaia Bylund, O.; Bessner, M.; Besson, N.; Betancourt, C.; Bethani, A.; Bethke, S.; Bevan, A. J.; Beyer, J.; Bianchi, R. M.; Biebel, O.; Biedermann, D.; Bielski, R.; Biesuz, N. V.; Biglietti, M.; Bilbao De Mendizabal, J.; Billoud, T. R. V.; Bilokon, H.; Bindi, M.; Bingul, A.; Bini, C.; Biondi, S.; Bisanz, T.; Bittrich, C.; Bjergaard, D. M.; Black, C. W.; Black, J. E.; Black, K. M.; Blair, R. E.; Blazek, T.; Bloch, I.; Blocker, C.; Blue, A.; Blum, W.; Blumenschein, U.; Blunier, S.; Bobbink, G. J.; Bobrovnikov, V. S.; Bocchetta, S. S.; Bocci, A.; Bock, C.; Boehler, M.; Boerner, D.; Bogavac, D.; Bogdanchikov, A. G.; Bohm, C.; Boisvert, V.; Bokan, P.; Bold, T.; Boldyrev, A. S.; Bolz, A. E.; Bomben, M.; Bona, M.; Boonekamp, M.; Borisov, A.; Borissov, G.; Bortfeldt, J.; Bortoletto, D.; Bortolotto, V.; Boscherini, D.; Bosman, M.; Bossio Sola, J. D.; Boudreau, J.; Bouffard, J.; Bouhova-Thacker, E. V.; Boumediene, D.; Bourdarios, C.; Boutle, S. K.; Boveia, A.; Boyd, J.; Boyko, I. R.; Bracinik, J.; Brandt, A.; Brandt, G.; Brandt, O.; Bratzler, U.; Brau, B.; Brau, J. E.; Breaden Madden, W. D.; Brendlinger, K.; Brennan, A. J.; Brenner, L.; Brenner, R.; Bressler, S.; Briglin, D. L.; Bristow, T. M.; Britton, D.; Britzger, D.; Brochu, F. M.; Brock, I.; Brock, R.; Brooijmans, G.; Brooks, T.; Brooks, W. K.; Brosamer, J.; Brost, E.; Broughton, J. H.; Bruckman de Renstrom, P. A.; Bruncko, D.; Bruni, A.; Bruni, G.; Bruni, L. 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H.; Takeshita, T.; Takubo, Y.; Talby, M.; Talyshev, A. A.; Tanaka, J.; Tanaka, M.; Tanaka, R.; Tanaka, S.; Tanioka, R.; Tannenwald, B. B.; Tapia Araya, S.; Tapprogge, S.; Tarem, S.; Tartarelli, G. F.; Tas, P.; Tasevsky, M.; Tashiro, T.; Tassi, E.; Tavares Delgado, A.; Tayalati, Y.; Taylor, A. C.; Taylor, G. N.; Taylor, P. T. E.; Taylor, W.; Teixeira-Dias, P.; Temple, D.; Ten Kate, H.; Teng, P. K.; Teoh, J. J.; Tepel, F.; Terada, S.; Terashi, K.; Terron, J.; Terzo, S.; Testa, M.; Teuscher, R. J.; Theveneaux-Pelzer, T.; Thomas, J. P.; Thomas-Wilsker, J.; Thompson, P. D.; Thompson, A. S.; Thomsen, L. A.; Thomson, E.; Tibbetts, M. J.; Ticse Torres, R. E.; Tikhomirov, V. O.; Tikhonov, Yu. A.; Timoshenko, S.; Tipton, P.; Tisserant, S.; Todome, K.; Todorova-Nova, S.; Tojo, J.; Tokár, S.; Tokushuku, K.; Tolley, E.; Tomlinson, L.; Tomoto, M.; Tompkins, L.; Toms, K.; Tong, B.; Tornambe, P.; Torrence, E.; Torres, H.; Torró Pastor, E.; Toth, J.; Touchard, F.; Tovey, D. R.; Treado, C. J.; Trefzger, T.; Tresoldi, F.; Tricoli, A.; Trigger, I. M.; Trincaz-Duvoid, S.; Tripiana, M. F.; Trischuk, W.; Trocmé, B.; Trofymov, A.; Troncon, C.; Trottier-McDonald, M.; Trovatelli, M.; Truong, L.; Trzebinski, M.; Trzupek, A.; Tsang, K. W.; Tseng, J. C.-L.; Tsiareshka, P. V.; Tsipolitis, G.; Tsirintanis, N.; Tsiskaridze, S.; Tsiskaridze, V.; Tskhadadze, E. G.; Tsui, K. M.; Tsukerman, I. I.; Tsulaia, V.; Tsuno, S.; Tsybychev, D.; Tu, Y.; Tudorache, A.; Tudorache, V.; Tulbure, T. T.; Tuna, A. N.; Tupputi, S. A.; Turchikhin, S.; Turgeman, D.; Turk Cakir, I.; Turra, R.; Tuts, P. M.; Ucchielli, G.; Ueda, I.; Ughetto, M.; Ukegawa, F.; Unal, G.; Undrus, A.; Unel, G.; Ungaro, F. C.; Unno, Y.; Unverdorben, C.; Urban, J.; Urquijo, P.; Urrejola, P.; Usai, G.; Usui, J.; Vacavant, L.; Vacek, V.; Vachon, B.; Vaidya, A.; Valderanis, C.; Valdes Santurio, E.; Valentinetti, S.; Valero, A.; Valéry, L.; Valkar, S.; Vallier, A.; Valls Ferrer, J. A.; Van Den Wollenberg, W.; van der Graaf, H.; van Gemmeren, P.; Van Nieuwkoop, J.; van Vulpen, I.; van Woerden, M. C.; Vanadia, M.; Vandelli, W.; Vaniachine, A.; Vankov, P.; Vardanyan, G.; Vari, R.; Varnes, E. W.; Varni, C.; Varol, T.; Varouchas, D.; Vartapetian, A.; Varvell, K. E.; Vasquez, J. G.; Vasquez, G. A.; Vazeille, F.; Vazquez Schroeder, T.; Veatch, J.; Veeraraghavan, V.; Veloce, L. M.; Veloso, F.; Veneziano, S.; Ventura, A.; Venturi, M.; Venturi, N.; Venturini, A.; Vercesi, V.; Verducci, M.; Verkerke, W.; Vermeulen, A. T.; Vermeulen, J. C.; Vetterli, M. C.; Viaux Maira, N.; Viazlo, O.; Vichou, I.; Vickey, T.; Boeriu, O. E. Vickey; Viehhauser, G. H. A.; Viel, S.; Vigani, L.; Villa, M.; Villaplana Perez, M.; Vilucchi, E.; Vincter, M. G.; Vinogradov, V. B.; Vishwakarma, A.; Vittori, C.; Vivarelli, I.; Vlachos, S.; Vogel, M.; Vokac, P.; Volpi, G.; von der Schmitt, H.; von Toerne, E.; Vorobel, V.; Vorobev, K.; Vos, M.; Voss, R.; Vossebeld, J. H.; Vranjes, N.; Vranjes Milosavljevic, M.; Vrba, V.; Vreeswijk, M.; Vuillermet, R.; Vukotic, I.; Wagner, P.; Wagner, W.; Wagner-Kuhr, J.; Wahlberg, H.; Wahrmund, S.; Wakabayashi, J.; Walder, J.; Walker, R.; Walkowiak, W.; Wallangen, V.; Wang, C.; Wang, C.; Wang, F.; Wang, H.; Wang, H.; Wang, J.; Wang, J.; Wang, Q.; Wang, R.; Wang, S. M.; Wang, T.; Wang, W.; Wang, W.; Wang, Z.; Wanotayaroj, C.; Warburton, A.; Ward, C. P.; Wardrope, D. R.; Washbrook, A.; Watkins, P. M.; Watson, A. T.; Watson, M. F.; Watts, G.; Watts, S.; Waugh, B. M.; Webb, A. F.; Webb, S.; Weber, M. S.; Weber, S. W.; Weber, S. A.; Webster, J. S.; Weidberg, A. R.; Weinert, B.; Weingarten, J.; Weirich, M.; Weiser, C.; Weits, H.; Wells, P. S.; Wenaus, T.; Wengler, T.; Wenig, S.; Wermes, N.; Werner, M. D.; Werner, P.; Wessels, M.; Whalen, K.; Whallon, N. L.; Wharton, A. M.; White, A. S.; White, A.; White, M. J.; White, R.; Whiteson, D.; Whitmore, B. W.; Wickens, F. J.; Wiedenmann, W.; Wielers, M.; Wiglesworth, C.; Wiik-Fuchs, L. A. M.; Wildauer, A.; Wilk, F.; Wilkens, H. G.; Williams, H. H.; Williams, S.; Willis, C.; Willocq, S.; Wilson, J. A.; Wingerter-Seez, I.; Winkels, E.; Winklmeier, F.; Winston, O. J.; Winter, B. T.; Wittgen, M.; Wobisch, M.; Wolf, T. M. H.; Wolff, R.; Wolter, M. W.; Wolters, H.; Wong, V. W. S.; Worm, S. D.; Wosiek, B. K.; Wotschack, J.; Wozniak, K. W.; Wu, M.; Wu, S. L.; Wu, X.; Wu, Y.; Wyatt, T. R.; Wynne, B. M.; Xella, S.; Xi, Z.; Xia, L.; Xu, D.; Xu, L.; Xu, T.; Yabsley, B.; Yacoob, S.; Yamaguchi, D.; Yamaguchi, Y.; Yamamoto, A.; Yamamoto, S.; Yamanaka, T.; Yamatani, M.; Yamauchi, K.; Yamazaki, Y.; Yan, Z.; Yang, H.; Yang, H.; Yang, Y.; Yang, Z.; Yao, W.-M.; Yap, Y. C.; Yasu, Y.; Yatsenko, E.; Yau Wong, K. H.; Ye, J.; Ye, S.; Yeletskikh, I.; Yigitbasi, E.; Yildirim, E.; Yorita, K.; Yoshihara, K.; Young, C.; Young, C. J. S.; Yu, J.; Yu, J.; Yuen, S. P. Y.; Yusuff, I.; Zabinski, B.; Zacharis, G.; Zaidan, R.; Zaitsev, A. M.; Zakharchuk, N.; Zalieckas, J.; Zaman, A.; Zambito, S.; Zanzi, D.; Zeitnitz, C.; Zemaityte, G.; Zemla, A.; Zeng, J. C.; Zeng, Q.; Zenin, O.; Ženiš, T.; Zerwas, D.; Zhang, D.; Zhang, F.; Zhang, G.; Zhang, H.; Zhang, J.; Zhang, L.; Zhang, L.; Zhang, M.; Zhang, P.; Zhang, R.; Zhang, R.; Zhang, X.; Zhang, Y.; Zhang, Z.; Zhao, X.; Zhao, Y.; Zhao, Z.; Zhemchugov, A.; Zhou, B.; Zhou, C.; Zhou, L.; Zhou, M.; Zhou, M.; Zhou, N.; Zhu, C. G.; Zhu, H.; Zhu, J.; Zhu, Y.; Zhuang, X.; Zhukov, K.; Zibell, A.; Zieminska, D.; Zimine, N. I.; Zimmermann, C.; Zimmermann, S.; Zinonos, Z.; Zinser, M.; Ziolkowski, M.; Živković, L.; Zobernig, G.; Zoccoli, A.; Zou, R.; zur Nedden, M.; Zwalinski, L.

2017-12-01

The ATLAS inner detector comprises three different sub-detectors: the pixel detector, the silicon strip tracker, and the transition-radiation drift-tube tracker. The Insertable B-Layer, a new innermost pixel layer, was installed during the shutdown period in 2014, together with modifications to the layout of the cables and support structures of the existing pixel detector. The material in the inner detector is studied with several methods, using a low-luminosity √s=13 TeV pp collision sample corresponding to around 2.0 nb-1 collected in 2015 with the ATLAS experiment at the LHC. In this paper, the material within the innermost barrel region is studied using reconstructed hadronic interaction and photon conversion vertices. For the forward rapidity region, the material is probed by a measurement of the efficiency with which single tracks reconstructed from pixel detector hits alone can be extended with hits on the track in the strip layers. The results of these studies have been taken into account in an improved description of the material in the ATLAS inner detector simulation, resulting in a reduction in the uncertainties associated with the charged-particle reconstruction efficiency determined from simulation.

Study of the material of the ATLAS inner detector for Run 2 of the LHC

DOE PAGES

Aaboud, M.; Aad, G.; Abbott, B.; ...

2017-12-07

The ATLAS inner detector comprises three different sub-detectors: the pixel detector, the silicon strip tracker, and the transition-radiation drift-tube tracker. The Insertable B-Layer, a new innermost pixel layer, was installed during the shutdown period in 2014, together with modifications to the layout of the cables and support structures of the existing pixel detector. The material in the inner detector is studied with several methods, using a low-luminosity √s = 13 TeV pp collision sample corresponding to around 2.0 nb -1 collected in 2015 with the ATLAS experiment at the LHC. In this paper, the material within the innermost barrel regionmore » is studied using reconstructed hadronic interaction and photon conversion vertices. For the forward rapidity region, the material is probed by a measurement of the efficiency with which single tracks reconstructed from pixel detector hits alone can be extended with hits on the track in the strip layers. The results of these studies have been taken into account in an improved description of the material in the ATLAS inner detector simulation, resulting in a reduction in the uncertainties associated with the charged-particle reconstruction efficiency determined from simulation.« less

Is There an Association Between Heparin-Induced Thrombocytopenia (HIT) and Autoimmune Disease?

PubMed

Klinkhammer, Brent; Gruchalla, Michael

2018-03-01

Heparin-induced thrombocytopenia (HIT) is a drug-induced, immunoglobulin G medicated autoimmune disorder associated with several negative clinical outcomes including increased morbidity, mortality, and increased medical costs. Previous studies have shown associations between comorbid autoimmune diseases, but there is little known about associations between HIT and autoimmunity. To provide clinical data to suggest an association between HIT and autoimmunity. Retrospective chart review of 59 cases with a diagnosis of HIT and 251 matched controls without a HIT diagnosis, comparing the prevalence of autoimmunity in each group. A single, large upper Midwest health care system. Patients with a diagnosis of HIT were significantly more likely to have a comorbid autoimmune disease than those without a HIT diagnosis (55.9% vs 10.8%, P < 0.001). In disease-specific analyses, patients with a diagnosis of HIT were significantly more likely to have a diagnosis of antiphospholipid syndrome (15.3% vs 0.0%, P < 0.001), systemic lupus erythematous (8.5% vs 0.4%, P = 0.001), rheumatoid arthritis (5.1% vs 0.0%, P = 0.007), Hashimoto's thyroiditis (13.6% vs 3.6%, P = 0.006), or nonischemic cardiomyopathy (5.1% vs 0.0%, P = 0.007). Patients diagnosed with HIT were significantly older than controls ( P < 0.001). This novel study gives evidence to suggest an association between HIT and autoimmune disease and suggests a need for more research into the relationship between HIT and autoimmunity. These results could alter the anticoagulation management of venous thromboembolism and acute coronary syndrome in patients with a previously identified autoimmune disease. Copyright© Wisconsin Medical Society.

Development of n-in-p pixel modules for the ATLAS upgrade at HL-LHC

NASA Astrophysics Data System (ADS)

Macchiolo, A.; Nisius, R.; Savic, N.; Terzo, S.

2016-09-01

Thin planar pixel modules are promising candidates to instrument the inner layers of the new ATLAS pixel detector for HL-LHC, thanks to the reduced contribution to the material budget and their high charge collection efficiency after irradiation. 100-200 μm thick sensors, interconnected to FE-I4 read-out chips, have been characterized with radioactive sources and beam tests at the CERN-SPS and DESY. The results of these measurements are reported for devices before and after irradiation up to a fluence of 14 ×1015 neq /cm2 . The charge collection and tracking efficiency of the different sensor thicknesses are compared. The outlook for future planar pixel sensor production is discussed, with a focus on sensor design with the pixel pitches (50×50 and 25×100 μm2) foreseen for the RD53 Collaboration read-out chip in 65 nm CMOS technology. An optimization of the biasing structures in the pixel cells is required to avoid the hit efficiency loss presently observed in the punch-through region after irradiation. For this purpose the performance of different layouts have been compared in FE-I4 compatible sensors at various fluence levels by using beam test data. Highly segmented sensors will represent a challenge for the tracking in the forward region of the pixel system at HL-LHC. In order to reproduce the performance of 50×50 μm2 pixels at high pseudo-rapidity values, FE-I4 compatible planar pixel sensors have been studied before and after irradiation in beam tests at high incidence angle (80°) with respect to the short pixel direction. Results on cluster shapes, charge collection and hit efficiency will be shown.

Emerging Issues and Opportunities in Health Information Technology.

PubMed

Nardi, Elizabeth A; Lentz, Lisa Korin; Winckworth-Prejsnar, Katherine; Abernethy, Amy P; Carlson, Robert W

2016-10-01

When used effectively, health information technology (HIT) can transform clinical care and contribute to new research discoveries. Despite advances in HIT and increased electronic health record adoption, many challenges to optimal use, interoperability, and data sharing exist. Data standardization across systems is limited, and scanned medical note documents result in unstructured data that make reporting on quality measures for reimbursement burdensome. Different policies and initiatives, including the Health Information Technology for Economic and Clinical Health Act, the Medicare Access and CHIP Reauthorization Act, and the National Cancer Moonshot initiative, among others, all recognize the impact that HIT can have on cancer care. Given the growing role HIT plays in health care, it is vital to have effective and efficient HIT systems that can exchange information, collect credible data that is analyzable at the point of care, and improves the patient-provider relationship. In June 2016, NCCN hosted the Emerging Issues and Opportunities in Health Information Technology Policy Summit. The summit addressed challenges, issues, and opportunities in HIT as they relate to cancer care. Keynote presentations and panelists discussed moving beyond Meaningful Use, HIT readiness to support and report on quality care, the role of HIT in precision medicine, the role of HIT in the National Cancer Moonshot initiative, and leveraging HIT to improve quality of clinical care. Copyright © 2016 by the National Comprehensive Cancer Network.

HIT implementation in critical access hospitals: extent of implementation and business strategies supporting IT use.

PubMed

Bahensky, James A; Ward, Marcia M; Nyarko, Kwame; Li, Pengxiang

2011-08-01

Small rural hospitals face considerable financial and personnel resource shortages which hinder their efforts to implement complex health information technology (HIT) systems. A survey on the use of HIT was completed by 85% of Iowa's 82 Critical Access Hospitals (CAH). Analyses indicate that low IT staffing in CAHs is a barrier to implementing HIT solutions. CAHs with fewer staff tend to employ alternative business strategies. There is a clear relationship between having IT staff at a CAH and the types of technologies used. Many CAHs report having difficulty expanding upon HIT functionalities due to the challenges of finding IT staff with healthcare expertise. Most CAHs are in the transition point of planning for or beginning implementation of complex clinical information systems. Strategies for addressing these challenges will need to evolve as the HIT investments by rural hospitals race to keep pace with the goals for the nation.

Unintended consequences of information technologies in health care--an interactive sociotechnical analysis.

PubMed

Harrison, Michael I; Koppel, Ross; Bar-Lev, Shirly

2007-01-01

Many unintended and undesired consequences of Healthcare Information Technologies (HIT) flow from interactions between the HIT and the healthcare organization's sociotechnical system-its workflows, culture, social interactions, and technologies. This paper develops and illustrates a conceptual model of these processes that we call Interactive Sociotechnical Analysis (ISTA). ISTA captures common types of interaction with special emphasis on recursive processes, i.e., feedback loops that alter the newly introduced HIT and promote second-level changes in the social system. ISTA draws on prior studies of unintended consequences, along with research in sociotechnical systems, ergonomics, social informatics, technology-in-practice, and social construction of technology. We present five types of sociotechnical interaction and illustrate each with cases from published research. The ISTA model should further research on emergent and recursive processes in HIT implementation and their unintended consequences. Familiarity with the model can also foster practitioners' awareness of unanticipated consequences that only become evident during HIT implementation.

Usability Methods for Ensuring Health Information Technology Safety: Evidence-Based Approaches. Contribution of the IMIA Working Group Health Informatics for Patient Safety.

PubMed

Borycki, E; Kushniruk, A; Nohr, C; Takeda, H; Kuwata, S; Carvalho, C; Bainbridge, M; Kannry, J

2013-01-01

Issues related to lack of system usability and potential safety hazards continue to be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used to ensure improved system usability and they are also beginning to be applied more widely for ensuring the safety of HIT applications. These methods are being used in the design and implementation of many HIT systems. In this paper we describe evidence-based approaches to applying usability engineering methods. A multi-phased approach to ensuring system usability and safety in healthcare is described. Usability inspection methods are first described including the development of evidence-based safety heuristics for HIT. Laboratory-based usability testing is then conducted under artificial conditions to test if a system has any base level usability problems that need to be corrected. Usability problems that are detected are corrected and then a new phase is initiated where the system is tested under more realistic conditions using clinical simulations. This phase may involve testing the system with simulated patients. Finally, an additional phase may be conducted, involving a naturalistic study of system use under real-world clinical conditions. The methods described have been employed in the analysis of the usability and safety of a wide range of HIT applications, including electronic health record systems, decision support systems and consumer health applications. It has been found that at least usability inspection and usability testing should be applied prior to the widespread release of HIT. However, wherever possible, additional layers of testing involving clinical simulations and a naturalistic evaluation will likely detect usability and safety issues that may not otherwise be detected prior to widespread system release. The framework presented in the paper can be applied in order to develop more usable and safer HIT, based on multiple layers of evidence.

Two Methods for Efficient Solution of the Hitting-Set Problem

NASA Technical Reports Server (NTRS)

Vatan, Farrokh; Fijany, Amir

2005-01-01

A paper addresses much of the same subject matter as that of Fast Algorithms for Model-Based Diagnosis (NPO-30582), which appears elsewhere in this issue of NASA Tech Briefs. However, in the paper, the emphasis is more on the hitting-set problem (also known as the transversal problem), which is well known among experts in combinatorics. The authors primary interest in the hitting-set problem lies in its connection to the diagnosis problem: it is a theorem of model-based diagnosis that in the set-theory representation of the components of a system, the minimal diagnoses of a system are the minimal hitting sets of the system. In the paper, the hitting-set problem (and, hence, the diagnosis problem) is translated from a combinatorial to a computational problem by mapping it onto the Boolean satisfiability and integer- programming problems. The paper goes on to describe developments nearly identical to those summarized in the cited companion NASA Tech Briefs article, including the utilization of Boolean-satisfiability and integer- programming techniques to reduce the computation time and/or memory needed to solve the hitting-set problem.

An ideal-typical model for comparing interprofessional relations and skill mix in health care.

PubMed

Schönfelder, Walter; Nilsen, Elin Anita

2016-11-08

Comparisons of health system performance, including the regulations of interprofessional relations and the skill mix between health professions are challenging. National strategies for regulating interprofessional relations vary widely across European health care systems. Unambiguously defined and generally accepted performance indicators have to remain generic, with limited power for recognizing the organizational structures regulating interprofessional relations in different health systems. A coherent framework for in-depth comparisons of different models for organizing interprofessional relations and the skill mix between professional groups is currently not available. This study aims to develop an ideal-typical framework for categorizing skill mix and interprofessional relations in health care, and to assess the potential impact for different ideal types on care coordination and integrated service delivery. A document analysis of the Health Systems in Transition (HiT) reports published by the European Observatory on Health Systems and Policies was conducted. The HiT reports to 31 European health systems were analyzed using a qualitative content analysis and a process of meaning condensation. The educational tracks available to nurses have an impact on the professional autonomy for nurses, the hierarchy between professional groups, the emphasis given to negotiating skill mix, interdisciplinary teamwork and the extent of cooperation across the health and social service interface. Based on the results of the document analysis, three ideal types for regulating interprofessional relations and skill mix in health care are delimited. For each ideal type, outcomes on service coordination and holistic service delivery are described. Comparisons of interprofessional relations are necessary for proactive health human resource policies. The proposed ideal-typical framework provides the means for in-depth comparisons of interprofessional relations in the health care workforce beyond of what is possible with directly comparable, but generic performance indicators.

A prototype scintillating fibre beam profile monitor for Ion Therapy beams

NASA Astrophysics Data System (ADS)

Leverington, B. D.; Dziewiecki, M.; Renner, L.; Runze, R.

2018-05-01

A prototype plastic scintillating fibre based beam profile monitor was tested at the Heidelberg Ion Therapy Centre/Heidelberg Ionenstrahl Therapiezentrum (HIT) in 2016 to determine its beam property reconstruction performance and the feasibility of further developing an expanded system. At HIT protons, helium, carbon, and oxygen ions are available for therapy and experiments. The beam can be scanned in two dimensions using fast deflection magnets. A tracking system is used to monitor beam position and to adjust scanning magnet currents online. A new detector system with a finer granularity and without the drift time delay of the current MWPC system with a similar amount of material along the beamline would prove valuable in patient treatment. The sensitive detector components in the tested prototype detector are double-clad Kuraray SCSF-78MJ scintillating fibres with a diameter of 0.250 mm wound as a thin multi-layer ribbon. The scintillation light is detected at the end of the ribbon with Hamamatsu S11865-64 photodiode arrays with a pitch of 0.8 mm. Commercial or readily available readout electronics have been used to evaluate the system feasibility. The results shown in this paper include the linearity with respect to beam intensity, the RMS of the beam intensity as measured by two planes, along with the RMS of the mean position, and the measured beam width RMS. The Signal-to-Noise ratio of the current system is also measured as an indicator of potential performance. Additionally, the non-linear light yield of the scintillating fibres as measured by the photodiode arrays is compared to two models which describe the light yield as a function of the ion stopping power and Lorentz β.

Veterans’ Preferences for Exchanging Information Using Veterans Affairs Health Information Technologies: Focus Group Results and Modeling Simulations

PubMed Central

Chavez, Margeaux; Nazi, Kim; Antinori, Nicole; Melillo, Christine; Cotner, Bridget A; Hathaway, Wendy; Cook, Ashley; Wilck, Nancy; Noonan, Abigail

2017-01-01

Background The Department of Veterans Affairs (VA) has multiple health information technology (HIT) resources for veterans to support their health care management. These include a patient portal, VetLink Kiosks, mobile apps, and telehealth services. The veteran patient population has a variety of needs and preferences that can inform current VA HIT redesign efforts to meet consumer needs. Objective This study aimed to describe veterans’ experiences using the current VA HIT and identify their vision for the future of an integrated VA HIT system. Methods Two rounds of focus group interviews were conducted with a single cohort of 47 veterans and one female caregiver recruited from Bedford, Massachusetts, and Tampa, Florida. Focus group interviews included simulation modeling activities and a self-administered survey. This study also used an expert panel group to provide data and input throughout the study process. High-fidelity, interactive simulations were created and used to facilitate collection of qualitative data. The simulations were developed based on system requirements, data collected through operational efforts, and participants' reported preferences for using VA HIT. Pairwise comparison activities of HIT resources were conducted with both focus groups and the expert panel. Rapid iterative content analysis was used to analyze qualitative data. Descriptive statistics summarized quantitative data. Results Data themes included (1) current use of VA HIT, (2) non-VA HIT use, and (3) preferences for future use of VA HIT. Data indicated that, although the Secure Messaging feature was often preferred, a full range of HIT options are needed. These data were then used to develop veteran-driven simulations that illustrate user needs and expectations when using a HIT system and services to access VA health care services. Conclusions Patient participant redesign processes present critical opportunities for creating a human-centered design. Veterans value virtual health care options and prefer standardized, integrated, and synchronized user-friendly interface designs. PMID:29061553

Quiet eye gaze behavior of expert, and near-expert, baseball plate umpires.

PubMed

Millslagle, Duane G; Hines, Bridget B; Smith, Melissa S

2013-02-01

The quiet eye gaze behavior of 4 near-expert and 4 expert baseball umpires who called balls and strikes in simulated pitch-hit situations was assessed with a mobile eye cornea tracker system. Statistical analyses of the umpires' gaze behavior (fixation/pursuit tracking, saccades, and blinks)--onset, duration, offset, and frequency--were performed between and within 4 stages (pitcher's preparation, pitcher's delivery, ball in flight, and umpire call) by umpire's skill level. The results indicated that the quiet eye of expert umpires at onset of the pitcher's release point occurred earlier and was longer in duration than near-expert umpires. Expert expert umpires. The area outside the pitcher's ball release point may be the key environment cue for the behind-the-plate umpire.

Clinical picture of heparin-induced thrombocytopenia (HIT) and its differentiation from non-HIT thrombocytopenia.

PubMed

Warkentin, Theodore E

2016-10-28

HIT is an acquired antibody-mediated disorder strongly associated with thrombosis, including microthrombosis secondary to disseminated intravascular dissemination (DIC). The clinical features of HIT are reviewed from the perspective of the 4Ts scoring system for HIT, which emphasises its characteristic timing of onset of thrombocytopenia. HIT antibodies recognize multimolecular complexes of platelet factor 4 (PF4)/heparin. However, a subset of HIT sera recognise PF4 bound to platelet chondroitin sulfate; these antibodies activate platelets in vitro and in vivo even in the absence of heparin, thus explaining: delayed-onset HIT (where HIT begins or worsens after stopping heparin); persisting HIT (where HIT takes several weeks to recover); spontaneous HIT syndrome (a disorder clinically and serologically resembling HIT but without proximate heparin exposure); and fondaparinux-associated HIT (four distinct syndromes featuring thrombocytopenia that begins or worsens during treatment with fondaparinux), with a new patient case presented with ongoing thrombocytopenia (and fatal haemorrhage) during treatment of HIT with fondaparinux, with fondaparinux-dependent platelet activation induced by patient serum ("fondaparinux cross-reactivity"). Ironically, despite existence of fondaparinux-associated HIT, this pentasaccharide anticoagulant is a frequent treatment for HIT (including one used by the author). HIT can be confused with other disorders, including those with a) timing similar to HIT (e. g. abciximab-associated thrombocytopenia of delayed-onset); b) combined thrombocytopenia/thrombosis (e. g. symmetrical peripheral gangrene secondary to acute DIC and shock liver); and c) both timing of onset and thrombosis (e. g. warfarin-associated venous limb gangrene complicating cancer-associated DIC). By understanding clinical and pathophysiological similarities and differences between HIT and non-HIT mimicking disorders, the clinician is better able to make the correct diagnosis.

A simple and rapid method for high-resolution visualization of single-ion tracks

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

Omichi, Masaaki; Center for Collaborative Research, Anan National College of Technology, Anan, Tokushima 774-0017; Choi, Wookjin

2014-11-15

Prompt determination of spatial points of single-ion tracks plays a key role in high-energy particle induced-cancer therapy and gene/plant mutations. In this study, a simple method for the high-resolution visualization of single-ion tracks without etching was developed through the use of polyacrylic acid (PAA)-N, N’-methylene bisacrylamide (MBAAm) blend films. One of the steps of the proposed method includes exposure of the irradiated films to water vapor for several minutes. Water vapor was found to promote the cross-linking reaction of PAA and MBAAm to form a bulky cross-linked structure; the ion-track scars were detectable at a nanometer scale by atomic forcemore » microscopy. This study demonstrated that each scar is easily distinguishable, and the amount of generated radicals of the ion tracks can be estimated by measuring the height of the scars, even in highly dense ion tracks. This method is suitable for the visualization of the penumbra region in a single-ion track with a high spatial resolution of 50 nm, which is sufficiently small to confirm that a single ion hits a cell nucleus with a size ranging between 5 and 20 μm.« less

Argatroban for an alternative anticoagulant in HIT during ECMO.

PubMed

Rougé, Alain; Pelen, Felix; Durand, Michel; Schwebel, Carole

2017-01-01

Extracorporeal membrane oxygenation (ECMO) have become more frequently used in daily ICU practice, heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication while on extracorporeal membrane oxygenation (ECMO). HIT confirmation directly impacts on anticoagulant strategy requiring no delay unfractionated heparin discontinuation to be replaced by alternative systemic anticoagulant treatment. We report two clinical cases of HIT occurring during ECMO in various settings with subsequent recovery with argatroban and provide literature review to help physicians treat HIT during ECMO in clinical daily practice. HIT during ECMO is uncommon, and despite the absence of recommendation, argatroban seems to be an appropriate and safe therapeutic option. Finally, there are not enough arguments favouring routine circuit change in the event of HIT during ECMO.

Where are we on the diffusion curve? Trends and drivers of primary care physicians' use of health information technology.

PubMed

Audet, Anne-Marie; Squires, David; Doty, Michelle M

2014-02-01

To describe trends in primary care physicians' use of health information technology (HIT) between 2009 and 2012, examine practice characteristics associated with greater HIT capacity in 2012, and explore factors such as delivery system and payment reforms that may affect adoption and functionality. We used data from the 2012 and 2009 Commonwealth Fund International Health Policy Surveys of Primary Care Physicians. The data were collected in both years by postal mail between March and July among a nationally representative sample of primary care physicians in the United States. We compared primary care physicians' HIT capacity in 2009 and 2012. We employed multivariable logistic regression to analyze whether participating in an integrated delivery system, sharing resources and support with other practices, and being eligible for financial incentives were associated with greater HIT capacity in 2012. Primary care physicians' HIT capacity has significantly expanded since 2009, although solo practices continue to lag. Practices that are part of an integrated delivery system or share resources with other practices have higher rates of electronic medical record (EMR) adoption, multifunctional HIT, electronic information exchange, and electronic access for patients. Receiving or being eligible for financial incentives is associated with greater adoption of EMRs and information exchange. Federal efforts to increase adoption have coincided with a rapid increase in HIT capacity. Delivery system and payment reforms and federally funded extension programs could offer promising pathways for further diffusion. © Health Research and Educational Trust.

Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV.

PubMed

Bull, Sheana; Thomas, Deborah Sk; Nyanza, Elias C; Ngallaba, Sospatro E

2018-01-15

The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV. ©Sheana Bull, Deborah SK Thomas, Elias C Nyanza, Sospatro E Ngallaba. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.01.2018.

Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV

PubMed Central

Bull, Sheana; Nyanza, Elias C; Ngallaba, Sospatro E

2018-01-01

Background The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. Objective The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. Methods We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. Results Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. Conclusions T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV. PMID:29335236

Aftermath of early Hit-and-Run collisions in the Inner Solar System

NASA Astrophysics Data System (ADS)

Sarid, Gal; Stewart, Sarah T.; Leinhardt, zoe M.

2015-08-01

Planet formation epoch, in the terrestrial planet region and the asteroid belt, was characterized by a vigorous dynamical environment that was conducive to giant impacts among planetary embryos and asteroidal parent bodies, leading to diverse outcomes. Among these the greatest potential for producing diverse end-members lies is the erosive Hit-and-Run regime (small mass ratios, off-axis oblique impacts and non-negligible ejected mass), which is also more probable in terms of the early dynamical encounter configuration in the inner solar system. This collision regime has been invoked to explain outstanding issues, such as planetary volatile loss records, origin of the Moon and mantle stripping from Mercury and some of the larger asteroids (Vesta, Psyche).We performed and analyzed a set of simulations of Hit-and-Run events, covering a large range of mass ratios (1-20), impact parameters (0.25-0.96, for near head-on to barely grazing) and impact velocities (~1.5-5 times the mutual escape velocity, as dependent on the mass ratio). We used an SPH code with tabulated EOS and a nominal simlated time >1 day, to track the collisional shock processing and the provenance of material components. of collision debris. Prior to impact runs, all bodies were allowed to initially settle to negligible particle velocities in isolation, within ~20 simulated hrs. The total number of particles involved in each of our collision simulations was between (1-3 x 105). Resulting configurations include stripped mantles, melting/vaporization of rock and/or iron cores and strong variations of asteroid parent bodies fromcanonical chondritic composition.In the context of large planetary formation simulations, velocity and impact angle distributions are necessary to asses impact probabilities. The mass distribution and interaction within planetary embryo and asteroid swarms depends both on gravitational dynamics and the applied fragmentation mechanism. We will present results pertaining to general projectile remnant scaling relations, constitution of ejected unbound material and the composition of variedcollision remnants, which become available to seed the asteroid belt.

Transforming rural health care through information technology: an interventional study in China.

PubMed

Liu, Gordon Guoen; Chen, Yiqun; Qin, Xuezheng

2014-12-01

This article estimates the impacts of health information technology (HIT) on health-care delivery in the Wenchuan County of China, where the devastation of the 2008 Great Wenchuan Earthquake and the subsequent large-scale HIT implementation (the Healthy Wenchuan Program) offers a 'natural experiment' opportunity, enabling us to conduct a difference-in-difference evaluation of the potential benefits of HIT on accessibility, affordability and appropriateness of health-care services in the underdeveloped rural area. Based on data collected from two field surveys in township hospitals, we find that for both the inpatient and outpatient samples, the HIT system promotes access to medical care by increasing doctor referrals and encouraging within-county medical utilization, reduces patient financial burden in certain expenditure categories, and contributes to higher patient satisfaction on medical care quality. On the other hand, we also find that HIT leads to increased patient waiting time for hospital registration, reflecting the unique challenges in implementing HIT in the underdeveloped areas. Our study contributes to the growing body of literature on evaluating the impacts of HIT application in the developing regions, and provides implications on the potential role of HIT in China's national health system reforms. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Defining health information technology-related errors: new developments since to err is human.

PubMed

Sittig, Dean F; Singh, Hardeep

2011-07-25

Despite the promise of health information technology (HIT), recent literature has revealed possible safety hazards associated with its use. The Office of the National Coordinator for HIT recently sponsored an Institute of Medicine committee to synthesize evidence and experience from the field on how HIT affects patient safety. To lay the groundwork for defining, measuring, and analyzing HIT-related safety hazards, we propose that HIT-related error occurs anytime HIT is unavailable for use, malfunctions during use, is used incorrectly by someone, or when HIT interacts with another system component incorrectly, resulting in data being lost or incorrectly entered, displayed, or transmitted. These errors, or the decisions that result from them, significantly increase the risk of adverse events and patient harm. We describe how a sociotechnical approach can be used to understand the complex origins of HIT errors, which may have roots in rapidly evolving technological, professional, organizational, and policy initiatives.

Progress on FIR interferometry and Thomson Scattering measurements on HIT-SI3

NASA Astrophysics Data System (ADS)

Everson, Christopher; Jarboe, Thomas; Morgan, Kyle

2017-10-01

Spatially resolved measurements of the electron temperature (Te) and density (ne) will be fundamental in assessing the degree to which HIT-SI3 demonstrates closed magnetic flux and energy confinement. Further, electron temperature measurements have not yet been made on an inductively-driven spheromak. Far infrared (FIR) interferometer and Thomson Scattering (TS) systems have been installed on the HIT-SI3 spheromak. The TS system currently implemented on HIT-SI3 was originally designed for other magnetic confinement experiments, and progress continues toward modifying and optimizing for HIT-SI3 plasmas. Initial results suggest that the electron temperature is of order 10 eV. Plans to modify the TS system to provide more sensitivity and accuracy at low temperatures are presented. The line-integrated ne is measured on one chord by the FIR interferometer, with densities near 5x1019 m-3. Four cylindrical volumes have been added to the HIT-SI3 apparatus to enhance passive pumping. It is hoped that this will allow for more control of the density during the 2 ms discharges. Density measurements from before and after the installation of the passive pumping volumes are presented for comparison.

Deployment and Evaluation of the Helicopter In-Flight Tracking System (HITS)

NASA Technical Reports Server (NTRS)

Daskalakis, Anastasios; Martone, Patrick

2004-01-01

The Gulf of Mexico airspace has two major operating regions: low altitude offshore (below 7,000 ft) and high altitude oceanic (above 18,000 ft). Both regions suffer significant inefficiencies due to the lack of continuous surveillance during Instrument Flight Rules operations. Provision of surveillance in the offshore region is hindered by its low-altitude nature, which makes coverage by conventional radars economically infeasible. Significant portions of the oceanic sectors are inaccessible to shore-based sensors, as they are beyond line-of-sight. Two emerging surveillance technologies were assessed that are relatively low cost and can be deployed on offshore platforms Wide Area Multilateration and Automatic Dependent Surveillance Broadcast. Performance criteria were formulated using existing FAA specifications. Three configurations were developed and deployed representative of systems serving full-size and reduced-sized domestic terminal areas and an en-route/oceanic region. These configurations were evaluated during nine flight test periods using fixed- and rotary-wing aircraft.

The relationship between the external environment and physician e-mail communication: The mediating role of health information technology availability.

PubMed

Mazurenko, Olena; Hearld, Larry R; Menachemi, Nir

Physician e-mail communication, with patients and other providers, is one of the cornerstones of effective care coordination but varies significantly across physicians. A physician's external environment may contribute to such variations by enabling or constraining a physician's ability to adopt innovations such as health information technology (HIT) that can be used to support e-mail communication. The aim of the study was to examine whether the relationship of the external environment and physician e-mail communication with patients and other providers is mediated by the practice's HIT availability. The data were obtained from the Health Tracking Physician Survey (2008) and the Area Resource File (2008). Cross-sectional multivariable subgroup path analysis was used to investigate the mediating role of HIT availability across 2,850 U.S. physicians. Solo physicians' perceptions about malpractice were associated with 0.97 lower odds (p < .05) of e-mail communication with patients and other providers, as compared to group and hospital practices, even when mediated by HIT availability. Subgroup analyses indicated that different types of practices are responsive to the different dimensions of the external environment. Specifically, solo practitioners were more responsive to the availability of resources in their environment, with per capita income associated with lower likelihood of physician e-mail communication (OR = 0.99, p < .01). In contrast, physicians working in the group practices were more responsive to the complexity of their environment, with a physician's perception of practicing in environments with higher malpractice risks associated with greater information technology availability, which in turn was associated with a greater likelihood of communicating via e-mail with patients (OR = 1.02, p < .05) and other physicians (OR = 1.03, p < .001). The association between physician e-mail communication and the external environment is mediated by the practice's HIT availability. Efforts to improve physician e-mail communication and HIT adoption may need to reflect the varied perceptions of different types of practices.

Eye movement accuracy determines natural interception strategies.

PubMed

Fooken, Jolande; Yeo, Sang-Hoon; Pai, Dinesh K; Spering, Miriam

2016-11-01

Eye movements aid visual perception and guide actions such as reaching or grasping. Most previous work on eye-hand coordination has focused on saccadic eye movements. Here we show that smooth pursuit eye movement accuracy strongly predicts both interception accuracy and the strategy used to intercept a moving object. We developed a naturalistic task in which participants (n = 42 varsity baseball players) intercepted a moving dot (a "2D fly ball") with their index finger in a designated "hit zone." Participants were instructed to track the ball with their eyes, but were only shown its initial launch (100-300 ms). Better smooth pursuit resulted in more accurate interceptions and determined the strategy used for interception, i.e., whether interception was early or late in the hit zone. Even though early and late interceptors showed equally accurate interceptions, they may have relied on distinct tactics: early interceptors used cognitive heuristics, whereas late interceptors' performance was best predicted by pursuit accuracy. Late interception may be beneficial in real-world tasks as it provides more time for decision and adjustment. Supporting this view, baseball players who were more senior were more likely to be late interceptors. Our findings suggest that interception strategies are optimally adapted to the proficiency of the pursuit system.

Optimization and Modification of the SeaQuest Trigger Efficiency Program

NASA Astrophysics Data System (ADS)

White, Nattapat

2017-09-01

The primary purpose E906/SeaQuest is to examine the quark and antiquark distributions within the nucleon. This experiment uses the proton beam from the 120 GeV Fermi National Accelerator Laboratory Main Injector to collide with one of several fixed targets. From the collision, a pair of muons produced by the Drell-Yan process directly probes the nucleon sea antiquarks. The Seaquest spectrometer consists of two focusing magnets, several detectors, and multiple planes of scintillating hodoscopes that helped track and analyze the properties of particles. Hodoscope hits are compared to predetermined hit combinations that would result from a pair of muons that originated in the target. Understanding the trigger efficiency is part of the path to determine the probability of Drell Yan muon pair production in the experiment. Over the years of data taking, the trigger efficiency varied as individual scintillator detection efficiency changed. To accurately determine how the trigger efficiency varied over time, the trigger efficiency program needed to be upgraded to include the effects of inefficiencies in the 284 individual channels in the hodoscope systems. The optimization, modification, and results of the upgraded trigger efficiency program will be presented. Supported by U.S. D.O.E. Medium Energy Nuclear Physics under Grant DE-FG02-03ER41243.

Scan path entropy and arrow plots: capturing scanning behavior of multiple observers

PubMed Central

Hooge, Ignace; Camps, Guido

2013-01-01

Designers of visual communication material want their material to attract and retain attention. In marketing research, heat maps, dwell time, and time to AOI first hit are often used as evaluation parameters. Here we present two additional measures (1) “scan path entropy” to quantify gaze guidance and (2) the “arrow plot” to visualize the average scan path. Both are based on string representations of scan paths. The latter also incorporates transition matrices and time required for 50% of the observers to first hit AOIs (T50). The new measures were tested in an eye tracking study (48 observers, 39 advertisements). Scan path entropy is a sensible measure for gaze guidance and the new visualization method reveals aspects of the average scan path and gives a better indication in what order global scanning takes place. PMID:24399993

Applying Human Factors Principles to Mitigate Usability Issues Related to Embedded Assumptions in Health Information Technology Design

PubMed Central

Lowry, Svetlana Z; Patterson, Emily S

2014-01-01

Background There is growing recognition that design flaws in health information technology (HIT) lead to increased cognitive work, impact workflows, and produce other undesirable user experiences that contribute to usability issues and, in some cases, patient harm. These usability issues may in turn contribute to HIT utilization disparities and patient safety concerns, particularly among “non-typical” HIT users and their health care providers. Health care disparities are associated with poor health outcomes, premature death, and increased health care costs. HIT has the potential to reduce these disparate outcomes. In the computer science field, it has long been recognized that embedded cultural assumptions can reduce the usability, usefulness, and safety of HIT systems for populations whose characteristics differ from “stereotypical” users. Among these non-typical users, inappropriate embedded design assumptions may contribute to health care disparities. It is unclear how to address potentially inappropriate embedded HIT design assumptions once detected. Objective The objective of this paper is to explain HIT universal design principles derived from the human factors engineering literature that can help to overcome potential usability and/or patient safety issues that are associated with unrecognized, embedded assumptions about cultural groups when designing HIT systems. Methods Existing best practices, guidance, and standards in software usability and accessibility were subjected to a 5-step expert review process to identify and summarize those best practices, guidance, and standards that could help identify and/or address embedded design assumptions in HIT that could negatively impact patient safety, particularly for non-majority HIT user populations. An iterative consensus-based process was then used to derive evidence-based design principles from the data to address potentially inappropriate embedded cultural assumptions. Results Design principles that may help identify and address embedded HIT design assumptions are available in the existing literature. Conclusions Evidence-based HIT design principles derived from existing human factors and informatics literature can help HIT developers identify and address embedded cultural assumptions that may underlie HIT-associated usability and patient safety concerns as well as health care disparities. PMID:27025349

Applying Human Factors Principles to Mitigate Usability Issues Related to Embedded Assumptions in Health Information Technology Design.

PubMed

Gibbons, Michael C; Lowry, Svetlana Z; Patterson, Emily S

2014-12-18

There is growing recognition that design flaws in health information technology (HIT) lead to increased cognitive work, impact workflows, and produce other undesirable user experiences that contribute to usability issues and, in some cases, patient harm. These usability issues may in turn contribute to HIT utilization disparities and patient safety concerns, particularly among "non-typical" HIT users and their health care providers. Health care disparities are associated with poor health outcomes, premature death, and increased health care costs. HIT has the potential to reduce these disparate outcomes. In the computer science field, it has long been recognized that embedded cultural assumptions can reduce the usability, usefulness, and safety of HIT systems for populations whose characteristics differ from "stereotypical" users. Among these non-typical users, inappropriate embedded design assumptions may contribute to health care disparities. It is unclear how to address potentially inappropriate embedded HIT design assumptions once detected. The objective of this paper is to explain HIT universal design principles derived from the human factors engineering literature that can help to overcome potential usability and/or patient safety issues that are associated with unrecognized, embedded assumptions about cultural groups when designing HIT systems. Existing best practices, guidance, and standards in software usability and accessibility were subjected to a 5-step expert review process to identify and summarize those best practices, guidance, and standards that could help identify and/or address embedded design assumptions in HIT that could negatively impact patient safety, particularly for non-majority HIT user populations. An iterative consensus-based process was then used to derive evidence-based design principles from the data to address potentially inappropriate embedded cultural assumptions. Design principles that may help identify and address embedded HIT design assumptions are available in the existing literature. Evidence-based HIT design principles derived from existing human factors and informatics literature can help HIT developers identify and address embedded cultural assumptions that may underlie HIT-associated usability and patient safety concerns as well as health care disparities.

Veterans' Preferences for Exchanging Information Using Veterans Affairs Health Information Technologies: Focus Group Results and Modeling Simulations.

PubMed

Haun, Jolie N; Chavez, Margeaux; Nazi, Kim; Antinori, Nicole; Melillo, Christine; Cotner, Bridget A; Hathaway, Wendy; Cook, Ashley; Wilck, Nancy; Noonan, Abigail

2017-10-23

The Department of Veterans Affairs (VA) has multiple health information technology (HIT) resources for veterans to support their health care management. These include a patient portal, VetLink Kiosks, mobile apps, and telehealth services. The veteran patient population has a variety of needs and preferences that can inform current VA HIT redesign efforts to meet consumer needs. This study aimed to describe veterans' experiences using the current VA HIT and identify their vision for the future of an integrated VA HIT system. Two rounds of focus group interviews were conducted with a single cohort of 47 veterans and one female caregiver recruited from Bedford, Massachusetts, and Tampa, Florida. Focus group interviews included simulation modeling activities and a self-administered survey. This study also used an expert panel group to provide data and input throughout the study process. High-fidelity, interactive simulations were created and used to facilitate collection of qualitative data. The simulations were developed based on system requirements, data collected through operational efforts, and participants' reported preferences for using VA HIT. Pairwise comparison activities of HIT resources were conducted with both focus groups and the expert panel. Rapid iterative content analysis was used to analyze qualitative data. Descriptive statistics summarized quantitative data. Data themes included (1) current use of VA HIT, (2) non-VA HIT use, and (3) preferences for future use of VA HIT. Data indicated that, although the Secure Messaging feature was often preferred, a full range of HIT options are needed. These data were then used to develop veteran-driven simulations that illustrate user needs and expectations when using a HIT system and services to access VA health care services. Patient participant redesign processes present critical opportunities for creating a human-centered design. Veterans value virtual health care options and prefer standardized, integrated, and synchronized user-friendly interface designs. ©Jolie N. Haun, Margeaux Chavez, Kim Nazi, Nicole Antinori, Christine Melillo, Bridget A Cotner, Wendy Hathaway, Ashley Cook, Nancy Wilck, Abigail Noonan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.10.2017.

Testbeam results of irradiated ams H18 HV-CMOS pixel sensor prototypes

NASA Astrophysics Data System (ADS)

Benoit, M.; Braccini, S.; Casse, G.; Chen, H.; Chen, K.; Di Bello, F. A.; Ferrere, D.; Golling, T.; Gonzalez-Sevilla, S.; Iacobucci, G.; Kiehn, M.; Lanni, F.; Liu, H.; Meng, L.; Merlassino, C.; Miucci, A.; Muenstermann, D.; Nessi, M.; Okawa, H.; Perić, I.; Rimoldi, M.; Ristić, B.; Barrero Pinto, M. Vicente; Vossebeld, J.; Weber, M.; Weston, T.; Wu, W.; Xu, L.; Zaffaroni, E.

2018-02-01

HV-CMOS pixel sensors are a promising option for the tracker upgrade of the ATLAS experiment at the LHC, as well as for other future tracking applications in which large areas are to be instrumented with radiation-tolerant silicon pixel sensors. We present results of testbeam characterisations of the 4th generation of Capacitively Coupled Pixel Detectors (CCPDv4) produced with the ams H18 HV-CMOS process that have been irradiated with different particles (reactor neutrons and 18 MeV protons) to fluences between 1× 1014 and 5× 1015 1-MeV- neq. The sensors were glued to ATLAS FE-I4 pixel readout chips and measured at the CERN SPS H8 beamline using the FE-I4 beam telescope. Results for all fluences are very encouraging with all hit efficiencies being better than 97% for bias voltages of 85 V. The sample irradiated to a fluence of 1× 1015 neq—a relevant value for a large volume of the upgraded tracker—exhibited 99.7% average hit efficiency. The results give strong evidence for the radiation tolerance of HV-CMOS sensors and their suitability as sensors for the experimental HL-LHC upgrades and future large-area silicon-based tracking detectors in high-radiation environments.

Asic developments for radiation imaging applications: The medipix and timepix family

NASA Astrophysics Data System (ADS)

Ballabriga, Rafael; Campbell, Michael; Llopart, Xavier

2018-01-01

Hybrid pixel detectors were developed to meet the requirements for tracking in the inner layers at the LHC experiments. With low input capacitance per channel (10-100 fF) it is relatively straightforward to design pulse processing readout electronics with input referred noise of ∼ 100 e-rms and pulse shaping times consistent with tagging of events to a single LHC bunch crossing providing clean 'images' of the ionising tracks generated. In the Medipix Collaborations the same concept has been adapted to provide practically noise hit free imaging in a wide range of applications. This paper reports on the development of three generations of readout ASICs. Two distinctive streams of development can be identified: the Medipix ASICs which integrate data from multiple hits on a pixel and provide the images in the form of frames and the Timepix ASICs who aim to send as much information about individual interactions as possible off-chip for further processing. One outstanding circumstance in the use of these devices has been their numerous successful applications, thanks to a large and active community of developers and users. That process has even permitted new developments for detectors for High Energy Physics. This paper reviews the ASICs themselves and details some of the many applications.

Event Reconstruction for Many-core Architectures using Java

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

Graf, Norman A.; /SLAC

Although Moore's Law remains technically valid, the performance enhancements in computing which traditionally resulted from increased CPU speeds ended years ago. Chip manufacturers have chosen to increase the number of core CPUs per chip instead of increasing clock speed. Unfortunately, these extra CPUs do not automatically result in improvements in simulation or reconstruction times. To take advantage of this extra computing power requires changing how software is written. Event reconstruction is globally serial, in the sense that raw data has to be unpacked first, channels have to be clustered to produce hits before those hits are identified as belonging tomore » a track or shower, tracks have to be found and fit before they are vertexed, etc. However, many of the individual procedures along the reconstruction chain are intrinsically independent and are perfect candidates for optimization using multi-core architecture. Threading is perhaps the simplest approach to parallelizing a program and Java includes a powerful threading facility built into the language. We have developed a fast and flexible reconstruction package (org.lcsim) written in Java that has been used for numerous physics and detector optimization studies. In this paper we present the results of our studies on optimizing the performance of this toolkit using multiple threads on many-core architectures.« less

Reducing risk with clinical decision support: a study of closed malpractice claims.

PubMed

Zuccotti, G; Maloney, F L; Feblowitz, J; Samal, L; Sato, L; Wright, A

2014-01-01

Identify clinical opportunities to intervene to prevent a malpractice event and determine the proportion of malpractice claims potentially preventable by clinical decision support (CDS). Cross-sectional review of closed malpractice claims over seven years from one malpractice insurance company and seven hospitals in the Boston area. For each event, clinical opportunities to intervene to avert the malpractice event and the presence or absence of CDS that might have a role in preventing the event, were assigned by a panel of expert raters. Compensation paid out to resolve a claim (indemnity), was associated with each CDS type. Of the 477 closed malpractice cases, 359 (75.3%) were categorized as substantiated and 195 (54%) had at least one opportunity to intervene. Common opportunities to intervene related to performance of procedure, diagnosis, and fall prevention. We identified at least one CDS type for 63% of substantiated claims. The 41 CDS types identified included clinically significant test result alerting, diagnostic decision support and electronic tracking of instruments. Cases with at least one associated intervention accounted for $40.3 million (58.9%) of indemnity. CDS systems and other forms of health information technology (HIT) are expected to improve quality of care, but their potential to mitigate risk had not previously been quantified. Our results suggest that, in addition to their known benefits for quality and safety, CDS systems within HIT have a potential role in decreasing malpractice payments. More than half of malpractice events and over $40 million of indemnity were potentially preventable with CDS.

Heterogeneous Defensive Naval Weapon Assignment To Swarming Threats In Real Time

DTIC Science & Technology

2016-03-01

threat Damage potential of target t if it hits the ship [integer from 0 to 3] _ ttarget phit Probability that target t hits the ship [probability...secondary weapon systems on target t [integer] _ tsec phit Probability that secondary weapon systems launched from target t hit the ship...pairing. These parameters are calculated as follows: 310 _ _t t tpriority target threat target phit = × × (3.1) 3_ 10 _ _t t tsec priority sec

Workarounds to Intended Use of Health Information Technology: A Narrative Review of the Human Factors Engineering Literature.

PubMed

Patterson, Emily S

2018-05-01

Objective To integrate and synthesize insights from recent studies of workarounds to the intended use of health information technology (HIT) by health care professionals. Background Systems are safest when the documentation of how work is done in policies and procedures closely matches what people actually do when they are working. Proactively identifying and managing workarounds to the intended use of technology, including deviations from expected workflows, can improve system safety. Method A narrative review of studies of workarounds with HIT was conducted to identify themes in the literature. Results Three themes were identified: (1) Users circumvented new additional steps in the workflow when using HIT, (2) interdisciplinary team members communicated via HIT in text fields that were intended for other purposes, and (3) locally developed paper-based and manual whiteboard systems were used instead of HIT to support situation awareness of individuals and groups; an example of a locally developed system was handwritten notes about a patient on a piece of paper folded up and carried in a nurse's pocket. Conclusion Workarounds were employed to avoid changes to workflow, enable interdisciplinary communication, coordinate activities, and have real-time portable access to summarized and synthesized information. Application Implications for practice include providing summary overview displays, explicitly supporting role-based communication and coordination through HIT, and reducing the risk to reputation due to electronic monitoring of individual performance.

Stochastic simulation of radium-223 dichloride therapy at the sub-cellular level

NASA Astrophysics Data System (ADS)

Gholami, Y.; Zhu, X.; Fulton, R.; Meikle, S.; El-Fakhri, G.; Kuncic, Z.

2015-08-01

Radium-223 dichloride (223Ra) is an alpha particle emitter and a natural bone-seeking radionuclide that is currently used for treating osteoblastic bone metastases associated with prostate cancer. The stochastic nature of alpha emission, hits and energy deposition poses some challenges for estimating radiation damage. In this paper we investigate the distribution of hits to cells by multiple alpha particles corresponding to a typical clinically delivered dose using a Monte Carlo model to simulate the stochastic effects. The number of hits and dose deposition were recorded in the cytoplasm and nucleus of each cell. Alpha particle tracks were also visualized. We found that the stochastic variation in dose deposited in cell nuclei (≃ 40%) can be attributed in part to the variation in LET with pathlength. We also found that ≃ 18% of cell nuclei receive less than one sigma below the average dose per cell (≃ 15.4 Gy). One possible implication of this is that the efficacy of cell kill in alpha particle therapy need not rely solely on ionization clustering on DNA but possibly also on indirect DNA damage through the production of free radicals and ensuing intracellular signaling.

Effects of prolonged exposure of lettuce seeds to HZE particles on orbital stations

NASA Astrophysics Data System (ADS)

Nevzgodina, L. V.; Maksimova, E. N.; Kaminskaya, E. V.

In a study of the biological effects of cosmic HZE particles, lettuce (Lactuca sativa) seeds were flown on the orbital stations Salyut 6 and 7 for varying periods of time (from 40 to 457 days). The dependence of the biological damage on flight duration, physical parameters and the fact of passage of an HZE particle through the seed was estimated using the criterion of the frequency of aberrant cells. The arrangement of the flight biological container Biobloc made it possible to trace the location of tracks of individual HZE particles with Z>=6 and LET 200 keV/um. In seeds hit by HZE particles, for all exposure times, a statistically significant much higher yield of aberrant cells and also of cells containing multiple chromosome aberrations was observed than in the control material. The frequency of aberrant cells is markedly higher (by a factor of 1,5) in seeds hit than in non-hit ones. The changes of the yield of aberrant cells as a function of the absorbed dose (3.2-63.4 mGy) and the fluence (4.8-44.2 particles/cm2) are linear for the exposure duration ranging from 40 to 457 days.

An Overview of Research and Design Activities at CTFusion

NASA Astrophysics Data System (ADS)

Sutherland, D. A.; Jarboe, T. R.; Hossack, A. C.

2016-10-01

CTFusion, a newly formed company dedicated to the development of compact, toroidal fusion energy, is a spin-off from the University of Washington that will build upon the successes of the HIT-SI research program. The mission of the company to develop net-gain fusion power cores that will serve as the heart of economical fusion power plants or radioactive-waste destroying burner reactors. The overarching vision and development plan of the company will be presented, along with a detailed justification and design for our next device, the HIT-TD (Technology Demonstration) prototype. By externally driving the edge current and imposing non-axisymmetric magnetic perturbations, HIT-TD should demonstrate the sustainment of stable spheromak configurations with Imposed-Dynamo Current Drive (IDCD), as was accomplished in the HIT-SI device, with higher current gains and temperatures than previously possible. HIT-TD, if successful, will be an instrumental step along this path to economical fusion energy, and will serve as the stepping stone to our Proof-Of-Principle device (HIT-PoP). Beyond the implications of higher performance, sustained spheromaks for fusion applications, the HIT-TD platform will provide a unique system to observe plasma self-organizational phenomena of interest for other fusion devices, and astrophysical systems as well. Lastly, preliminary nuclear engineering design simulations with the MCNP6 code of the HIT-FNSF (Fusion Nuclear Science Facility) device will be presented.

Validation of a rapid DNA process with the RapidHIT® ID system using GlobalFiler® Express chemistry, a platform optimized for decentralized testing environments.

PubMed

Salceda, Susana; Barican, Arnaldo; Buscaino, Jacklyn; Goldman, Bruce; Klevenberg, Jim; Kuhn, Melissa; Lehto, Dennis; Lin, Frank; Nguyen, Phong; Park, Charles; Pearson, Francesca; Pittaro, Rick; Salodkar, Sayali; Schueren, Robert; Smith, Corey; Troup, Charles; Tsou, Dean; Vangbo, Mattias; Wunderle, Justus; King, David

2017-05-01

The RapidHIT ® ID is a fully automated sample-to-answer system for short tandem repeat (STR)-based human identification. The RapidHIT ID has been optimized for use in decentralized environments and processes presumed single source DNA samples, generating Combined DNA Index System (CODIS)-compatible DNA profiles in less than 90min. The system is easy to use, requiring less than one minute of hands-on time. Profiles are reviewed using centralized linking software, RapidLINK™ (IntegenX, Pleasanton, CA), a software tool designed to collate DNA profiles from single or multiple RapidHIT ID systems at different geographic locations. The RapidHIT ID has been designed to employ GlobalFiler ® Express and AmpFLSTR ® NGMSElect™, Thermo Fisher Scientific (Waltham, MA) STR chemistries. The Developmental Validation studies were performed using GlobalFiler ® Express with single source reference samples according to Scientific Working Group for DNA Analysis Methods guidelines. These results show that multiple RapidHIT ID systems networked with RapidLINK software form a highly reliable system for wide-scale deployment in locations such as police booking stations and border crossings enabling real-time testing of arrestees, potential human trafficking victims, and other instances where rapid turnaround is essential. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Recovery from major storms

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

Holeman, J.S.

1980-01-01

Public Service Company of Oklahoma's transmission and distribution system is in tornado alley, and it seems the number of tornados hitting some part of the system is increasing each year. In the past 30 years, Tulsa his been hit 7 times, and experienced 3 very wide and destructive tornado storm systems between 1971 and 1975.

Impact of Thailand universal coverage scheme on the country's health information systems and health information technology.

PubMed

Kijsanayotin, Boonchai

2013-01-01

Thailand achieved universal healthcare coverage with the implementation of the Universal Coverage Scheme (UCS) in 2001. This study employed qualitative method to explore the impact of the UCS on the country's health information systems (HIS) and health information technology (HIT) development. The results show that health insurance beneficiary registration system helps improve providers' service workflow and country vital statistics. Implementation of casemix financing tool, Thai Diagnosis-Related Groups, has stimulated health providers' HIS and HIT capacity building, data and medical record quality and the adoption of national administrative data standards. The system called "Disease Management Information Systems" aiming at reimbursement for select diseases increased the fragmentation of HIS and increase burden on data management to providers. The financial incentive of outpatient data quality improvement project enhance providers' HIS and HIT investment and also induce data fraudulence tendency. Implementation of UCS has largely brought favorable impact on the country HIS and HIT development. However, the unfavorable effects are also evident.

NASA/French Satellite Data Reveal New Details of Tsunami

NASA Image and Video Library

2005-01-12

Displayed in blue color is the height of sea surface (shown in blue) measured by the Jason satellite two hours after the initial magnitude 9 earthquake hit the region (shown in red) southwest of Sumatra on December 26, 2004. The data were taken by a radar altimeter onboard the satellite along a track traversing the Indian Ocean when the tsunami waves had just filled the entire Bay of Bengal (see the model simulation inset image). The data shown are the changes of sea surface height from previous observations made along the same track 20-30 days before the earthquake, reflecting the signals of the tsunami waves. The maximum height of the leading wave crest was about 50 cm (or 1.6 ft), followed by a trough of sea surface depression of 40 cm. The directions of wave propagation along the satellite track are shown by the blue arrows. http://photojournal.jpl.nasa.gov/catalog/PIA07219

First Plasma Results from the HIT-SI Spheromak

NASA Astrophysics Data System (ADS)

Sieck, P. E.; Hamp, W. T.; Izzo, V. A.; Jarboe, T. R.; Nelson, B. A.; O'Neill, R. G.; Redd, A. J.; Smith, R. J.

2003-10-01

HIT-SI is the newest device in the Helicity Injected Torus (HIT) program. HIT-SI is a ``bow tie'' spheromak formed and sustained by Steady Inductive Helicity Injection (SIHI) current drive. SIHI injects helicity at a nearly constant rate with no open field lines intersecting the boundary. (T. R. Jarboe, Fusion Technology 36) (1), p. 85, 1999 HIT-SI has been designed with a bow tie geometry to achieve stable high-β (>10%) spheromak equilibria. (U. Shumlak and T. R. Jarboe, Phys. Plasmas 7) (7), p. 2959, 2000 Diagnostics currently include surface magnetic probes and flux loops, visible light imaging, H-alpha line radiation monitors, voltage measurements across insulating breaks, injector current Rogowski coils, and injector flux loops. HIT-SI is currently operating in parallel with experiments on HIT-II. At the conclusion of HIT-II operations, HIT-SI will inherit a multi-point Thomson Scattering system, a scanning two-chord FIR interferometer, and other advanced diagnostics, as well as more power supplies to extend the discharge duration. Results are presented which characterize injector operation and possible evidence for spheromak formation.

Health information technology and sociotechnical systems: a progress report on recent developments within the UK National Health Service (NHS).

PubMed

Waterson, Patrick

2014-03-01

This paper summarises some of the research that Ken Eason and colleagues at Loughborough University have carried out in the last few years on the introduction of Health Information Technologies (HIT) within the UK National Health Service (NHS). In particular, the paper focuses on three examples which illustrate aspects of the introduction of HIT within the NHS and the role played by the UK National Programme for Information Technology (NPfIT). The studies focus on stages of planning and preparation, implementation and use, adaptation and evolution of HIT (e.g., electronic patient records, virtual wards) within primary, secondary and community care settings. Our findings point to a number of common themes which characterise the use of these systems. These include tensions between national and local strategies for implementing HIT and poor fit between healthcare work systems and the design of HIT. The findings are discussed in the light of other large-scale, national attempts to introduce similar technologies, as well as drawing out a set of wider lessons learnt from the NPfIT programme based on Ken Eason's earlier work and other research on the implementation of large-scale HIT. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation

PubMed Central

McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-01-01

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. PMID:28882812

Organizational factors influencing health information technology adoption in long-term-care facilities.

PubMed

Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

2014-01-01

Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary.

Evaluation of heparin-induced thrombocytopenia (HIT) laboratory testing and the 4Ts scoring system in the intensive care unit.

PubMed

Pierce, Wesly; Mazur, Joseph; Greenberg, Charles; Mueller, Joan; Foster, Joyce; Lazarchick, John

2013-01-01

Over-diagnosis of heparin-induced thrombocytopenia (HIT) results in costly and unnecessary laboratory screening and treatment with direct thrombin inhibitors. Our aim was to evaluate the utility of the 4Ts scoring system to predict HIT in multiple ICU settings and to characterize our treatment of these cases. Eighty-two patients from multiple ICU settings who underwent laboratory testing for HIT were classified as low-, intermediate-, or high-risk patients based on retrospectively adjudicated 4Ts scores. These results were compared with platelet-factor 4 enzyme-linked immunosorbent assays (PF4 ELISAs), optical density (OD) values, and serotonin-release assays (SRAs) to assess the utility of the 4Ts score to rule out ICU-related HIT and reduce laboratory and drug expenditures. Of the 82 patients reviewed, only 12 (11.4%) were PF4-positive and only 1 (1.2%) was SRA-positive for HIT. Heparin was discontinued in only 63.4% of patients suspected to have HIT. There were no significant differences in mean day of platelet fall, mean platelet nadir, and mean percent fall in platelet count between PF4-positive and negative patients (all p > 0.2). There was, however, a significantly higher proportion of patients with an intermediate to high 4Ts score in the PF4-positive group than in the PF4-negative group (66% vs. 30%, respectively; p = 0.02). The mean PF4 OD value in patients with intermediate to high 4Ts scores was significantly higher than in patients with low 4Ts scores (0.658 vs. 0.258, respectively; p < 0.001). The negative predictive values of the 4Ts score relative to the PF4 and SRA were 92% and 100%, respectively. The estimated laboratory and pharmacologic cost avoidance potential of the scoring system in this cohort was $21,450. Our modified 4Ts scoring system appears to be an effective tool for predicting HIT in the ICU and could avoid significant drug and laboratory expenditures if implemented prospectively. The clinical management of patients suspected of HIT is highly variable at our institution. Clinical protocols and education encouraging the proper identification and treatment of suspected HIT need to be established.

The impact of health information technology on organ transplant care: A systematic review.

PubMed

Niazkhani, Zahra; Pirnejad, Habibollah; Rashidi Khazaee, Parviz

2017-04-01

Health Information Technology (HIT) has a potential to promote transplant care. However, a systematic appraisal on how HIT application has so far affected transplant care is greatly missing from the literature. We systematically reviewed trials that evaluated HIT impact on process and patient outcomes as well as costs in organ transplant care. A systematic search was conducted in OVID versions of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane, and IEEE databases from January 1990 to December 2015. Studies were included if they: (i) evaluated HIT interventions; (ii) reported results for organ transplant population; (iii) reported quantitative data on process, patient, and cost outcomes; and (iv) used a randomized controlled trial or quasi-experimental study design. Primarily, 12,440 publications were identified; from which ten met inclusion criteria. Among HIT systems, uses of clinical decision support systems (CDSS) targeting different aspects of the complex organ transplant care were common. In terms of process outcomes, HIT positively impacted the timeliness of care, laboratory and medication management practices such as promoting therapeutic or diagnostic protocol compliance by clinicians, and reducing medication errors. Regarding patient outcomes, HIT demonstrated a beneficial impact on the percentage of post-transplant patients with normal lab values and decreasing immunosuppressive toxicity and also deviation from the predefined immunosuppressive therapeutic window. However, in terms of mortality, readmission, rejection, and antiviral resistance rates, the impact was not clearly established in the literature. Finally, these systems were associated with savings in the costs of transplant care in three studies. This is the first study reviewing HIT impact on transplant care outcomes. CDSSs have mainly been reported to support transplant care in realizing the above-mentioned benefits. However, to make conclusions, more evidence with less risk of bias is warranted. Several gaps in the literature, including comparison of the impact of commercial systems in different transplant settings, was identified which can motivate future research. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of a pretest scoring system (4Ts) for the diagnosis of heparin-induced thrombocytopenia in a university hospital setting.

PubMed

Vatanparast, Rodina; Lantz, Sarah; Ward, Kristine; Crilley, Pamela Ann; Styler, Michael

2012-11-01

The initial diagnosis of heparin-induced thrombocytopenia (HIT) is made on clinical grounds because the assays with the highest sensitivity (eg, heparin-platelet factor 4 antibody enzyme-linked immunosorbent assay [ELISA]) and specificity (eg, serotonin release assay) may not be readily available. The clinical utility of the pretest scoring system, the 4Ts, was developed and validated by Lo et al in the Journal of Thrombosis and Haemostasis in 2006. The pretest scoring system looks at the degree and timing of thrombocytopenia, thrombosis, and the possibility of other etiologies. Based on the 4T score, patients can be categorized as having a high, intermediate, or low probability of having HIT. We conducted a retrospective study of 100 consecutive patients who were tested for HIT during their hospitalization at Hahnemann University Hospital (Philadelphia, PA) in 2009. Of the 100 patients analyzed, 72, 23, and 5 patients had 4T pretest probability scores of low, intermediate, and high, respectively. A positive HIT ELISA (optical density > 1.0 unit) was detected in 0 of 72 patients (0%) in the low probability group, in 5 of 23 patients (22%) in the intermediate probability group, and in 2 of 5 patients (40%) in the high probability group. The average turnaround time for the HIT ELISA was 4 to 5 days. Fourteen (19%) of the 72 patients with a low pretest probability of HIT were treated with a direct thrombin inhibitor. Ten (71%) of the 14 patients in the low probability group treated with a direct thrombin inhibitor had a major complication of bleeding requiring blood transfusion support. In this retrospective study, a low 4T score showed 100% correlation with a negative HIT antibody assay. We recommend incorporating the 4T scoring system into institutional core measures when assessing a patient with suspected HIT, selecting only patients with intermediate to high probability for therapeutic intervention, which may translate into reduced morbidity and lower health care costs.

Increased Use of Care Management Processes and Expanded Health Information Technology Functions by Practice Ownership and Medicaid Revenue.

PubMed

Rodriguez, Hector P; McClellan, Sean R; Bibi, Salma; Casalino, Lawrence P; Ramsay, Patricia P; Shortell, Stephen M

2016-06-01

Practice ownership and Medicaid revenue may affect the use of care management processes (CMPs) for chronic conditions and expansion of health information technology (HIT). Using a national cohort of medical practices, we compared the use of CMPs and HIT from 2006/2008 to 2013 by practice ownership and level of Medicaid revenue. Poisson regression models estimated changes in CMP use, and linear regression estimated changes in HIT, by practice ownership and Medicaid patient revenue, controlling for other practice characteristics. Compared with physician-owned practices, system-owned practices adopted a greater number of CMPs and HIT functions over time (p < .001). High Medicaid revenue (≥30.0%) was associated with less adoption of CMPs (p < .001) and HIT (p < .01). System-owned practices (p < .001) and community health centers (p < .001) with high Medicaid revenue were more likely than physician-owned practices with high Medicaid revenue to adopt CMPs over time. System and community health center ownership appear to help high Medicaid practices overcome CMP adoption constraints. © The Author(s) 2015.

Validation of the Impact of Health Information Technology (I-HIT) Scale: an international collaborative.

PubMed

Dykes, Patricia C; Hurley, Ann C; Brown, Suzanne; Carr, Robyn; Cashen, Margaret; Collins, Rita; Cook, Robyn; Currie, Leanne; Docherty, Charles; Ensio, Anneli; Foster, Joanne; Hardiker, Nicholas R; Honey, Michelle L L; Killalea, Rosaleen; Murphy, Judy; Saranto, Kaija; Sensmeier, Joyce; Weaver, Charlotte

2009-01-01

In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.

A framework for reporting on human factor/usability studies of health information technologies.

PubMed

Peute, Linda W; Driest, Keiko F; Marcilly, Romaric; Bras Da Costa, Sabrina; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W M

2013-01-01

Increasingly, studies are being published on the potential negative effect of introducing poor designed Health Information Technology (HIT) into clinical settings, relating to technology-induced errors and adverse events. Academic research on HIT design and evaluation is an extremely important source of information in providing new insights into factors contributing to successful system (re)design efforts, system user-friendliness and usability issues and safety critical aspects of HIT design. However, these studies have been inconsistent and incomprehensive in their reporting, complicating the appraisal of outcomes, generalizability of study findings, meta-analysis and harmonization of the available evidence. To improve identification of type of use errors and safety related issues regarding design and implementation of HIT, consensus on issues to be reported on in scientific publications is a necessary step forward. This study presents the first approach to a framework providing a set of principles to follow for comprehensive and unambiguous reporting of HIT design and usability evaluation studies with the objective to reduce variation, improve on the publication reporting quality and proper indexation of these studies. This framework may be helpful in expanding the knowledge base not only concerning the application of Human Factors (HF)/Usability studies of HIT but also improve the knowledge base of how to (re)design and implement effective, efficient and safe HIT.

A Compact Magnetic Field-Based Obstacle Detection and Avoidance System for Miniature Spherical Robots.

PubMed

Wu, Fang; Vibhute, Akash; Soh, Gim Song; Wood, Kristin L; Foong, Shaohui

2017-05-28

Due to their efficient locomotion and natural tolerance to hazardous environments, spherical robots have wide applications in security surveillance, exploration of unknown territory and emergency response. Numerous studies have been conducted on the driving mechanism, motion planning and trajectory tracking methods of spherical robots, yet very limited studies have been conducted regarding the obstacle avoidance capability of spherical robots. Most of the existing spherical robots rely on the "hit and run" technique, which has been argued to be a reasonable strategy because spherical robots have an inherent ability to recover from collisions. Without protruding components, they will not become stuck and can simply roll back after running into bstacles. However, for small scale spherical robots that contain sensitive surveillance sensors and cannot afford to utilize heavy protective shells, the absence of obstacle avoidance solutions would leave the robot at the mercy of potentially dangerous obstacles. In this paper, a compact magnetic field-based obstacle detection and avoidance system has been developed for miniature spherical robots. It utilizes a passive magnetic field so that the system is both compact and power efficient. The proposed system can detect not only the presence, but also the approaching direction of a ferromagnetic obstacle, therefore, an intelligent avoidance behavior can be generated by adapting the trajectory tracking method with the detection information. Design optimization is conducted to enhance the obstacle detection performance and detailed avoidance strategies are devised. Experimental results are also presented for validation purposes.

Solar Storms, Devils, Dunes, and Gullies

NASA Technical Reports Server (NTRS)

2003-01-01

[figure removed for brevity, see original site]

Released 12 December 2003

Man, there sure is a lot going on here! This image was acquired during the peak of the late October record breaking solar storm outbursts. The white dots in this image were in fact caused when the charged particles from the sun hit our camera. One can also see the enigmatic gullies, dark barchan sand dunes and numerous dust devil tracks. This image is in the Noachis region of the heavily cratered southern hemisphere.

Image information: VIS instrument. Latitude -42.1, Longitude 328.2 East (31.8 West). 19 meter/pixel resolution.

Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

Costs and benefits of health information technology.

PubMed

Shekelle, Paul G; Morton, Sally C; Keeler, Emmett B

2006-04-01

An evidence report was prepared to assess the evidence base regarding benefits and costs of health information technology (HIT) systems, that is, the value of discrete HIT functions and systems in various healthcare settings, particularly those providing pediatric care. PubMed, the Cochrane Controlled Clinical Trials Register, and the Cochrane Database of Reviews of Effectiveness (DARE) were electronically searched for articles published since 1995. Several reports prepared by private industry were also reviewed. Of 855 studies screened, 256 were included in the final analyses. These included systematic reviews, meta-analyses, studies that tested a hypothesis, and predictive analyses. Each article was reviewed independently by two reviewers; disagreement was resolved by consensus. Of the 256 studies, 156 concerned decision support, 84 assessed the electronic medical record, and 30 were about computerized physician order entry (categories are not mutually exclusive). One hundred twenty four of the studies assessed the effect of the HIT system in the outpatient or ambulatory setting; 82 assessed its use in the hospital or inpatient setting. Ninety-seven studies used a randomized design. There were 11 other controlled clinical trials, 33 studies using a pre-post design, and 20 studies using a time series. Another 17 were case studies with a concurrent control. Of the 211 hypothesis-testing studies, 82 contained at least some cost data. We identified no study or collection of studies, outside of those from a handful of HIT leaders, that would allow a reader to make a determination about the generalizable knowledge of the study's reported benefit. Beside these studies from HIT leaders, no other research assessed HIT systems that had comprehensive functionality and included data on costs, relevant information on organizational context and process change, and data on implementation. A small body of literature supports a role for HIT in improving the quality of pediatric care. Insufficient data were available on the costs or cost-effectiveness of implementing such systems. The ability of Electronic Health Records (EHRs) to improve the quality of care in ambulatory care settings was demonstrated in a small series of studies conducted at four sites (three U.S. medical centers and one in the Netherlands). The studies demonstrated improvements in provider performance when clinical information management and decision support tools were made available within an EHR system, particularly when the EHRs had the capacity to store data with high fidelity, to make those data readily accessible, and to help translate them into context-specific information that can empower providers in their work. Despite the heterogeneity in the analytic methods used, all cost-benefit analyses predicted substantial savings from EHR (and health care information exchange and interoperability) implementation: The quantifiable benefits are projected to outweigh the investment costs. However, the predicted time needed to break even varied from three to as many as 13 years. HIT has the potential to enable a dramatic transformation in the delivery of health care, making it safer, more effective, and more efficient. Some organizations have already realized major gains through the implementation of multifunctional, interoperable HIT systems built around an EHR. However, widespread implementation of HIT has been limited by a lack of generalizable knowledge about what types of HIT and implementation methods will improve care and manage costs for specific health organizations. The reporting of HIT development and implementation requires fuller descriptions of both the intervention and the organizational/economic environment in which it is implemented.

Collision victim travels for "seven kilometres" on top of the car that hit him.

PubMed

Heide, Steffen; Stiller, Dankwart; Kleiber, Manfred; Bluemke, Karen

2012-10-01

A 26-year-old man, after a drinking binge, drove into a tram building site and collided with a track-grinding machine which left a fist-size hole in his windscreen. He then hit a construction worker who was catapulted onto the car roof. The worker held on to the antenna and the windscreen hole, while the car drove on for 7 km, reaching speeds of 90 km h(-1). The victim suffered several fractures and survived with relatively little consequential damage. The investigation showed the driver to have been under the influence of alcohol and cannabis. In trial, he claimed loss of memory and stated that he had noticed neither the accident nor the man on his car roof. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The first bump-bonded pixel detectors on CVD diamond

NASA Astrophysics Data System (ADS)

Adam, W.; Bauer, C.; Berdermann, E.; Bergonzo, P.; Bogani, F.; Borchi, E.; Brambilla, A.; Bruzzi, M.; Colledani, C.; Conway, J.; Dabrowski, W.; Delpierre, P.; Deneuville, A.; Dulinski, W.; van Eijk, B.; Fallou, A.; Fizzotti, F.; Foulon, F.; Friedl, M.; Gan, K. K.; Gheeraert, E.; Grigoriev, E.; Hallewell, G.; Hall-Wilton, R.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kania, D.; Kaplon, J.; Karl, C.; Kass, R.; Krammer, M.; Logiudice, A.; Lu, R.; Manfredi, P. F.; Manfredotti, C.; Marshall, R. D.; Meier, D.; Mishina, M.; Oh, A.; Palmieri, V. G.; Pan, L. S.; Peitz, A.; Pernicka, M.; Pirollo, S.; Polesello, P.; Pretzl, K.; Re, V.; Riester, J. L.; Roe, S.; Roff, D.; Rudge, A.; Schnetzer, S.; Sciortino, S.; Speziali, V.; Stelzer, H.; Steuerer, J.; Stone, R.; Tapper, R. J.; Tesarek, R.; Trawick, M.; Trischuk, W.; Turchetta, R.; Vittone, E.; Wagner, A.; Walsh, A. M.; Wedenig, R.; Weilhammer, P.; Zeuner, W.; Ziock, H.; Zoeller, M.; Charles, E.; Ciocio, A.; Dao, K.; Einsweiler, K.; Fasching, D.; Gilchriese, M.; Joshi, A.; Kleinfelder, S.; Milgrome, O.; Palaio, N.; Richardson, J.; Sinervo, P.; Zizka, G.; RD42 Collaboration

1999-11-01

Diamond is a nearly ideal material for detecting ionising radiation. Its outstanding radiation hardness, fast charge collection and low leakage current allow it to be used in high radiation environments. These characteristics make diamond sensors particularly appealing for use in the next generation of pixel detectors. Over the last year, the RD42 collaboration has worked with several groups that have developed pixel readout electronics in order to optimise diamond sensors for bump-bonding. This effort resulted in an operational diamond pixel sensor that was tested in a pion beam. We demonstrate that greater than 98% of the channels were successfully bump-bonded and functioning. The device shows good overall hit efficiency as well as clear spatial hit correlation to tracks measured in a silicon reference telescope. A position resolution of 14.8 μm was observed, consistent with expectations given the detector pitch.

Increasing Human Papillomavirus Vaccine Initiation among Publically-Insured Florida Adolescents

PubMed Central

Staras, Stephanie A. S.; Vadaparampil, Susan T.; Livingston, Melvin D.; Thompson, Lindsay A.; Sanders, Ashley H.; Shenkman, Elizabeth A.

2014-01-01

Purpose We evaluated the feasibility of a multi-level intervention to increase HPV vaccine initiation among adolescents. Methods We used a four-arm factorial quasi-experimental trial to assess feasibility and short-term, preliminary effectiveness of a health system-level, gender-specific postcard campaign and an in-clinic health information technology (HIT) system. Between August to November 2013, we tested the intervention among 11–17 year olds without prior HPV vaccine claims in Florida Medicaid or Children’s Health Insurance Program encounters (2773 girls and 3350 boys) who attended or were assigned to primary care clinics in North Central Florida. Results At least one postcard was deliverable to 95% of parents. Most parents (91% boys’ and 80% girls’) who participated in the process evaluation survey (n=162) reported seeking additional information about the vaccine after receiving the postcard. Only 8% (57 of the 1062) of adolescents assigned to a HIT provider with an office visit during the study used the HIT system. When compared with arms not containing that component, HPV vaccine initiation increased with the postcard campaign [girls Odds Ratio (OR) = 1.6, 95% Confidence Interval (CI) = 1.1–2.3 and boys = not significant], the HIT system (girls OR = 1.5, 95% CI =1.0–2.3 and boys OR = 1.4, 95% CI=1.0–2.0), and the combined HIT and postcard intervention (girls OR = 2.4, 95% CI =1.4–4.3 and boys OR = 1.6, 95% CI=1.0–2.5). Conclusions A system-level postcard campaign was feasible. Despite low recruitment to the inclinic HIT system, the intervention demonstrated short-term, preliminary effectiveness similar to prior HPV vaccine interventions. PMID:25863554

Use of health information technology to advance evidence-based care: lessons from the VA QUERI program.

PubMed

Hynes, Denise M; Weddle, Timothy; Smith, Nina; Whittier, Erika; Atkins, David; Francis, Joseph

2010-01-01

As the Department of Veterans Affairs (VA) Health Services Research and Development Service's Quality Enhancement Research Initiative (QUERI) has progressed, health information technology (HIT) has occupied a crucial role in implementation research projects. We evaluated the role of HIT in VA QUERI implementation research, including HIT use and development, the contributions implementation research has made to HIT development, and HIT-related barriers and facilitators to implementation research. Key informants from nine disease-specific QUERI Centers. Documentation analysis of 86 implementation project abstracts followed up by semi-structured interviews with key informants from each of the nine QUERI centers. We used qualitative and descriptive analyses. We found: (1) HIT provided data and information to facilitate implementation research, (2) implementation research helped to further HIT development in a variety of uses including the development of clinical decision support systems (23 of 86 implementation research projects), and (3) common HIT barriers to implementation research existed but could be overcome by collaborations with clinical and administrative leadership. Our review of the implementation research progress in the VA revealed interdependency on an HIT infrastructure and research-based development. Collaboration with multiple stakeholders is a key factor in successful use and development of HIT in implementation research efforts and in advancing evidence-based practice.

Video head impulse test: a review of the literature.

PubMed

Alhabib, Salman F; Saliba, Issam

2017-03-01

Video head impulse test (vHIT) is a new testing which able to identify the overt and covert saccades and study the gain of vestibulo-ocular reflex (VOR) of each semicircular canal. The aim of this study is to review the clinical use of vHIT in patients with vestibular disorders in different diseases. PubMed and Cochrane databases were searched for all articles that defined vHIT, compared vHIT with another clinical test, and studied the efficacy of vHIT as diagnostic tools with vestibular disease. 37 articles about vHIT were reviewed. All articles studied the vHIT in English and French languages up to May 2015 were included in the review. Editorial articles or short comments, conference abstracts, animal studies, and language restriction were excluded from the review. Four systems were used in the literature to do the vHIT. vHIT is physiological quick test, which studied the VOR at high frequency of each semicircular canal by calculating the duration ratio between the head impulse and gaze deviation. vHIT is more sensitive than clinical head impulse test (cHIT), especially in patient with isolated covert saccades. vHIT test is diagnostic of vestibular weakness by gain reduction and the appearance of overt and covert saccades. If the vHIT is normal, then caloric test is mandatory to rule out a peripheral origin of vertigo. It is recommended to test each semicircular canal, as isolated vertical canal weakness was identified in the literature. More investigation would be required to determine the evolution of the VOR gain with the progression of the vestibular disease.

Laboratory Testing Protocols for Heparin-Induced Thrombocytopenia (HIT) Testing.

PubMed

Lau, Kun Kan Edwin; Mohammed, Soma; Pasalic, Leonardo; Favaloro, Emmanuel J

2017-01-01

Heparin-induced thrombocytopenia (HIT) represents a significant high morbidity complication of heparin therapy. The clinicopathological diagnosis of HIT remains challenging for many reasons; thus, laboratory testing represents an important component of an accurate diagnosis. Although there are many assays available to assess HIT, these essentially fall into two categories-(a) immunological assays, and (b) functional assays. The current chapter presents protocols for several HIT assays, being those that are most commonly performed in laboratory practice and have the widest geographic distribution. These comprise a manual lateral flow-based system (STiC), a fully automated latex immunoturbidimetric assay, a fully automated chemiluminescent assay (CLIA), light transmission aggregation (LTA), and whole blood aggregation (Multiplate).

Rapid development of two factor IXa inhibitors from hit to lead.

PubMed

Parker, Dann L; Walsh, Shawn; Li, Bing; Kim, Esther; Sharipour, Aurash; Smith, Cameron; Chen, Yi-Heng; Berger, Richard; Harper, Bart; Zhang, Ting; Park, Min; Shu, Min; Wu, Jane; Xu, Jiayi; Dewnani, Sunita; Sherer, Edward C; Hruza, Alan; Reichert, Paul; Geissler, Wayne; Sonatore, Lisa; Ellsworth, Kenneth; Balkovec, James; Greenlee, William; Wood, Harold B

2015-06-01

Two high-throughput screening hits were investigated for SAR against human factor IXa. Both hits feature a benzamide linked to a [6-5]-heteroaryl via an alkyl amine. In the case where this system is a benzimidazolyl-ethyl amine the binding potency for the hit was improved >500-fold, from 9 μM to 0.016 μM. For the other hit, which contains a tetrahydropyrido-indazole amine, potency was improved 20-fold, from 2 μM to 0.09 μM. X-ray crystal structures were obtained for an example of each class which improved understanding of the binding, and will enable further drug discovery efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

High-Throughput Screening and Hit Validation of Extracellular-Related Kinase 5 (ERK5) Inhibitors.

PubMed

Myers, Stephanie M; Bawn, Ruth H; Bisset, Louise C; Blackburn, Timothy J; Cottyn, Betty; Molyneux, Lauren; Wong, Ai-Ching; Cano, Celine; Clegg, William; Harrington, Ross W; Leung, Hing; Rigoreau, Laurent; Vidot, Sandrine; Golding, Bernard T; Griffin, Roger J; Hammonds, Tim; Newell, David R; Hardcastle, Ian R

2016-08-08

The extracellular-related kinase 5 (ERK5) is a promising target for cancer therapy. A high-throughput screen was developed for ERK5, based on the IMAP FP progressive binding system, and used to identify hits from a library of 57 617 compounds. Four distinct chemical series were evident within the screening hits. Resynthesis and reassay of the hits demonstrated that one series did not return active compounds, whereas three series returned active hits. Structure-activity studies demonstrated that the 4-benzoylpyrrole-2-carboxamide pharmacophore had excellent potential for further development. The minimum kinase binding pharmacophore was identified, and key examples demonstrated good selectivity for ERK5 over p38α kinase.

A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.

PubMed

Haun, Jolie N; Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

2015-02-27

The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans' preferences for using VA HIT to manage their health conditions and exchange health information. The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences.

A Participatory Approach to Designing and Enhancing Integrated Health Information Technology Systems for Veterans: Protocol

PubMed Central

Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

2015-01-01

Background The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. Objective The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans’ preferences for using VA HIT to manage their health conditions and exchange health information. Methods The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. Results This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. Conclusions This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences. PMID:25803324

Organic Over-the-Horizon Targeting for the 2025 Surface Fleet

DTIC Science & Technology

2015-06-01

Detection Phit Probability of Hit Pk Probability of Kill PLAN People’s Liberation Army Navy PMEL Pacific Marine Environmental Laboratory...probability of hit ( Phit ). 2. Top-Level Functional Flow Block Diagram With the high-level functions of the project’s systems of systems properly

Cargo Throughput and Survivability Trade-Offs in Force Sustainment Operations

DTIC Science & Technology

2008-06-01

more correlation with direct human activity. Mines are able to simply ‘sit and wait,’ thus allowing for easier mathematical and statistical ...1.2) Since the ships will likely travel in groups along the same programmed GPS track, modeling several transitors to the identical path is assumed...setting of 1/2 was used for the actuation probability maximum. The ‘threat profile’ will give the probability that the nth transitor will hit a mine

Testbeam results of irradiated ams H18 HV-CMOS pixel sensor prototypes

DOE PAGES

Benoit, M.; Braccini, S.; Casse, G.; ...

2018-02-08

HV-CMOS pixel sensors are a promising option for the tracker upgrade of the ATLAS experiment at the LHC, as well as for other future tracking applications in which large areas are to be instrumented with radiation-tolerant silicon pixel sensors. We present results of testbeam characterisations of the 4 th generation of Capacitively Coupled Pixel Detectors (CCPDv4) produced with the ams H18 HV-CMOS process that have been irradiated with different particles (reactor neutrons and 18 MeV protons) to fluences between 1×10 14 and 5×10 15 1–MeV– n eq. The sensors were glued to ATLAS FE-I4 pixel readout chips and measured atmore » the CERN SPS H8 beamline using the FE-I4 beam telescope. Results for all fluences are very encouraging with all hit efficiencies being better than 97% for bias voltages of 85 V. The sample irradiated to a fluence of 1×10 15 neq—a relevant value for a large volume of the upgraded tracker—exhibited 99.7% average hit efficiency. Furthermore, the results give strong evidence for the radiation tolerance of HV-CMOS sensors and their suitability as sensors for the experimental HL-LHC upgrades and future large-area silicon-based tracking detectors in high-radiation environments.« less

Testbeam results of irradiated ams H18 HV-CMOS pixel sensor prototypes

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

Benoit, M.; Braccini, S.; Casse, G.

HV-CMOS pixel sensors are a promising option for the tracker upgrade of the ATLAS experiment at the LHC, as well as for other future tracking applications in which large areas are to be instrumented with radiation-tolerant silicon pixel sensors. We present results of testbeam characterisations of the 4 th generation of Capacitively Coupled Pixel Detectors (CCPDv4) produced with the ams H18 HV-CMOS process that have been irradiated with different particles (reactor neutrons and 18 MeV protons) to fluences between 1×10 14 and 5×10 15 1–MeV– n eq. The sensors were glued to ATLAS FE-I4 pixel readout chips and measured atmore » the CERN SPS H8 beamline using the FE-I4 beam telescope. Results for all fluences are very encouraging with all hit efficiencies being better than 97% for bias voltages of 85 V. The sample irradiated to a fluence of 1×10 15 neq—a relevant value for a large volume of the upgraded tracker—exhibited 99.7% average hit efficiency. Furthermore, the results give strong evidence for the radiation tolerance of HV-CMOS sensors and their suitability as sensors for the experimental HL-LHC upgrades and future large-area silicon-based tracking detectors in high-radiation environments.« less

Objective Tracking of Tropical Cyclones in the North-West Pacific Basin Based on Wind Field Information only

NASA Astrophysics Data System (ADS)

Leckebusch, G. C.; Befort, D. J.; Kruschke, T.

2016-12-01

Although only ca. 12% of the global insured losses of natural disasters occurred in Asia, there are two major reasons to be concerned about risks in Asia: a) The fraction of loss events was substantial higher with 39% of which 94% were due to atmospheric processes; b) Asia and especially China, is undergoing quick transitions and especially the insurance market is rapidly growing. In order to allow for the estimation of potential future (loss) impacts in East-Asia, in this study we further developed and applied a feature tracking system based on extreme wind speed occurrences to tropical cyclones, which was originally developed for extra-tropical cyclones (Leckebusch et al., 2008). In principle, wind fields will be identified and tracked once a coherent exceedance of local percentile thresholds is identified. The focus on severe wind impact will allow an objective link between the strength of a cyclone and its potential damages over land. The wind tracking is developed in such a way to be applicable also to course-gridded AOGCM simulation. In the presented configuration the wind tracking algorithm is applied to the Japanese reanalysis (JRA55) and TC Identification is based on 850hPa wind speeds (6h resolution) from 1979 to 2014 over the Western North Pacific region. For validation the IBTrACS Best Track archive version v03r8 is used. Out of all 904 observed tracks, about 62% can be matched to at least one windstorm event identified in JRA55. It is found that the relative amount of matched best tracks increases with the maximum intensity. Thus, a positive matching (hit rate) of above 98% for Violent Typhoons (VTY), above 90% for Very Strong Typhoons (VSTY), about 75% for Typhoons (TY), and still some 50% for less intense TCs (TD, TS, STS) is found. This result is extremely encouraging to apply this technique to AOGCM outputs and to derive information about affected regions and intensity-frequency distributions potentially changed under future climate conditions.

The Association between Health Information Technology Adoption and Family Physicians' Practice Patterns in Canada: Evidence from 2007 and 2010 National Physician Surveys

PubMed Central

Sarma, Sisira; Hajizadeh, Mohammad; Thind, Amardeep; Chan, Rick

2013-01-01

Objective: To describe the association between health information technology (HIT) adoption and family physicians' patient visit length in Canada after controlling for physician and practice characteristics. Method: HIT adoption is defined in terms of four types of HIT usage: no HIT use (NO), basic HIT use without electronic medical record system (HIT), basic HIT use with electronic medical record (EMR) and advanced HIT use (EMR + HIT). The outcome variable is the average time spent on a patient visit (visit length). The data for this study came from the 2007 and 2010 National Physician Surveys. A log-linear model was used to analyze our visit length outcome. Results: The average time worked per week was found to be in the neighbourhood of 36 hours in both 2007 and 2010, but users of EMR and EMR + HIT were undertaking fewer patient visits per week relative to NO users. Multivariable analysis showed that EMR and EMR + HIT were associated with longer average time spent per patient visit by about 7.7% (p<0.05) and 6.7% (p<0.01), respectively, compared to NO users in 2007. In 2010, EMR was not statistically significant and EMR + HIT was associated with a 4% (p<0.1) increased visit length. A variety of practice-related variables such as the mode of remuneration, work setting and interprofessional practice influenced visit length in the expected direction. Conclusion: Use of HIT is found to be associated with fewer patient visits and longer visit length among family physicians in Canada relative to NO users, but this association weakened in the multivariable analysis of 2010. PMID:23968677

Recent advances in the diagnosis and treatment of heparin-induced thrombocytopenia

PubMed Central

Bakchoul, Tamam

2012-01-01

Heparin-induced thrombocytopenia (HIT) is a drug-mediated, prothrombotic disorder caused by immunization against platelet factor 4 (PF4) after complex formation with heparin or other polyanions. After their binding to PF4/heparin complexes on the platelet surface, HIT antibodies are capable of intravascular platelet activation by cross-linking Fcγ receptor IIA leading to a platelet count decrease and/or thrombosis. Diagnosis of HIT is often difficult. This, and the low specificity of the commercially available immunoassays, leads currently to substantial overdiagnosis of HIT. Timing of onset, the moderate nature of thrombocytopenia, and the common concurrence of thrombosis are very important factors, which help to differentiate HIT from other potential causes of thrombocytopenia. A combination of a clinical pretest scoring system and laboratory investigation is usually necessary to diagnose HIT. Although HIT is considered to be a rare complication of heparin treatment, the very high number of hospital inpatients, and increasingly also hospital outpatients receiving heparin, still result in a considerable number of patients developing HIT. If HIT occurs, potentially devastating complications such as life-threatening thrombosis make it one of the most serious adverse drug reactions. If HIT is strongly suspected, all heparin must be stopped and an alternative nonheparin anticoagulant started at a therapeutic dose to prevent thromboembolic complications. However, the nonheparin alternative anticoagulants bear a considerable bleeding risk, especially if given to patients with thrombocytopenia due to other reasons than HIT. While established drugs for HIT are disappearing from the market (lepirudin, danaparoid), bivalirudin, fondaparinux and potentially the new anticoagulants such as dabigatran, rivaroxaban and apixaban provide new treatment options. PMID:23606934

Comparison of Document Index Graph Using TextRank and HITS Weighting Method in Automatic Text Summarization

NASA Astrophysics Data System (ADS)

Hadyan, Fadhlil; Shaufiah; Arif Bijaksana, Moch.

2017-01-01

Automatic summarization is a system that can help someone to take the core information of a long text instantly. The system can help by summarizing text automatically. there’s Already many summarization systems that have been developed at this time but there are still many problems in those system. In this final task proposed summarization method using document index graph. This method utilizes the PageRank and HITS formula used to assess the web page, adapted to make an assessment of words in the sentences in a text document. The expected outcome of this final task is a system that can do summarization of a single document, by utilizing document index graph with TextRank and HITS to improve the quality of the summary results automatically.

A Field-Programmable Gate Array (FPGA) TDC for the Fermilab SeaQuest (E906) Experiment and Its Test with a Novel External Wave Union Launcher

NASA Astrophysics Data System (ADS)

Wang, Su-Yin; Wu, Jinyuan; Yao, Shi-Hong; Chang, Wen-Chen

2014-12-01

We developed a field-programmable gate array (FPGA) TDC module for the tracking detectors of the Fermilab SeaQuest (E906) experiment, including drift chambers, proportional tubes, and hodoscopes. This 64-channel TDC module had a 6U VMEbus form factor and was equipped with a low-power, radiation-hardened Microsemi ProASIC3 Flash-based FPGA. The design of the new FPGA firmware (Run2-TDC) aimed to reduce the data volume and data acquisition (DAQ) deadtime. The firmware digitized multiple input hits of both polarities while allowing users to turn on a multiple-hit elimination logic to remove after-pulses in the wire chambers and proportional tubes. A scaler was implemented in the firmware to allow for recording the number of hits in each channel. The TDC resolution was determined by an internal cell delay of 450 ps. A measurement precision of 200 ps was achieved. We used five kinds of tests to ensure the qualification of 93 TDCs in mass production. We utilized the external wave union launcher in our test to improve the TDC's measurement precision and also to illustrate how to construct the Wave Union TDC using an existing multi-hit TDC without modifying its firmware. Measurement precision was improved by a factor of about two (108 ps) based on the four-edge wave union. Better measurement precision (69 ps) was achieved by combining the approaches of Wave Union TDC and multiple-channel ganging.

Reducing Risk with Clinical Decision Support

PubMed Central

Maloney, F.L.; Feblowitz, J.; Samal, L.; Sato, L.; Wright, A.

2014-01-01

Summary Objective Identify clinical opportunities to intervene to prevent a malpractice event and determine the proportion of malpractice claims potentially preventable by clinical decision support (CDS). Materials and Methods Cross-sectional review of closed malpractice claims over seven years from one malpractice insurance company and seven hospitals in the Boston area. For each event, clinical opportunities to intervene to avert the malpractice event and the presence or absence of CDS that might have a role in preventing the event, were assigned by a panel of expert raters. Compensation paid out to resolve a claim (indemnity), was associated with each CDS type. Results Of the 477 closed malpractice cases, 359 (75.3%) were categorized as substantiated and 195 (54%) had at least one opportunity to intervene. Common opportunities to intervene related to performance of procedure, diagnosis, and fall prevention. We identified at least one CDS type for 63% of substantiated claims. The 41 CDS types identified included clinically significant test result alerting, diagnostic decision support and electronic tracking of instruments. Cases with at least one associated intervention accounted for $40.3 million (58.9%) of indemnity. Discussion CDS systems and other forms of health information technology (HIT) are expected to improve quality of care, but their potential to mitigate risk had not previously been quantified. Our results suggest that, in addition to their known benefits for quality and safety, CDS systems within HIT have a potential role in decreasing malpractice payments. Conclusion More than half of malpractice events and over $40 million of indemnity were potentially preventable with CDS. PMID:25298814

Assessment of the 4Ts pretest clinical scoring system as a predictor of heparin-induced thrombocytopenia.

PubMed

Strutt, Jaclyn K; Mackey, Jennifer E; Johnson, Stephen M; Sylvia, Lynne M

2011-02-01

To evaluate the utility of the 4Ts clinical scoring system as a pretest probability method for the detection of heparin-induced thrombocytopenia (HIT). Prospective observational study. Medical and surgical inpatients at a tertiary care medical center. Eighty consecutive patients with suspicion of HIT who had a polyspecific enzyme-linked immunosorbent assay (ELISA) performed between December 1, 2008, and April 1, 2009, for detection of platelet factor 4 (PF4)-heparin antibodies. The predictive value of the 4Ts scoring system as determined by using a standard laboratory marker of HIT--the ELISA--and the interrater reliability of the scoring system were assessed. Sixty-seven (84%) of the 80 patients had low clinical probability of HIT based on the calculated 4Ts score. The ELISA result was negative for PF4-heparin antibodies in 74 patients (93%). Based on the results of the ELISA, the negative predictive value of the 4Ts score was 91%. Each 4Ts score was calculated by two independent investigators and adjudicated by a third investigator when necessary. The interrater reliability of the scoring system was fair (Cohen κ coefficient 0.362, 95% confidence interval [CI] 0.222-0.502; weighted κ coefficient 0.554 (95% CI 0.441-0.667). Determination of the timing of HIT was associated with the largest number of discrepancies (16) between evaluators, followed by other causes of thrombocytopenia (15), degree of decline in platelet count (14), and the presence of thrombosis or other sequelae (2). A low 4Ts score supports a low probability of HIT based on the results of the polyspecific ELISA. Overall, the interrater reliability of the scoring system was fair. Components of the 4Ts scoring system need to be further clarified or modified in order to improve interrater reliability and thereby increase the clinical utility of this pretest probability model.

Health information technology capacity at federally qualified health centers: a mechanism for improving quality of care

PubMed Central

2013-01-01

Background The adoption of health information technology has been recommended as a viable mechanism for improving quality of care and patient health outcomes. However, the capacity of health information technology (i.e., availability and use of multiple and advanced functionalities), particularly in federally qualified health centers (FQHCs) on improving quality of care is not well understood. We examined associations between health information technology (HIT) capacity at FQHCs and quality of care, measured by the receipt of discharge summary, frequency of patients receiving reminders/notifications for preventive care/follow-up care, and timely appointment for specialty care. Methods The analyses used 2009 data from the National Survey of Federally Qualified Health Centers. The study included 776 of the FQHCs that participated in the survey. We examined the extent of HIT use and tested the hypothesis that level of HIT capacity is associated with quality of care. Multivariable logistic regressions, reporting unadjusted and adjusted odds ratios, were used to examine whether ‘FQHCs’ HIT capacity’ is associated with the outcome measures. Results The results showed a positive association between health information technology capacity and quality of care. FQHCs with higher HIT capacity were significantly more likely to have improved quality of care, measured by the receipt of discharge summaries (OR=1.43; CI=1.01, 2.40), the use of a patient notification system for preventive and follow-up care (OR=1.74; CI=1.23, 2.45), and timely appointment for specialty care (OR=1.77; CI=1.24, 2.53). Conclusions Our findings highlight the promise of HIT in improving quality of care, particularly for vulnerable populations who seek care at FQHCs. The results also show that FQHCs may not be maximizing the benefits of HIT. Efforts to implement HIT must include strategies that facilitate the implementation of comprehensive and advanced functionalities, as well as promote meaningful use of these systems. Further examination of the role of health information systems in clinical decision-making and improvements in patient outcomes are needed to better understand the benefits of HIT in improving overall quality of care. PMID:23363660

Health information technology capacity at federally qualified health centers: a mechanism for improving quality of care.

PubMed

Frimpong, Jemima A; Jackson, Bradford E; Stewart, LaShonda M; Singh, Karan P; Rivers, Patrick A; Bae, Sejong

2013-01-31

The adoption of health information technology has been recommended as a viable mechanism for improving quality of care and patient health outcomes. However, the capacity of health information technology (i.e., availability and use of multiple and advanced functionalities), particularly in federally qualified health centers (FQHCs) on improving quality of care is not well understood. We examined associations between health information technology (HIT) capacity at FQHCs and quality of care, measured by the receipt of discharge summary, frequency of patients receiving reminders/notifications for preventive care/follow-up care, and timely appointment for specialty care. The analyses used 2009 data from the National Survey of Federally Qualified Health Centers. The study included 776 of the FQHCs that participated in the survey. We examined the extent of HIT use and tested the hypothesis that level of HIT capacity is associated with quality of care. Multivariable logistic regressions, reporting unadjusted and adjusted odds ratios, were used to examine whether 'FQHCs' HIT capacity' is associated with the outcome measures. The results showed a positive association between health information technology capacity and quality of care. FQHCs with higher HIT capacity were significantly more likely to have improved quality of care, measured by the receipt of discharge summaries (OR=1.43; CI=1.01, 2.40), the use of a patient notification system for preventive and follow-up care (OR=1.74; CI=1.23, 2.45), and timely appointment for specialty care (OR=1.77; CI=1.24, 2.53). Our findings highlight the promise of HIT in improving quality of care, particularly for vulnerable populations who seek care at FQHCs. The results also show that FQHCs may not be maximizing the benefits of HIT. Efforts to implement HIT must include strategies that facilitate the implementation of comprehensive and advanced functionalities, as well as promote meaningful use of these systems. Further examination of the role of health information systems in clinical decision-making and improvements in patient outcomes are needed to better understand the benefits of HIT in improving overall quality of care.

Examining the use of HIT functions among physicians serving minority populations.

PubMed

Tarver, Will; Menachemi, Nir

2014-02-01

The Institute of Medicine highlighted the fact that the U.S. health care system does not provide consistent, high quality medical care to all people. The routine use of health information technology (HIT) that includes certain key functions may be critical in reducing such disparities. We used logistic regression analyses to examine differences when it comes to the routine use of key HIT functions that are linked to improvements in clinical care. Physicians predominantly serving Black patients were more likely than physicians predominantly serving White patients to routinely use HIT to generate reminders for clinicians and patients about preventive services. Similarly, physicians predominantly serving Hispanic patients were more likely than physicians predominantly serving White patients to routinely use HIT to access patients' preferred language. Importantly, although minority-serving institutions have lower adoption rates overall, differences exist in the routine use of key HIT functions that have the potential to reduce health disparities.

Data Quality Monitoring System for New GEM Muon Detectors for the CMS Experiment Upgrade

NASA Astrophysics Data System (ADS)

King, Robert; CMS Muon Group Team

2017-01-01

The Gas Electron Multiplier (GEM) detectors are novel detectors designed to improve the muon trigger and tracking performance in CMS experiment for the high luminosity upgrade of the LHC. Partial installation of GEM detectors is planned during the 2016-2017 technical stop. Before the GEM system is installed underground, its data acquisition (DAQ) electronics must be thoroughly tested. The DAQ system includes several commercial and custom-built electronic boards running custom firmware. The front-end electronics are radiation-hard and communicate via optical fibers. The data quality monitoring (DQM) software framework has been designed to provide online verification of the integrity of the data produced by the detector electronics, and to promptly identify potential hardware or firmware malfunctions in the system. Local hits reconstruction and clustering algorithms allow quality control of the data produced by each GEM chamber. Once the new detectors are installed, the DQM will monitor the stability and performance of the system during normal data-taking operations. We discuss the design of the DQM system, the software being developed to read out and process the detector data, and the methods used to identify and report hardware and firmware malfunctions of the system.

Tests of the Monte Carlo simulation of the photon-tagger focal-plane electronics at the MAX IV Laboratory

NASA Astrophysics Data System (ADS)

Preston, M. F.; Myers, L. S.; Annand, J. R. M.; Fissum, K. G.; Hansen, K.; Isaksson, L.; Jebali, R.; Lundin, M.

2014-04-01

Rate-dependent effects in the electronics used to instrument the tagger focal plane at the MAX IV Laboratory were recently investigated using the novel approach of Monte Carlo simulation to allow for normalization of high-rate experimental data acquired with single-hit time-to-digital converters (TDCs). The instrumentation of the tagger focal plane has now been expanded to include multi-hit TDCs. The agreement between results obtained from data taken using single-hit and multi-hit TDCs demonstrate a thorough understanding of the behavior of the detector system.

Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: a report of an AMIA special task force.

PubMed

Goodman, Kenneth W; Berner, Eta S; Dente, Mark A; Kaplan, Bonnie; Koppel, Ross; Rucker, Donald; Sands, Daniel Z; Winkelstein, Peter

2011-01-01

The current commercial health information technology (HIT) arena encompasses a number of competing firms that provide electronic health applications to hospitals, clinical practices, and other healthcare-related entities. Such applications collect, store, and analyze patient information. Some vendors incorporate contract language whereby purchasers of HIT systems, such as hospitals and clinics, must indemnify vendors for malpractice or personal injury claims, even if those events are not caused or fostered by the purchasers. Some vendors require contract clauses that force HIT system purchasers to adopt vendor-defined policies that prevent the disclosure of errors, bugs, design flaws, and other HIT-software-related hazards. To address this issue, the AMIA Board of Directors appointed a Task Force to provide an analysis and insights. Task Force findings and recommendations include: patient safety should trump all other values; corporate concerns about liability and intellectual property ownership may be valid but should not over-ride all other considerations; transparency and a commitment to patient safety should govern vendor contracts; institutions are duty-bound to provide ethics education to purchasers and users, and should commit publicly to standards of corporate conduct; and vendors, system purchasers, and users should encourage and assist in each others' efforts to adopt best practices. Finally, the HIT community should re-examine whether and how regulation of electronic health applications could foster improved care, public health, and patient safety.

Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: a report of an AMIA special task force

PubMed Central

Berner, Eta S; Dente, Mark A; Kaplan, Bonnie; Koppel, Ross; Rucker, Donald; Sands, Daniel Z; Winkelstein, Peter

2010-01-01

The current commercial health information technology (HIT) arena encompasses a number of competing firms that provide electronic health applications to hospitals, clinical practices, and other healthcare-related entities. Such applications collect, store, and analyze patient information. Some vendors incorporate contract language whereby purchasers of HIT systems, such as hospitals and clinics, must indemnify vendors for malpractice or personal injury claims, even if those events are not caused or fostered by the purchasers. Some vendors require contract clauses that force HIT system purchasers to adopt vendor-defined policies that prevent the disclosure of errors, bugs, design flaws, and other HIT-software-related hazards. To address this issue, the AMIA Board of Directors appointed a Task Force to provide an analysis and insights. Task Force findings and recommendations include: patient safety should trump all other values; corporate concerns about liability and intellectual property ownership may be valid but should not over-ride all other considerations; transparency and a commitment to patient safety should govern vendor contracts; institutions are duty-bound to provide ethics education to purchasers and users, and should commit publicly to standards of corporate conduct; and vendors, system purchasers, and users should encourage and assist in each others' efforts to adopt best practices. Finally, the HIT community should re-examine whether and how regulation of electronic health applications could foster improved care, public health, and patient safety. PMID:21075789

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation.

PubMed

Yen, Po-Yin; McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-09-07

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. ©Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 07.09.2017.

Universal Hitting Time Statistics for Integrable Flows

NASA Astrophysics Data System (ADS)

Dettmann, Carl P.; Marklof, Jens; Strömbergsson, Andreas

2017-02-01

The perceived randomness in the time evolution of "chaotic" dynamical systems can be characterized by universal probabilistic limit laws, which do not depend on the fine features of the individual system. One important example is the Poisson law for the times at which a particle with random initial data hits a small set. This was proved in various settings for dynamical systems with strong mixing properties. The key result of the present study is that, despite the absence of mixing, the hitting times of integrable flows also satisfy universal limit laws which are, however, not Poisson. We describe the limit distributions for "generic" integrable flows and a natural class of target sets, and illustrate our findings with two examples: the dynamics in central force fields and ellipse billiards. The convergence of the hitting time process follows from a new equidistribution theorem in the space of lattices, which is of independent interest. Its proof exploits Ratner's measure classification theorem for unipotent flows, and extends earlier work of Elkies and McMullen.

High-Intensity Training Improves Global and Segmental Strains in Severe Congestive Heart Failure.

PubMed

Blumberg, Yair; Ertracht, Offir; Gershon, Itai; Bachner-Hinenzon, Noa; Reuveni, Tali; Atar, Shaul

2017-05-01

High-intensity training (HIT) is superior to moderate aerobic training (MAT) for improving quality of life in congestive heart failure (CHF) patients. Speckle-tracking echocardiography (STE) has recently been suggested for estimation of left ventricle global and regional function. We evaluated the utility of STE for characterizing differences in cardiac function following MAT or HIT in a CHF rat model. After baseline physiologic assessment, CHF was induced by means of coronary artery ligation in Sprague-Dawley rats. Repeated measurements confirmed the presence of CHF (ejection fraction 52 ± 10%, global circumferential strain (GCS) 10.5 ± 4, and maximal oxygen uptake (V˙O 2 max ) 71 ± 11 mL⋅min -1 ⋅kg -1 ; P < .001 vs baseline for all). Subsequently, rats were divided into training protocols: sedentary (SED), MAT, or HIT. After the training period, rats underwent the same measurements and were killed. Training intensity improved V˙O 2 max (73 ± 13 mL⋅min -1 ⋅kg -1 in MAT [P < .01 vs baseline] and 82 ± 6 mL⋅min -1 ⋅kg -1 in HIT [P < .05 vs baseline or SED] and ejection fraction (50 ± 21% in MAT [P < .001 vs baseline] and 66 ± 7% in HIT [P > .05 vs baseline]). In addition, strains of specific segments adjacent to the infarct zone regained basal values (P > .05 vs baseline), whereas global cardiac functional parameters as assessed with the use of 2-dimensional echocardiography did not improve. High-intensity exercise training improved function in myocardial segments remote from the scar, which resulted in compensatory cardiac remodeling. This effect is prominent, yet it could be detected only with the use of STE. Copyright © 2017 Elsevier Inc. All rights reserved.

Experimental Study of Inertial Particle-Pair Relative Velocity in Isotropic Turbulence

NASA Astrophysics Data System (ADS)

Dou, Zhongwang

The investigation of turbulence-enhanced inertial particle collision in isotropic turbulence could improve our understanding and modeling of many particle-laden turbulent flows in engineering and nature. In this study, we investigate one of the most critical factors of particle collision - particle-pair relative velocity (RV) in three major steps. First, to generate a reliable homogeneous and isotropic turbulence (HIT) field, we have designed and implemented a high Reynolds number (R lambda), enclosed, fan-driven HIT chamber in the shape of 'soccer ball', conducive for studying inertial particle dynamics using whole-field imaging techniques. The characterization of turbulence in this near-zero-mean flow chamber was performed using a new two-scale particle imaging velocimetry (PIV) approach. The measurement results showed that turbulence in the apparatus achieved high homogeneity and isotropy in a large central region (48mm diameter) of the chamber with minimized gravity effect. A maximum Rlambda of 384 was achieved. Second, to measure particle-pair RV accurately, we have employed numerical experiments to systemically analyze the measurement error in the previous particle-pair RV measurement by holographic PIV. We found that accurate RV measurement requires high accuracy of both particle positioning and particle pairing. To meet these requirements, we have devised a novel planar 4-frame particle tracking velocimetry technique (4F-PTV) combining two PIV systems. It tracks particles in four consecutive frames in high speed to increase particle pairing accuracy. Furthermore, the particles are tracked only in a thin laser light sheet, thus negating the intrinsic position uncertainty in the depth direction in holographic PIV. In addition, we have studied the laser thickness effect on the RV measurement and attempted to use Monte Carlo analysis to correct this effect. Third, and most importantly, to better understand turbulence-enhanced inertial particle collision, we have systematically investigated the effects of Reynolds number and Stokes number (St) on particle-pair RV using the planar 4F-PTV technique in the HIT chamber. Two experiments were performed: varying Rlambda between 246 and 357 at six fixed St values, and varying St between 0.02 and 4.63 at five fixed Rlambda values. Measured mean inward particle-pair RV as a function of separation distance r were compared against DNS under closely matched conditions. At all experimental conditions, an excellent agreement was achieved except when particle separation distance r<˜10eta (eta : Kolmogorov length scale), where experimental was consistently higher, possibly due to particle polydispersity and finite laser thickness in experiment. Through these three steps, we found that, at any fixed St, the mean inward particle-pair RV, was essentially independent of Rlambda, echoing DNS findings by Ireland et al. (2016a). At any fixed R lambda, increased with St at small r, showing dominance of the path-history effect in the dissipation range when St ≥ O(1), but decreased with St at large r, indicating dominance of the inertial filtering effect. What I provided here are the first experimental observation of the independence of mean inward particle-pair RV on Reynolds number, and the first experimental observation of these two mechanisms on the mean inward particle-pair RV over a large range of particle separation distances.

Communications Patterns in a Symbolic Multiprocessor.

DTIC Science & Technology

1987-06-01

instruction references that Multilisp programs make. The cache hit ratio is greatest when instruction references have a high degree of -- locality. Another...future touches hit an undetermined future. N, The only exception is Consim, in which one third of future touches hit unde- termined futures. Task...Cambridge, MA, June 1985. [52] S. Sugimoto, K. Agusa, K. Tabata , and Y. Ohno. A multi-microprocessor system for concurrent Lisp. In Proceedings of

Measuring mid-rapidity multiplicity in PHOBOS

NASA Astrophysics Data System (ADS)

Iordanova, Aneta; Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Chai, Z.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Halliwell, C.; Hamblen, J.; Hauer, M.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Holynski, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Seals, H.; Sedykh, I.; Smith, C. E.; Stankiewicz, M. A.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Vaurynovich, S. S.; Verdier, R.; Veres, G. I.; Wenger, E.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wyslouch, B.; PHOBOS Collaboration

2005-01-01

Several techniques have been developed by PHOBOS for measuring the multiplicity of charged particles produced in Au + Au collisions. We will discuss one of these techniques (the 'Tracklet' method) which utilizes two-hit tracks which intersect at the reconstructed collision vertex position. The physics that comes from these measurements can give valuable insight into the underlying mechanisms of particle production over a center of mass energy range of surdSNN = 19.6 GeV to the maximum RHIC energy of surdSNN = 200 GeV.

Logistics Implications of the B-52G in a Conventional Role in Support of the Air Land Battle and Beyond

DTIC Science & Technology

1988-01-01

Operation. This regulation details the concepts and capabilities for the mobility of SAC forces in support of contingency operations. Also, 28-43 defines...cases may be quite significant stand off ranges, the SOM must be capable of hitting small, hardened, and sometimes mobile targets all with using a...radar will allow for detection and tracking of smaller more mobile targets. This calculation presupposes the need for such a modification and can be

On the accuracy of the Head Impact Telemetry (HIT) System used in football helmets.

PubMed

Jadischke, Ron; Viano, David C; Dau, Nathan; King, Albert I; McCarthy, Joe

2013-09-03

On-field measurement of head impacts has relied on the Head Impact Telemetry (HIT) System, which uses helmet mounted accelerometers to determine linear and angular head accelerations. HIT is used in youth and collegiate football to assess the frequency and severity of helmet impacts. This paper evaluates the accuracy of HIT for individual head impacts. Most HIT validations used a medium helmet on a Hybrid III head. However, the appropriate helmet is large based on the Hybrid III head circumference (58 cm) and manufacturer's fitting instructions. An instrumented skull cap was used to measure the pressure between the head of football players (n=63) and their helmet. The average pressure with a large helmet on the Hybrid III was comparable to the average pressure from helmets used by players. A medium helmet on the Hybrid III produced average pressures greater than the 99th percentile volunteer pressure level. Linear impactor tests were conducted using a large and medium helmet on the Hybrid III. Testing was conducted by two independent laboratories. HIT data were compared to data from the Hybrid III equipped with a 3-2-2-2 accelerometer array. The absolute and root mean square error (RMSE) for HIT were computed for each impact (n=90). Fifty-five percent (n=49) had an absolute error greater than 15% while the RMSE was 59.1% for peak linear acceleration. Copyright © 2013 Elsevier Ltd. All rights reserved.

FastSim: A Fast Simulation for the SuperB Detector

NASA Astrophysics Data System (ADS)

Andreassen, R.; Arnaud, N.; Brown, D. N.; Burmistrov, L.; Carlson, J.; Cheng, C.-h.; Di Simone, A.; Gaponenko, I.; Manoni, E.; Perez, A.; Rama, M.; Roberts, D.; Rotondo, M.; Simi, G.; Sokoloff, M.; Suzuki, A.; Walsh, J.

2011-12-01

We have developed a parameterized (fast) simulation for detector optimization and physics reach studies of the proposed SuperB Flavor Factory in Italy. Detector components are modeled as thin sections of planes, cylinders, disks or cones. Particle-material interactions are modeled using simplified cross-sections and formulas. Active detectors are modeled using parameterized response functions. Geometry and response parameters are configured using xml files with a custom-designed schema. Reconstruction algorithms adapted from BaBar are used to build tracks and clusters. Multiple sources of background signals can be merged with primary signals. Pattern recognition errors are modeled statistically by randomly misassigning nearby tracking hits. Standard BaBar analysis tuples are used as an event output. Hadronic B meson pair events can be simulated at roughly 10Hz.

Test beam performance measurements for the Phase I upgrade of the CMS pixel detector

NASA Astrophysics Data System (ADS)

Dragicevic, M.; Friedl, M.; Hrubec, J.; Steininger, H.; Gädda, A.; Härkönen, J.; Lampén, T.; Luukka, P.; Peltola, T.; Tuominen, E.; Tuovinen, E.; Winkler, A.; Eerola, P.; Tuuva, T.; Baulieu, G.; Boudoul, G.; Caponetto, L.; Combaret, C.; Contardo, D.; Dupasquier, T.; Gallbit, G.; Lumb, N.; Mirabito, L.; Perries, S.; Vander Donckt, M.; Viret, S.; Bonnin, C.; Charles, L.; Gross, L.; Hosselet, J.; Tromson, D.; Feld, L.; Karpinski, W.; Klein, K.; Lipinski, M.; Pierschel, G.; Preuten, M.; Rauch, M.; Wlochal, M.; Aldaya, M.; Asawatangtrakuldee, C.; Beernaert, K.; Bertsche, D.; Contreras-Campana, C.; Eckerlin, G.; Eckstein, D.; Eichhorn, T.; Gallo, E.; Garay Garcia, J.; Hansen, K.; Haranko, M.; Harb, A.; Hauk, J.; Keaveney, J.; Kalogeropoulos, A.; Kleinwort, C.; Lohmann, W.; Mankel, R.; Maser, H.; Mittag, G.; Muhl, C.; Mussgiller, A.; Pitzl, D.; Reichelt, O.; Savitskyi, M.; Schütze, P.; Sola, V.; Spannagel, S.; Walsh, R.; Zuber, A.; Biskop, H.; Buhmann, P.; Centis-Vignali, M.; Garutti, E.; Haller, J.; Hoffmann, M.; Klanner, R.; Lapsien, T.; Matysek, M.; Perieanu, A.; Scharf, Ch.; Schleper, P.; Schmidt, A.; Schwandt, J.; Sonneveld, J.; Steinbrück, G.; Vormwald, B.; Wellhausen, J.; Abbas, M.; Amstutz, C.; Barvich, T.; Barth, Ch.; Boegelspacher, F.; De Boer, W.; Butz, E.; Casele, M.; Colombo, F.; Dierlamm, A.; Freund, B.; Hartmann, F.; Heindl, S.; Husemann, U.; Kornmeyer, A.; Kudella, S.; Muller, Th.; Simonis, H. J.; Steck, P.; Weber, M.; Weiler, Th.; Kiss, T.; Siklér, F.; Tölyhi, T.; Veszprémi, V.; Cariola, P.; Creanza, D.; De Palma, M.; De Robertis, G.; Fiore, L.; Franco, M.; Loddo, F.; Sala, G.; Silvestris, L.; Maggi, G.; My, S.; Selvaggi, G.; Albergo, S.; Cappello, G.; Costa, S.; Di Mattia, A.; Giordano, F.; Potenza, R.; Saizu, M. A.; Tricomi, A.; Tuve, C.; Focardi, E.; Dinardo, M. E.; Fiorendi, S.; Gennai, S.; Malvezzi, S.; Manzoni, R. A.; Menasce, D.; Moroni, L.; Pedrini, D.; Azzi, P.; Bacchetta, N.; Bisello, D.; Dall'Osso, M.; Pozzobon, N.; Tosi, M.; Alunni Solestizi, L.; Biasini, M.; Bilei, G. M.; Cecchi, C.; Checcucci, B.; Ciangottini, D.; Fanò, L.; Gentsos, C.; Ionica, M.; Leonardi, R.; Manoni, E.; Mantovani, G.; Marconi, S.; Mariani, V.; Menichelli, M.; Modak, A.; Morozzi, A.; Moscatelli, F.; Passeri, D.; Placidi, P.; Postolache, V.; Rossi, A.; Saha, A.; Santocchia, A.; Storchi, L.; Spiga, D.; Androsov, K.; Azzurri, P.; Bagliesi, G.; Basti, A.; Boccali, T.; Borrello, L.; Bosi, F.; Castaldi, R.; Ceccanti, M.; Ciocci, M. A.; Dell'Orso, R.; Donato, S.; Fedi, G.; Giassi, A.; Grippo, M. T.; Ligabue, F.; Magazzu, G.; Mammini, P.; Mariani, F.; Mazzoni, E.; Messineo, A.; Moggi, A.; Morsani, F.; Palla, F.; Palmonari, F.; Profeti, A.; Raffaelli, F.; Ragonesi, A.; Rizzi, A.; Soldani, A.; Spagnolo, P.; Tenchini, R.; Tonelli, G.; Venturi, A.; Verdini, P. G.; Abbaneo, D.; Ahmed, I.; Albert, E.; Auzinger, G.; Berruti, G.; Bonnaud, J.; Daguin, J.; D'Auria, A.; Detraz, S.; Dondelewski, O.; Engegaard, B.; Faccio, F.; Frank, N.; Gill, K.; Honma, A.; Kornmayer, A.; Labaza, A.; Manolescu, F.; McGill, I.; Mersi, S.; Michelis, S.; Onnela, A.; Ostrega, M.; Pavis, S.; Peisert, A.; Pernot, J.-F.; Petagna, P.; Postema, H.; Rapacz, K.; Sigaud, C.; Tropea, P.; Troska, J.; Tsirou, A.; Vasey, F.; Verlaat, B.; Vichoudis, P.; Zwalinski, L.; Bachmair, F.; Becker, R.; di Calafiori, D.; Casal, B.; Berger, P.; Djambazov, L.; Donega, M.; Grab, C.; Hits, D.; Hoss, J.; Kasieczka, G.; Lustermann, W.; Mangano, B.; Marionneau, M.; Martinez Ruiz del Arbol, P.; Masciovecchio, M.; Meinhard, M.; Perozzi, L.; Roeser, U.; Starodumov, A.; Tavolaro, V.; Wallny, R.; Zhu, D.; Amsler, C.; Bösiger, K.; Caminada, L.; Canelli, F.; Chiochia, V.; de Cosa, A.; Galloni, C.; Hreus, T.; Kilminster, B.; Lange, C.; Maier, R.; Ngadiuba, J.; Pinna, D.; Robmann, P.; Taroni, S.; Yang, Y.; Bertl, W.; Deiters, K.; Erdmann, W.; Horisberger, R.; Kaestli, H.-C.; Kotlinski, D.; Langenegger, U.; Meier, B.; Rohe, T.; Streuli, S.; Chen, P.-H.; Dietz, C.; Fiori, F.; Grundler, U.; Hou, W.-S.; Lu, R.-S.; Moya, M.; Tsai, J.-F.; Tzeng, Y. M.; Cussans, D.; Goldstein, J.; Grimes, M.; Newbold, D.; Hobson, P.; Reid, I. D.; Auzinger, G.; Bainbridge, R.; Dauncey, P.; Hall, G.; James, T.; Magnan, A.-M.; Pesaresi, M.; Raymond, D. M.; Uchida, K.; Durkin, T.; Harder, K.; Shepherd-Themistocleous, C.; Chertok, M.; Conway, J.; Conway, R.; Flores, C.; Lander, R.; Pellett, D.; Ricci-Tam, F.; Squires, M.; Thomson, J.; Yohay, R.; Burt, K.; Ellison, J.; Hanson, G.; Olmedo, M.; Si, W.; Yates, B. R.; Dominguez, A.; Bartek, R.; Bentele, B.; Cumalat, J. P.; Ford, W. T.; Jensen, F.; Johnson, A.; Krohn, M.; Leontsinis, S.; Mulholland, T.; Stenson, K.; Wagner, S. R.; Apresyan, A.; Bolla, G.; Burkett, K.; Butler, J. N.; Canepa, A.; Cheung, H. W. K.; Christian, D.; Cooper, W. E.; Deptuch, G.; Derylo, G.; Gingu, C.; Grünendahl, S.; Hasegawa, S.; Hoff, J.; Howell, J.; Hrycyk, M.; Jindariani, S.; Johnson, M.; Kahlid, F.; Kwan, S.; Lei, C. M.; Lipton, R.; Lopes De Sá, R.; Liu, T.; Los, S.; Matulik, M.; Merkel, P.; Nahn, S.; Prosser, A.; Rivera, R.; Schneider, B.; Sellberg, G.; Shenai, A.; Siehl, K.; Spiegel, L.; Tran, N.; Uplegger, L.; Voirin, E.; Berry, D. R.; Chen, X.; Ennesser, L.; Evdokimov, A.; Gerber, C. E.; Makauda, S.; Mills, C.; Sandoval Gonzalez, I. D.; Alimena, J.; Antonelli, L. J.; Francis, B.; Hart, A.; Hill, C. S.; Parashar, N.; Stupak, J.; Bortoletto, D.; Bubna, M.; Hinton, N.; Jones, M.; Miller, D. H.; Shi, X.; Baringer, P.; Bean, A.; Khalil, S.; Kropivnitskaya, A.; Majumder, D.; Schmitz, E.; Wilson, G.; Ivanov, A.; Mendis, R.; Mitchell, T.; Skhirtladze, N.; Taylor, R.; Anderson, I.; Fehling, D.; Gritsan, A.; Maksimovic, P.; Martin, C.; Nash, K.; Osherson, M.; Swartz, M.; Xiao, M.; Acosta, J. G.; Cremaldi, L. M.; Oliveros, S.; Perera, L.; Summers, D.; Bloom, K.; Claes, D. R.; Fangmeier, C.; Gonzalez Suarez, R.; Monroy, J.; Siado, J.; Bartz, E.; Gershtein, Y.; Halkiadakis, E.; Kyriacou, S.; Lath, A.; Nash, K.; Osherson, M.; Schnetzer, S.; Stone, R.; Walker, M.; Malik, S.; Norberg, S.; Ramirez Vargas, J. E.; Alyari, M.; Dolen, J.; Godshalk, A.; Harrington, C.; Iashvili, I.; Kharchilava, A.; Nguyen, D.; Parker, A.; Rappoccio, S.; Roozbahani, B.; Alexander, J.; Chaves, J.; Chu, J.; Dittmer, S.; McDermott, K.; Mirman, N.; Rinkevicius, A.; Ryd, A.; Salvati, E.; Skinnari, L.; Soffi, L.; Tao, Z.; Thom, J.; Tucker, J.; Zientek, M.; Akgün, B.; Ecklund, K. M.; Kilpatrick, M.; Nussbaum, T.; Zabel, J.; D'Angelo, P.; Johns, W.; Rose, K.; Choudhury, S.; Korol, I.; Seitz, C.; Vargas Trevino, A.; Dolinska, G.

2017-05-01

A new pixel detector for the CMS experiment was built in order to cope with the instantaneous luminosities anticipated for the Phase I Upgrade of the LHC . The new CMS pixel detector provides four-hit tracking with a reduced material budget as well as new cooling and powering schemes. A new front-end readout chip mitigates buffering and bandwidth limitations, and allows operation at low comparator thresholds. In this paper, comprehensive test beam studies are presented, which have been conducted to verify the design and to quantify the performance of the new detector assemblies in terms of tracking efficiency and spatial resolution. Under optimal conditions, the tracking efficiency is 99.95 ± 0.05%, while the intrinsic spatial resolutions are 4.80 ± 0.25 μm and 7.99 ± 0.21 μm along the 100 μm and 150 μm pixel pitch, respectively. The findings are compared to a detailed Monte Carlo simulation of the pixel detector and good agreement is found.

Search for disappearing tracks in proton-proton collisions at √s = 8 TeV

DOE PAGES

Khachatryan, V.

2015-01-19

In this study, a search is presented for long-lived charged particles that decay within the CMS detector and produce the signature of a disappearing track. Disappearing tracks are identified as those with little or no associated calorimeter energy deposits and with missing hits in the outer layers of the tracker. The search uses proton-proton collision data recorded at √s = 8 TeV that corresponds to an integrated luminosity of 19.5 fb –1. The results of the search are interpreted in the context of the anomaly-mediated supersymmetry breaking (AMSB) model. The number of observed events is in agreement with the backgroundmore » expectation, and limits are set on the cross section of direct electroweak chargino production in terms of the chargino mass and mean proper lifetime. At 95% confidence level, AMSB models with a chargino mass less than 260 GeV, corresponding to a mean proper lifetime of 0.2 ns, are excluded.« less

Evaluation of flow cytometric HIT assays in relation to an IgG-Specific immunoassay and clinical outcome.

PubMed

Kerényi, Adrienne; Beke Debreceni, Ildikó; Oláh, Zsolt; Ilonczai, Péter; Bereczky, Zsuzsanna; Nagy, Béla; Muszbek, László; Kappelmayer, János

2017-09-01

Heparin-induced thrombocytopenia (HIT) is a severe side effect of heparin treatment caused by platelet activating IgG antibodies generated against the platelet factor 4 (PF4)-heparin complex. Thrombocytopenia and thrombosis are the leading clinical symptoms of HIT. The clinical pretest probability of HIT was evaluated by the 4T score system. Laboratory testing of HIT was performed by immunological detection of antibodies against PF4-heparin complex (EIA) and two functional assays. Heparin-dependent activation of donor platelets by patient plasma was detected by flow cytometry. Increased binding of Annexin-V to platelets and elevated number of platelet-derived microparticles (PMP) were the indicators of platelet activation. EIA for IgG isotype HIT antibodies was performed in 405 suspected HIT patients. Based on negative EIA results, HIT was excluded in 365 (90%) of cases. In 40 patients with positive EIA test result functional tests were performed. Platelet activating antibodies were detected in 17 cases by Annexin V binding. PMP count analysis provided nearly identical results. The probability of a positive flow cytometric assay result was higher in patients with elevated antibody titer. 71% of patients with positive EIA and functional assay had thrombosis. EIA is an important first line laboratory test in the diagnosis of HIT; however, HIT must be confirmed by a functional test. Annexin V binding and PMP assays using flow cytometry are functional HIT tests convenient in a clinical diagnostic laboratory. The positive results of functional assays may predict the onset of thrombosis. © 2016 International Clinical Cytometry Society. © 2016 International Clinical Cytometry Society.

Creating a safe place for pediatric care: A no hit zone.

PubMed

Frazier, Erin R; Liu, Gilbert C; Dauk, Kelly L

2014-07-01

Our goal was to create and implement a program, Kosair Children's Hospital's No Hit Zone, which trains health care workers in de-escalation techniques to address parental disruptive behaviors and physical discipline of children commonly encountered in the hospital environment. The Child Abuse Task Force, a multidisciplinary group, along with key hospital administrators developed specific content for the policy, as well as marketing and educational materials. The No Hit Zone policy designates Kosair Children's Hospital as "an environment in which no adult shall hit a child, no adult shall hit another adult, no child shall hit an adult, and no child shall hit another child. When hitting is observed, it is everyone's responsibility to interrupt the behavior as well as communicate system policy to those present." Via a multidisciplinary, collaborative approach, the No Hit Zone was successfully implemented at Kosair Children's Hospital in 2012. Cost was nominal, and the support of key hospital administrators was critical to the program's success. Education of health professionals on de-escalation techniques and intervention with families at the early signs of parental stress occurred via live sessions and online training via case-based scenarios. The No Hit Zone is an important program used to provide a safe and caring environment for all families and staff of Kosair Children's Hospital. Demand for the program continues, demonstrated by the establishment of No Hit Zones at other local hospitals and multiple outpatient clinics. This article offers information for other organizations planning to conduct similar initiatives. Copyright © 2014 by the American Academy of Pediatrics.

42 CFR 495.330 - Termination of FFP for failure to provide access to information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.330 Termination... HIT planning and implementation efforts, and the systems used to interoperate with electronic HIT...

Heparin-Induced Thrombocytopenia Antibody Test

MedlinePlus

... HIT II is clinically suspected. There is a pre-test scoring system that is typically used to determine ... The HIT antibody test is performed when this pre-scoring test shows that a person has a moderate to ...

Performance verification of the CMS Phase-1 Upgrade Pixel detector

NASA Astrophysics Data System (ADS)

Veszpremi, V.

2017-12-01

The CMS tracker consists of two tracking systems utilizing semiconductor technology: the inner pixel and the outer strip detectors. The tracker detectors occupy the volume around the beam interaction region between 3 cm and 110 cm in radius and up to 280 cm along the beam axis. The pixel detector consists of 124 million pixels, corresponding to about 2 m 2 total area. It plays a vital role in the seeding of the track reconstruction algorithms and in the reconstruction of primary interactions and secondary decay vertices. It is surrounded by the strip tracker with 10 million read-out channels, corresponding to 200 m 2 total area. The tracker is operated in a high-occupancy and high-radiation environment established by particle collisions in the LHC . The current strip detector continues to perform very well. The pixel detector that has been used in Run 1 and in the first half of Run 2 was, however, replaced with the so-called Phase-1 Upgrade detector. The new system is better suited to match the increased instantaneous luminosity the LHC would reach before 2023. It was built to operate at an instantaneous luminosity of around 2×1034 cm-2s-1. The detector's new layout has an additional inner layer with respect to the previous one; it allows for more efficient tracking with smaller fake rate at higher event pile-up. The paper focuses on the first results obtained during the commissioning of the new detector. It also includes challenges faced during the first data taking to reach the optimal measurement efficiency. Details will be given on the performance at high occupancy with respect to observables such as data-rate, hit reconstruction efficiency, and resolution.

USER FRUSTRATION IN HIT INTERFACES: EXPLORING PAST HCI RESEARCH FOR A BETTER UNDERSTANDING OF CLINICIANS’ EXPERIENCES

PubMed Central

Opoku-Boateng, Gloria A.

2015-01-01

User frustration research has been one way of looking into clinicians’ experience with health information technology use and interaction. In order to understand how clinician frustration with Health Information Technology (HIT) use occurs, there is the need to explore Human-Computer Interaction (HCI) literature that addresses both frustration and HIT use. In the past three decades, HCI frustration research has increased and expanded. Researchers have done a lot of work to understand emotions, end-user frustration and affect. This paper uses a historical literature review approach to review the origins of emotion and frustration research and explore the research question; Does HCI research on frustration provide insights on clinicians’ frustration with HIT interfaces? From the literature review HCI research on emotion and frustration provides additional insights that can indeed help explain user frustration in HIT. Different approaches and HCI perspectives also help frame HIT user frustration research as well as inform HIT system design. The paper concludes with a suggested directions on how future design and research may take. PMID:26958238

USER FRUSTRATION IN HIT INTERFACES: EXPLORING PAST HCI RESEARCH FOR A BETTER UNDERSTANDING OF CLINICIANS' EXPERIENCES.

PubMed

Opoku-Boateng, Gloria A

2015-01-01

User frustration research has been one way of looking into clinicians' experience with health information technology use and interaction. In order to understand how clinician frustration with Health Information Technology (HIT) use occurs, there is the need to explore Human-Computer Interaction (HCI) literature that addresses both frustration and HIT use. In the past three decades, HCI frustration research has increased and expanded. Researchers have done a lot of work to understand emotions, end-user frustration and affect. This paper uses a historical literature review approach to review the origins of emotion and frustration research and explore the research question; Does HCI research on frustration provide insights on clinicians' frustration with HIT interfaces? From the literature review HCI research on emotion and frustration provides additional insights that can indeed help explain user frustration in HIT. Different approaches and HCI perspectives also help frame HIT user frustration research as well as inform HIT system design. The paper concludes with a suggested directions on how future design and research may take.

Data acquisition system

DOEpatents

Shapiro, Stephen L.; Mani, Sudhindra; Atlas, Eugene L.; Cords, Dieter H. W.; Holbrook, Britt

1997-01-01

A data acquisition circuit for a particle detection system that allows for time tagging of particles detected by the system. The particle detection system screens out background noise and discriminate between hits from scattered and unscattered particles. The detection system can also be adapted to detect a wide variety of particle types. The detection system utilizes a particle detection pixel array, each pixel containing a back-biased PIN diode, and a data acquisition pixel array. Each pixel in the particle detection pixel array is in electrical contact with a pixel in the data acquisition pixel array. In response to a particle hit, the affected PIN diodes generate a current, which is detected by the corresponding data acquisition pixels. This current is integrated to produce a voltage across a capacitor, the voltage being related to the amount of energy deposited in the pixel by the particle. The current is also used to trigger a read of the pixel hit by the particle.

Hit detection in serial femtosecond crystallography using X-ray spectroscopy of plasma emission.

PubMed

Jönsson, H Olof; Caleman, Carl; Andreasson, Jakob; Tîmneanu, Nicuşor

2017-11-01

Serial femtosecond crystallography is an emerging and promising method for determining protein structures, making use of the ultrafast and bright X-ray pulses from X-ray free-electron lasers. The upcoming X-ray laser sources will produce well above 1000 pulses per second and will pose a new challenge: how to quickly determine successful crystal hits and avoid a high-rate data deluge. Proposed here is a hit-finding scheme based on detecting photons from plasma emission after the sample has been intercepted by the X-ray laser. Plasma emission spectra are simulated for systems exposed to high-intensity femtosecond pulses, for both protein crystals and the liquid carrier systems that are used for sample delivery. The thermal radiation from the glowing plasma gives a strong background in the XUV region that depends on the intensity of the pulse, around the emission lines from light elements (carbon, nitrogen, oxygen). Sample hits can be reliably distinguished from the carrier liquid based on the characteristic emission lines from heavier elements present only in the sample, such as sulfur. For buffer systems with sulfur present, selenomethionine substitution is suggested, where the selenium emission lines could be used both as an indication of a hit and as an aid in phasing and structural reconstruction of the protein.

Think of HIT.

PubMed

Warkentin, Theodore E

2006-01-01

Heparin-induced thrombocytopenia, or HIT, can present in many ways, ranging from common-isolated thrombocytopenia, venous thromboembolism, acute limb ischemia-to less common but specific presentations-necrotizing skin lesions at heparin injection sites, post-bolus acute systemic reactions, and adrenal hemorrhagic necrosis (secondary to adrenal vein thrombosis). Many patients with HIT have mild or moderate thrombocytopenia: the median platelet count nadir is 60 x 10(9)/L, and ranges from 15 to 150 x 10(9)/L in 90% of patients, most of whom evince a 50% or greater fall in the platelet count. HIT that begins after stopping heparin ("delayed-onset HIT") is increasingly recognized. Factors influencing risk of HIT include type of heparin (unfractionated heparin > low-molecular-weight heparin), type of patient (surgical > medical), and gender (female > male). Since timely diagnosis and treatment of HIT may reduce the risk of adverse outcomes, this review focuses on those clinical circumstances that should prompt the clinician to "think of HIT." Coumarin anticoagulants such as warfarin are ineffective in acute HIT and can even be deleterious by predisposing to micro-thrombosis via protein C depletion (venous limb gangrene and skin necrosis syndromes). Thus, it is important to avoid or postpone coumarin while managing HIT hypercoagulability, focusing on agents that inhibit thrombin directly (lepirudin, argatroban) or that inhibit its generation (danaparoid, fondaparinux). Post-marketing experience suggests that standard dosing of lepirudin is too high; current recommendations are to avoid the initial lepirudin bolus and to begin with lower infusion rates, even in patients without overt renal dysfunction.

Design and testing of the first 2D Prototype Vertically Integrated Pattern Recognition Associative Memory

NASA Astrophysics Data System (ADS)

Liu, T.; Deptuch, G.; Hoff, J.; Jindariani, S.; Joshi, S.; Olsen, J.; Tran, N.; Trimpl, M.

2015-02-01

An associative memory-based track finding approach has been proposed for a Level 1 tracking trigger to cope with increasing luminosities at the LHC. The associative memory uses a massively parallel architecture to tackle the intrinsically complex combinatorics of track finding algorithms, thus avoiding the typical power law dependence of execution time on occupancy and solving the pattern recognition in times roughly proportional to the number of hits. This is of crucial importance given the large occupancies typical of hadronic collisions. The design of an associative memory system capable of dealing with the complexity of HL-LHC collisions and with the short latency required by Level 1 triggering poses significant, as yet unsolved, technical challenges. For this reason, an aggressive R&D program has been launched at Fermilab to advance state of-the-art associative memory technology, the so called VIPRAM (Vertically Integrated Pattern Recognition Associative Memory) project. The VIPRAM leverages emerging 3D vertical integration technology to build faster and denser Associative Memory devices. The first step is to implement in conventional VLSI the associative memory building blocks that can be used in 3D stacking; in other words, the building blocks are laid out as if it is a 3D design. In this paper, we report on the first successful implementation of a 2D VIPRAM demonstrator chip (protoVIPRAM00). The results show that these building blocks are ready for 3D stacking.

Design and testing of the first 2D Prototype Vertically Integrated Pattern Recognition Associative Memory

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

Liu, T.; Deptuch, G.; Hoff, J.

An associative memory-based track finding approach has been proposed for a Level 1 tracking trigger to cope with increasing luminosities at the LHC. The associative memory uses a massively parallel architecture to tackle the intrinsically complex combinatorics of track finding algorithms, thus avoiding the typical power law dependence of execution time on occupancy and solving the pattern recognition in times roughly proportional to the number of hits. This is of crucial importance given the large occupancies typical of hadronic collisions. The design of an associative memory system capable of dealing with the complexity of HL-LHC collisions and with the shortmore » latency required by Level 1 triggering poses significant, as yet unsolved, technical challenges. For this reason, an aggressive R&D program has been launched at Fermilab to advance state of-the-art associative memory technology, the so called VIPRAM (Vertically Integrated Pattern Recognition Associative Memory) project. The VIPRAM leverages emerging 3D vertical integration technology to build faster and denser Associative Memory devices. The first step is to implement in conventional VLSI the associative memory building blocks that can be used in 3D stacking, in other words, the building blocks are laid out as if it is a 3D design. In this paper, we report on the first successful implementation of a 2D VIPRAM demonstrator chip (protoVIPRAM00). The results show that these building blocks are ready for 3D stacking.« less

Improvements to the ion Doppler spectrometer diagnostic on the HIT-SI experiments.

PubMed

Hossack, Aaron; Chandra, Rian; Everson, Chris; Jarboe, Tom

2018-03-01

An ion Doppler spectrometer diagnostic system measuring impurity ion temperature and velocity on the HIT-SI and HIT-SI3 spheromak devices has been improved with higher spatiotemporal resolution and lower error than previously described devices. Hardware and software improvements to the established technique have resulted in a record of 6.9 μs temporal and ≤2.8 cm spatial resolution in the midplane of each device. These allow Ciii and Oii flow, displacement, and temperature profiles to be observed simultaneously. With 72 fused-silica fiber channels in two independent bundles, and an f/8.5 Czerny-Turner spectrometer coupled to a video camera, frame rates of up to ten times the imposed magnetic perturbation frequency of 14.5 kHz were achieved in HIT-SI, viewing the upper half of the midplane. In HIT-SI3, frame rates of up to eight times the perturbation frequency were achieved viewing both halves of the midplane. Biorthogonal decomposition is used as a novel filtering tool, reducing uncertainty in ion temperature from ≲13 to ≲5 eV (with an instrument temperature of 8-16 eV) and uncertainty in velocity from ≲2 to ≲1 km/s. Doppler shift and broadening are calculated via the Levenberg-Marquardt algorithm, after which the errors in velocity and temperature are uniquely specified. Axisymmetric temperature profiles on HIT-SI3 for Ciii peaked near the inboard current separatrix at ≈40 eV are observed. Axisymmetric plasma displacement profiles have been measured on HIT-SI3, peaking at ≈6 cm at the outboard separatrix. Both profiles agree with the upper half of the midplane observable by HIT-SI. With its complete midplane view, HIT-SI3 has unambiguously extracted axisymmetric, toroidal current dependent rotation of up to 3 km/s. Analysis of the temporal phase of the displacement uncovers a coherent structure, locked to the applied perturbation. Previously described diagnostic systems could not achieve such results.

Improvements to the ion Doppler spectrometer diagnostic on the HIT-SI experiments

NASA Astrophysics Data System (ADS)

Hossack, Aaron; Chandra, Rian; Everson, Chris; Jarboe, Tom

2018-03-01

An ion Doppler spectrometer diagnostic system measuring impurity ion temperature and velocity on the HIT-SI and HIT-SI3 spheromak devices has been improved with higher spatiotemporal resolution and lower error than previously described devices. Hardware and software improvements to the established technique have resulted in a record of 6.9 μs temporal and ≤2.8 cm spatial resolution in the midplane of each device. These allow Ciii and Oii flow, displacement, and temperature profiles to be observed simultaneously. With 72 fused-silica fiber channels in two independent bundles, and an f/8.5 Czerny-Turner spectrometer coupled to a video camera, frame rates of up to ten times the imposed magnetic perturbation frequency of 14.5 kHz were achieved in HIT-SI, viewing the upper half of the midplane. In HIT-SI3, frame rates of up to eight times the perturbation frequency were achieved viewing both halves of the midplane. Biorthogonal decomposition is used as a novel filtering tool, reducing uncertainty in ion temperature from ≲13 to ≲5 eV (with an instrument temperature of 8-16 eV) and uncertainty in velocity from ≲2 to ≲1 km/s. Doppler shift and broadening are calculated via the Levenberg-Marquardt algorithm, after which the errors in velocity and temperature are uniquely specified. Axisymmetric temperature profiles on HIT-SI3 for Ciii peaked near the inboard current separatrix at ≈40 eV are observed. Axisymmetric plasma displacement profiles have been measured on HIT-SI3, peaking at ≈6 cm at the outboard separatrix. Both profiles agree with the upper half of the midplane observable by HIT-SI. With its complete midplane view, HIT-SI3 has unambiguously extracted axisymmetric, toroidal current dependent rotation of up to 3 km/s. Analysis of the temporal phase of the displacement uncovers a coherent structure, locked to the applied perturbation. Previously described diagnostic systems could not achieve such results.

Improvements to the Ion Doppler Spectrometer Diagnostic on the HIT-SI Experiments

DOE PAGES

Hossack, Aaron; Chandra, Rian; Everson, Christopher; ...

2018-03-09

An Ion Doppler Spectrometer diagnostic system measuring impurity ion temperature and velocity on the HIT-SI and HIT-SI3 spheromak devices has been improved with higher spatiotemporal resolution and lower error than previously described devices. Hardware and software improvements to the established technique have resulted in a record 6.9 µs temporal and <=2.8 cm spatial resolution in the midplane of each device. These allow C III and O II flow, displacement, and temperature profiles to be simultaneously observed. With 72 fused-silica fiber channels in two independent bundles, and an f/8.5 Czerny-Turner spectrometer coupled to video camera, frame-rates of up to ten timesmore » the imposed magnetic perturbation frequency of 14.5 kHz were achieved in HIT-SI, viewing the upper 1/2 of the midplane. In HIT-SI3 frame-rates of up to eight times the perturbation frequency were achieved viewing both halves of the midplane. Biorthogonal Decomposition is used as a novel filtering tool, reducing uncertainty in ion temperature from <=13 to <=5 eV (with an instrument temperature of 8-16 eV), and uncertainty in velocity from <=2 to <=1 km/s. Doppler shift and broadening is calculated via the Levenberg-Marquart algorithm, after which errors in velocity and temperature are uniquely specified. Axisymmetric temperature profiles on HIT-SI3 for C III peaked near the inboard current separatrix at approximately 40 eV are observed. Axisymmetric plasma displacement profiles have been measured on HIT-SI3, peaking at approximately 6 cm at the outboard separatrix. Both profiles agree with the upper half of the midplane observable by HIT-SI. With its complete midplane view, HIT-SI3 has unambiguously extracted axisymmetric, toroidal current dependent rotation of up to 3 km/s. Analysis of the temporal phase of the displacement uncovers a coherent structure, locked to the applied perturbation. Previously described diagnostic systems could not achieve such results.« less

Improvements to the Ion Doppler Spectrometer Diagnostic on the HIT-SI Experiments

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

Hossack, Aaron; Chandra, Rian; Everson, Christopher

An Ion Doppler Spectrometer diagnostic system measuring impurity ion temperature and velocity on the HIT-SI and HIT-SI3 spheromak devices has been improved with higher spatiotemporal resolution and lower error than previously described devices. Hardware and software improvements to the established technique have resulted in a record 6.9 µs temporal and <=2.8 cm spatial resolution in the midplane of each device. These allow C III and O II flow, displacement, and temperature profiles to be simultaneously observed. With 72 fused-silica fiber channels in two independent bundles, and an f/8.5 Czerny-Turner spectrometer coupled to video camera, frame-rates of up to ten timesmore » the imposed magnetic perturbation frequency of 14.5 kHz were achieved in HIT-SI, viewing the upper 1/2 of the midplane. In HIT-SI3 frame-rates of up to eight times the perturbation frequency were achieved viewing both halves of the midplane. Biorthogonal Decomposition is used as a novel filtering tool, reducing uncertainty in ion temperature from <=13 to <=5 eV (with an instrument temperature of 8-16 eV), and uncertainty in velocity from <=2 to <=1 km/s. Doppler shift and broadening is calculated via the Levenberg-Marquart algorithm, after which errors in velocity and temperature are uniquely specified. Axisymmetric temperature profiles on HIT-SI3 for C III peaked near the inboard current separatrix at approximately 40 eV are observed. Axisymmetric plasma displacement profiles have been measured on HIT-SI3, peaking at approximately 6 cm at the outboard separatrix. Both profiles agree with the upper half of the midplane observable by HIT-SI. With its complete midplane view, HIT-SI3 has unambiguously extracted axisymmetric, toroidal current dependent rotation of up to 3 km/s. Analysis of the temporal phase of the displacement uncovers a coherent structure, locked to the applied perturbation. Previously described diagnostic systems could not achieve such results.« less

Measuring Workload Demand of Informatics Systems with the Clinical Case Demand Index

PubMed Central

Iyengar, M. Sriram; Rogith, Deevakar; Florez-Arango, Jose F

2017-01-01

Introduction: The increasing use of Health Information Technology (HIT) can add substantially to workload on clinical providers. Current methods for assessing workload do not take into account the nature of clinical cases and the use of HIT tools while solving them. Methods: The Clinical Case Demand Index (CCDI), consisting of a summary score and visual representation, was developed to meet this need. Consistency with current perceived workload measures was evaluated in a Randomized Control Trial of a mobile health system. Results: CCDI is significantly correlated with existing workload measures and inversely related to provider performance. Discussion: CCDI combines subjective and objective characteristics of clinical cases along with cognitive and clinical dimensions. Applications include evaluation of HIT tools, clinician scheduling, medical education. Conclusion: CCDI supports comparative effectiveness research of HIT tools. In addition, CCDI could have numerous applications including training, clinical trials, design of clinical workflows, and others. PMID:29854166

Achieving U.S. Health information technology adoption: the need for a third hand.

PubMed

Middleton, Blackford

2005-01-01

The U.S. health care information technology (HIT) market is broken; broad-scale adoption of HIT is not occurring despite considerable evidence of its impact on the quality of care and patient safety. Although adoption of HIT will not cure all that ails health care, it is an important step toward transformation of the U.S. health care delivery system. In this commentary I describe several critical issues pertaining to the HIT market failure and several ways in which the federal government may act as a deft and gentle "Third Hand" to assist the Invisible Hand of Adam Smith.

Heavy ion action on yeast cells: Inhibition of ribosomal-RNA synthesis, loss of colony forming ability and induction of mutants

NASA Astrophysics Data System (ADS)

Kiefer, J.; Rase, S.; Schöpfer, F.; Schneider, E.; Weber, K.; Kraft, G.

The action of heavy ions (Ar to U) accelerated to specific energies up to about 10 MeV/u (u=atomic mass unit) on different functions of yeast cells was studied. Ribosomal-RNA synthesis is inhibited according to a single-hit mechanism. Inactivation cross-sections were linearly related to the ratio of the squares of the effective charge Z* and the velocity of the ions. It is concluded from the analysis that the range of the most energetic δ-electrons is larger than previously assumed. There is no such dependence for survival and induction of mutants. In both cases cross-sections increase with the ion's specific-energy indicating an important contribution of long-range δ-electrons. The analysis shows that diploid yeast is not killed by a single-hit mechanism even by very heavy ions if the track width is too small. The relative importance of the penumbral region is even more pronounced with the more sensitive strains.

USN shipboard infrared search and track (IRST) program

NASA Astrophysics Data System (ADS)

Misanin, Joseph E.

1997-08-01

On May 17, 1987 two EXOCET missiles hit and crippled the frigate USS STARK. Thirty seven sailors lost their lives due to the inability of the ship to defend itself against a sea- skimming cruise missile attack. In 1991, as a result of this incident, Congress mandated the establishment of a Program Executive Office for Ship Self Defense. The purpose of the legislation was to preclude another incident by placing a high priority on the combat system engineering process used to design and field the anti-ship cruise missile (ASCM) defense capability of surface ships. Over 35 countries now have sea- skimming ASCMs and this type of threat continues to proliferate. The use of IRST is a critical element of ship self defense, providing early and reliable detection of sea- skimming cruise missiles. This paper describes the contribution of IRST in providing self-defense and the current status of the United States Navy (USN) shipboard IRST development program.

Increased Health Information Technology Adoption and Use Among Small Primary Care Physician Practices Over Time: A National Cohort Study.

PubMed

Rittenhouse, Diane R; Ramsay, Patricia P; Casalino, Lawrence P; McClellan, Sean; Kandel, Zosha K; Shortell, Stephen M

2017-01-01

Implementation and meaningful use of health information technology (HIT) has been shown to facilitate delivery system transformation, yet implementation is far from universal. This study examined correlates of greater HIT implementation over time among a national cohort of small primary care practices in the United States. We used data from a 40-minute telephone panel survey of 566 small primary care practices having 8 or fewer physicians to investigate adoption and use of HIT in 2007-2010 and 2012-2013. We used generalized estimating equations (GEE) to estimate the association of practice characteristics and external incentives with the adoption and use of HIT. We studied 18 measures of HIT functionalities, including record keeping, clinical decision support, patient communication, and health information exchange with hospitals and pharmacies. Overall, use of 16 HIT functionalities increased significantly over time, whereas use of 2 decreased significantly. On average, compared with physician-owned practices, hospital-owned practices used 1.48 (95% CI, 1.07-1.88; P <.001) more HIT processes. And relative to smaller practices, practices with 3 to 8 physicians used 2.49 (95% CI, 2.26-2.72; P <.001) more HIT processes. Participation in pay-for-performance programs, participation in public reporting of clinical quality data, and a larger proportion of revenue from Medicare were also associated with greater adoption and use of HIT. The new Medicare Access and CHIP Reauthorization Act (MACRA) will provide payment incentives and technical support to speed HIT adoption and use by small practices. We found that external incentives were, indeed, positively associated with greater adoption and use of HIT. Our findings also support a strategy of targeting assistance to smaller physician practices and those that are physician owned. © 2017 Annals of Family Medicine, Inc.

Getting Hit by Pitch in Professional Baseball: Analysis of Injury Patterns, Risk Factors, Concussions, and Days Missed for Batters.

PubMed

Camp, Christopher L; Wang, Dean; Sinatro, Alec S; D'Angelo, John; Coleman, Struan H; Dines, Joshua S; Fealy, Stephen; Conte, Stan

2018-05-01

Although batters are frequently hit by pitch (HBP) in baseball, the effect of HBP injuries remains undefined in the literature. To determine the effect of HBP injuries in terms of time out of play, injury patterns resulting in the greatest time out of play, and the value of protective gear such as helmets and elbow pads. Descriptive laboratory study. Based on the Major League Baseball (MLB) Health and Injury Tracking System, all injuries to batters HBP during the 2011-2015 MLB and Minor League Baseball (MiLB) seasons were identified and analyzed. Video analysis was performed on all HBP events from the 2015 MLB season. Multivariate stepwise regression analysis was utilized to determine the predictive capacity of multiple variables (velocity, pitch type, location, etc) on injury status and severity. A total of 2920 HBP injuries resulted in 24,624 days missed (DM) over the 5 seasons. MLB HBP injuries occurred at a rate of 1 per 2554 plate appearances (1 per 9780 pitches thrown). Mean DM per injury were 8.4 (11.7 for MLB vs 8.0 for MiLB, P < .001). Surgery was required for 3.1% of MLB injuries and 1.2% of MiLB injuries ( P = .005). The most common body regions injured were the hand/fingers (n = 638, 21.8%), head/face (n = 497, 17.0%), and elbow (n = 440, 15.7%), and there were 146 (5.0%) concussions. Injury rates and mean DM correlated with velocity in a near linear fashion. Players hit in the head/face (odds ratio, 28.7) or distal upper extremity (odds ratio, 6.4) were more likely to be injured than players HBP in other locations. Players with an unprotected elbow missed 1.7 more days (95% CI, -4.1 to 7.6) than those with an elbow protector ( P = .554) when injured after being HBP. Although HBP injuries occur infrequently in the course of normal play, they collectively represent a significant source of time out of play. The most common body regions injured include the hands/fingers and head/face, and batters hit in these locations are significantly more likely to be injured. After contusions, concussions were the most common injury diagnosis.

Studies on fast triggering and high precision tracking with Resistive Plate Chambers

NASA Astrophysics Data System (ADS)

Aielli, G.; Ball, R.; Bilki, B.; Chapman, J. W.; Cardarelli, R.; Dai, T.; Diehl, E.; Dubbert, J.; Ferretti, C.; Feng, H.; Francis, K.; Guan, L.; Han, L.; Hou, S.; Levin, D.; Li, B.; Liu, L.; Paolozzi, L.; Repond, J.; Roloff, J.; Santonico, R.; Song, H. Y.; Wang, X. L.; Wu, Y.; Xia, L.; Xu, L.; Zhao, T.; Zhao, Z.; Zhou, B.; Zhu, J.

2013-06-01

We report on studies of fast triggering and high precision tracking using Resistive Plate Chambers (RPCs). Two beam tests were carried out with the 180 GeV/c muon beam at CERN using glass RPCs with gas gaps of 1.15 mm and equipped with readout strips with 1.27 mm pitch. This is the first beam test of RPCs with fine-pitch readout strips that explores precision tracking and triggering capabilities. RPC signals were acquired with precision timing and charge integrating readout electronics at both ends of the strips. The time resolution was measured to be better than 600 ps and the average spatial resolution was found to be 220 μm using charge information and 287 μm only using signal arrival time information. The dual-ended readout allows the determination of the average and the difference of the signal arrival times. The average time was found to be independent of the incident particle position along the strip and is useful for triggering purposes. The time difference yielded a determination of the hit position with a precision of 7.5 mm along the strip. These results demonstrate the feasibility using RPCs for fast and high-resolution triggering and tracking.

A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue.

PubMed

Behkami, Nima A; Dorr, David A; Morrice, Stuart

2010-01-01

The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis.

IA-Regional-Radio - Social Network for Radio Recommendation

NASA Astrophysics Data System (ADS)

Dziczkowski, Grzegorz; Bougueroua, Lamine; Wegrzyn-Wolska, Katarzyna

This chapter describes the functions of a system proposed for the music hit recommendation from social network data base. This system carries out the automatic collection, evaluation and rating of music reviewers and the possibility for listeners to rate musical hits and recommendations deduced from auditor's profiles in the form of regional Internet radio. First, the system searches and retrieves probable music reviews from the Internet. Subsequently, the system carries out an evaluation and rating of those reviews. From this list of music hits, the system directly allows notation from our application. Finally, the system automatically creates the record list diffused each day depending on the region, the year season, the day hours and the age of listeners. Our system uses linguistics and statistic methods for classifying music opinions and data mining techniques for recommendation part needed for recorded list creation. The principal task is the creation of popular intelligent radio adaptive on auditor's age and region - IA-Regional-Radio.

Revisiting adoption of high transmission PSM: pros, cons and path forward

NASA Astrophysics Data System (ADS)

Ma, Z. Mark; McDonald, Steve; Progler, Chris

2009-12-01

High transmission attenuated phase shift masks (Hi-T PSM) have been successfully applied in volume manufacturing for certain memory devices. Moreover, numerous studies have shown the potential benefits of Hi-T PSM for specific lithography applications. In this paper, the potential for extending Hi-T PSM to logic devices, is revisited with an emphasis on understanding layout, transmission, and manufacturing of Hi-T PSM versus traditional 6% embedded attenuated phase shift mask (EAPSM). Simulations on various layouts show Hi-T PSM has advantage over EAPSM in low duty cycle line patterns and high duty cycle space patterns. The overall process window can be enhanced when Hi- T PSM is combined with optimized optical proximity correction (OPC), sub-resolution assist features (SRAF), and source illumination. Therefore, Hi-T PSM may be a viable and lower cost alternative to other complex resolution enhancement technology (RET) approaches. Aerial image measurement system (AIMS) results on test masks, based on an inverse lithography technology (ILT) generated layout, confirm the simulation results. New advancement in high transmission blanks also make low topography Hi-T PSM a reality, which can minimize scattering effects in high NA lithography.

Effect of health information technology interventions on lipid management in clinical practice: a systematic review of randomized controlled trials.

PubMed

Aspry, Karen E; Furman, Roy; Karalis, Dean G; Jacobson, Terry A; Zhang, Audrey M; Liptak, Gregory S; Cohen, Jerome D

2013-01-01

Large gaps in lipid treatment and medication adherence persist in high-risk outpatients in the United States. Health information technology (HIT) is being applied to close quality gaps in chronic illness care, but its utility for lipid management has not been widely studied. To perform a qualitative review of the impact of HIT interventions on lipid management processes of care (screening or testing; drug initiation, titration or adherence; or referrals) or clinical outcomes (percent at low density lipoprotein cholesterol goal; absolute lipid levels; absolute risk scores; or cardiac hospitalizations) in outpatients with coronary heart disease or at increased risk. PubMed and Google Scholar databases were searched using Medical Subject Headings related to clinical informatics and cholesterol or lipid management. English language articles that described a randomized controlled design, tested at least one HIT tool in high risk outpatients, and reported at least 1 lipid management process measure or clinical outcome, were included. Thirty-four studies that enrolled 87,874 persons were identified. Study ratings, outcomes, and magnitude of effects varied widely. Twenty-three trials reported a significant positive effect from a HIT tool on lipid management, but only 14 showed evidence that HIT interventions improve clinical outcomes. There was mixed evidence that provider-level computerized decision support improves outcomes. There was more evidence in support of patient-level tools that provide connectivity to the healthcare system, as well as system-level interventions that involve database monitoring and outreach by centralized care teams. Randomized controlled trials show wide variability in the effects of HIT on lipid management outcomes. Evidence suggests that multilevel HIT approaches that target not only providers but include patients and systems approaches will be needed to improve lipid treatment, adherence and quality. Copyright © 2013 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Statistical analysis of the distribution of chromosome aberrations in human lymphocytes induced by low and high energy heavy ions

NASA Astrophysics Data System (ADS)

Deperas-Standylo, Joanna; Lee, Ryonfa; Nasonova, Elena; Ritter, Sylvia; Gudowska-Nowak, Ewa; Kac, M.; Smoluchowski, M.

Differences in the track structure of high LET (Linear Energy Transfer) particles are clearly visible on chromosomal level, in particular in the number of lesions produced by an ion traversal through a cell nucleus and in the distribution of aberrations among the cells. In the present study we focus on the effects of low energy C-and Cr-ions (<10 MeV/u) in comparison with high energy C-ions (90 MeV/u). For the experiments human lymphocytes were exposed to 9.5 MeV/u C-ions, 4.1 MeV/u Cr-ions or 90 MeV/u C-ions with LET values of 175 keV/µm, 3160 keV/µm and 29 keV/µm, respectively. Chromosome aberrations were measured at several post-irradiation sampling times (48, 60, 72 and 84h) in first cycle metaphases following Giemsa-staining. For 90 MeV/u C-ions, where the track radius is larger than the cell nucleus, the distribution of aberrations did not change significantly with sampling time and has been well described by Poisson statistics. In contrast, for low energy C-ions, where the track radius is smaller than the cell nucleus, distribution of aberration strongly deviates from uni-modal and displays two peaks representative for subpopulations of non-hit and hit cells, respectively. Following this pattern, also damage-dependent cell cycle delay was observed. At 48 h after irradiation a high number of undamaged and probably unhit cells was found to reach mitosis. This number of undamaged cells decreased further with sampling time, while the frequencies of cells carrying aberrations (1-11 per cell) were increasing. All distributions were found to conform a compound Poisson (Neyman-type A) statistics which allows estimating the average number of particle traversals through a cell nucleus and the average number of aberrations induced by one particle traversal. Similar response has also been observed at 48h after Cr-ion exposure. In this case, however, non-aberrant cells have been found to dominate in the population even at later sampling times and a low number of heavily damaged cells up to 24 aberrations have been detected. Accordingly, the distribution of aberrations in cells collected at >48 h could not be then described by a standard Neyman statistics. Obtained results suggest that most cells hit by more than one Cr-ion do not reach mitosis. This observation was confirmed by parallel measurements showing that Cr-ion exposure produces a high fraction of apoptotic cells.

Spotting and tracking good biometrics with the human visual system

NASA Astrophysics Data System (ADS)

Szu, Harold; Jenkins, Jeffrey; Hsu, Charles

2011-06-01

We mathematically model the mammalian Visual System's (VS) capability of spotting objects. How can a hawk see a tiny running rabbit from miles above ground? How could that rabbit see the approaching hawk? This predatorprey interaction draws parallels with spotting a familiar person in a crowd. We assume that mammal eyes use peripheral vision to perceive unexpected changes from our memory, and then use our central vision (fovea) to pay attention. The difference between an image and our memory of that image is usually small, mathematically known as a 'sparse representation'. The VS communicates with the brain using a finite reservoir of neurotransmittents, which produces an on-center and thus off-surround Hubel/Wiesel Mexican hat receptive field. This is the basis of our model. This change detection mechanism could drive our attention, allowing us to hit a curveball. If we are about to hit a baseball, what information extracted by our HVS tells us where to swing? Physical human features such as faces, irises, and fingerprints have been successfully used for identification (Biometrics) for decades, recently including voice and walking style for identification from further away. Biologically, humans must use a change detection strategy to achieve an ordered sparseness and use a sigmoid threshold for noisy measurements in our Hetero-Associative Memory [HAM] classifier for fault tolerant recall. Human biometrics is dynamic, and therefore involves more than just the surface, requiring a 3 dimensional measurement (i.e. Daugman/Gabor iris features). Such a measurement can be achieved using the partial coherence of a laser's reflection from a 3-D biometric surface, creating more degrees of freedom (d.o.f.) to meet the Army's challenge of distant Biometrics. Thus, one might be able to increase the standoff loss of less distinguished degrees of freedom (DOF).

Health Informatics and Technology for Integrated Elderly Care in the Context of Hong Kong: A Case Study.

PubMed

Chau, Cheuk Wing; Leung, Eman

2017-01-01

The aging population creates tremendous pressure to healthcare. To resolve, scholars recognized the solution to this challenge is integrated care. To facilitate integrated care, health information technologies (HIT) is a critical enabler. This paper will first review how technology enhanced integrated care, and review on the existing literatures in system effective use and the three key external factors that enable HIT implementation. Applying Burton-Jones and Volkoff's contextualized theories of effective use of HIT to understand the role of health informatics and technology in the unique context of Hong Kong, we have conducted a case study research to identify the levers for improving HK integration of care through HIT.

Internal validation of the RapidHIT® ID system.

PubMed

Wiley, Rachel; Sage, Kelly; LaRue, Bobby; Budowle, Bruce

2017-11-01

Traditionally, forensic DNA analysis has required highly skilled forensic geneticists in a dedicated laboratory to generate short tandem repeat (STR) profiles. STR profiles are routinely used either to associate or exclude potential donors of forensic biological evidence. The typing of forensic reference samples has become more demanding, especially with the requirement in some jurisdictions to DNA profile arrestees. The Rapid DNA (RDNA) platform, the RapidHIT ® ID (IntegenX ® , Pleasanton, CA), is a fully automated system capable of processing reference samples in approximately 90min with minimal human intervention. Thus, the RapidHIT ID instrument can be deployed to non-laboratory environments (e.g., booking stations) and run by trained atypical personnel such as law enforcement. In order to implement the RapidHIT ID platform, validation studies are needed to define the performance and limitations of the system. Internal validation studies were undertaken with four early-production RapidHIT ID units. Reliable and concordant STR profiles were obtained from reference buccal swabs. Throughout the study, no contamination was observed. The overall first-pass success rate with an "expert-like system" was 72%, which is comparable to another current RDNA platform commercially available. The system's second-pass success rate (involving manual interpretation on first-pass inconclusive results) increased to 90%. Inhibitors (i.e., coffee, smoking tobacco, and chewing tobacco) did not appear to affect typing by the instrument system; however, substrate (i.e., swab type) did impact typing success. Additionally, one desirable feature not available with other Rapid systems is that in the event of a system failed run, a swab can be recovered and subsequently re-analyzed in a new sample cartridge. Therefore, rarely should additional sampling or swab consumption be necessary. The RapidHIT ID system is a robust and reliable tool capable of generating complete STR profiles within the forensic DNA typing laboratory or with proper training in decentralized environments by non-laboratory personnel. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of electronic health information technology implementation on nursing home resident outcomes.

PubMed

Pillemer, Karl; Meador, Rhoda H; Teresi, Jeanne A; Chen, Emily K; Henderson, Charles R; Lachs, Mark S; Boratgis, Gabriel; Silver, Stephanie; Eimicke, Joseph P

2012-02-01

To examine the effects of electronic health information technology (HIT) on nursing home residents. The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior. © The Author(s) 2012

Health information technology and the medical school curriculum.

PubMed

Triola, Marc M; Friedman, Erica; Cimino, Christopher; Geyer, Enid M; Wiederhorn, Jo; Mainiero, Crystal

2010-12-01

Medical schools must teach core biomedical informatics competencies that address health information technology (HIT), including explaining electronic medical record systems and computerized provider order entry systems and their role in patient safety; describing the research uses and limitations of a clinical data warehouse; understanding the concepts and importance of information system interoperability; explaining the difference between biomedical informatics and HIT; and explaining the ways clinical information systems can fail. Barriers to including these topics in the curricula include lack of teachers; the perception that informatics competencies are not applicable during preclinical courses and there is no place in the clerkships to teach them; and the legal and policy issues that conflict with students' need to develop skills. However, curricular reform efforts are creating opportunities to teach these topics with new emphasis on patient safety, team-based medical practice, and evidence-based care. Overarching HIT competencies empower our students to be lifelong technology learners.

Development of a health information technology-based data system in community-based hospice and palliative care.

PubMed

Abernethy, Amy P; Wheeler, Jane L; Bull, Janet

2011-05-01

Few hospice and palliative care organizations use health information technology (HIT) for data collection and management; the feasibility and utility of a HIT-based approach in this multi-faceted, interdisciplinary context is unclear. To develop a HIT-based data infrastructure that serves multiple hospice and palliative care sites, meeting clinical and administrative needs with data, technical, and analytic support. Through a multi-site academic/community partnership, a data infrastructure was collaboratively developed, pilot-tested at a community-based site, refined, and demonstrated for data collection and preliminary analysis. Additional sites, which participated in system development, became prepared to contribute data to the growing aggregate database. Electronic data collection proved feasible in community-based hospice and palliative care. The project highlighted "success factors" for implementing HIT in this field: engagement of site-based project "champions" to promote the system from within; involvement of stakeholders at all levels of the organization, to promote culture change and buy-in; attention to local needs (e.g., data for quality reporting) and requirements (e.g., affordable cost, efficiency); consideration of practical factors (e.g., potential to interfere with clinical flow); provision of adequate software, technical, analytic, and statistical support; availability of flexible HIT options (e.g., different data-collection platforms); and adoption of a consortium approach in which sites can support one another, learn from each others' experiences, pool data, and benefit from economies of scale. In hospice and palliative care, HIT-based data collection/management has potential to generate better understanding of populations and outcomes, support quality assessment/quality improvement, and prepare sites to participate in research. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Acute intraoperative heparin-induced thrombocytopenia (HIT) and thrombosis during coronary artery bypass grafting: Two case reports providing evidence for the role of preoperative LMWH in triggering sensitization.

PubMed

Khoury, M; Pitsis, A; Poumpouridou-Kioura, H; Soufla, G; Kanthou, C; Matoula, N; Angelidis, A; Melissari, E

2016-10-01

Systemic anticoagulation is necessary during cardiac surgery. To date, the only well established anticoagulation protocol involves the use of heparin. However, heparin can cause heparin-induced thrombocytopenia (HIT) a potentially life threatening immune-mediated thromboembolic syndrome. Until now, devastating consequences of HIT syndrome in patients undergoing heart surgery have been described, but only postoperatively. Here we report the development of HIT syndrome during cardiac revascularization by intra-operative heparin administration in two patients previously exposed to LMWH. We report on two patients who developed rapid and profound intravascular coagulation with severe thrombocytopenia (platelet count decreased from ≥250×10 9 /L to 50×10 9 /L) due to HIT development caused by heparin administration during coronary artery bypass graft surgery. In addition we report that fondaparinux, given intra-operatively in association with antithrombin, may be a suitable alternative anticoagulant for successfully preventing the devastating consequences of intra-operative HIT development. To our knowledge, this is the first report describing the development of acute intra-operative HIT, secondary to high-dose UFH administered for coronary revascularization, in which the unexpected presence of platelet-activating anti-PF4/heparin antibodies at surgery was explained by preoperative administration of a one-week course of LMWH but without any preoperative evidence for HIT. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments.

PubMed

Nirel, Nurit; Rosen, Bruce; Sharon, Assaf; Blondheim, Orna; Sherf, Michael; Samuel, Hadar; Cohen, Arnon D

2010-09-01

In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK's use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals. Examining the frequency of OFEK's use with its own track-log data; comparing, "before" and "after", quality indicators and service utilization data in experimental (CHS patients) versus control groups (other patients). OFEK's use increased by tens of percentages each year, Internal Medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests performed compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in General Surgery wards. The study helps evaluate the extent to which OFEK's targets were achieved and contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Hit-and-run, hit-and-stay, and commensal bacteria present different peptide content when viewed from the perspective of the T cell.

PubMed

He, Lu; De Groot, Anne S; Bailey-Kellogg, Chris

2015-11-27

Different types of bacteria face different pressures from the immune system, with those that persist ("hit-and-stay") potentially having to adapt more in order to escape than those prone to short-lived infection ("hit-and-run"), and with commensal bacteria potentially different from both due to additional physical mechanisms for avoiding immune detection. The Janus Immunogenicity Score (JIS) was recently developed to assess the likelihood of T cell recognition of an antigen, using an analysis that considers both binding of a peptide within the antigen by major histocompatability complex (MHC) and recognition of the peptide:MHC complex by cognate T cell receptor (TCR). This score was shown to be predictive of T effector vs. T regulatory or null responses in experimental data, as well as to distinguish viruses representative of the hit-and-stay vs. hit-and-run phenotypes. Here, JIS-based analyses were conducted in order to characterize the extent to which the pressure to avoid T cell recognition is manifested in genomic differences among representative hit-and-run, hit-and-stay, and commensal bacteria. Overall, extracellular proteins were found to have different JIS profiles from cytoplasmic ones. Contrasting the bacterial groups, extracellular proteins were shown to be quite different across the groups, much more so than intracellular proteins. The differences were evident even at the level of corresponding peptides in homologous protein pairs from hit-and-run and hit-and-stay bacteria. The multi-level analysis of patterns of immunogenicity across different groups of bacteria provides a new way to approach questions of bacterial immune camouflage or escape, as well as to approach the selection and optimization of candidates for vaccine design. Copyright © 2015 Elsevier Ltd. All rights reserved.

Spot Weight Adaptation for Moving Target in Spot Scanning Proton Therapy.

PubMed

Morel, Paul; Wu, Xiaodong; Blin, Guillaume; Vialette, Stéphane; Flynn, Ryan; Hyer, Daniel; Wang, Dongxu

2015-01-01

This study describes a real-time spot weight adaptation method in spot-scanning proton therapy for moving target or moving patient, so that the resultant dose distribution closely matches the planned dose distribution. The method proposed in this study adapts the weight (MU) of the delivering pencil beam to that of the target spot; it will actually hit during patient/target motion. The target spot that a certain delivering pencil beam may hit relies on patient monitoring and/or motion modeling using four-dimensional (4D) CT. After the adapted delivery, the required total weight [Monitor Unit (MU)] for this target spot is then subtracted from the planned value. With continuous patient motion and continuous spot scanning, the planned doses to all target spots will eventually be all fulfilled. In a proof-of-principle test, a lung case was presented with realistic temporal and motion parameters; the resultant dose distribution using spot weight adaptation was compared to that without using this method. The impact of the real-time patient/target position tracking or prediction was also investigated. For moderate motion (i.e., mean amplitude 0.5 cm), D95% to the planning target volume (PTV) was only 81.5% of the prescription (RX) dose; with spot weight adaptation PTV D95% achieves 97.7% RX. For large motion amplitude (i.e., 1.5 cm), without spot weight adaptation PTV D95% is only 42.9% of RX; with spot weight adaptation, PTV D95% achieves 97.7% RX. Larger errors in patient/target position tracking or prediction led to worse final target coverage; an error of 3 mm or smaller in patient/target position tracking is preferred. The proposed spot weight adaptation method was able to deliver the planned dose distribution and maintain target coverage when patient motion was involved. The successful implementation of this method would rely on accurate monitoring or prediction of patient/target motion.

U.K. science budget. Gene jocks, data crunchers hit jackpot.

PubMed

Pickrell, J

2000-12-01

Unveiling its science spending plan for the next 3 years, the U.K. government last week announced major new investments in three key areas: tracking disease genes, leveraging the Internet for data analysis, and supporting emerging industries such as nanotechnology and bioengineering. Although these programs cut across a range of disciplines funded by the U.K.'s science councils, the government also bestowed a long-anticipated gift on astronomers: membership in the European Southern Observatory, which will give U.K. researchers access to the world's largest optical telescope.

Proceedings of the Near-Earth-Object Interception Workshop

NASA Technical Reports Server (NTRS)

Canavan, G. J. (Editor); Solem, J. C. (Editor); Rather, John D. G. (Editor)

1993-01-01

The National Aeronautics and Space Administration Headquarters sponsored the Near-Earth-Object Interception Workshop hosted by the Los Alamos National Laboratory on 14-16 Jan. 1992 at the J. Robert Oppenheimer Study Center in Los Alamos, New Mexico. The Workshop evaluated the issues involved in intercepting celestial objects that could hit the Earth. It covered the technologies for acquiring, tracking, and homing, as well as those for sending interceptors to inspect, rendezvous with, land on, irradiate, deflect, or destroy them. This report records the presentations and technical options reviewed.

Clinical effectiveness of a Bayesian algorithm for the diagnosis and management of heparin-induced thrombocytopenia.

PubMed

Raschke, R A; Gallo, T; Curry, S C; Whiting, T; Padilla-Jones, A; Warkentin, T E; Puri, A

2017-08-01

Essentials We previously published a diagnostic algorithm for heparin-induced thrombocytopenia (HIT). In this study, we validated the algorithm in an independent large healthcare system. The accuracy was 98%, sensitivity 82% and specificity 99%. The algorithm has potential to improve accuracy and efficiency in the diagnosis of HIT. Background Heparin-induced thrombocytopenia (HIT) is a life-threatening drug reaction caused by antiplatelet factor 4/heparin (anti-PF4/H) antibodies. Commercial tests to detect these antibodies have suboptimal operating characteristics. We previously developed a diagnostic algorithm for HIT that incorporated 'four Ts' (4Ts) scoring and a stratified interpretation of an anti-PF4/H enzyme-linked immunosorbent assay (ELISA) and yielded a discriminant accuracy of 0.97 (95% confidence interval [CI], 0.93-1.00). Objectives The purpose of this study was to validate the algorithm in an independent patient population and quantitate effects that algorithm adherence could have on clinical care. Methods A retrospective cohort comprised patients who had undergone anti-PF4/H ELISA and serotonin release assay (SRA) testing in our healthcare system from 2010 to 2014. We determined the algorithm recommendation for each patient, compared recommendations with the clinical care received, and enumerated consequences of discrepancies. Operating characteristics were calculated for algorithm recommendations using SRA as the reference standard. Results Analysis was performed on 181 patients, 10 of whom were ruled in for HIT. The algorithm accurately stratified 98% of patients (95% CI, 95-99%), ruling out HIT in 158, ruling in HIT in 10 and recommending an SRA in 13 patients. Algorithm adherence would have obviated 165 SRAs and prevented 30 courses of unnecessary antithrombotic therapy for HIT. Diagnostic sensitivity was 0.82 (95% CI, 0.48-0.98), specificity 0.99 (95% CI, 0.97-1.00), PPV 0.90 (95% CI, 0.56-0.99) and NPV 0.99 (95% CI, 0.96-1.00). Conclusions An algorithm incorporating 4Ts scoring and a stratified interpretation of the anti-PF4/H ELISA has good operating characteristics and the potential to improve management of suspected HIT patients. © 2017 International Society on Thrombosis and Haemostasis.

The role of health information technology in care coordination in the United States.

PubMed

Hsiao, Chun-Ju; King, Jennifer; Hing, Esther; Simon, Alan E

2015-02-01

Examine the extent to which office-based physicians in the United States receive patient health information necessary to coordinate care across settings and determine whether receipt of information needed to coordinate care is associated with use of health information technology (HIT) (defined by presence or absence of electronic health record system and electronic sharing of information). Cross-sectional study using the 2012 National Electronic Health Records Survey (65% weighted response rate). Office-based physicians. Use of HIT and 3 types of patient health information needed to coordinate care. In 2012, 64% of physicians routinely received the results of a patient's consultation with a provider outside of their practice, whereas 46% routinely received a patient's history and reason for a referred consultation from a provider outside of their practice. About 54% of physicians reported routinely receiving a patient's hospital discharge information. In adjusted analysis, significant differences in receiving necessary information were observed by use of HIT. Compared with those not using HIT, a lower percentage of physicians who used an electronic health record system and shared patient health information electronically failed to receive the results of outside consultations or patient's history and reason for a referred consultation. No significant differences were observed for the receipt of hospital discharge information by use of HIT. Among physicians routinely receiving information needed for care coordination, at least 54% of them did not receive the information electronically. Although a higher percentage of physicians using HIT received patient information necessary for care coordination than those who did not use HIT, more than one third did not routinely receive the needed patient information at all.

Informatics technology mimics ecology: dense, mutualistic collaboration networks are associated with higher publication rates.

PubMed

Sorani, Marco D

2012-01-01

Information technology (IT) adoption enables biomedical research. Publications are an accepted measure of research output, and network models can describe the collaborative nature of publication. In particular, ecological networks can serve as analogies for publication and technology adoption. We constructed network models of adoption of bioinformatics programming languages and health IT (HIT) from the literature.We selected seven programming languages and four types of HIT. We performed PubMed searches to identify publications since 2001. We calculated summary statistics and analyzed spatiotemporal relationships. Then, we assessed ecological models of specialization, cooperativity, competition, evolution, biodiversity, and stability associated with publications.Adoption of HIT has been variable, while scripting languages have experienced rapid adoption. Hospital systems had the largest HIT research corpus, while Perl had the largest language corpus. Scripting languages represented the largest connected network components. The relationship between edges and nodes was linear, though Bioconductor had more edges than expected and Perl had fewer. Spatiotemporal relationships were weak. Most languages shared a bioinformatics specialization and appeared mutualistic or competitive. HIT specializations varied. Specialization was highest for Bioconductor and radiology systems. Specialization and cooperativity were positively correlated among languages but negatively correlated among HIT. Rates of language evolution were similar. Biodiversity among languages grew in the first half of the decade and stabilized, while diversity among HIT was variable but flat. Compared with publications in 2001, correlation with publications one year later was positive while correlation after ten years was weak and negative.Adoption of new technologies can be unpredictable. Spatiotemporal relationships facilitate adoption but are not sufficient. As with ecosystems, dense, mutualistic, specialized co-habitation is associated with faster growth. There are rapidly changing trends in external technological and macroeconomic influences. We propose that a better understanding of how technologies are adopted can facilitate their development.

TJC: HCOs need to be on alert for HIT problems related to sociotechnical factors, take steps to improve safety culture, process, and leadership.

PubMed

2015-06-01

Noting that too many errors related to health information technology (HIT) are resulting in adverse consequences, The Joint Commission (TJC) has issued a Sentinel Event Alert, urging health care providers to take steps to improve their safety culture, approach to process improvement, and leadership in this area. In this latest alert, the accrediting agency is taking particular aim at risks posed by sociotechnical factors--or the ways in which HIT is implemented and used. Experts say that many of these risks are, in fact, exemplified at a higher level in the emergency setting, where providers are under constant pressure to see more patients and move them though the system faster. In an analysis of 3,375 sentinel events that resulted in permanent patient harm or death between January 1, 2010, and June 20, 2013, The Joint Commission (TJC) found that 120 events included HIT-related contributing factors. Many of the problems cited by TJC relate to orders or medicines being prescribed for the wrong patients. These can result from toggling errors or pop-up screens where providers are asked to click on the appropriate patient or medicine, and they mistakenly click on the wrong selection. In the ED, experts recommend the creation of a multidisciplinary performance improvement group to continuously monitor the ED information system (EDIS), recognize problems, and work with the vendor to resolve them. Also important is a quick and easy way for providers to report HIT-related problems. Experts add that emergency providers need to be fully engaged in the process of selecting HIT that they will be using, and that health care organizations should arrange for usability assessments before purchasing HIT.

Care coordination gaps due to lack of interoperability in the United States: a qualitative study and literature review.

PubMed

Samal, Lipika; Dykes, Patricia C; Greenberg, Jeffrey O; Hasan, Omar; Venkatesh, Arjun K; Volk, Lynn A; Bates, David W

2016-04-22

Health information technology (HIT) could improve care coordination by providing clinicians remote access to information, improving legibility, and allowing asynchronous communication, among other mechanisms. We sought to determine, from a clinician perspective, how care is coordinated and to what extent HIT is involved when transitioning patients between emergency departments, acute care hospitals, skilled nursing facilities, and home health agencies in settings across the United States. We performed a qualitative study with clinicians and information technology professionals from six regions of the U.S. which were chosen as national leaders in HIT. We analyzed data through a two person consensus approach, assigning responses to each of nine care coordination activities. We also conducted a literature review of MEDLINE®, CINAHL®, and Embase, analyzing results of studies that examined interventions to improve information transfer during transitions of care. We enrolled 29 respondents from 17 organizations and conducted six focus groups. Respondents reported how HIT is currently used for care coordination activities. HIT is currently used to monitor patients and to align systems-level resources with population needs. However, we identified multiple areas where the lack of interoperability leads to inefficient processes and missing data. Additionally, the literature review identified ten intervention studies that address information transfer, seven of which employed HIT and three of which utilized other communication methods such as telephone calls, faxed records, and nurse case management. Significant care coordination gaps exist due to the lack of interoperability across the United States. We must design, evaluate, and incentivize the use of HIT for care coordination. We should focus on the domains where we found the largest gaps: information transfer, systems to monitor patients, tools to support patients' self-management goals, and tools to link patients and their caregivers with community resources.

Healthcare professionals' organisational barriers to health information technologies-a literature review.

PubMed

Lluch, Maria

2011-12-01

This literature review identifies and categorises, from an organisational management perspective, barriers to the use of HIT or ICT for health. Based on the review, it offers policy interventions. This systematic literature review was carried out during December 2009 and January 2010. Additional on-going reviews of updates through automated system alerts took place up until this paper was submitted. A total of thirty-one sources were searched including nine software platforms/databases, fifteen specialised websites/targeted databases, Google Scholar, ISI Science Citation Index and five journals hand-searched. The study covers seventy-nine articles on organisational barriers to ICT adoption by healthcare professionals. These are categorised under five main headings - (I) Structure of healthcare organisations; (II) Tasks; (III) People policies; (IV) Incentives; and (V) Information and decision processes. A total of ten subcategories are also identified. By adopting an organisational management approach, some recommendations to remove organisational management barriers are made. Despite their apparent promise, health information technologies (HIT) have proved difficult to implement. This systematic review reveals the implementation barriers associated to organisational management and their interrelations. Several important future directions in the field are also suggested: (1) there is a need for further research providing evidence of HIT cost-effectiveness as well as the development of optimal HIT applications; (2) more information is needed regarding organisational change, incentives, liability issues, end-users HIT competences and skills, structure and work process issues involved in realising the benefits from HIT. Future policy interventions should consider the five dimensions identified when addressing the impact of HIT in healthcare organisational systems, and how the impact of an intervention aimed at a particular dimension would interrelate with others. 2011 Elsevier Ireland Ltd. All rights reserved.

Discovery of a new chemical series of BRD4(1) inhibitors using protein-ligand docking and structure-guided design.

PubMed

Duffy, Bryan C; Liu, Shuang; Martin, Gregory S; Wang, Ruifang; Hsia, Ming Min; Zhao, He; Guo, Cheng; Ellis, Michael; Quinn, John F; Kharenko, Olesya A; Norek, Karen; Gesner, Emily M; Young, Peter R; McLure, Kevin G; Wagner, Gregory S; Lakshminarasimhan, Damodharan; White, Andre; Suto, Robert K; Hansen, Henrik C; Kitchen, Douglas B

2015-07-15

Bromodomains are key transcriptional regulators that are thought to be druggable epigenetic targets for cancer, inflammation, diabetes and cardiovascular therapeutics. Of particular importance is the first of two bromodomains in bromodomain containing 4 protein (BRD4(1)). Protein-ligand docking in BRD4(1) was used to purchase a small, focused screening set of compounds possessing a large variety of core structures. Within this set, a small number of weak hits each contained a dihydroquinoxalinone ring system. We purchased other analogs with this ring system and further validated the new hit series and obtained improvement in binding inhibition. Limited exploration by new analog synthesis showed that the binding inhibition in a FRET assay could be improved to the low μM level making this new core a potential hit-to-lead series. Additionally, the predicted geometries of the initial hit and an improved analog were confirmed by X-ray co-crystallography with BRD4(1). Copyright © 2015 Elsevier Ltd. All rights reserved.

Automated recycling of chemistry for virtual screening and library design.

PubMed

Vainio, Mikko J; Kogej, Thierry; Raubacher, Florian

2012-07-23

An early stage drug discovery project needs to identify a number of chemically diverse and attractive compounds. These hit compounds are typically found through high-throughput screening campaigns. The diversity of the chemical libraries used in screening is therefore important. In this study, we describe a virtual high-throughput screening system called Virtual Library. The system automatically "recycles" validated synthetic protocols and available starting materials to generate a large number of virtual compound libraries, and allows for fast searches in the generated libraries using a 2D fingerprint based screening method. Virtual Library links the returned virtual hit compounds back to experimental protocols to quickly assess the synthetic accessibility of the hits. The system can be used as an idea generator for library design to enrich the screening collection and to explore the structure-activity landscape around a specific active compound.

Are We There Yet? Human Factors Knowledge and Health Information Technology - the Challenges of Implementation and Impact.

PubMed

Turner, P; Kushniruk, A; Nohr, C

2017-08-01

Objective: To review the developments in human factors (HF) research on the challenges of health information technology (HIT) implementation and impact given the continuing incidence of usability problems and unintended consequences from HIT development and use. Methods: A search of PubMed/Medline and Web of Science® identified HF research published in 2015 and 2016. Electronic health records (EHRs) and patient-centred HIT emerged as significant foci of recent HF research. The authors selected prominent papers highlighting ongoing HF and usability challenges in these areas. This selective rather than systematic review of recent HF research highlights these key challenges and reflects on their implications on the future impact of HF research on HIT. Results: Research provides evidence of continued poor design, implementation, and usability of HIT, as well as technology-induced errors and unintended consequences. The paper highlights support for: (i) strengthening the evidence base on the benefits of HF approaches; (ii) improving knowledge translation in the implementation of HF approaches during HIT design, implementation, and evaluation; (iii) increasing transparency, governance, and enforcement of HF best practices at all stages of the HIT system development life cycle. Discussion and Conclusion: HF and usability approaches are yet to become embedded as integral components of HIT development, implementation, and impact assessment. As HIT becomes ever-more pervasive including with patients as end-users, there is a need to expand our conceptualisation of the problems to be addressed and the suite of tactics and strategies to be used to calibrate our pro-active involvement in its improvement. Georg Thieme Verlag KG Stuttgart.

Test beam demonstration of silicon microstrip modules with transverse momentum discrimination for the future CMS tracking detector

NASA Astrophysics Data System (ADS)

Adam, W.; Bergauer, T.; Brondolin, E.; Dragicevic, M.; Friedl, M.; Frühwirth, R.; Hoch, M.; Hrubec, J.; König, A.; Steininger, H.; Treberspurg, W.; Waltenberger, W.; Alderweireldt, S.; Beaumont, W.; Janssen, X.; Lauwers, J.; Van Mechelen, P.; Van Remortel, N.; Van Spilbeeck, A.; Beghin, D.; Brun, H.; Clerbaux, B.; De Lentdecker, G.; Delannoy, H.; Fasanella, G.; Favart, L.; Goldouzian, R.; Grebenyuk, A.; Karapostoli, G.; Lenzi, T.; Léonard, A.; Luetic, J.; Maerschalk, T.; Marinov, A.; Postiau, N.; Randle-Conde, A.; Seva, T.; Vanlaer, P.; Vannerom, D.; Yonamine, R.; Wang, Q.; Yang, Y.; Zenoni, F.; Zhang, F.; Abu Zeid, S.; Blekman, F.; De Bruyn, I.; De Clercq, J.; D'Hondt, J.; Deroover, K.; Lowette, S.; Moortgat, S.; Moreels, L.; Python, Q.; Skovpen, K.; Van Mulders, P.; Van Parijs, I.; Bakhshiansohi, H.; Bondu, O.; Brochet, S.; Bruno, G.; Caudron, A.; Delaere, C.; Delcourt, M.; De Visscher, S.; Francois, B.; Giammanco, A.; Jafari, A.; Cabrera Jamoulle, J.; De Favereau De Jeneret, J.; Komm, M.; Krintiras, G.; Lemaitre, V.; Magitteri, A.; Mertens, A.; Michotte, D.; Musich, M.; Piotrzkowski, K.; Quertenmont, L.; Szilasi, N.; Vidal Marono, M.; Wertz, S.; Beliy, N.; Caebergs, T.; Daubie, E.; Hammad, G. H.; Härkönen, J.; Lampén, T.; Luukka, P.; Peltola, T.; Tuominen, E.; Tuovinen, E.; Eerola, P.; Baulieu, G.; Boudoul, G.; Caponetto, L.; Combaret, C.; Contardo, D.; Dupasquier, T.; Gallbit, G.; Lumb, N.; Mirabito, L.; Perries, S.; Vander Donckt, M.; Viret, S.; Agram, J.-L.; Andrea, J.; Bloch, D.; Bonnin, C.; Brom, J.-M.; Chabert, E.; Chanon, N.; Charles, L.; Conte, E.; Fontaine, J.-Ch.; Gross, L.; Hosselet, J.; Jansova, M.; Tromson, D.; Autermann, C.; Feld, L.; Karpinski, W.; Kiesel, K. M.; Klein, K.; Lipinski, M.; Ostapchuk, A.; Pierschel, G.; Preuten, M.; Rauch, M.; Schael, S.; Schomakers, C.; Schulz, J.; Schwering, G.; Wlochal, M.; Zhukov, V.; Pistone, C.; Fluegge, G.; Kuensken, A.; Pooth, O.; Stahl, A.; Aldaya, M.; Asawatangtrakuldee, C.; Beernaert, K.; Bertsche, D.; Contreras-Campana, C.; Eckerlin, G.; Eckstein, D.; Eichhorn, T.; Gallo, E.; Garay Garcia, J.; Hansen, K.; Haranko, M.; Harb, A.; Hauk, J.; Keaveney, J.; Kalogeropoulos, A.; Kleinwort, C.; Lohmann, W.; Mankel, R.; Maser, H.; Mittag, G.; Muhl, C.; Mussgiller, A.; Pitzl, D.; Reichelt, O.; Savitskyi, M.; Schuetze, P.; Walsh, R.; Zuber, A.; Biskop, H.; Buhmann, P.; Centis-Vignali, M.; Garutti, E.; Haller, J.; Hoffmann, M.; Klanner, R.; Matysek, M.; Perieanu, A.; Scharf, Ch.; Schleper, P.; Schmidt, A.; Schwandt, J.; Sonneveld, J.; Steinbrück, G.; Vormwald, B.; Wellhausen, J.; Abbas, M.; Amstutz, C.; Barvich, T.; Barth, Ch.; Boegelspacher, F.; De Boer, W.; Butz, E.; Casele, M.; Colombo, F.; Dierlamm, A.; Freund, B.; Hartmann, F.; Heindl, S.; Husemann, U.; Kornmeyer, A.; Kudella, S.; Muller, Th.; Printz, M.; Simonis, H. J.; Steck, P.; Weber, M.; Weiler, Th.; Anagnostou, G.; Asenov, P.; Assiouras, P.; Daskalakis, G.; Kyriakis, A.; Loukas, D.; Paspalaki, L.; Siklér, F.; Veszprémi, V.; Bhardwaj, A.; Dalal, R.; Jain, G.; Ranjan, K.; Dutta, S.; Chowdhury, S. Roy; Bakhshiansohl, H.; Behnamian, H.; Khakzad, M.; Naseri, M.; Cariola, P.; Creanza, D.; De Palma, M.; De Robertis, G.; Fiore, L.; Franco, M.; Loddo, F.; Sala, G.; Silvestris, L.; Maggi, G.; My, S.; Selvaggi, G.; Albergo, S.; Costa, S.; Di Mattia, A.; Giordano, F.; Potenza, R.; Saizu, M. A.; Tricomi, A.; Tuve, C.; Barbagli, G.; Brianzi, M.; Ciaranfi, R.; Ciulli, V.; Civinini, C.; D'Alessandro, R.; Focardi, E.; Latino, G.; Lenzi, P.; Meschini, M.; Paoletti, S.; Russo, L.; Scarlini, E.; Sguazzoni, G.; Strom, D.; Viliani, L.; Ferro, F.; Lo Vetere, M.; Robutti, E.; Dinardo, M. E.; Fiorendi, S.; Gennai, S.; Malvezzi, S.; Manzoni, R. A.; Menasce, D.; Moroni, L.; Pedrini, D.; Azzi, P.; Bacchetta, N.; Bisello, D.; Dall'Osso, M.; Pozzobon, N.; Tosi, M.; De Canio, F.; Gaioni, L.; Manghisoni, M.; Nodari, B.; Riceputi, E.; Re, V.; Traversi, G.; Comotti, D.; Ratti, L.; Alunni Solestizi, L.; Biasini, M.; Bilei, G. M.; Cecchi, C.; Checcucci, B.; Ciangottini, D.; Fanò, L.; Gentsos, C.; Ionica, M.; Leonardi, R.; Manoni, E.; Mantovani, G.; Marconi, S.; Mariani, V.; Menichelli, M.; Modak, A.; Morozzi, A.; Moscatelli, F.; Passeri, D.; Placidi, P.; Postolache, V.; Rossi, A.; Saha, A.; Santocchia, A.; Storchi, L.; Spiga, D.; Androsov, K.; Azzurri, P.; Arezzini, S.; Bagliesi, G.; Basti, A.; Boccali, T.; Borrello, L.; Bosi, F.; Castaldi, R.; Ciampa, A.; Ciocci, M. A.; Dell'Orso, R.; Donato, S.; Fedi, G.; Giassi, A.; Grippo, M. T.; Ligabue, F.; Lomtadze, T.; Magazzu, G.; Martini, L.; Mazzoni, E.; Messineo, A.; Moggi, A.; Morsani, F.; Palla, F.; Palmonari, F.; Raffaelli, F.; Rizzi, A.; Savoy-Navarro, A.; Spagnolo, P.; Tenchini, R.; Tonelli, G.; Venturi, A.; Verdini, P. G.; Bellan, R.; Costa, M.; Covarelli, R.; Da Rocha Rolo, M.; Demaria, N.; Rivetti, A.; Dellacasa, G.; Mazza, G.; Migliore, E.; Monteil, E.; Pacher, L.; Ravera, F.; Solano, A.; Fernandez, M.; Gomez, G.; Jaramillo Echeverria, R.; Moya, D.; Gonzalez Sanchez, F. J.; Vila, I.; Virto, A. L.; Abbaneo, D.; Ahmed, I.; Albert, E.; Auzinger, G.; Berruti, G.; Bianchi, G.; Blanchot, G.; Bonnaud, J.; Caratelli, A.; Ceresa, D.; Christiansen, J.; Cichy, K.; Daguin, J.; D'Auria, A.; Detraz, S.; Deyrail, D.; Dondelewski, O.; Faccio, F.; Frank, N.; Gadek, T.; Gill, K.; Honma, A.; Hugo, G.; Jara Casas, L. M.; Kaplon, J.; Kornmayer, A.; Kottelat, L.; Kovacs, M.; Krammer, M.; Lenoir, P.; Mannelli, M.; Marchioro, A.; Marconi, S.; Mersi, S.; Martina, S.; Michelis, S.; Moll, M.; Onnela, A.; Orfanelli, S.; Pavis, S.; Peisert, A.; Pernot, J.-F.; Petagna, P.; Petrucciani, G.; Postema, H.; Rose, P.; Tropea, P.; Troska, J.; Tsirou, A.; Vasey, F.; Vichoudis, P.; Verlaat, B.; Zwalinski, L.; Bachmair, F.; Becker, R.; di Calafiori, D.; Casal, B.; Berger, P.; Djambazov, L.; Donega, M.; Grab, C.; Hits, D.; Hoss, J.; Kasieczka, G.; Lustermann, W.; Mangano, B.; Marionneau, M.; Martinez Ruiz del Arbol, P.; Masciovecchio, M.; Meinhard, M.; Perozzi, L.; Roeser, U.; Starodumov, A.; Tavolaro, V.; Wallny, R.; Zhu, D.; Amsler, C.; Bösiger, K.; Caminada, L.; Canelli, F.; Chiochia, V.; de Cosa, A.; Galloni, C.; Hreus, T.; Kilminster, B.; Lange, C.; Maier, R.; Ngadiuba, J.; Pinna, D.; Robmann, P.; Taroni, S.; Yang, Y.; Bertl, W.; Deiters, K.; Erdmann, W.; Horisberger, R.; Kaestli, H.-C.; Kotlinski, D.; Langenegger, U.; Meier, B.; Rohe, T.; Streuli, S.; Chen, P.-H.; Dietz, C.; Grundler, U.; Hou, W.-S.; Lu, R.-S.; Moya, M.; Cussans, D.; Flacher, H.; Goldstein, J.; Grimes, M.; Jacob, J.; Seif El Nasr-Storey, S.; Cole, J.; Hoad, C.; Hobson, P.; Morton, A.; Reid, I. D.; Auzinger, G.; Bainbridge, R.; Dauncey, P.; Fulcher, J.; Hall, G.; James, T.; Magnan, A.-M.; Pesaresi, M.; Raymond, D. M.; Uchida, K.; Braga, D.; Coughlan, J. A.; Harder, K.; Jones, L.; Ilic, J.; Murray, P.; Prydderch, M.; Tomalin, I. R.; Garabedian, A.; Heintz, U.; Narain, M.; Nelson, J.; Sagir, S.; Speer, T.; Swanson, J.; Tersegno, D.; Watson-Daniels, J.; Chertok, M.; Conway, J.; Conway, R.; Flores, C.; Lander, R.; Pellett, D.; Ricci-Tam, F.; Squires, M.; Thomson, J.; Yohay, R.; Burt, K.; Ellison, J.; Hanson, G.; Olmedo, M.; Si, W.; Yates, B. R.; Gerosa, R.; Sharma, V.; Vartak, A.; Yagil, A.; Zevi Della Porta, G.; Dutta, V.; Gouskos, L.; Incandela, J.; Kyre, S.; Mullin, S.; Qu, H.; White, D.; Dominguez, A.; Bartek, R.; Cumalat, J. P.; Ford, W. T.; Jensen, F.; Johnson, A.; Krohn, M.; Leontsinis, S.; Mulholland, T.; Stenson, K.; Wagner, S. R.; Apresyan, A.; Bolla, G.; Burkett, K.; Butler, J. N.; Cheung, H. W. K.; Chramowicz, J.; Christian, D.; Cooper, W. E.; Deptuch, G.; Derylo, G.; Gingu, C.; Grünendahl, S.; Hasegawa, S.; Hoff, J.; Howell, J.; Hrycyk, M.; Jindariani, S.; Johnson, M.; Kahlid, F.; Lei, C. M.; Lipton, R.; Lopes De Sá, R.; Liu, T.; Los, S.; Matulik, M.; Merkel, P.; Nahn, S.; Prosser, A.; Rivera, R.; Schneider, B.; Sellberg, G.; Shenai, A.; Spiegel, L.; Tran, N.; Uplegger, L.; Voirin, E.; Berry, D. R.; Chen, X.; Ennesser, L.; Evdokimov, A.; Evdokimov, O.; Gerber, C. E.; Hofman, D. J.; Makauda, S.; Mills, C.; Sandoval Gonzalez, I. D.; Alimena, J.; Antonelli, L. J.; Francis, B.; Hart, A.; Hill, C. S.; Parashar, N.; Stupak, J.; Bortoletto, D.; Bubna, M.; Hinton, N.; Jones, M.; Miller, D. H.; Shi, X.; Tan, P.; Baringer, P.; Bean, A.; Khalil, S.; Kropivnitskaya, A.; Majumder, D.; Wilson, G.; Ivanov, A.; Mendis, R.; Mitchell, T.; Skhirtladze, N.; Taylor, R.; Anderson, I.; Fehling, D.; Gritsan, A.; Maksimovic, P.; Martin, C.; Nash, K.; Osherson, M.; Swartz, M.; Xiao, M.; Acosta, J. G.; Cremaldi, L. M.; Oliveros, S.; Perera, L.; Summers, D.; Bloom, K.; Claes, D. R.; Fangmeier, C.; Gonzalez Suarez, R.; Monroy, J.; Siado, J.; Hahn, K.; Sevova, S.; Sung, K.; Trovato, M.; Bartz, E.; Gershtein, Y.; Halkiadakis, E.; Kyriacou, S.; Lath, A.; Nash, K.; Osherson, M.; Schnetzer, S.; Stone, R.; Walker, M.; Malik, S.; Norberg, S.; Ramirez Vargas, J. E.; Alyari, M.; Dolen, J.; Godshalk, A.; Harrington, C.; Iashvili, I.; Kharchilava, A.; Nguyen, D.; Parker, A.; Rappoccio, S.; Roozbahani, B.; Alexander, J.; Chaves, J.; Chu, J.; Dittmer, S.; McDermott, K.; Mirman, N.; Rinkevicius, A.; Ryd, A.; Salvati, E.; Skinnari, L.; Soffi, L.; Tao, Z.; Thom, J.; Tucker, J.; Zientek, M.; Akgün, B.; Ecklund, K. M.; Kilpatrick, M.; Nussbaum, T.; Zabel, J.; Betchart, B.; Covarelli, R.; Demina, R.; Hindrichs, O.; Petrillo, G.; Eusebi, R.; Patel, R.; Perloff, A.; Ulmer, K. A.; Delannoy, A. G.; D'Angelo, P.; Johns, W.

2018-03-01

A new CMS Tracker is under development for operation at the High Luminosity LHC from 2026 onwards. It includes an outer tracker based on dedicated modules that will reconstruct short track segments, called stubs, using spatially coincident clusters in two closely spaced silicon sensor layers. These modules allow the rejection of low transverse momentum track hits and reduce the data volume before transmission to the first level trigger. The inclusion of tracking information in the trigger decision is essential to limit the first level trigger accept rate. A customized front-end readout chip, the CMS Binary Chip (CBC), containing stub finding logic has been designed for this purpose. A prototype module, equipped with the CBC chip, has been constructed and operated for the first time in a 4 GeemVem/emc positron beam at DESY. The behaviour of the stub finding was studied for different angles of beam incidence on a module, which allows an estimate of the sensitivity to transverse momentum within the future CMS detector. A sharp transverse momentum threshold around 2 emVem/emc was demonstrated, which meets the requirement to reject a large fraction of low momentum tracks present in the LHC environment on-detector. This is the first realistic demonstration of a silicon tracking module that is able to select data, based on the particle's transverse momentum, for use in a first level trigger at the LHC . The results from this test are described here.

Incidence and diagnosis of heparin-induced thrombocytopenia (HIT) in patients with traumatic injuries treated with unfractioned or low-molecular-weight heparin: a literature review.

PubMed

Bloemen, A; Testroote, M J G; Janssen-Heijnen, M L G; Janzing, H M J

2012-05-01

The incidence of thromboembolic complications after major traumatic injuries is high (>50%). Thromboprophylaxis, often by low-molecular-weight heparin (LMWH) or unfractioned heparin (UH) is therefore routinely administered. Thromboprophylaxis is also advised after immobilisation for isolated lower leg injuries. Heparin induced thrombocytopenia (HIT) is a rare but very serious immune mediated complication of treatment with LMWH, which can cause potentially fatal thromboembolism. In the general medical and surgical population the incidence of HIT is 0.2%. Little is known about the incidence of HIT and value of screening in trauma patients and in isolated lower extremity injuries. Therefore, we performed a systematic literature review. The online databases Medline and EMBASE were searched independently by two authors. Manuscripts were selected for analysis by quantitative and qualitative selection. After eliminating duplicate articles and irrelevant studies, seven relevant papers reporting on the incidence of HIT in trauma patients were identified and two studies reported the incidence of HIT in patients with lower leg injuries. The selected papers varied in study design: three randomised controlled trials, three cohort studies and one case report were identified. The methodological quality of the studies varied. In a total population of 1920 patients, HIT was identified in seven patients (0.36%). Pooling of data was impossible due to heterogeneity in study design and populations. No HIT was reported in 826 patients with lower extremity injuries, requiring immobilisation. Only a few studies have reported on the incidence of HIT in trauma patients who receive prophylactic LMWH. In the heterogenous populations of the available studies, the incidence of HIT appears to be very low and comparable to other patient populations. There is hardly any literature on the incidence of HIT in patients with isolated lower leg injuries receiving LMWH, but incidence seems to be very low. The incidence of HIT in trauma patients who receive LMWH thromboprophylaxis appears to be low (0.36%). Incidence of HIT in patients with isolated lower leg injuries receiving LMWH seems very low. Monitoring of platelet count could be considered in hospitalised patients with a high risk for development of HIT. A pre-test scoring system may identify these patients. Copyright © 2011. Published by Elsevier Ltd.

A biomechanical comparison in the lower limb and lumbar spine between a hit and drag flick in field hockey.

PubMed

Ng, Leo; Rosalie, Simon M; Sherry, Dorianne; Loh, Wei Bing; Sjurseth, Andreas M; Iyengar, Shrikant; Wild, Catherine Y

2018-03-01

Research has revealed that field hockey drag flickers have greater odds of hip and lumbar injuries compared to non-drag flickers (DF). This study aimed to compare the biomechanics of a field hockey hit and a specialised field hockey drag flick. Eighteen male and seven female specialised hockey DF performed a hit and a drag flick in a motion analysis laboratory with an 18-camera three-dimensional motion analysis system and a calibrated multichannel force platform to examine differences in lower limb and lumbar kinematics and kinetics. Results revealed that drag flicks were performed with more of a forward lunge on the left lower limb resulting in significantly greater left ankle dorsiflexion, knee, hip and lumbar flexion (Ps<0.001) compared to a hit. Drag flicks were also performed with significantly greater lateral flexion (P < 0.002) and rotation of the lumbar spine (P < 0.006) compared to a hit. Differences in kinematics lead to greater shear, compression and tensile forces in multiple left lower limb and lumbar joints in the drag flick compared to the hit (P < 0.05). The biomechanical differences in drag flicks compared to a hit may have ramifications with respect to injury in field hockey drag flickers.

How I treat double-hit lymphoma.

PubMed

Friedberg, Jonathan W

2017-08-03

The 2016 revision of the World Health Organization (WHO) classification for lymphoma has included a new category of lymphoma, separate from diffuse large B-cell lymphoma, termed high-grade B-cell lymphoma with translocations involving myc and bcl-2 or bcl-6 . These lymphomas, which occur in <10% of cases of diffuse large B-cell lymphoma, have been referred to as double-hit lymphomas (or triple-hit lymphomas if all 3 rearrangements are present). It is important to differentiate these lymphomas from the larger group of double-expressor lymphomas, which have increased expression of MYC and BCL-2 and/or BCL-6 by immunohistochemistry, by using variable cutoff percentages to define positivity. Patients with double-hit lymphomas have a poor prognosis when treated with standard chemoimmunotherapy and have increased risk of central nervous system involvement and progression. Double-hit lymphomas may arise as a consequence of the transformation of the underlying indolent lymphoma. There are no published prospective trials in double-hit lymphoma, however retrospective studies strongly suggest that aggressive induction regimens may confer a superior outcome. In this article, I review my approach to the evaluation and treatment of double-hit lymphoma, with an eye toward future clinical trials incorporating rational targeted agents into the therapeutic armamentarium. © 2017 by The American Society of Hematology.

An Analytic Model for the Success Rate of a Robotic Actuator System in Hitting Random Targets.

PubMed

Bradley, Stuart

2015-11-20

Autonomous robotic systems are increasingly being used in a wide range of applications such as precision agriculture, medicine, and the military. These systems have common features which often includes an action by an "actuator" interacting with a target. While simulations and measurements exist for the success rate of hitting targets by some systems, there is a dearth of analytic models which can give insight into, and guidance on optimization, of new robotic systems. The present paper develops a simple model for estimation of the success rate for hitting random targets from a moving platform. The model has two main dimensionless parameters: the ratio of actuator spacing to target diameter; and the ratio of platform distance moved (between actuator "firings") to the target diameter. It is found that regions of parameter space having specified high success are described by simple equations, providing guidance on design. The role of a "cost function" is introduced which, when minimized, provides optimization of design, operating, and risk mitigation costs.

Syndromic surveillance for health information system failures: a feasibility study.

PubMed

Ong, Mei-Sing; Magrabi, Farah; Coiera, Enrico

2013-05-01

To explore the applicability of a syndromic surveillance method to the early detection of health information technology (HIT) system failures. A syndromic surveillance system was developed to monitor a laboratory information system at a tertiary hospital. Four indices were monitored: (1) total laboratory records being created; (2) total records with missing results; (3) average serum potassium results; and (4) total duplicated tests on a patient. The goal was to detect HIT system failures causing: data loss at the record level; data loss at the field level; erroneous data; and unintended duplication of data. Time-series models of the indices were constructed, and statistical process control charts were used to detect unexpected behaviors. The ability of the models to detect HIT system failures was evaluated using simulated failures, each lasting for 24 h, with error rates ranging from 1% to 35%. In detecting data loss at the record level, the model achieved a sensitivity of 0.26 when the simulated error rate was 1%, while maintaining a specificity of 0.98. Detection performance improved with increasing error rates, achieving a perfect sensitivity when the error rate was 35%. In the detection of missing results, erroneous serum potassium results and unintended repetition of tests, perfect sensitivity was attained when the error rate was as small as 5%. Decreasing the error rate to 1% resulted in a drop in sensitivity to 0.65-0.85. Syndromic surveillance methods can potentially be applied to monitor HIT systems, to facilitate the early detection of failures.

Muon reconstruction with a geometrical model in JUNO

NASA Astrophysics Data System (ADS)

Genster, C.; Schever, M.; Ludhova, L.; Soiron, M.; Stahl, A.; Wiebusch, C.

2018-03-01

The Jiangmen Neutrino Underground Observatory (JUNO) is a 20 kton liquid scintillator detector currently under construction near Kaiping in China. The physics program focuses on the determination of the neutrino mass hierarchy with reactor anti-neutrinos. For this purpose, JUNO is located 650 m underground with a distance of 53 km to two nuclear power plants. As a result, it is exposed to a muon flux that requires a precise muon reconstruction to make a veto of cosmogenic backgrounds viable. Established muon tracking algorithms use time residuals to a track hypothesis. We developed an alternative muon tracking algorithm that utilizes the geometrical shape of the fastest light. It models the full shape of the first, direct light produced along the muon track. From the intersection with the spherical PMT array, the track parameters are extracted with a likelihood fit. The algorithm finds a selection of PMTs based on their first hit times and charges. Subsequently, it fits on timing information only. On a sample of through-going muons with a full simulation of readout electronics, we report a spatial resolution of 20 cm of distance from the detector's center and an angular resolution of 1.6o over the whole detector. Additionally, a dead time estimation is performed to measure the impact of the muon veto. Including the step of waveform reconstruction on top of the track reconstruction, a loss in exposure of only 4% can be achieved compared to the case of a perfect tracking algorithm. When including only the PMT time resolution, but no further electronics simulation and waveform reconstruction, the exposure loss is only 1%.

Test beam performance measurements for the Phase I upgrade of the CMS pixel detector

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

Dragicevic, M.; Friedl, M.; Hrubec, J.

A new pixel detector for the CMS experiment was built in order to cope with the instantaneous luminosities anticipated for the Phase~I Upgrade of the LHC. The new CMS pixel detector provides four-hit tracking with a reduced material budget as well as new cooling and powering schemes. A new front-end readout chip mitigates buffering and bandwidth limitations, and allows operation at low comparator thresholds. Here in this paper, comprehensive test beam studies are presented, which have been conducted to verify the design and to quantify the performance of the new detector assemblies in terms of tracking efficiency and spatial resolution. Under optimal conditions, the tracking efficiency ismore » $$99.95\\pm0.05\\,\\%$$, while the intrinsic spatial resolutions are $$4.80\\pm0.25\\,\\mu \\mathrm{m}$$ and $$7.99\\pm0.21\\,\\mu \\mathrm{m}$$ along the $$100\\,\\mu \\mathrm{m}$$ and $$150\\,\\mu \\mathrm{m}$$ pixel pitch, respectively. The findings are compared to a detailed Monte Carlo simulation of the pixel detector and good agreement is found.« less

Test beam performance measurements for the Phase I upgrade of the CMS pixel detector

DOE PAGES

Dragicevic, M.; Friedl, M.; Hrubec, J.; ...

2017-05-30

A new pixel detector for the CMS experiment was built in order to cope with the instantaneous luminosities anticipated for the Phase~I Upgrade of the LHC. The new CMS pixel detector provides four-hit tracking with a reduced material budget as well as new cooling and powering schemes. A new front-end readout chip mitigates buffering and bandwidth limitations, and allows operation at low comparator thresholds. Here in this paper, comprehensive test beam studies are presented, which have been conducted to verify the design and to quantify the performance of the new detector assemblies in terms of tracking efficiency and spatial resolution. Under optimal conditions, the tracking efficiency ismore » $$99.95\\pm0.05\\,\\%$$, while the intrinsic spatial resolutions are $$4.80\\pm0.25\\,\\mu \\mathrm{m}$$ and $$7.99\\pm0.21\\,\\mu \\mathrm{m}$$ along the $$100\\,\\mu \\mathrm{m}$$ and $$150\\,\\mu \\mathrm{m}$$ pixel pitch, respectively. The findings are compared to a detailed Monte Carlo simulation of the pixel detector and good agreement is found.« less

Development and application of compact and on-chip electron linear accelerators for dynamic tracking cancer therapy and DNA damage/repair analysis

NASA Astrophysics Data System (ADS)

Uesaka, M.; Demachi, K.; Fujiwara, T.; Dobashi, K.; Fujisawa, H.; Chhatkuli, R. B.; Tsuda, A.; Tanaka, S.; Matsumura, Y.; Otsuki, S.; Kusano, J.; Yamamoto, M.; Nakamura, N.; Tanabe, E.; Koyama, K.; Yoshida, M.; Fujimori, R.; Yasui, A.

2015-06-01

We are developing compact electron linear accelerators (hereafter linac) with high RF (Radio Frequency) frequency (9.3 GHz, wavelength 32.3 mm) of X-band and applying to medicine and non-destructive testing. Especially, potable 950 keV and 3.95 MeV linac X-ray sources have been developed for on-site transmission testing at several industrial plants and civil infrastructures including bridges. 6 MeV linac have been made for pinpoint X-ray dynamic tracking cancer therapy. The length of the accelerating tube is ∼600 mm. The electron beam size at the X-ray target is less than 1 mm and X-ray spot size at the cancer is less than 3 mm. Several hardware and software are under construction for dynamic tracking therapy for moving lung cancer. Moreover, as an ultimate compact linac, we are designing and manufacturing a laser dielectric linac of ∼1 MeV with Yr fiber laser (283 THz, wavelength 1.06 pm). Since the wavelength is 1.06 μm, the length of one accelerating strcture is tens pm and the electron beam size is in sub-micro meter. Since the sizes of cell and nuclear are about 10 and 1 μm, respectively, we plan to use this “On-chip” linac for radiation-induced DNA damage/repair analysis. We are thinking a system where DNA in a nucleus of cell is hit by ∼1 μm electron or X-ray beam and observe its repair by proteins and enzymes in live cells in-situ.

Track reconstruction for the Mu3e experiment based on a novel Multiple Scattering fit

NASA Astrophysics Data System (ADS)

Kozlinskiy, Alexandr

2017-08-01

The Mu3e experiment is designed to search for the lepton flavor violating decay μ+ → e+e+e-. The aim of the experiment is to reach a branching ratio sensitivity of 10-16. In a first phase the experiment will be performed at an existing beam line at the Paul-Scherrer Institute (Switzerland) providing 108 muons per second, which will allow to reach a sensitivity of 2 · 10-15. The muons with a momentum of about 28 MeV/c are stopped and decay at rest on a target. The decay products (positrons and electrons) with energies below 53MeV are measured by a tracking detector consisting of two double layers of 50 μm thin silicon pixel sensors. The high granularity of the pixel detector with a pixel size of 80 μm × 80 μm allows for a precise track reconstruction in the high multiplicity environment of the Mu3e experiment, reaching 100 tracks per reconstruction frame of 50 ns in the final phase of the experiment. To deal with such high rates and combinatorics, the Mu3e track reconstruction uses a novel fit algorithm that in the simplest case takes into account only the multiple scattering, which allows for a fast online tracking on a GPU based filter farm. An implementation of the 3-dimensional multiple scattering fit based on hit triplets is described. The extension of the fit that takes into account energy losses and pixel size is used for offline track reconstruction. The algorithm and performance of the offline track reconstruction based on a full Geant4 simulation of the Mu3e detector are presented.

Warship Combat System Selection Methodology Based on Discrete Event Simulation

DTIC Science & Technology

2010-09-01

Platform (from Spanish) PD Damage Probability xiv PHit Hit Probability PKill Kill Probability RSM Response Surface Model SAM Surface-Air Missile...such a large target allows an assumption that the probability of a hit ( PHit ) is one. This structure can be considered as a bridge; therefore, the

a Portable Pixel Detector Operating as AN Active Nuclear Emulsion and its Application for X-Ray and Neutron Tomography

NASA Astrophysics Data System (ADS)

Vykydal, Z.; Jakubek, J.; Holy, T.; Pospisil, S.

2006-04-01

This work is devoted to the development of a USB1.1 (Universal Serial Bus) based read out system for the Medipix2 detector to achieve maximum portability of this position sensitive detecting device. All necessary detector support is integrated into one compact system (80 × 50 × 20 mm3) including the detector bias source (up to 100 V). The read out interface can control external I2C based devices, so in case of tomography it is easy to synchronize detector shutter with stepper motor control. An additional significant advantage of the USB interface is the support of back side pulse processing. This feature enables to determine the energy additionally to the position of a heavy charged particle hitting the sensor. Due to the small pixel dimensions it is also possible to distinguish the type of single quanta of radiation from the track created in the pixel detector as in case of an active nuclear emulsion.

Intra- and Interexaminer Variability of Two Separate Video Head Impulse Test Systems Assessing All Six Semicircular Canals.

PubMed

Abrahamsen, Emil Riis; Christensen, Ann-Eva; Hougaard, Dan Dupont

2018-02-01

To evaluate intra- and interexaminer variability of the video Head Impulse Test (v-HIT) when assessing all six semicircular canals (SCCs) of two separate v-HIT systems. Prospective study. Department of Otolaryngology, Head and Neck Surgery, Aalborg University Hospital, Denmark. One hundred twenty healthy subjects. Four separate tests of all six SCCs with either system A or system B. Two examiners tested all subjects twice. Pretest randomization included type of v-HIT system, order of paired SCC testing, as well as initial examiner. Gain values and the presence of pathological saccades were registered. Ninety-five percent limits of agreement (LOAs) were calculated for both intra- and interexaminer variability. Adding or subtracting the value from the mean difference achieves the upper and lower bound LOA. Ninety-five percent of the differences lie within these limits. Interexaminer reliability: System A: LOAs between 0.13 and 0.24 for the horizontal SCCs and between 0.42 and 0.74 for the vertical SCCs. System B: LOAs between 0.09 and 0.13 for the horizontal SCCs and between 0.13 and 0.20 for the vertical SCCs. Intraexaminer reliability: System A: LOAs were 0.19 and 0.14 for the horizontal SCCs and varied from 0.43 to 0.53 for the vertical SCCs. System B: LOAs were 0.14 for the horizontal SCCs and varied from 0.13 to 0.22 for the vertical SCCs. Horizontal SCC testing: both v-HIT systems displayed good intra- and interexaminer variability. Vertical SCC testing: System B displayed good intra- and interexaminer variability whereas the opposite was true with system A.

Emerging Trends in China’s Development of Unmanned Systems

DTIC Science & Technology

2015-01-01

missions is another area of emphasis, as highlighted by reports about such systems’ use during the 2008 Sichuan earth - quake , and unmanned systems could...China Strategic Perspectives No. 5, National Defense University, September 2012. 27 “Drones Dispatched to Capture Images of Quake -Hit Regions,” Xinhua...china-deliver-packages-even-a- birthday-cake/ “Drones Dispatched to Capture Images of Quake -Hit Regions,” Xinhua, April 20, 2013. Easton, Ian M

Designing Patient-facing Health Information Technologies for the Outpatient Settings: A Literature Review.

PubMed

Yang, Yushi; Asan, Onur

2016-04-06

  The implementation of health information technologies (HITs) has changed the dynamics of doctor-patient communication in outpatient settings. Designing patient-facing HITs provides patients with easy access to healthcare information during the visit and has the potential to enhance the patient-centred care.  The objectives of this study are to systematically review how the designs of patient-facing HITs have been suggested and evaluated, and how they may potentially affect the doctor-patient communication and patient-centred care.  We conducted an online database search to identify articles published before December 2014 relevant to the objectives of this study. A total of nine papers have been identified and reviewed in this study.  Designing patient-facing HITs is at an early stage. The current literature has been exploring the impact of HITs on doctor-patient communication dynamics. Based on the findings of these studies, there is an emergent need to design more patient-centred HITs. There are also some papers that focus on the usability evaluation of some preliminary prototypes of the patient-facing HITs. The design styles of patient-facing HITs included sharing the health information with the patients on: (1) a separate patient display, (2) a projector, (3) a portable tablet, (4) a touch-based screen and (5) a shared computer display that can be viewed by both doctors and patients. Each of them had the strengths and limitations to facilitate the patient-centred care, and it is worthwhile to make a comparison of them in order to identify future research directions.  The designs of patient-facing HITs in outpatient settings are promising in facilitating the doctor-patient communication and patient engagement. However, their effectiveness and usefulness need to be further evaluated and improved from a systems perspective.

Validation of concussion risk curves for collegiate football players derived from HITS data.

PubMed

Funk, James R; Rowson, Steven; Daniel, Ray W; Duma, Stefan M

2012-01-01

For several years, Virginia Tech and other schools have measured the frequency and severity of head impacts sustained by collegiate American football players in real time using the Head Impact Telemetry (HIT) System of helmet-mounted accelerometers. In this study, data from 37,128 head impacts collected at Virginia Tech during games from 2006 to 2010 were analyzed. Peak head acceleration exceeded 100 g in 516 impacts, and the Head Injury Criterion (HIC) exceeded 200 in 468 impacts. Four instrumented players in the dataset sustained a concussion. These data were used to develop risk curves for concussion as a function of peak head acceleration and HIC. The validity of this biomechanical approach was assessed using epidemiological data on concussion incidence from other sources. Two specific aspects of concussion incidence were addressed: the variation by player position, and the frequency of repeat concussions. The HIT System data indicated that linemen sustained the highest overall number of head impacts, while skill positions sustained a higher number of more severe head impacts (peak acceleration > 100 g or HIC > 200). When weighted using injury risk curves, the HIT System data predicted a higher incidence of concussion in skill positions compared to linemen at rates that were in strong agreement with the epidemiological literature (Pearson's r = 0.72-0.87). The predicted rates of repeat concussions (21-39% over one season and 33-50% over five seasons) were somewhat higher than the ranges reported in the epidemiological literature. These analyses demonstrate that simple biomechanical parameters that can be measured by the HIT System possess a high level of power for predicting concussion.

Online Data Reduction for the Belle II Experiment using DATCON

NASA Astrophysics Data System (ADS)

Bernlochner, Florian; Deschamps, Bruno; Dingfelder, Jochen; Marinas, Carlos; Wessel, Christian

2017-08-01

The new Belle II experiment at the asymmetric e+e-accelerator SuperKEKB at KEK in Japan is designed to deliver a peak luminosity of 8 × 1035cm-2s-1. To perform high-precision track reconstruction, e.g. for measurements of time-dependent CP-violating decays and secondary vertices, the Belle II detector is equipped with a highly segmented pixel detector (PXD). The high instantaneous luminosity and short bunch crossing times result in a large stream of data in the PXD, which needs to be significantly reduced for offline storage. The data reduction is performed using an FPGA-based Data Acquisition Tracking and Concentrator Online Node (DATCON), which uses information from the Belle II silicon strip vertex detector (SVD) surrounding the PXD to carry out online track reconstruction, extrapolation to the PXD, and Region of Interest (ROI) determination on the PXD. The data stream is reduced by a factor of ten with an ROI finding efficiency of >90% for PXD hits inside the ROI down to 50MeV in pT of the stable particles. We will present the current status of the implementation of the track reconstruction using Hough transformations, and the results obtained for simulated ϒ(4S) → BB¯ events.

Optical Diagnostics on HIT-SI3

NASA Astrophysics Data System (ADS)

Everson, Christopher; Jarboe, Thomas; Morgan, Kyle

2016-10-01

Interferometry and Thomson Scattering are implemented on the HIT-SI3 (Helicity Injected Torus - Steady Inductive 3) device to provide time resolved measurements of electron density and spatially resolved measurements of electron temperature, respectively. HIT-SI3 is a modification of the original HIT-SI apparatus that uses three injectors instead of two. The scientific aim of HIT-SI3 is to develop a deeper understanding of how injector behavior and interactions influence current drive and spheromak stability. The interferometer system makes use of an intermediate frequency between two parallel 184.3 μm Far-Infrared (FIR) laser cavities which are optically pumped by a CO2 laser. The phase shift in this beat frequency due to the plasma index of refraction is used to calculate the line-integrated electron density. To measure the electron temperature, Thomson Scattered light from a 20 J (1 GW pulse) Ruby laser off of free electrons in the HIT-SI3 plasma is measured simultaneously at four locations across the spheromak (nominally 23 cm minor radius). Polychromators bin the collected light into 3 spectral bands to detect the relative level of scattering. Work supported by the D.O.E.

Embryogenesis and organogenesis of Carausius morosus under spaceflight conditions.

PubMed

Bucker, H; Facius, R; Horneck, G; Reitz, G; Graul, E H; Berger, H; Hoffken, H; Ruther, W; Heinrich, W; Beaujean, R; Enge, W

1986-01-01

The influence of cosmic radiation and/or microgravity on insect development was studied during the 7 day German Spacelab Mission D1. Eggs of Carausius morosus of five stages differing in sensitivity to radiation and in capacity to regeneration were allowed to continue their development in the BIORACK 22 degrees C incubator, either at microgravity conditions or on the 1 g reference centrifuge. Using the Biostack concept--eggs in monolayers were sandwiched between visual track detectors--and the 1 g reference centrifuge, we were able to separate radiation effects from microgravity effects and also from combined effects of these two factors in space. After retrieval, hatching rates, growth kinetics and anomaly frequencies were determined in the different test samples. The early stages of development turned out to be highly sensitive to single hits of cosmic ray particles as well as to the temporary exposure to microgravity during their development. In some cases, the combined action of radiation and microgravity even amplified the effects exerted by the single parameters of space. Hits by single HZE particles caused early effects, such as body anomalies, as well as late effects, such as retarded growth after hatching. Microgravity exposure lead to a reduced hatching rate. A synergistic action of HZE particle hits and microgravity was established in the unexpectedly high frequency of anomal larvae. However, it cannot be excluded, that cosmic background radiation or low LET HZE particles are also causally involved in damage observed in the microgravity samples.

Why hospitals adopt patient engagement functionalities at different speeds? A moderated trend analysis.

PubMed

Asagbra, O Elijah; Burke, Darrell; Liang, Huigang

2018-03-01

To investigate acute care hospitals' adoption speed of patient engagement health information technology (HIT) functionalities from 2008 to 2013 and how this speed is contingent on environmental factors and hospital characteristics. Data on non-government acute care hospitals located in the United States was obtained from merging three databases: the American Hospital Association's (AHA) annual survey information technology supplement, AHA annual survey, and the Area Health Resource File (AHRF). The variables obtained from these datasets were the amount of annually adopted patient engagement HIT functionalities and environmental and organizational characteristics. Environmental factors included were uncertainty, munificence, and complexity. Hospital characteristics included size, system membership, ownership, and teaching status. A regression analysis of 4176 hospital-year observations revealed a positive trend in the adoption of HIT functionalities for patient engagement (β= 1.109, p < 0.05). Moreover, the study showed that large, system-affiliated, not-for-profit, teaching hospitals adopt patient engagement HIT functionalities at a faster speed than their counterparts. Environmental munificence and uncertainty were also associated with an accelerating speed of adoption. Environmental complexity however did not show a significant impact on the speed of adoption. From 2008 to 2013, there was a significant acceleration in the speed of adopting patient engagement HIT functionalities. Further efforts should be made to ensure proper adoption and consistent use by patients in order to reap the benefits of these IT investments. Hospitals adopted at least one HIT functionality for patient engagement per year. The adoption speed varied across hospitals, depending on both environmental and organizational factors. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical Computer Systems Survey (CLICS): learning about health information technology (HIT) in its context of use.

PubMed

Lichtner, Valentina; Cornford, Tony; Klecun, Ela

2013-01-01

Successful health information technology (HIT) implementations need to be informed on the context of use and on users' attitudes. To this end, we developed the CLinical Computer Systems Survey (CLICS) instrument. CLICS reflects a socio-technical view of HIT adoption, and is designed to encompass all members of the clinical team. We used the survey in a large English hospital as part of its internal evaluation of the implementation of an electronic patient record system (EPR). The survey revealed extent and type of use of the EPR; how it related to and integrated with other existing systems; and people's views on its use, usability and emergent safety issues. Significantly, participants really appreciated 'being asked'. They also reminded us of the wider range of administrative roles engaged with EPR. This observation reveals pertinent questions as to our understanding of the boundaries between administrative tasks and clinical medicine - what we propose as the field of 'administrative medicine'.

Stimulus bill implementation: expanding meaningful use of health IT.

PubMed

Cunningham, Rob

2009-08-25

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish HIT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government's leadership role in promoting HIT. But successful adoption and utilization across the health system will also require development of a supportive infrastructure and broad-based efforts by providers, vendors, state-based agencies, and other health system stakeholders. Optimal use of IT for health care may require extensive reengineering of medical practice and of existing systems of payment. The future course of HIT adoption will also be subject to the effects of any health care reform legislation and of technological innovation in the fast-changing world of electronic communications

Clustered DNA damages induced by high and low LET radiation, including heavy ions

NASA Technical Reports Server (NTRS)

Sutherland, B. M.; Bennett, P. V.; Schenk, H.; Sidorkina, O.; Laval, J.; Trunk, J.; Monteleone, D.; Sutherland, J.; Lowenstein, D. I. (Principal Investigator)

2001-01-01

Clustered DNA damages--here defined as two or more lesions (strand breaks, oxidized purines, oxidized pyrimidines or abasic sites) within a few helical turns--have been postulated as difficult to repair accurately, and thus highly significant biological lesions. Further, attempted repair of clusters may produce double strand breaks (DSBs). However, until recently, there was no way to measure ionizing radiation-induced clustered damages, except DSB. We recently described an approach for measuring classes of clustered damages (oxidized purine clusters, oxidized pyrimidine clusters, abasic clusters, along with DSB). We showed that ionizing radiation (gamma rays and Fe ions, 1 GeV/amu) does induce such clusters in genomic DNA in solution and in human cells. These studies also showed that each damage cluster results from one radiation hit (and its track), thus indicating that they can be induced by very low doses of radiation, i.e. two independent hits are not required for cluster induction. Further, among all complex damages, double strand breaks comprise--at most-- 20%, with the other clustered damages being at least 80%.

Syndromic surveillance for health information system failures: a feasibility study

PubMed Central

Ong, Mei-Sing; Magrabi, Farah; Coiera, Enrico

2013-01-01

Objective To explore the applicability of a syndromic surveillance method to the early detection of health information technology (HIT) system failures. Methods A syndromic surveillance system was developed to monitor a laboratory information system at a tertiary hospital. Four indices were monitored: (1) total laboratory records being created; (2) total records with missing results; (3) average serum potassium results; and (4) total duplicated tests on a patient. The goal was to detect HIT system failures causing: data loss at the record level; data loss at the field level; erroneous data; and unintended duplication of data. Time-series models of the indices were constructed, and statistical process control charts were used to detect unexpected behaviors. The ability of the models to detect HIT system failures was evaluated using simulated failures, each lasting for 24 h, with error rates ranging from 1% to 35%. Results In detecting data loss at the record level, the model achieved a sensitivity of 0.26 when the simulated error rate was 1%, while maintaining a specificity of 0.98. Detection performance improved with increasing error rates, achieving a perfect sensitivity when the error rate was 35%. In the detection of missing results, erroneous serum potassium results and unintended repetition of tests, perfect sensitivity was attained when the error rate was as small as 5%. Decreasing the error rate to 1% resulted in a drop in sensitivity to 0.65–0.85. Conclusions Syndromic surveillance methods can potentially be applied to monitor HIT systems, to facilitate the early detection of failures. PMID:23184193

A Dutch and American commentary on IT in health care: roundtable discussions on IT and innovations in health care.

PubMed

Savage, Grant T; van der Reis, Leo

2012-01-01

This chapter reports on experts' perspectives on health information technology (HIT) and how it may be used to improve health care quality and to lower health care costs. Two roundtables were convened that focused on how to best use HIT to improve the quality of health care while ensuring it is accessible and affordable. Participants drew upon lessons learned in the Netherlands, the United States, and other countries. The first roundtable focused on the use of (1) electronic health records (EHRs) by health care providers, (2) cloud computing for EHRs and health portals for consumers, and (3) data registries and networks for public health surveillance. The second roundtable highlighted (1) the rapid growth of personalized medicine, (2) the corresponding growth and sophistication of bioinformatics and analytics, (3) the increasing presence of mobile HIT, and (4) the disruptive changes in the institutional structures of biomedical research and development. Governmental sponsorship of small pilot projects to solve practicable health system problems would encourage HIT innovation among key stakeholders. However, large-scale HIT solutions developed through small pilot projects--should be pursued through public-private partnerships. At the same time, governments should speed up legislative and regulatory procedures to encourage adoption of cost-effective HIT innovations. Mobile HIT and social media are capable of fostering disease prevention and encouraging personal responsibility for improving or stabilizing chronic diseases. Both health services researchers and policy makers should find this chapter of value since it highlights trends in HIT and addresses how health care quality may be improved while costs are contained.

Safety performance evaluation of cable median barriers on freeways in Florida.

PubMed

Alluri, Priyanka; Haleem, Kirolos; Gan, Albert; Mauthner, John

2016-07-03

This article aims to evaluate the safety performance of cable median barriers on freeways in Florida. The safety performance evaluation was based on the percentages of barrier and median crossovers by vehicle type, crash severity, and cable median barrier type (Trinity Cable Safety System [CASS] and Gibraltar system). Twenty-three locations with cable median barriers totaling about 101 miles were identified. Police reports of 6,524 crashes from years 2005-2010 at these locations were reviewed to verify and obtain detailed crash information. A total of 549 crashes were determined to be barrier related (i.e., crashes involving vehicles hitting the cable median barrier) and were reviewed in further detail to identify crossover crashes and the manner in which the vehicles crossed the barriers; that is, by either overriding, underriding, or penetrating the barriers. Overall, 2.6% of vehicles that hit the cable median barrier crossed the median and traversed into the opposite travel lane. Overall, 98.1% of cars and 95.5% of light trucks that hit the barrier were prevented from crossing the median. In other words, 1.9% of cars and 4.5% of light trucks that hit the barrier had crossed the median and encroached on the opposite travel lanes. There is no significant difference in the performance of cable median barrier for cars versus light trucks in terms of crossover crashes. In terms of severity, overrides were more severe compared to underrides and penetrations. The statistics showed that the CASS and Gibraltar systems performed similarly in terms of crossover crashes. However, the Gibraltar system experienced a higher proportion of penetrations compared to the CASS system. The CASS system resulted in a slightly higher percentage of moderate and minor injury crashes compared to the Gibraltar system. Cable median barriers are successful in preventing median crossover crashes; 97.4% of the cable median barrier crashes were prevented from crossing over the median. Of all of the vehicles that hit the barrier, 83.6% were either redirected or contained by the cable barrier system. Barrier crossover crashes were found to be more severe compared to barrier noncrossover crashes. In addition, overrides were found to be more severe compared to underrides and penetrations.

Mars Science Laboratory Interplanetary Navigation Performance

NASA Technical Reports Server (NTRS)

Martin-Mur, Tomas J.; Kruizinga, Gerhard; Wong, Mau

2013-01-01

The Mars Science Laboratory spacecraft, carrying the Curiosity rover to Mars, hit the top of the Martian atmosphere just 200 meters from where it had been predicted more than six days earlier, and 2.6 million kilometers away. This un-expected level of accuracy was achieved by a combination of factors including: spacecraft performance, tracking data processing, dynamical modeling choices, and navigation filter setup. This paper will describe our best understanding of what were the factors that contributed to this excellent interplanetary trajectory prediction performance. The accurate interplanetary navigation contributed to the very precise landing performance, and to the overall success of the mission.

Early Hits and Long-Term Consequences: Tracking the Lasting Impact of Prenatal Smoke Exposure on Telomere Length in Children

PubMed Central

McKasson, Sarah; Mabile, Emily; Dunaway, Lauren F.; Drury, Stacy S.

2013-01-01

We examined the association between telomere length and prenatal tobacco exposure (PTE) in 104 children aged 4 to 14 years. Salivary telomere length (STL) was determined from salivary DNA using quantitative polymerase chain reaction. Of the children, 18% had maternal reported PTE. Mean STL was significantly lower among children with PTE (6.4 vs 7.5, P < .05). Findings extend the literature demonstrating the negative long-term effects of PTE to include a cellular marker of aging linked to multiple negative health outcomes. PMID:23927510

Informatics Technology Mimics Ecology: Dense, Mutualistic Collaboration Networks Are Associated with Higher Publication Rates

PubMed Central

Sorani, Marco D.

2012-01-01

Information technology (IT) adoption enables biomedical research. Publications are an accepted measure of research output, and network models can describe the collaborative nature of publication. In particular, ecological networks can serve as analogies for publication and technology adoption. We constructed network models of adoption of bioinformatics programming languages and health IT (HIT) from the literature. We selected seven programming languages and four types of HIT. We performed PubMed searches to identify publications since 2001. We calculated summary statistics and analyzed spatiotemporal relationships. Then, we assessed ecological models of specialization, cooperativity, competition, evolution, biodiversity, and stability associated with publications. Adoption of HIT has been variable, while scripting languages have experienced rapid adoption. Hospital systems had the largest HIT research corpus, while Perl had the largest language corpus. Scripting languages represented the largest connected network components. The relationship between edges and nodes was linear, though Bioconductor had more edges than expected and Perl had fewer. Spatiotemporal relationships were weak. Most languages shared a bioinformatics specialization and appeared mutualistic or competitive. HIT specializations varied. Specialization was highest for Bioconductor and radiology systems. Specialization and cooperativity were positively correlated among languages but negatively correlated among HIT. Rates of language evolution were similar. Biodiversity among languages grew in the first half of the decade and stabilized, while diversity among HIT was variable but flat. Compared with publications in 2001, correlation with publications one year later was positive while correlation after ten years was weak and negative. Adoption of new technologies can be unpredictable. Spatiotemporal relationships facilitate adoption but are not sufficient. As with ecosystems, dense, mutualistic, specialized co-habitation is associated with faster growth. There are rapidly changing trends in external technological and macroeconomic influences. We propose that a better understanding of how technologies are adopted can facilitate their development. PMID:22279593

Estimating residual fault hitting rates by recapture sampling

NASA Technical Reports Server (NTRS)

Lee, Larry; Gupta, Rajan

1988-01-01

For the recapture debugging design introduced by Nayak (1988) the problem of estimating the hitting rates of the faults remaining in the system is considered. In the context of a conditional likelihood, moment estimators are derived and are shown to be asymptotically normal and fully efficient. Fixed sample properties of the moment estimators are compared, through simulation, with those of the conditional maximum likelihood estimators. Properties of the conditional model are investigated such as the asymptotic distribution of linear functions of the fault hitting frequencies and a representation of the full data vector in terms of a sequence of independent random vectors. It is assumed that the residual hitting rates follow a log linear rate model and that the testing process is truncated when the gaps between the detection of new errors exceed a fixed amount of time.

Interval training at 95% and 100% of the velocity at VO2 max: effects on aerobic physiological indexes and running performance.

PubMed

Denadai, Benedito S; Ortiz, Marcelo J; Greco, Camila C; de Mello, Marco T

2006-12-01

The objective of this study was to analyze the effect of two different high-intensity interval training (HIT) programs on selected aerobic physiological indices and 1500 and 5000 m running performance in well-trained runners. The following tests were completed (n=17): (i) incremental treadmill test to determine maximal oxygen uptake (VO2 max), running velocity associated with VO2 max (vVO2 max), and the velocity corresponding to 3.5 mmol/L of blood lactate concentration (vOBLA); (ii) submaximal constant-intensity test to determine running economy (RE); and (iii) 1500 and 5000 m time trials on a 400 m track. Runners were then randomized into 95% vVO2 max or 100% vVO2 max groups, and undertook a 4 week training program consisting of 2 HIT sessions (performed at 95% or 100% vVO2 max, respectively) and 4 submaximal run sessions per week. Runners were retested on all parameters at the completion of the training program. The VO2 max values were not different after training for both groups. There was a significant increase in post-training vVO2 max, RE, and 1500 m running performance in the 100% vVO2 max group. The vOBLA and 5000 m running performance were significantly higher after the training period for both groups. We conclude that vOBLA and 5000 m running performance can be significantly improved in well-trained runners using a 4 week training program consisting of 2 HIT sessions (performed at 95% or 100% vVO2 max) and 4 submaximal run sessions per week. However, the improvement in vVO2 max, RE, and 1500 m running performance seems to be dependent on the HIT program at 100% vVO2 max.

Continuous adaptive beam pointing and tracking for laser power transmission.

PubMed

Schäfer, Christian A

2010-06-21

The adaptive beam pointing concept has been revisited for the purpose of controlled transmission of laser energy from an optical transmitter to a target. After illumination, a bidirectional link is established by a retro-reflector on the target and an amplifier-phase conjugate mirror (A-PCM) on the transmitter. By setting the retro-reflector's aperture smaller than the diffraction limited spot size but big enough to provide sufficient amount of optical feedback, a stable link can be maintained and light that hits the retro-reflector's surrounded area can simultaneously be reconverted into usable electric energy. The phase conjugate feedback ensures that amplifier's distortions are compensated and the target tracked accurately.After deriving basic arithmetic expressions for the proposed system, a section is devoted for the motivation of free-space laser power transmission which is supposed to find varied applicability in space. As an example, power transmission from a satellite to the earth is described where recently proposed solar power generating structures on high-altitudes receive the power above the clouds to provide constant energy supply.In the experimental part, an A-PCM setup with reflectivity of about R(A-PCM) = 100 was realized using a semiconductor optical amplifier and a photorefractive self-pumped PCM. Simulation results show that a reflectivity of R(A-PCM)>1000 could be obtained by improving the self-pumped PCM's efficiency. That would lead to a transmission efficiency of eta>90%.

Hospital IT adoption strategies associated with implementation success: implications for achieving meaningful use.

PubMed

Ford, Eric W; Menachemi, Nir; Huerta, Timothy R; Yu, Feliciano

2010-01-01

Health systems are facing significant pressure to either implement health information technology (HIT) systems that have "certified" electronic health record applications and that fulfill the federal government's definition of "meaningful use" or risk substantial financial penalties in the near future. To this end, hospitals have adopted one of three strategies, described as "best of breed," "best of suite," and "single vendor," to meet organizational and regulatory demands. The single-vendor strategy is used by the simple majority of U.S. hospitals, but is it the most effective mode for achieving full implementation? Moreover, what are the implications of adopting this strategy for achieving meaningful use? The simple answer to the first question is that the hospitals using the hybrid best of suite strategy had fully implemented HIT systems in significantly greater proportions than did hospitals employing either of the other strategies. Nonprofit and system-affiliated hospitals were more likely to have fully implemented their HIT systems. In addition, increased health maintenance organization market penetration rates were positively correlated with complete implementation rates. These results have ongoing implications for achieving meaningful use in the near term. The federal government's rewards and incentives program related to the meaningful use of HIT in hospitals has created an organizational imperative to implement such systems. For hospitals that have not begun systemwide implementation, pursuing a best of suite strategy may provide the greatest chance for achieving all or some of the meaningful use targets in the near term or at least avoiding future penalties scheduled to begin in 2015.

Variability in clubhead presentation characteristics and ball impact location for golfers' drives.

PubMed

Betzler, Nils F; Monk, Stuart A; Wallace, Eric S; Otto, Steve R

2012-01-01

The purpose of the present study was to analyse the variability in clubhead presentation to the ball and the resulting ball impact location on the club face for a range of golfers of different ability. A total of 285 male and female participants hit multiple shots using one of four proprietary drivers. Self-reported handicap was used to quantify a participant's golfing ability. A bespoke motion capture system and user-written algorithms was used to track the clubhead just before and at impact, measuring clubhead speed, clubhead orientation, and impact location. A Doppler radar was used to measure golf ball speed. Generally, golfers of higher skill (lower handicap) generated increased clubhead speed and increased efficiency (ratio of ball speed to clubhead speed). Non-parametric statistical tests showed that low-handicap golfers exhibit significantly lower variability from shot to shot in clubhead speed, efficiency, impact location, attack angle, club path, and face angle compared with high-handicap golfers.

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

Zhang, Aiwu; Hohlmann, Marcus; Azmoun, Babak

Here, we study the position sensitivity of radial zigzag strips intended to read out large GEM detectors for tracking at future experiments. Zigzag strips can cover a readout area with fewer strips than regular straight strips while maintaining good spatial resolution. Consequently, they can reduce the number of required electronic channels and related cost for large-area GEM detector systems. A non-linear relation between incident particle position and hit position measured from charge sharing among zigzag strips was observed in a previous study. We significantly reduce this non-linearity by improving the interleaving of adjacent physical zigzag strips. Zigzag readout structures aremore » implemented on PCBs and on a flexible foil and are tested using a 10 cm × 10 cm triple-GEM detector scanned with a strongly collimated X-ray gun on a 2D motorized stage. Lastly, angular resolutions of 60–84 μrad are achieved with a 1.37 mrad angular strip pitch at a radius of 784 mm. On a linear scale this corresponds to resolutions below 100 μm.« less

The Hawaii Teleschool: An Evaluation of Distance Learning for Advanced Placement Calculus Instruction in "Paradise."

ERIC Educational Resources Information Center

Barker, Bruce O.; Bannon, James

This paper describes the Hawaii Interactive Television System (HITS) program and provides an evaluation of the first year of broadcasts for the advanced placement (AP) calculus course. HITS allows two-way video-audio interaction among origination sites, but the configuration used by the Department of Education for its Teleschool program is the…

The ATLAS SemiConductor Tracker operation and performance

NASA Astrophysics Data System (ADS)

Pater, J. R.

2012-04-01

The ATLAS SemiConductor Tracker (SCT) is a key precision tracking detector in the ATLAS experiment at CERN's Large Hadron Collider. The SCT is composed of 4088 planar p-in-n silicon micro-strip detectors. The signals from the strips are processed in the front-end ABCD3TA ASICs, which operate in binary readout mode; data are transferred to the off-detector readout electronics via optical fibres. The SCT was completed in 2007. An extensive commissioning phase followed, during which calibration data were collected and analysed to determine the noise performance of the system, and further performance parameters of the detector were determined using cosmic ray data, both with and without magnetic field. After the commissioning phase, the SCT was ready for the first LHC proton-proton collisions in December 2009. From the beginning of data taking, the completed SCT has been in very good shape with more than 99% of its 6.3 million strips operational; the detector is well timed-in and the operational channels are 99.9% efficient in data acquisition. The noise occupancy and hit efficiency are better than the design specifications. The detector geometry is monitored continuously with a laser-based alignment system and is stable to the few-micron level; the alignment accuracy as determined by tracks is near specification and improving as statistics increase. The sensor behaviour in the 2T solenoidal magnetic field has been studied by measuring the Lorentz angle. Radiation damage in the silicon is monitored by periodic measurements of the leakage current; these measurements are in reasonable agreement with predictions.

Butterfly Ejecta

NASA Technical Reports Server (NTRS)

2003-01-01

[figure removed for brevity, see original site]

Released 4 September 2003

In the heavily cratered southern highlands of Mars, the type of crater seen in this THEMIS visible image is relatively rare. Elliptical craters with 'butterfly' ejecta patterns make up roughly 5% of the total crater population of Mars. They are caused by impactors which hit the surface at oblique, or very shallow angles. Similar craters are also seen in about the same abundance on the Moon and Venus.

Image information: VIS instrument. Latitude -24.6, Longitude 41 East (319 West). 19 meter/pixel resolution.

Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

Optimistic, pessimistic, realistic: Event-related potential evidence for how depressive symptoms influences expectation formation in the Human brain.

PubMed

Hsu, Yi-Fang; Vincent, Romain; Waszak, Florian

2015-08-27

Recent research suggested a link between the prediction mechanism and depressive symptoms. While healthy people tend to maintain unrealistic optimism in the face of reality challenging their beliefs, depressed people show systematic pessimism. However, it remains unclear at which stage these individual differences in optimism/pessimism arise in the brain. In the current study we designed a simple gambling task with two difficulty levels, the easy game and the hard game. Participants were required to press one of four keys to gain a bonus signalled by a sinusoidal tone. For three of the four keys, the probability of getting a large bonus was 80% in the easy game and 8% in the hard game. In both games, the fourth key, randomly determined in each trial, yielded a large bonus with a probability of 100%. This arrangement allowed us to observe less/more depressed participants׳ optimistic/pessimistic expectations about hitting the key that guarantees a large bonus. The opposite expectation patterns of less/more depressed participants were reflected on the N1 amplitude. Meanwhile, all participants were well aware of the true probability of obtaining certain bonus in each game as reflected on the P3 amplitude. The results suggest that the subjective system (tracking subjective beliefs) and the objective system (tracking objective evidence) are dissociable in the human brain, with the former feeding information into sensory areas and the latter representing prediction errors on a higher level. Moreover, individual differences arise from variability in the former rather than the latter. Copyright © 2015 Elsevier B.V. All rights reserved.

Changes in mitochondrial function and mitochondria associated protein expression in response to 2-weeks of high intensity interval training

PubMed Central

Vincent, Grace; Lamon, Séverine; Gant, Nicholas; Vincent, Peter J.; MacDonald, Julia R.; Markworth, James F.; Edge, Johann A.; Hickey, Anthony J. R.

2015-01-01

Purpose: High-intensity short-duration interval training (HIT) stimulates functional and metabolic adaptation in skeletal muscle, but the influence of HIT on mitochondrial function remains poorly studied in humans. Mitochondrial metabolism as well as mitochondrial-associated protein expression were tested in untrained participants performing HIT over a 2-week period. Methods: Eight males performed a single-leg cycling protocol (12 × 1 min intervals at 120% peak power output, 90 s recovery, 4 days/week). Muscle biopsies (vastus lateralis) were taken pre- and post-HIT. Mitochondrial respiration in permeabilized fibers, citrate synthase (CS) activity and protein expression of peroxisome proliferator-activated receptor gamma coactivator (PGC-1α) and respiratory complex components were measured. Results: HIT training improved peak power and time to fatigue. Increases in absolute oxidative phosphorylation (OXPHOS) capacities and CS activity were observed, but not in the ratio of CCO to the electron transport system (CCO/ETS), the respiratory control ratios (RCR-1 and RCR-2) or mitochondrial-associated protein expression. Specific increases in OXPHOS flux were not apparent after normalization to CS, indicating that gross changes mainly resulted from increased mitochondrial mass. Conclusion: Over only 2 weeks HIT significantly increased mitochondrial function in skeletal muscle independently of detectable changes in mitochondrial-associated and mitogenic protein expression. PMID:25759671

High intensity aerobic exercise training improves chronic intermittent hypoxia-induced insulin resistance without basal autophagy modulation.

PubMed

Pauly, Marion; Assense, Allan; Rondon, Aurélie; Thomas, Amandine; Dubouchaud, Hervé; Freyssenet, Damien; Benoit, Henri; Castells, Josiane; Flore, Patrice

2017-03-03

Chronic intermittent hypoxia (IH) associated with obstructive sleep apnea (OSA) is a major risk factor for cardiovascular and metabolic diseases (insulin resistance: IR). Autophagy is involved in the pathophysiology of IR and high intensity training (HIT) has recently emerged as a potential therapy. We aimed to confirm IH-induced IR in a tissue-dependent way and to explore the preventive effect of HIT on IR-induced by IH. Thirty Swiss 129 male mice were randomly assigned to Normoxia (N), Intermittent Hypoxia (IH: 21-5% FiO 2 , 30 s cycle, 8 h/day) or IH associated with high intensity training (IH HIT). After 8 days of HIT (2*24 min, 50 to 90% of Maximal Aerobic Speed or MAS on a treadmill) mice underwent 14 days IH or N. We found that IH induced IR, characterized by a greater glycemia, an impaired insulin sensitivity and lower AKT phosphorylation in adipose tissue and liver. Nevertheless, MAS and AKT phosphorylation were greater in muscle after IH. IH associated with HIT induced better systemic insulin sensitivity and AKT phosphorylation in liver. Autophagy markers were not altered in both conditions. These findings suggest that HIT could represent a preventive strategy to limit IH-induced IR without change of basal autophagy.

High intensity aerobic exercise training improves chronic intermittent hypoxia-induced insulin resistance without basal autophagy modulation

PubMed Central

Pauly, Marion; Assense, Allan; Rondon, Aurélie; Thomas, Amandine; Dubouchaud, Hervé; Freyssenet, Damien; Benoit, Henri; Castells, Josiane; Flore, Patrice

2017-01-01

Chronic intermittent hypoxia (IH) associated with obstructive sleep apnea (OSA) is a major risk factor for cardiovascular and metabolic diseases (insulin resistance: IR). Autophagy is involved in the pathophysiology of IR and high intensity training (HIT) has recently emerged as a potential therapy. We aimed to confirm IH-induced IR in a tissue-dependent way and to explore the preventive effect of HIT on IR-induced by IH. Thirty Swiss 129 male mice were randomly assigned to Normoxia (N), Intermittent Hypoxia (IH: 21–5% FiO2, 30 s cycle, 8 h/day) or IH associated with high intensity training (IH HIT). After 8 days of HIT (2*24 min, 50 to 90% of Maximal Aerobic Speed or MAS on a treadmill) mice underwent 14 days IH or N. We found that IH induced IR, characterized by a greater glycemia, an impaired insulin sensitivity and lower AKT phosphorylation in adipose tissue and liver. Nevertheless, MAS and AKT phosphorylation were greater in muscle after IH. IH associated with HIT induced better systemic insulin sensitivity and AKT phosphorylation in liver. Autophagy markers were not altered in both conditions. These findings suggest that HIT could represent a preventive strategy to limit IH-induced IR without change of basal autophagy. PMID:28255159

Financial effects of health information technology: a systematic review.

PubMed

Low, Alexander F H; Phillips, Andrew B; Ancker, Jessica S; Patel, Ashwin R; Kern, Lisa M; Kaushal, Rainu

2013-11-01

Health information technology (HIT) is widely viewed as an important lever with which to improve the quality and efficiency of the healthcare system. However, there has long been debate about its financial effects. To characterize the existing data on the financial effects of HIT and to consider the implications for the effect of HIT on healthcare spending. Systematic literature review. We identified articles by (1) searching PubMed using the intersection of terms related to HIT applications and terms related to financial or economic effect; and (2) reviewing the reference lists of the included articles as well as additional policy articles and literature reviews. A total of 57 articles met our inclusion criteria, including 43 articles (75%) reporting financial benefits to a stakeholder associated with HIT. These included 26 articles (46%) reporting cost savings, 6 articles (11%) reporting revenue gains, and 11 articles (19%) reporting a mixture of cost savings and revenue gains. Among articles with experimental study designs, 22 of 34 (65%) reported financial benefits; and among articles explicitly measuring costs and benefits, 19 of 21 (90%) reported financial benefits. The most prevalent mechanisms were savings on administrative goods and/or personnel, savings on pharmaceuticals, and revenue gains through improved billing. Overall there is a dearth of articles on this topic, especially ones with strong study designs and financial analyses. HIT can have financial benefits, but more research is required, especially on HIT's effects under emerging delivery and payment reform efforts.

The value of health information technology: filling the knowledge gap.

PubMed

Rudin, Robert S; Jones, Spencer S; Shekelle, Paul; Hillestad, Richard J; Keeler, Emmett B

2014-11-01

Despite rapid growth in the rate of adoption of health information technology (HIT), and in the volume of evaluation studies, the existing knowledge base for the value of HIT is not advancing at a similar rate. Most evaluation articles are limited in that they use incomplete measures of value and fail to report the important contextual and implementation characteristics that would allow for an adequate understanding of how the study results were achieved. To address these deficiencies, we present a conceptual framework for measuring HIT value and we propose a checklist of characteristics that should be considered in HIT evaluation studies. The framework consists of 3 key principles: 1) value includes both costs and benefits; 2) value accrues over time; and 3) value depends on which stakeholder's perspective is used. Through examples, we show how these principles can be used to guide and improve HIT evaluation studies. The checklist includes a list of contextual and implementation characteristics that are important for interpretation of results. These improvements will make future studies more useful for policy makers and more relevant to the current needs of the healthcare system.

Guidelines to encourage the adoption and meaningful use of health information technologies in the South African healthcare landscape.

PubMed

Mostert-Phipps, Nicky; Pottas, Dalenca; Korpela, Mikko

2013-01-01

There are various benefits associated with the adoption and meaningful use of health information technologies (HITs) in the healthcare sector. Despite these benefits, the South African healthcare sector has been slow to adopt HITs such as electronic record systems. The purpose of this research project was to formulate guidelines to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. A three-round Delphi study was conducted to identify factors that should be addressed to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. The Delphi panel included 21 participants that were considered to be suitably knowledgeable regarding the area under consideration. Consensus was reached on 42 factors that were rated as having a direct to significant impact on the adoption and meaningful use of HITs in the South African context. These factors were further analysed to formulate 20 guidelines that indicate that there are a wide range of factors that would have to be addressed involving a multitude of stakeholders.

A large ungated TPC with GEM amplification

NASA Astrophysics Data System (ADS)

Berger, M.; Ball, M.; Fabbietti, L.; Ketzer, B.; Arora, R.; Beck, R.; Böhmer, F. V.; Chen, J.-C.; Cusanno, F.; Dørheim, S.; García, F.; Hehner, J.; Herrmann, N.; Höppner, C.; Kaiser, D.; Kis̆, M.; Kleipa, V.; Konorov, I.; Kunkel, J.; Kurz, N.; Leifels, Y.; Müllner, P.; Münzer, R.; Neubert, S.; Rauch, J.; Schmidt, C. J.; Schmitz, R.; Soyk, D.; Vandenbroucke, M.; Voss, B.; Walther, D.; Zmeskal, J.

2017-10-01

A Time Projection Chamber (TPC) is an ideal device for the detection of charged particle tracks in a large volume covering a solid angle of almost 4 π. The high density of hits on a given particle track facilitates the task of pattern recognition in a high-occupancy environment and in addition provides particle identification by measuring the specific energy loss for each track. For these reasons, TPCs with Multiwire Proportional Chamber (MWPC) amplification have been and are widely used in experiments recording heavy-ion collisions. A significant drawback, however, is the large dead time of the order of 1 ms per event generated by the use of a gating grid, which is mandatory to prevent ions created in the amplification region from drifting back into the drift volume, where they would severely distort the drift path of subsequent tracks. For experiments with higher event rates this concept of a conventional TPC operating with a triggered gating grid can therefore not be applied without a significant loss of data. A continuous readout of the signals is the more appropriate way of operation. This, however, constitutes a change of paradigm with considerable challenges to be met concerning the amplification region, the design and bandwidth of the readout electronics, and the data handling. A mandatory prerequisite for such an operation is a sufficiently good suppression of the ion backflow from the avalanche region, which otherwise limits the tracking and particle identification capabilities of such a detector. Gas Electron Multipliers (GEM) are a promising candidate to combine excellent spatial resolution with an intrinsic suppression of ions. In this paper we describe the design, construction and the commissioning of a large TPC with GEM amplification and without gating grid (GEM-TPC). The design requirements have driven innovations in the construction of a light-weight field-cage, a supporting media flange, the GEM amplification and the readout system, which are presented in this paper. We further describe the support infrastructure such as gas, cooling and slow control. Finally, we report on the operation of the GEM-TPC in the FOPI experiment, and describe the calibration procedures which are applied to achieve the design performance of the device.

Discovery of four new low-mass white-dwarf companions in the Kepler data

NASA Astrophysics Data System (ADS)

Faigler, Simchon; Kull, Ilya; Mazeh, Tsevi; Kiefer, Flavien; Latham, David W.; Bloemen, Steven

2015-12-01

We report the discovery of four new short-period eclipsing systems in the Kepler light curves, consisting of an A-star primary and a low-mass white-dwarf (WD) secondary (dA+WD) - KIC 4169521, KOI-3818, KIC 2851474 and KIC 9285587. These add to the 6 Kepler, and 19 non-Kepler, previously known short-period eclipsing dA+WD binaries.The discoveries were made through searching the light curves of bright Kepler stars for BEaming, Ellipsoidal and Reflection (BEER) modulations that are consistent with a compact companion, using the BEER search algorithm. This was followed by inspection of the search top hits, looking for eclipsing systems with a secondary eclipse deeper than the primary one, as expected for a WD that is hotter than the primary star. Follow-up spectroscopic radial-velocity (RV) observations confirmed the binarity of the systems. We derive the systems' parameters through analyses of the light curves' eclipses and phase modulations, combined with RV orbital solutions and stellar evolution models.The four systems' orbital periods of 1.17-3.82 days and WD masses of 0.19-0.22 Msun are similar to those reported for the previously known systems. These values are consistent with evolution models of such systems, that undergo a stable mass transfer from the WD progenitor to the current A star.For KIC 4169521 we derive a bloated WD radius of 0.09 Rsun that is well within the WD radius range of 0.04-0.43 Rsun of the known systems. For the remaining three systems we report WD radii of 0.026-0.035 Rsun, the smallest WD radii derived so far for short-period eclipsing dA+WD binaries.As suggested before, the previously known systems, together with KIC 4169521, all with hot and bloated WD secondaries, represent young systems probably at a proto-WD, or initial WD cooling track stage. The other three new systems - KOI-3818, KIC 2851474, and KIC 9285587, are probably positioned further along the WD cooling track, and extend the known population to older systems with cooler and smaller WD secondaries.

Centroid tracker and aimpoint selection

NASA Astrophysics Data System (ADS)

Venkateswarlu, Ronda; Sujata, K. V.; Venkateswara Rao, B.

1992-11-01

Autonomous fire and forget weapons have gained importance to achieve accurate first pass kill by hitting the target at an appropriate aim point. Centroid of the image presented by a target in the field of view (FOV) of a sensor is generally accepted as the aimpoint for these weapons. Centroid trackers are applicable only when the target image is of significant size in the FOV of the sensor but does not overflow the FOV. But as the range between the sensor and the target decreases the image of the target will grow and finally overflow the FOV at close ranges and the centroid point on the target will keep on changing which is not desirable. And also centroid need not be the most desired/vulnerable point on the target. For hardened targets like tanks, proper aimpoint selection and guidance up to almost zero range is essential to achieve maximum kill probability. This paper presents a centroid tracker realization. As centroid offers a stable tracking point, it can be used as a reference to select the proper aimpoint. The centroid and the desired aimpoint are simultaneously tracked to avoid jamming by flares and also to take care of the problems arising due to image overflow. Thresholding of gray level image to binary image is a crucial step in centroid tracker. Different thresholding algorithms are discussed and a suitable algorithm is chosen. The real-time hardware implementation of centroid tracker with a suitable thresholding technique is presented including the interfacing to a multimode tracker for autonomous target tracking and aimpoint selection. The hardware uses very high speed arithmetic and programmable logic devices to meet the speed requirement and a microprocessor based subsystem for the system control. The tracker has been evaluated in a field environment.

Quasi-steady state reduction of molecular motor-based models of directed intermittent search.

PubMed

Newby, Jay M; Bressloff, Paul C

2010-10-01

We present a quasi-steady state reduction of a linear reaction-hyperbolic master equation describing the directed intermittent search for a hidden target by a motor-driven particle moving on a one-dimensional filament track. The particle is injected at one end of the track and randomly switches between stationary search phases and mobile nonsearch phases that are biased in the anterograde direction. There is a finite possibility that the particle fails to find the target due to an absorbing boundary at the other end of the track. Such a scenario is exemplified by the motor-driven transport of vesicular cargo to synaptic targets located on the axon or dendrites of a neuron. The reduced model is described by a scalar Fokker-Planck (FP) equation, which has an additional inhomogeneous decay term that takes into account absorption by the target. The FP equation is used to compute the probability of finding the hidden target (hitting probability) and the corresponding conditional mean first passage time (MFPT) in terms of the effective drift velocity V, diffusivity D, and target absorption rate λ of the random search. The quasi-steady state reduction determines V, D, and λ in terms of the various biophysical parameters of the underlying motor transport model. We first apply our analysis to a simple 3-state model and show that our quasi-steady state reduction yields results that are in excellent agreement with Monte Carlo simulations of the full system under physiologically reasonable conditions. We then consider a more complex multiple motor model of bidirectional transport, in which opposing motors compete in a "tug-of-war", and use this to explore how ATP concentration might regulate the delivery of cargo to synaptic targets.

Analysis of Physical Collisions in Elite National Rugby League Match Play.

PubMed

Cummins, Cloe; Orr, Rhonda

2015-09-01

To investigate the impact forces of collision events during both attack and defense in elite rugby league match play and to compare the collision profiles between playing positions. 26 elite rugby league players. Player collisions were recorded using an integrated accelerometer in global positioning system units (SPI-Pro X, GPSports). Impact forces of collisions in attack (hit-ups) and defense (tackles) were analyzed from 359 files from outside backs (n = 78), adjustables (n = 97), wide-running forwards (n = 136), and hit-up forwards (n = 48) over 1 National Rugby League season. Hit-up forwards were involved in 0.8 collisions/min, significantly more than all other positional groups (wide-running forwards P = .050, adjustables P = .042, and outside backs P = .000). Outside backs experienced 25% fewer collisions per minute than hit-up forwards. Hit-up forwards experienced a collision within the 2 highest classifications of force (≥ 10 g) every 2.5 min of match play compared with 1 every 5 and 9 min for adjustables and outside backs, respectively. Hit-up forwards performed 0.5 tackles per minute of match play, 5 times that of outside backs (ES = 1.90; 95% CI [0.26,3.16]), and 0.2 hit-ups per minute of match play, twice as many as adjustables. During a rugby league match, players are exposed to a significant number of collision events. Positional differences exist, with hit-up and wide-running forwards experiencing greater collision events than adjustables and outside backs. Although these results may be unique to the individual team's defensive- and attacking-play strategies, they are indicative of the significant collision profiles in professional rugby league.

Vestibular evoked myogenic potentials and video head impulse test in patients with vertigo, dizziness and imbalance.

PubMed

Skorić, Magdalena Krbot; Adamec, Ivan; Pavičić, Tin; Pavlović, Ivan; Ruška, Berislav; Crnošija, Luka; Habek, Mario

2017-05-01

The aim of this study was to compare vestibular evoked myogenic potentials (VEMP) and video head impulse test (vHIT) results in patients presenting with vertigo and dizziness. We retrospectively analyzed data of all patients with the chief complaint of vertigo, dizziness, or imbalance that underwent VEMP and vHIT from January 2015 to January 2016. A total of 117 patients (73 females, mean age 53.92±16.76) fulfilled inclusion criteria: group 1 included patients with the final diagnosis of vestibular neuritis (VN) (N=31 (16 right and 15 left VN)), group 2 included patients with the final diagnosis of vertigo of central origin (N=23) and group 3 included patients with the final diagnosis of unspecified dizziness (N=63). There was significant correlation between oVEMP asymmetry and asymmetry of the lateral canals 60ms gains on vHIT (r=0.225, p=0.026). Significant correlation between oVEMP and vHIT asymmetry was present in VN patients (r=0.749, p<0.001), while no correlation was found in the groups 2 and 3. oVEMP and vHIT lateral canals asymmetries were significantly greater in patients with vestibular neuritis. Furthermore, positive correlations of oVEMP amplitudes with 60ms gain of the lateral semicircular canal and slope of the anterior semicircular canal on vHIT, and cVEMP with slope of the posterior semicircular canal on the vHIT were found. These changes were significantly more pronounced in patients with vestibular neuritis. In conclusion, VEMPs and vHIT data should be used complementarily; asymmetry on both tests strongly supports peripheral vestibular system involvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review.

PubMed

Kruse, Clemens Scott; Beane, Amanda

2018-02-05

Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively. A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames. ©Clemens Scott Kruse, Amanda Beane. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.02.2018.

Simulation studies of reconstruction of hadron shower direction in INO ICAL detector

NASA Astrophysics Data System (ADS)

Devi, M. M.; Dighe, A.; Indumathi, D.; Lakshmi, S. M.

2018-03-01

The proposed Iron Calorimeter (ICAL) at India-based Neutrino Observatory (INO) will be a 50 kt magnetised iron detector for the detection of atmospheric neutrinos. The atmospheric neutrinos interact via both charged current (CC) and neutral current (NC) interactions with the target iron to produce the detectable final state particles. While CC νμ (bar nuμ) leave a muon track and a hadron shower in the detector, the NC will leave only a hadron shower apart from the secondary invisible neutrino. A GEANT4 based simulation studies to reconstruct hadron showers in CC and NC, using two techniques namely the Orientation Matrix Method (OMM) and the Raw Hit Method (RHM) are presented here. While OMM requires information about the interaction vertex obtained from muon track reconstruction, RHM requires only the shower hit positions and timings and no vertex information and hence can be used for NC events as well. Hadrons from neutrino events generated with NUANCE neutrino generator are analysed. For hadrons in the energy range 0.5-15 GeV produced in CC νμ and bar nuμ interactions, a Δθ'h resolution of around 19o-9o (around 20.5o-12o) is obtained in the |cosθ'h|=[0.8, 1] bin with OMM (RHM). For NC events in the same true energy and direction bins, Δθ'h resolution varies from around 20.5o-13o, from RHM only. OMM (RHM) gives a resolution of about 55o-20o (38o-14o) for the angle between the muon and the hadron shower, βμ h', in the [E'had;cos θ'h] range [0.5-15 GeV; [0.8,1.0

Chasing Ghosts in Space Radiobiology Research: The Lost Focus on Non-Targeted Effects

NASA Astrophysics Data System (ADS)

Cucinotta, Francis; Saganti, Premkumar; Cacao, Eliedonna

2016-07-01

The doses and dose-rates of astronaut exposures to galactic cosmic rays (GCR) are accurately known, and lead to particle hits per cell nucleus from high charge and energy (HZE) particles of much less than one hit per cell per week. A large number of experiments have shown that additivity of biological effects is a valid assumption for space radiation exposures, while experiments at higher doses and dose-rates than occur in space continue to be a focus of the majority of space radiobiology research. Furthermore HZE particle exposures with mono-energetic particles manifest themselves as a mixed-radiation field due to the contributions of delta-rays and the random impact parameter of a particles track core to DNA and non-DNA targets in cells and tissues. The mixed-field manifestation of mono-energetic HZE particle exposures is well known from theoretical studies of microdosimetry and track structure. Additional mixed-field effects occur for single species experiments due to nuclear fragmentation in particle accelerator beam-lines and biological samples along with energy straggling. In contrast to these well known aspects of space radiobiology there are many open questions on the contribution of non-targeted effects to low dose and dose-rate exposures. Non-targeted effects (NTEs) include bystander effects and genomic instability, and have been shown to be the most important outstanding question for reducing uncertainties in space radiation cancer risk assessment. The dose-rate and radiation quality dependence of NTE's has not been established, while there is an over-arching need to develop 21st century experimental models of human cancer risk. We review possible mechanisms of NTE's and how new experiments to address these issues could be designed.

Track structure model of microscopic energy deposition by protons and heavy ions in segments of neuronal cell dendrites represented by cylinders or spheres

PubMed Central

Alp, Murat; Cucinotta, Francis A.

2017-01-01

Changes to cognition, including memory, following radiation exposure are a concern for cosmic ray exposures to astronauts and in Hadron therapy with proton and heavy ion beams. The purpose of the present work is to develop computational methods to evaluate microscopic energy deposition (ED) in volumes representative of neuron cell structures, including segments of dendrites and spines, using a stochastic track structure model. A challenge for biophysical models of neuronal damage is the large sizes (>100 μm) and variability in volumes of possible dendritic segments and pre-synaptic elements (spines and filopodia). We consider cylindrical and spherical microscopic volumes of varying geometric parameters and aspect ratios from 0.5 to 5 irradiated by protons, and 3He and 12C particles at energies corresponding to a distance of 1 cm to the Bragg peak, which represent particles of interest in Hadron therapy as well as space radiation exposure. We investigate the optimal axis length of dendritic segments to evaluate microscopic ED and hit probabilities along the dendritic branches at a given macroscopic dose. Because of large computation times to analyze ED in volumes of varying sizes, we developed an analytical method to find the mean primary dose in spheres that can guide numerical methods to find the primary dose distribution for cylinders. Considering cylindrical segments of varying aspect ratio at constant volume, we assess the chord length distribution, mean number of hits and ED profiles by primary particles and secondary electrons (δ-rays). For biophysical modeling applications, segments on dendritic branches are proposed to have equal diameters and axes lengths along the varying diameter of a dendritic branch. PMID:28554507

Track structure model of microscopic energy deposition by protons and heavy ions in segments of neuronal cell dendrites represented by cylinders or spheres

NASA Astrophysics Data System (ADS)

Alp, Murat; Cucinotta, Francis A.

2017-05-01

Changes to cognition, including memory, following radiation exposure are a concern for cosmic ray exposures to astronauts and in Hadron therapy with proton and heavy ion beams. The purpose of the present work is to develop computational methods to evaluate microscopic energy deposition (ED) in volumes representative of neuron cell structures, including segments of dendrites and spines, using a stochastic track structure model. A challenge for biophysical models of neuronal damage is the large sizes (> 100 μm) and variability in volumes of possible dendritic segments and pre-synaptic elements (spines and filopodia). We consider cylindrical and spherical microscopic volumes of varying geometric parameters and aspect ratios from 0.5 to 5 irradiated by protons, and 3He and 12C particles at energies corresponding to a distance of 1 cm to the Bragg peak, which represent particles of interest in Hadron therapy as well as space radiation exposure. We investigate the optimal axis length of dendritic segments to evaluate microscopic ED and hit probabilities along the dendritic branches at a given macroscopic dose. Because of large computation times to analyze ED in volumes of varying sizes, we developed an analytical method to find the mean primary dose in spheres that can guide numerical methods to find the primary dose distribution for cylinders. Considering cylindrical segments of varying aspect ratio at constant volume, we assess the chord length distribution, mean number of hits and ED profiles by primary particles and secondary electrons (δ-rays). For biophysical modeling applications, segments on dendritic branches are proposed to have equal diameters and axes lengths along the varying diameter of a dendritic branch.

Track structure model of microscopic energy deposition by protons and heavy ions in segments of neuronal cell dendrites represented by cylinders or spheres.

PubMed

Alp, Murat; Cucinotta, Francis A

2017-05-01

Changes to cognition, including memory, following radiation exposure are a concern for cosmic ray exposures to astronauts and in Hadron therapy with proton and heavy ion beams. The purpose of the present work is to develop computational methods to evaluate microscopic energy deposition (ED) in volumes representative of neuron cell structures, including segments of dendrites and spines, using a stochastic track structure model. A challenge for biophysical models of neuronal damage is the large sizes (> 100µm) and variability in volumes of possible dendritic segments and pre-synaptic elements (spines and filopodia). We consider cylindrical and spherical microscopic volumes of varying geometric parameters and aspect ratios from 0.5 to 5 irradiated by protons, and 3 He and 12 C particles at energies corresponding to a distance of 1cm to the Bragg peak, which represent particles of interest in Hadron therapy as well as space radiation exposure. We investigate the optimal axis length of dendritic segments to evaluate microscopic ED and hit probabilities along the dendritic branches at a given macroscopic dose. Because of large computation times to analyze ED in volumes of varying sizes, we developed an analytical method to find the mean primary dose in spheres that can guide numerical methods to find the primary dose distribution for cylinders. Considering cylindrical segments of varying aspect ratio at constant volume, we assess the chord length distribution, mean number of hits and ED profiles by primary particles and secondary electrons (δ-rays). For biophysical modeling applications, segments on dendritic branches are proposed to have equal diameters and axes lengths along the varying diameter of a dendritic branch. Copyright © 2017. Published by Elsevier Ltd.

HitWalker2: visual analytics for precision medicine and beyond.

PubMed

Bottomly, Daniel; McWeeney, Shannon K; Wilmot, Beth

2016-04-15

The lack of visualization frameworks to guide interpretation and facilitate discovery is a potential bottleneck for precision medicine, systems genetics and other studies. To address this we have developed an interactive, reproducible, web-based prioritization approach that builds on our earlier work. HitWalker2 is highly flexible and can utilize many data types and prioritization methods based upon available data and desired questions, allowing it to be utilized in a diverse range of studies such as cancer, infectious disease and psychiatric disorders. Source code is freely available at https://github.com/biodev/HitWalker2 and implemented using Python/Django, Neo4j and Javascript (D3.js and jQuery). We support major open source browsers (e.g. Firefox and Chromium/Chrome). wilmotb@ohsu.edu Supplementary data are available at Bioinformatics online. Additional information/instructions are available at https://github.com/biodev/HitWalker2/wiki. © The Author 2015. Published by Oxford University Press.

A Two-Hit Model of Autism: Adolescence as the Second Hit

PubMed Central

Picci, Giorgia; Scherf, K. Suzanne

2015-01-01

Adolescence brings dramatic changes in behavior and neural organization. Unfortunately, for some 30% of individuals with autism, there is marked decline in adaptive functioning during adolescence. We propose a two-hit model of autism. First, early perturbations in neural development function as a “first hit” that sets up a neural system that is “built to fail” in the face of a second hit. Second, the confluence of pubertal hormones, neural reorganization, and increasing social demands during adolescence provides the “second hit” that interferes with the ability to transition into adult social roles and levels of adaptive functioning. In support of this model, we review evidence about adolescent-specific neural and behavioral development in autism. We conclude with predictions and recommendations for empirical investigation about several domains in which developmental trajectories for individuals with autism may be uniquely deterred in adolescence. PMID:26609500

Influence of Running on Pistol Shot Hit Patterns.

PubMed

Kerkhoff, Wim; Bolck, Annabel; Mattijssen, Erwin J A T

2016-01-01

In shooting scene reconstructions, risk assessment of the situation can be important for the legal system. Shooting accuracy and precision, and thus risk assessment, might be correlated with the shooter's physical movement and experience. The hit patterns of inexperienced and experienced shooters, while shooting stationary (10 shots) and in running motion (10 shots) with a semi-automatic pistol, were compared visually (with confidence ellipses) and statistically. The results show a significant difference in precision (circumference of the hit patterns) between stationary shots and shots fired in motion for both inexperienced and experienced shooters. The decrease in precision for all shooters was significantly larger in the y-direction than in the x-direction. The precision of the experienced shooters is overall better than that of the inexperienced shooters. No significant change in accuracy (shift in the hit pattern center) between stationary shots and shots fired in motion can be seen for all shooters. © 2015 American Academy of Forensic Sciences.

Pediatric aspects of inpatient health information technology systems.

PubMed

Lehmann, Christoph U

2015-03-01

In the past 3 years, the Health Information Technology for Economic and Clinical Health Act accelerated the adoption of electronic health records (EHRs) with providers and hospitals, who can claim incentive monies related to meaningful use. Despite the increase in adoption of commercial EHRs in pediatric settings, there has been little support for EHR tools and functionalities that promote pediatric quality improvement and patient safety, and children remain at higher risk than adults for medical errors in inpatient environments. Health information technology (HIT) tailored to the needs of pediatric health care providers can improve care by reducing the likelihood of errors through information assurance and minimizing the harm that results from errors. This technical report outlines pediatric-specific concepts, child health needs and their data elements, and required functionalities in inpatient clinical information systems that may be missing in adult-oriented HIT systems with negative consequences for pediatric inpatient care. It is imperative that inpatient (and outpatient) HIT systems be adapted to improve their ability to properly support safe health care delivery for children. Copyright © 2015 by the American Academy of Pediatrics.

Sonic Simulation of Near Projectile Hits

NASA Technical Reports Server (NTRS)

Statman, J. I.; Rodemich, E. R.

1988-01-01

Measured frequencies identify projectiles and indicate miss distances. Developmental battlefield-simulation system for training soldiers uses sounds emitted by incoming projectiles to identify projectiles and indicate miss distances. Depending on projectile type and closeness of each hit, system generates "kill" or "near-kill" indication. Artillery shell simulated by lightweight plastic projectile launched by compressed air. Flow of air through groove in nose of projectile generates acoustic tone. Each participant carries audio receiver measure and process tone signal. System performs fast Fourier transforms of received tone to obtain dominant frequency during each succeeding interval of approximately 40 ms (an interval determined from practical signal-processing requirements). With modifications, system concept applicable to collision-warning or collision-avoidance systems.

Electromagnetic navigation system for CT-guided biopsy of small lesions.

PubMed

Appelbaum, Liat; Sosna, Jacob; Nissenbaum, Yizhak; Benshtein, Alexander; Goldberg, S Nahum

2011-05-01

The purpose of this study was to evaluate an electromagnetic navigation system for CT-guided biopsy of small lesions. Standardized CT anthropomorphic phantoms were biopsied by two attending radiologists. CT scans of the phantom and surface electromagnetic fiducial markers were imported into the memory of the 3D electromagnetic navigation system. Each radiologist assessed the accuracy of biopsy using electromagnetic navigation alone by targeting sets of nine lesions (size range, 8-14 mm; skin to target distance, 5.7-12.8 cm) under eight different conditions of detector field strength and orientation (n = 117). As a control, each radiologist also biopsied two sets of five targets using conventional CT-guided technique. Biopsy accuracy, number of needle passes, procedure time, and radiation dose were compared. Under optimal conditions (phantom perpendicular to the electromagnetic receiver at highest possible field strength), phantom accuracy to the center of the lesion was 2.6 ± 1.1 mm. This translated into hitting 84.4% (38/45) of targets in a single pass (1.1 ± 0.4 CT confirmations), which was significantly fewer than the 3.6 ± 1.3 CT checks required for conventional technique (p < 0.001). The mean targeting time was 38.8 ± 18.2 seconds per lesion. Including procedural planning (∼5.5 minutes) and final CT confirmation of placement (∼3.5 minutes), the full electromagnetic tracking procedure required significantly less time (551.6 ± 87.4 seconds [∼9 minutes]) than conventional CT (833.3 ± 283.8 seconds [∼14 minutes]) for successful targeting (p < 0.001). Less favorable conditions, including nonperpendicular relation between the axis of the machine and weaker field strength, resulted in statistically significant lower accuracy (3.7 ± 1 mm, p < 0.001). Nevertheless, first-pass biopsy accuracy was 58.3% (21/36) and second-pass (35/36) accuracy was 97.2%. Lesions farther from the skin than 20-25 cm were out of range for successful electromagnetic tracking. Virtual electromagnetic tracking appears to have high accuracy in needle placement, potentially reducing time and radiation exposure compared with those of conventional CT techniques in the biopsy of small lesions.

Biostack: A study of the biological effects on HZE galactic cosmic radiation

NASA Technical Reports Server (NTRS)

Buecker, H.

1975-01-01

The Biostack experiment designed to study the effect of individual heavy nucleii of the cosmic radiation environment upon biological systems during actual space flight is described. In each Biostack, several thousand biological objects were hit by an HZE particle. The response of the biological objects was studied. Results are discussed in terms of sensitivity to the hit.

Reflections on US health care information technology policy from a global perspective.

PubMed

Huerta, Timothy R; Ford, Eric W

2012-01-01

Health information technology (HIT) has been lauded as a foundation upon which the development of an integral solution to cost and quality problems facing many nations is predicated. Countries throughout the world have taken differing approaches in their efforts to advance that foundation through policy, financial, and cultural systems that come to support or hinder adoption. As we explore potential opportunities to learn from the experience of others, we pause to consider the environmental, regulatory, financial, and social dynamics that define the US context. This chapter outlines the framework for a comparative approach through four dimensions--environmental, regulation, financial, and social--through which comparative HIT studies should be explored. With such markedly different contexts in which their HIT is embedded, it is important to not simply look at other countries as a yardstick upon which we compare our failures and successes. Rather, we must look critically at these examples understanding that the dynamics at play in each context have created opportunities and obligations that have come to define each country's implementation. The need for a common framework through which scholars can explore comparative HIT systems, while remaining grounded in the US context is an important aspect of effective knowledge translation in adoption.

Quantum algorithms for Gibbs sampling and hitting-time estimation

DOE PAGES

Chowdhury, Anirban Narayan; Somma, Rolando D.

2017-02-01

In this paper, we present quantum algorithms for solving two problems regarding stochastic processes. The first algorithm prepares the thermal Gibbs state of a quantum system and runs in time almost linear in √Nβ/Ζ and polynomial in log(1/ϵ), where N is the Hilbert space dimension, β is the inverse temperature, Ζ is the partition function, and ϵ is the desired precision of the output state. Our quantum algorithm exponentially improves the dependence on 1/ϵ and quadratically improves the dependence on β of known quantum algorithms for this problem. The second algorithm estimates the hitting time of a Markov chain. Formore » a sparse stochastic matrix Ρ, it runs in time almost linear in 1/(ϵΔ 3/2), where ϵ is the absolute precision in the estimation and Δ is a parameter determined by Ρ, and whose inverse is an upper bound of the hitting time. Our quantum algorithm quadratically improves the dependence on 1/ϵ and 1/Δ of the analog classical algorithm for hitting-time estimation. Finally, both algorithms use tools recently developed in the context of Hamiltonian simulation, spectral gap amplification, and solving linear systems of equations.« less

Overview of HIT-SI3 experiment: Simulations, Diagnostics, and Summary of Current Results

NASA Astrophysics Data System (ADS)

Penna, James; Jarboe, Thomas; Nelson, Brian; Hossack, Aaron; Sutherland, Derek; Morgan, Kyle; Hansen, Chris; Benedett, Thomas; Everson, Chris; Victor, Brian

2016-10-01

The Helicity Injected Torus - Steady Inductive 3(HIT-SI3)experiment forms and maintains spheromaks via Steady Inductive Helicity Injection (SIHI). Three injector units allow for continuous injection of helicity into a copper flux conserver in order to sustain a spheromak. Firing of the injectors with a phase difference allows finite rotation of the plasma to provide a stabilizing effect. Simulations in the MHD code NIMROD and the fluid-model code PSI-TET provide validation and a basis for interpretation of the observed experimental data. Thompson Scattering (TS) and Far Infrared (FIR) Interferometer systems allow temperature and line-averaged density measurements to be taken. An Ion Doppler Spectroscopy (IDS) system allows measurement of the plasma rotation and velocity. HIT-SI3 data has been used for validation of IDCD predictions, in particular the projected impedance of helicity injectors according to the theory. The experimental impedances have been calculated here for the first time for different HIT-SI3 regimes. Such experimental evidence will contribute to the design of future experiments employing IDCD as a current-drive mechanism. Work supported by the D.O.E., Office of Science, Office of Fusion Science.

Experimental Study on Mechanical and Acoustic Emission Characteristics of Rock-Like Material Under Non-uniformly Distributed Loads

NASA Astrophysics Data System (ADS)

Wang, Xiao; Wen, Zhijie; Jiang, Yujing; Huang, Hao

2018-03-01

The mechanical and acoustic emission characteristics of rock-like materials under non-uniform loads were investigated by means of a self-developed mining-induced stress testing system and acoustic emission monitoring system. In the experiments, the specimens were divided into three regions and different initial vertical stresses and stress loading rates were used to simulate different mining conditions. The mechanical and acoustic emission characteristics between regions were compared, and the effects of different initial vertical stresses and different stress loading rates were analysed. The results showed that the mechanical properties and acoustic emission characteristics of rock-like materials can be notably localized. When the initial vertical stress and stress loading rate are fixed, the peak strength of region B is approximately two times that of region A, and the maximum acoustic emission hit value of region A is approximately 1-2 times that of region B. The effects of the initial vertical stress and stress loading rate on the peck strain, maximum hit value, and occurrence time of the maximum hit are similar in that when either of the former increase, the latter all decrease. However, peck strength will increase with the increase in loading rate and decrease with the increase in initial vertical stress. The acoustic emission hits can be used to analyse the damage in rock material, but the number of acoustic emission hits cannot be used alone to determine the degree of rock damage directly.

Neural reactivity to reward in school-age offspring of depressed mothers.

PubMed

Wiggins, Jillian Lee; Schwartz, Karen T G; Kryza-Lacombe, Maria; Spechler, Philip A; Blankenship, Sarah L; Dougherty, Lea R

2017-05-01

Identifying neural profiles predictive of future psychopathology in at-risk individuals is important to efficiently direct preventive care. Alterations in reward processing may be a risk factor for depression. The current study characterized neural substrates of reward processing in children at low- and high-risk for psychopathology due to maternal depression status. Children with (n=27) and without (n=19) maternal depression (ages 5.9-9.6 years) performed a monetary incentive delay task in which they received rewards, if they successfully hit a target, or no reward regardless of performance, during fMRI acquisition. Multiple dorsal prefrontal, temporal, and striatal regions showed significant Group (high- vs. low-risk)×Performance (hit vs. miss)×Condition (no reward vs. reward) interactions in a whole-brain analysis. All regions exhibited similar patterns, whereby the high-risk group showed blunted activation differences between trials with vs. without rewards when participants hit the target. Moreover, high-risk children showed activation differences between trials with vs. without rewards in the opposite direction, compared to the low-risk group, when they missed the target. This study had a modest sample size, though larger than existing studies. Children with maternal depression are at elevated risk for future psychopathology, yet not all experience clinically significant symptoms; longitudinal research is necessary to fully track the pathway from risk to disorder. Children of depressed mothers exhibited attenuated neural activation differences and activation patterns opposite to children without depressed mothers. Our findings may provide targets for hypothesis-driven preventive interventions and lead to earlier identification of individuals at risk. Copyright © 2017 Elsevier B.V. All rights reserved.

Simulation study of pixel detector charge digitization

NASA Astrophysics Data System (ADS)

Wang, Fuyue; Nachman, Benjamin; Sciveres, Maurice; Lawrence Berkeley National Laboratory Team

2017-01-01

Reconstruction of tracks from nearly overlapping particles, called Tracking in Dense Environments (TIDE), is an increasingly important component of many physics analyses at the Large Hadron Collider as signatures involving highly boosted jets are investigated. TIDE makes use of the charge distribution inside a pixel cluster to resolve tracks that share one of more of their pixel detector hits. In practice, the pixel charge is discretized using the Time-over-Threshold (ToT) technique. More charge information is better for discrimination, but more challenging for designing and operating the detector. A model of the silicon pixels has been developed in order to study the impact of the precision of the digitized charge distribution on distinguishing multi-particle clusters. The output of the GEANT4-based simulation is used to train neutral networks that predict the multiplicity and location of particles depositing energy inside one cluster of pixels. By studying the multi-particle cluster identification efficiency and position resolution, we quantify the trade-off between the number of ToT bits and low-level tracking inputs. As both ATLAS and CMS are designing upgraded detectors, this work provides guidance for the pixel module designs to meet TIDE needs. Work funded by the China Scholarship Council and the Office of High Energy Physics of the U.S. Department of Energy under contract DE-AC02-05CH11231.

Readiness for Meaningful Use of Health Information Technology and Patient Centered Medical Home Recognition Survey Results

PubMed Central

Shin, Peter; Sharac, Jessica

2013-01-01

Objective Determine the factors that impact HIT use and MU readiness for community health centers (CHCs). Background The HITECH Act allocates funds to Medicaid and Medicare providers to encourage the adoption of electronic health records (EHR), in an effort to improve health care quality and patient outcomes, and to reduce health care costs. Methods We surveyed CHCs on their Readiness for Meaningful Use (MU) of Health Information Technology (HIT) and Patient Centered Medical Home (PCMH) Recognition, then we combined responses with 2009 Uniform Data System data to determine which factors impact use of HIT and MU readiness. Results Nearly 70% of CHCs had full or partial EHR adoption at the time of survey. Results are presented for centers with EHR adoption, by the length of time that their EHR systems have been in operation. PMID:24834365

Interspecialty communication supported by health information technology associated with lower hospitalization rates for ambulatory care-sensitive conditions.

PubMed

O'Malley, Ann S; Reschovsky, James D; Saiontz-Martinez, Cynthia

2015-01-01

Practice tools such as health information technology (HIT) have the potential to support care processes, such as communication between health care providers, and influence care for "ambulatory care-sensitive conditions" (ACSCs). ACSCs are conditions for which good outpatient care can potentially prevent the need for hospitalization. To date, associations between such primary care practice capabilities and hospitalizations for ambulatory care-sensitive conditions have been primarily limited to smaller, local studies or unique delivery systems rather than nationally representative studies of primary care physicians in the United States. We analyzed a nationally representative sample of 1,819 primary care physicians who responded to the Center for Studying Health System Change's Physician Survey. We linked 3 years of Medicare claims (2007 to 2009) with these primary care physician survey respondents. This linkage resulted in the identification of 123,760 beneficiaries with one or more of 4 ambulatory care-sensitive chronic conditions (diabetes, chronic obstructive pulmonary disease, asthma, and congestive heart failure) for whom these physicians served as the usual provider. Key independent variables of interest were physicians' practice capabilities, including communication with specialists, use of care managers, participation in quality and performance measurement, use of patient registries, and HIT use. The dependent variable was a summary measure of ambulatory care-sensitive hospitalizations for one or more of these 4 conditions. Higher provider-reported levels of communication between primary care and specialist physicians were associated with lower rates of potentially avoidable hospitalizations. While there was no significant main effect between HIT use and ACSC hospitalizations, the associations between interspecialty communication and ACSC hospitalizations were magnified in the presence of higher HIT use. For example, patients in practices with both the highest level of interspecialty communication and the highest level of HIT use had lower odds of ambulatory care-sensitive hospitalizations than did those in practices with lower interspecialty communication and high HIT use (adjusted odds ratio, 0.70; 95% confidence limits, 0.59, 0.82). Greater primary care and specialist communication is associated with reduced hospitalizations for ambulatory care-sensitive conditions. This effect was magnified in the presence of higher provider-reported HIT use, suggesting that coordination of care with support from HIT is important in the treatment of ambulatory care-sensitive conditions. © Copyright 2015 by the American Board of Family Medicine.

Hit discovery and hit-to-lead approaches.

PubMed

Keseru, György M; Makara, Gergely M

2006-08-01

Hit discovery technologies range from traditional high-throughput screening to affinity selection of large libraries, fragment-based techniques and computer-aided de novo design, many of which have been extensively reviewed. Development of quality leads using hit confirmation and hit-to-lead approaches present their own challenges, depending on the hit discovery method used to identify the initial hits. In this paper, we summarize common industry practices adopted to tackle hit-to-lead challenges and review how the advantages and drawbacks of different hit discovery techniques could affect the various issues hit-to-lead groups face.

Chronic porcine two-hit model with hemorrhagic shock and Pseudomonas aeruginosa sepsis.

PubMed

Eissner, B; Matz, K; Smorodchenko, A; Röschmann, A; v Specht, B U

2002-01-01

Sepsis is still a major cause of death despite well-developed therapeutical strategies such as antibiotics and supportive medication. The aim of this study was to characterize the long-term effects of a two-hit porcine sepsis model with a hemorrhagic shock as 'first hit' followed by a Pseudomonas aeruginosa infusion as 'second hit'. Twelve juvenile healthy pigs were anesthetized and hemodynamically monitored. The two-hit group (n = 6) underwent a hemorrhagic shock with a 50% reduction of the mean arterial pressure and/or cardiac index for 45 min, followed by resuscitation, while the control group (n = 6) received no pretreatment. All chronically catheterized conscious pigs were challenged with a P. aeruginosa infusion (1.6 x 10(7) CFU/kg/h for the first 24 h followed by 1.6 x 10(6) CFU/kg/h for the next 24 h) and observed for another 48 h. The two-hit group showed the following significant differences to the control group: higher APACHE II scores prior to sepsis induction, increased persisting mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance index (PVRI) during bacterial challenge. In contrast, systemic vascular resistance (SVRI) was reduced at the end of the study. Throughout the observation period, the mean arterial pressure (MAP) was significantly reduced. The present study shows that the clinical course and hemodynamic effects of a P. aeruginosa sepsis will be aggravated by a preceding hemorrhagic shock during an observation period of 96 h. This two-hit model represents a valid, clinically relevant experimental protocol in sepsis research. Copyright 2002 S. Karger AG, Basel

Drug screening using model systems: some basics

PubMed Central

2016-01-01

ABSTRACT An increasing number of laboratories that focus on model systems are considering drug screening. Executing a drug screen is complicated enough. But the path for moving initial hits towards the clinic requires a different knowledge base and even a different mindset. In this Editorial I discuss the importance of doing some homework before you start screening. 'Lead hits', 'patentable chemical space' and 'druggability' are all concepts worth exploring when deciding which screening path to take. I discuss some of the lessons I learned that may be useful as you navigate the screening matrix. PMID:27821602

A z-Vertex Trigger for Belle II

NASA Astrophysics Data System (ADS)

Skambraks, S.; Abudinén, F.; Chen, Y.; Feindt, M.; Frühwirth, R.; Heck, M.; Kiesling, C.; Knoll, A.; Neuhaus, S.; Paul, S.; Schieck, J.

2015-08-01

The Belle II experiment will go into operation at the upgraded SuperKEKB collider in 2016. SuperKEKB is designed to deliver an instantaneous luminosity L = 8 ×1035 cm - 2 s - 1. The experiment will therefore have to cope with a much larger machine background than its predecessor Belle, in particular from events outside of the interaction region. We present the concept of a track trigger, based on a neural network approach, that is able to suppress a large fraction of this background by reconstructing the z (longitudinal) position of the event vertex within the latency of the first level trigger. The trigger uses the hit information from the Central Drift Chamber (CDC) of Belle II within narrow cones in polar and azimuthal angle as well as in transverse momentum (“sectors”), and estimates the z-vertex without explicit track reconstruction. The preprocessing for the track trigger is based on the track information provided by the standard CDC trigger. It takes input from the 2D track finder, adds information from the stereo wires of the CDC, and finds the appropriate sectors in the CDC for each track. Within the sector, the z-vertex is estimated by a specialized neural network, with the drift times from the CDC as input and a continuous output corresponding to the scaled z-vertex. The neural algorithm will be implemented in programmable hardware. To this end a Virtex 7 FPGA board will be used, which provides at present the most promising solution for a fully parallelized implementation of neural networks or alternative multivariate methods. A high speed interface for external memory will be integrated into the platform, to be able to store the O(109) parameters required. The contribution presents the results of our feasibility studies and discusses the details of the envisaged hardware solution.

Helicopter Air-to-Air Combat Test 4 (AACT 4) Maneuverability Analysis

DTIC Science & Technology

1992-07-01

histories during fuselage tail boom skin fatigue dam age ............................................................. 145 x LIST OF FIGURES (Continued...concerning X -Y-Z relative aircraft positions, velocities, headings, relative bearings, slant ranges (distance between aircraft), and closure rates. This...real-time hit feedback system such as a flashing aiming reticle would permit the pilot to assess the actual effort required to put hits on target

Bulk Chemical and Hf/W Isotopic Consequences of Lossy Accretion

NASA Astrophysics Data System (ADS)

Dwyer, C. A.; Nimmo, F.; Chambers, J.

2013-12-01

The late stages of planetary accretion involve stochastic, large collisions [1]. Many of these collisions likely resulted in hit-and-run events [2] or erosion of existing bodies' crusts [3] or mantles [4]. Here we present a preliminary investigation into the effects of lossy late-stage accretion on the bulk chemistry and isotopic characteristics of the resulting planets. Our model is composed of two parts: (1) an N-body accretion code [5] tracks the orbital and collisional evolution of the terrestrial bodies, including hit-and-run and fragmentation events; (2) post-processing evolves the chemistry in light of radioactive decay and impact-related mixing and partial equilibration. Sixteen runs were performed using the MERCURY N-body code [5]; each run contained Jupiter and Saturn in their current orbits as well as approx 150 initial bodies. Different collisional outcomes including fragmentation are possible depending on the velocity, angle, mass ratio, and total mass of the impact (modified from [6, 7]). The masses of the core and mantle of each body are tracked throughout the simulation. All bodies are assigned an initial mantle mass fraction, y, of 0.7. We track the Hf and W evolution of these bodies. Radioactive decay occurs between impacts. We calculate the effect of an impact by assuming an idealized model of mixing and partial equilibration [8]. The core equilibration factor is a free parameter; we use 0.4. Partition coefficients are assumed constant. Diversity increases as final mass decreases. The range in final y changes from 0.66-0.72 for approx Earth-mass planets to 0.41-1 for the smallest bodies in the simulation. The scatter in tungsten anomaly increases from 0.79-4.0 for approx Earth-mass to 0.11-18 for the smallest masses. This behavior is similar to that observed in our solar system in terms of both bulk and isotopic chemistry. There is no single impact event which defines the final state of the body, therefore talking about a single, specific age of formation does not make sense. Instead, it must be recognized that terrestrial planet formation occurs over a range of time spanning many tens to perhaps hundreds of millions of years. We are currently performing sensitivity analyses to determine the effect on the tungsten isotopic anomalies of the final bodies. [1] Agnor et al. (1999), Icarus 142, 219-237. [2] Asphaug et al. (2006), Nature 439, 155-160. [3] O'Neill & Palme (2008), Phil Trans R Soc Lond A 366, 4205-4238. [4] Benz et al. (2007), Sp SciRev 132, 189-202. [5] Chambers (2013), Icarus, 224, 43-56. [6] Genda et al. (2012), ApJ 744, 137. [7] Leinhardt & Stewart (2012), ApJ 745, 79. [8] Nimmo et al. (2010), EPSL 292, 363-370.

Airflow energy harvesting with high wind velocities for industrial applications

NASA Astrophysics Data System (ADS)

Chew, Z. J.; Tuddenham, S. B.; Zhu, M.

2016-11-01

An airflow energy harvester capable of harvesting energy from vortices at high speed is presented in this paper. The airflow energy harvester is implemented using a modified helical Savonius turbine and an electromagnetic generator. A power management module with maximum power point finding capability is used to manage the harvested energy and convert the low voltage magnitude from the generator to a usable level for wireless sensors. The airflow energy harvester is characterized using vortex generated by air hitting a plate in a wind tunnel. By using an aircraft environment with wind speed of 17 m/s as case study, the output power of the airflow energy harvester is measured to be 126 mW. The overall efficiency of the power management module is 45.76 to 61.2%, with maximum power point tracking efficiency of 94.21 to 99.72% for wind speed of 10 to 18 m/s, and has a quiescent current of 790 nA for the maximum power point tracking circuit.

Density and persistence analyze on the spreading models multi-regions multi-patchs

NASA Astrophysics Data System (ADS)

Hariyanto, Hanafi, Lukman; Wahyudi, Suhud

2017-08-01

The spread of the virus is widespread in some countries and even can reach some continents. This ever happened in the pandemic H1N1 virus outbreak in 2005 which covers 3 continents, as well as the H5N1 virus that hits several regions in Indonesia. If the virus spreads to the region as a source of the spread, the outbreak will occur due to the movement of infected individuals or vector that moves freely in other regions. The focus of this paper is to analyze the characteristics of the sub-population density, as well as the persistence of individuals moving on the path that connecting two areas of its distribution through mathematical models constructed by the spread of the virus in the three regions. The analysis results showed that the movement of individual sub-population exposure to all of the tracks or individual transfer on another track are having transition due to the genetic evolution of the virus and that causes potential outbreaks in the wider regions.

NASA puts JWST Back on Track, but ExoMars Collaboration Looks Unlikely; Marsquakes happening yesterday, geologically; UFOs from black holes control shape of galaxies

NASA Astrophysics Data System (ADS)

2012-04-01

NASA's funding plans put the James Webb Space Telescope firmly on track for a launch in 2018, to widespread relief, but the essentially flat funding settlement for 2013 overall means something has to go. Planetary science seems hardest hit, with the especial blow for European planetary scientists of NASA pulling out of ExoMars, the ESA-led mission to look for signs of life on Mars. Images from the High Resolution Imaging Science Experiment have shown boulders displaced by seismic activity on Mars in the past few million years, and possibly much more recently than that. The bigger the supermassive black hole at the centre of a galaxy, the faster the stars in the galactic bulge rotate. Why this should be so has been something of a puzzle, but now a mechanism that is both powerful and common enough to do the job has been identified.

News and Views: NASA puts JWST back on track, but ExoMars collaboration looks unlikely; Marsquakes happening yesterday, geologically; UFOs from black holes control shape of galaxies

NASA Astrophysics Data System (ADS)

2012-04-01

NASA's funding plans put the James Webb Space Telescope firmly on track for a launch in 2018, to widespread relief, but the essentially flat funding settlement for 2013 overall means something has to go. Planetary science seems hardest hit, with the especial blow for European planetary scientists of NASA pulling out of ExoMars, the ESA-led mission to look for signs of life on Mars. Images from the High Resolution Imaging Science Experiment have shown boulders displaced by seismic activity on Mars in the past few million years, and possibly much more recently than that. The bigger the supermassive black hole at the centre of a galaxy, the faster the stars in the galactic bulge rotate. Why this should be so has been something of a puzzle, but now a mechanism that is both powerful and common enough to do the job has been identified.

Monitoring The Stability Of Levees With Time-Series ENVISAT ASAR Images

NASA Astrophysics Data System (ADS)

Pei, Yuanyuan; Liao, Mingsheng; Wang, Teng; Zhang, Lu

2012-01-01

Levees are constructed to protect coastal cities from typhoon, flood, and sea tide. Since the stability of levees is important, it is necessary to monitor their deformation regularly. Repeat-track space-borne SAR images are useful for environment monitoring, especially for ground deformation monitoring. Shanghai resides on the Yangtze River Delta on China’s eastern coast. Each year, the city is hit by typhoons from the Pacific Ocean and threatened by the flood of the Yangtze River. We used Persistent Scatterer Interferometry to monitor the deformation of the levees. Our experiments show that the levees around Pudong airport and Lingang town suffer from serious deformation.

Exploring the Mode of Action of Bioactive Compounds by Microfluidic Transcriptional Profiling in Mycobacteria

PubMed Central

Lim, Vivian; Naim, Ahmad Nazri Mohamed; Bifani, Pablo; Boshoff, Helena I. M.; Sambandamurthy, Vasan K.; Dick, Thomas; Hibberd, Martin L.; Schreiber, Mark; Rao, Srinivasa P. S.

2013-01-01

Most candidate anti-bacterials are identified on the basis of their whole cell anti-bacterial activity. A critical bottleneck in the early discovery of novel anti-bacterials is tracking the structure activity relationship (SAR) of the novel compounds synthesized during the hit to lead and lead optimization stage. It is often very difficult for medicinal chemists to visualize if the novel compounds synthesized for understanding SAR of a particular scaffold have similar molecular mechanism of action (MoA) as that of the initial hit. The elucidation of the molecular MoA of bioactive inhibitors is critical. Here, a new strategy and routine assay for MoA de-convolution, using a microfluidic platform for transcriptional profiling of bacterial response to inhibitors with whole cell activity has been presented. First a reference transcriptome compendium of Mycobacterial response to various clinical and investigational drugs was built. Using feature reduction, it was demonstrated that subsets of biomarker genes representative of the whole genome are sufficient for MoA classification and deconvolution in a medium-throughput microfluidic format ultimately leading to a cost effective and rapid tool for routine antibacterial drug-discovery programs. PMID:23935951

Health information technology vendor selection strategies and total factor productivity.

PubMed

Ford, Eric W; Huerta, Timothy R; Menachemi, Nir; Thompson, Mark A; Yu, Feliciano

2013-01-01

The aim of this study was to compare health information technology (HIT) adoption strategies' relative performance on hospital-level productivity measures. The American Hospital Association's Annual Survey and Healthcare Information and Management Systems Society Analytics for fiscal years 2002 through 2007 were used for this study. A two-stage approach is employed. First, a Malmquist model is specified to calculate hospital-level productivity measures. A logistic regression model is then estimated to compare the three HIT adoption strategies' relative performance on the newly constructed productivity measures. The HIT vendor selection strategy impacts the amount of technological change required of an organization but does not appear to have either a positive or adverse impact on technical efficiency or total factor productivity. The higher levels in technological change experienced by hospitals using the best of breed and best of suite HIT vendor selection strategies may have a more direct impact on the organization early on in the process. However, these gains did not appear to translate into either increased technical efficiency or total factor productivity during the period studied. Over a longer period, one HIT vendor selection strategy may yet prove to be more effective at improving efficiency and productivity.

It's not about pager replacement: an in-depth look at the interprofessional nature of communication in healthcare.

PubMed

Quan, Sherman D; Wu, Robert C; Rossos, Peter G; Arany, Teri; Groe, Silvi; Morra, Dante; Wong, Brian M; Cavalcanti, Rodrigo; Coke, William; Lau, Francis Y

2013-03-01

Institutions have tried to replace the use of numeric pagers for clinical communication by implementing health information technology (HIT) solutions. However, failing to account for the sociotechnical aspects of HIT or the interplay of technology with existing clinical workflow, culture, and social interactions may create other unintended consequences. To evaluate a Web-based messaging system that allows asynchronous communication between health providers and identify the unintended consequences associated with implementing such technology. Intervention-a Web-based messaging system at the University Health Network to replace numeric paging practices in May 2010. The system facilitated clinical communication on the medical wards for coordinating patient care. Study design-pre-post mixed methods utilizing both quantitative and qualitative measures. Five residents, 8 nurses, 2 pharmacists, and 2 social workers were interviewed. Pre-post interruption-15 residents from 5 clinical teams in both periods. The study compared the type of messages sent to physicians before and after implementation of the Web-based messaging system; a constant comparative analysis of semistructured interviews was used to generate key themes related to unintended consequences. Interruptions increased 233%, from 3 pages received per resident per day pre-implementation to 10 messages received per resident per day post-implementation. Key themes relating to unintended consequences that emerged from the interviews included increase in interruptions, accountability, and tactics to improve personal productivity. Meaningful improvements in clinical communication can occur but require more than just replacing pagers. Introducing HIT without addressing the sociotechnical aspects of HIT that underlie clinical communication can lead to unintended consequences. Copyright © 2013 Society of Hospital Medicine.

A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems

PubMed Central

Sittig, Dean F.; Singh, Hardeep

2011-01-01

Conceptual models have been developed to address challenges inherent in studying health information technology (HIT). This manuscript introduces an 8-dimensional model specifically designed to address the socio-technical challenges involved in design, development, implementation, use, and evaluation of HIT within complex adaptive healthcare systems. The 8 dimensions are not independent, sequential, or hierarchical, but rather are interdependent and interrelated concepts similar to compositions of other complex adaptive systems. Hardware and software computing infrastructure refers to equipment and software used to power, support, and operate clinical applications and devices. Clinical content refers to textual or numeric data and images that constitute the “language” of clinical applications. The human computer interface includes all aspects of the computer that users can see, touch, or hear as they interact with it. People refers to everyone who interacts in some way with the system, from developer to end-user, including potential patient-users. Workflow and communication are the processes or steps involved in assuring that patient care tasks are carried out effectively. Two additional dimensions of the model are internal organizational features (e.g., policies, procedures, and culture) and external rules and regulations, both of which may facilitate or constrain many aspects of the preceding dimensions. The final dimension is measurement and monitoring, which refers to the process of measuring and evaluating both intended and unintended consequences of HIT implementation and use. We illustrate how our model has been successfully applied in real-world complex adaptive settings to understand and improve HIT applications at various stages of development and implementation. PMID:20959322

A new sociotechnical model for studying health information technology in complex adaptive healthcare systems.

PubMed

Sittig, Dean F; Singh, Hardeep

2010-10-01

Conceptual models have been developed to address challenges inherent in studying health information technology (HIT). This manuscript introduces an eight-dimensional model specifically designed to address the sociotechnical challenges involved in design, development, implementation, use and evaluation of HIT within complex adaptive healthcare systems. The eight dimensions are not independent, sequential or hierarchical, but rather are interdependent and inter-related concepts similar to compositions of other complex adaptive systems. Hardware and software computing infrastructure refers to equipment and software used to power, support and operate clinical applications and devices. Clinical content refers to textual or numeric data and images that constitute the 'language' of clinical applications. The human--computer interface includes all aspects of the computer that users can see, touch or hear as they interact with it. People refers to everyone who interacts in some way with the system, from developer to end user, including potential patient-users. Workflow and communication are the processes or steps involved in ensuring that patient care tasks are carried out effectively. Two additional dimensions of the model are internal organisational features (eg, policies, procedures and culture) and external rules and regulations, both of which may facilitate or constrain many aspects of the preceding dimensions. The final dimension is measurement and monitoring, which refers to the process of measuring and evaluating both intended and unintended consequences of HIT implementation and use. We illustrate how our model has been successfully applied in real-world complex adaptive settings to understand and improve HIT applications at various stages of development and implementation.

Health information technology workforce needs of rural primary care practices.

PubMed

Skillman, Susan M; Andrilla, C Holly A; Patterson, Davis G; Fenton, Susan H; Ostergard, Stefanie J

2015-01-01

This study assessed electronic health record (EHR) and health information technology (HIT) workforce resources needed by rural primary care practices, and their workforce-related barriers to implementing and using EHRs and HIT. Rural primary care practices (1,772) in 13 states (34.2% response) were surveyed in 2012 using mailed and Web-based questionnaires. EHRs or HIT were used by 70% of respondents. Among practices using or intending to use the technology, most did not plan to hire new employees to obtain EHR/HIT skills and even fewer planned to hire consultants or vendors to fill gaps. Many practices had staff with some basic/entry, intermediate and/or advanced-level skills, but nearly two-thirds (61.4%) needed more staff training. Affordable access to vendors/consultants who understand their needs and availability of community college and baccalaureate-level training were the workforce-related barriers cited by the highest percentages of respondents. Accessing the Web/Internet challenged nearly a quarter of practices in isolated rural areas, and nearly a fifth in small rural areas. Finding relevant vendors/consultants and qualified staff were greater barriers in small and isolated rural areas than in large rural areas. Rural primary care practices mainly will rely on existing staff for continued implementation and use of EHR/HIT systems. Infrastructure and workforce-related barriers remain and must be overcome before practices can fully manage patient populations and exchange patient information among care system partners. Efforts to monitor adoption of these skills and ongoing support for continuing education will likely benefit rural populations. © 2014 National Rural Health Association.

Computational Physics' Greatest Hits

NASA Astrophysics Data System (ADS)

Bug, Amy

2011-03-01

The digital computer, has worked its way so effectively into our profession that now, roughly 65 years after its invention, it is virtually impossible to find a field of experimental or theoretical physics unaided by computational innovation. It is tough to think of another device about which one can make that claim. In the session ``What is computational physics?'' speakers will distinguish computation within the field of computational physics from this ubiquitous importance across all subfields of physics. This talk will recap the invited session ``Great Advances...Past, Present and Future'' in which five dramatic areas of discovery (five of our ``greatest hits'') are chronicled: The physics of many-boson systems via Path Integral Monte Carlo, the thermodynamic behavior of a huge number of diverse systems via Monte Carlo Methods, the discovery of new pharmaceutical agents via molecular dynamics, predictive simulations of global climate change via detailed, cross-disciplinary earth system models, and an understanding of the formation of the first structures in our universe via galaxy formation simulations. The talk will also identify ``greatest hits'' in our field from the teaching and research perspectives of other members of DCOMP, including its Executive Committee.

Differentiating between child protection and family support in the Canadian child welfare system's response to intimate partner violence, corporal punishment, and child neglect.

PubMed

Trocmé, Nico; Fallon, Barbara; Sinha, Vandna; Van Wert, Melissa; Kozlowski, Anna; Maclaurin, Bruce

2013-01-01

Rates of reported child maltreatment nearly doubled in Canada over the period 1998-2003, an increase that reflects growing awareness of the harmful effects of an expanding array of parental behaviors, including corporal punishment, lack of supervision, and exposure to intimate partner violence (IPV). Some of these situations may benefit from voluntary family support programs outside of the child welfare system. Analyzing a sample of 11,807 investigations, this paper compares cases where the sole concern is exposure to IPV, or hitting a child, or neglect, or other forms of investigated maltreatment. Situations where exposure to IPV or potentially abusive hitting were the sole reason for investigation presented with fewer risk factors and were less likely to lead to ongoing child welfare interventions compared to other maltreatment investigations. While situations involving alleged neglect presented a higher risk profile and elicited a more intensive child welfare response than did exposure to IPV or hitting, opportunities for alternative services were nevertheless identified. The study also found that visible minority families were overrepresented in cases involving hitting and that Aboriginal families were overrepresented in cases involving neglect. Overall the findings support the development of alternative response programs in Canada.

Rapid immunoassays for diagnosis of heparin-induced thrombocytopenia: Comparison of diagnostic accuracy, reproducibility, and costs in clinical practice

PubMed Central

Bankova, Andriyana; Andres, Yvonne; Horn, Michael P.; Alberio, Lorenzo

2017-01-01

Background Immunoassays are crucial in the work-up of patients with suspected heparin-induced thrombocytopenia (HIT) and rapid tests have been recently developed. However, comparative data on diagnostic accuracy, reproducibility, and analytical costs of different immunoassays in clinical practice are limited. Methods Samples of 179 consecutive patients evaluated for suspected HIT in clinical practice using a polyspecific enzyme-linked immunoabsorbent assay (GTI diagnostics; ELISA) and a rapid particle gel immunoassay (PaGIA), were additionally analysed with a IgG-specific chemiluminescent immunoassay (AcuStar HIT-IgG). Presence of HIT was defined as a positive functional heparin-induced platelet aggregation test. Diagnostic accuracy was determined for low, intermediate and high thresholds as previously established (ELISA: optical density 0.4, 1.3, and 2.0 respectively; PaGIA: positive/negative, titre of 4, titre of 32; AcuStar HIT-IgG: 1.0 U/ml, 2.8, 9.4) and reproducibility was assessed by repeated measurements. Costs of test determination were calculated taking reagents, controls, and working time of technicians according to Swiss health care system into account. Results Data on PaGIA results were available for 171 patients (95.5%), ELISA for 144 patients (80.4%), and AcuStar HIT-IgG for 179 patients (100%). Sensitivity was above 95% for all assays at low and intermediate thresholds. Specificity increased with higher thresholds and was above 90% for all assays with intermediate and high thresholds. Specificity of AcuStar HIT-IgG (92.8%; 95% CI 87.7, 96.2) was significantly higher than PaGIA (83.0%; 95% CI 76.3, 88.5) and higher than ELISA (81.8%, 95% CI 74.2, 88.0) at low threshold (p<0.05). Reproducibility was adequate for all assays. Total costs per test were CHF 51.02 for ELISA, 117.70 for AcuStar HIT-IgG, and 83.13 for PaGIA. Conclusions We observed favourable diagnostic accuracy measures and a high reproducibility for PaGIA and AcuStar HIT-IgG. Implementation into 24-hours-service might improve patient care but the results must be confirmed in other settings and larger populations as well. PMID:28594835

The Role of Abcb5 Alleles in Susceptibility to Haloperidol-Induced Toxicity in Mice and Humans

PubMed Central

Zheng, Ming; Zhang, Haili; Dill, David L.; Clark, J. David; Tu, Susan; Yablonovitch, Arielle L.; Tan, Meng How; Zhang, Rui; Rujescu, Dan; Wu, Manhong; Tessarollo, Lino; Vieira, Wilfred; Gottesman, Michael M.; Deng, Suhua; Eberlin, Livia S.; Zare, Richard N.; Billard, Jean-Martin; Gillet, Jean-Pierre; Li, Jin Billy; Peltz, Gary

2015-01-01

Background We know very little about the genetic factors affecting susceptibility to drug-induced central nervous system (CNS) toxicities, and this has limited our ability to optimally utilize existing drugs or to develop new drugs for CNS disorders. For example, haloperidol is a potent dopamine antagonist that is used to treat psychotic disorders, but 50% of treated patients develop characteristic extrapyramidal symptoms caused by haloperidol-induced toxicity (HIT), which limits its clinical utility. We do not have any information about the genetic factors affecting this drug-induced toxicity. HIT in humans is directly mirrored in a murine genetic model, where inbred mouse strains are differentially susceptible to HIT. Therefore, we genetically analyzed this murine model and performed a translational human genetic association study. Methods and Findings A whole genome SNP database and computational genetic mapping were used to analyze the murine genetic model of HIT. Guided by the mouse genetic analysis, we demonstrate that genetic variation within an ABC-drug efflux transporter (Abcb5) affected susceptibility to HIT. In situ hybridization results reveal that Abcb5 is expressed in brain capillaries, and by cerebellar Purkinje cells. We also analyzed chromosome substitution strains, imaged haloperidol abundance in brain tissue sections and directly measured haloperidol (and its metabolite) levels in brain, and characterized Abcb5 knockout mice. Our results demonstrate that Abcb5 is part of the blood-brain barrier; it affects susceptibility to HIT by altering the brain concentration of haloperidol. Moreover, a genetic association study in a haloperidol-treated human cohort indicates that human ABCB5 alleles had a time-dependent effect on susceptibility to individual and combined measures of HIT. Abcb5 alleles are pharmacogenetic factors that affect susceptibility to HIT, but it is likely that additional pharmacogenetic susceptibility factors will be discovered. Conclusions ABCB5 alleles alter susceptibility to HIT in mouse and humans. This discovery leads to a new model that (at least in part) explains inter-individual differences in susceptibility to a drug-induced CNS toxicity. PMID:25647612

Hospital implementation of health information technology and quality of care: are they related?

PubMed

Restuccia, Joseph D; Cohen, Alan B; Horwitt, Jedediah N; Shwartz, Michael

2012-09-27

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians. We conducted surveys of quality managers and front-line clinicians (physicians and nurses) in 470 short-term, general hospitals to obtain data on hospitals' extent of HIT implementation, QI practices and strategies, assessments of quality performance, commitment to quality, and sufficiency of resources for QI. Of the 470 hospitals, 401 submitted complete data necessary for analysis. We also developed measures of hospital performance from several publicly data available sources: Hospital Compare adherence to process of care measures; Medicare Provider Analysis and Review (MEDPAR) file; and Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS® survey. We used Poisson regression analysis to examine the association between HIT implementation and QI practices and strategies, and general linear models to examine the relationship between HIT implementation and hospital performance measures. Controlling for potential confounders, we found that hospitals with high levels of HIT implementation engaged in a statistically significant greater number of QI practices and strategies, and had significantly better performance on mortality rates, patient satisfaction measures, and assessments of patient care quality by hospital quality managers; there was weaker evidence of higher assessments of patient care quality by front-line clinicians. Hospital implementation of HIT was positively associated with activities intended to improve patient care quality and with higher performance on four of six performance measures.

ALPIDE, the Monolithic Active Pixel Sensor for the ALICE ITS upgrade

NASA Astrophysics Data System (ADS)

Mager, M.; ALICE Collaboration

2016-07-01

A new 10 m2 inner tracking system based on seven concentric layers of Monolithic Active Pixel Sensors will be installed in the ALICE experiment during the second long shutdown of LHC in 2019-2020. The monolithic pixel sensors will be fabricated in the 180 nm CMOS Imaging Sensor process of TowerJazz. The ALPIDE design takes full advantage of a particular process feature, the deep p-well, which allows for full CMOS circuitry within the pixel matrix, while at the same time retaining the full charge collection efficiency. Together with the small feature size and the availability of six metal layers, this allowed a continuously active low-power front-end to be placed into each pixel and an in-matrix sparsification circuit to be used that sends only the addresses of hit pixels to the periphery. This approach led to a power consumption of less than 40 mWcm-2, a spatial resolution of around 5 μm, a peaking time of around 2 μs, while being radiation hard to some 1013 1 MeVneq /cm2, fulfilling or exceeding the ALICE requirements. Over the last years of R & D, several prototype circuits have been used to verify radiation hardness, and to optimize pixel geometry and in-pixel front-end circuitry. The positive results led to a submission of full-scale (3 cm×1.5 cm) sensor prototypes in 2014. They are being characterized in a comprehensive campaign that also involves several irradiation and beam tests. A summary of the results obtained and prospects towards the final sensor to instrument the ALICE Inner Tracking System are given.

Health Information Technology Evaluation Framework (HITREF) Comprehensiveness as Assessed in Electronic Point-of-Care Documentation Systems Evaluations.

PubMed

Sockolow, Paulina S; Bowles, Kathryn H; Rogers, Michelle

2015-01-01

We assessed the Health Information Technology (HIT) Reference-based Evaluation Framework (HITREF) comprehensiveness in two HIT evaluations in settings different from that in which the HITREF was developed. Clinician satisfaction themes that emerged from clinician interviews in the home care and the hospital studies were compared to the framework components. Across both studies, respondents commented on 12 of the 20 HITREF components within 5 of the 6 HITREF concepts. No new components emerged that were missing from the HITREF providing evidence that the HITREF is a comprehensive framework. HITREF use in a range of HIT evaluations by researchers new to the HITREF demonstrates that it can be used as intended. Therefore, we continue to recommend the HITREF as a comprehensive, research-based HIT evaluation framework to increase the capacity of informatics evaluators' use of best practice and evidence-based practice to support the credibility of their findings for fulfilling the purpose of program evaluation.

The e-health implementation toolkit: qualitative evaluation across four European countries

PubMed Central

2011-01-01

Background Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. Methods We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. Results e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. Conclusion The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems. PMID:22098945

The e-Health Implementation Toolkit: qualitative evaluation across four European countries.

PubMed

MacFarlane, Anne; Clerkin, Pauline; Murray, Elizabeth; Heaney, David J; Wakeling, Mary; Pesola, Ulla-Maija; Waterworth, Eva Lindh; Larsen, Frank; Makiniemi, Minna; Winblad, Ilkka

2011-11-19

Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems.

Use of health information technology (HIT) to improve statin adherence and low-density lipoprotein cholesterol goal attainment in high-risk patients: proceedings from a workshop.

PubMed

Cohen, Jerome D; Aspry, Karen E; Brown, Alan S; Foody, Joanne M; Furman, Roy; Jacobson, Terry A; Karalis, Dean G; Kris-Etherton, Penny M; Laforge, Ralph; O'Toole, Michael F; Scott, Ronald D; Underberg, James A; Valuck, Thomas B; Willard, Kaye-Eileen; Ziajka, Paul E; Ito, Matthew K

2013-01-01

The workshop discussions focused on how low-density lipoprotein cholesterol (LDL-C) goal attainment can be enhanced with the use of health information technology (HIT) in different clinical settings. A gap is acknowledged in LDL-C goal attainment, but because of the passage of the American Recovery & Reinvestment Act and the Health Information Technology for Economic and Clinical Health Acts there is now reason for optimism that this gap can be narrowed. For HIT to be effectively used to achieve treatment goals, it must be implemented in a setting in which the health care team is fully committed to achieving these goals. Implementation of HIT alone has not resulted in reducing the gap. It is critical to build an effective management strategy into the HIT platform without increasing the overall work/time burden on staff. By enhancing communication between the health care team and the patient, more timely adjustments to treatment plans can be made with greater opportunity for LDL-C goal attainment and improved efficiency in the long run. Patients would be encouraged to take a more active role. Support tools are available. The National Lipid Association has developed a toolkit designed to improve patient compliance and could be modified for use in an HIT system. The importance of a collaborative approach between nongovernmental organizations such as the National Lipid Association, National Quality Forum, HIT partners, and other members of the health care industry offers the best opportunity for long-term success and the real possibility that such efforts could be applied to other chronic conditions, for example, diabetes and hypertension. Copyright © 2013 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Using FDA reports to inform a classification for health information technology safety problems

PubMed Central

Ong, Mei-Sing; Runciman, William; Coiera, Enrico

2011-01-01

Objective To expand an emerging classification for problems with health information technology (HIT) using reports submitted to the US Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. Design HIT events submitted to MAUDE were retrieved using a standardized search strategy. Using an emerging classification with 32 categories of HIT problems, a subset of relevant events were iteratively analyzed to identify new categories. Two coders then independently classified the remaining events into one or more categories. Free-text descriptions were analyzed to identify the consequences of events. Measurements Descriptive statistics by number of reported problems per category and by consequence; inter-rater reliability analysis using the κ statistic for the major categories and consequences. Results A search of 899 768 reports from January 2008 to July 2010 yielded 1100 reports about HIT. After removing duplicate and unrelated reports, 678 reports describing 436 events remained. The authors identified four new categories to describe problems with software functionality, system configuration, interface with devices, and network configuration; the authors' classification with 32 categories of HIT problems was expanded by the addition of these four categories. Examination of the 436 events revealed 712 problems, 96% were machine-related, and 4% were problems at the human–computer interface. Almost half (46%) of the events related to hazardous circumstances. Of the 46 events (11%) associated with patient harm, four deaths were linked to HIT problems (0.9% of 436 events). Conclusions Only 0.1% of the MAUDE reports searched were related to HIT. Nevertheless, Food and Drug Administration reports did prove to be a useful new source of information about the nature of software problems and their safety implications with potential to inform strategies for safe design and implementation. PMID:21903979

Predictive saccade in the absence of smooth pursuit: interception of moving targets in the archer fish.

PubMed

Ben-Simon, Avi; Ben-Shahar, Ohad; Vasserman, Genadiy; Segev, Ronen

2012-12-15

Interception of fast-moving targets is a demanding task many animals solve. To handle it successfully, mammals employ both saccadic and smooth pursuit eye movements in order to confine the target to their area centralis. But how can non-mammalian vertebrates, which lack smooth pursuit, intercept moving targets? We studied this question by exploring eye movement strategies employed by archer fish, an animal that possesses an area centralis, lacks smooth pursuit eye movements, but can intercept moving targets by shooting jets of water at them. We tracked the gaze direction of fish during interception of moving targets and found that they employ saccadic eye movements based on prediction of target position when it is hit. The fish fixates on the target's initial position for ∼0.2 s from the onset of its motion, a time period used to predict whether a shot can be made before the projection of the target exits the area centralis. If the prediction indicates otherwise, the fish performs a saccade that overshoots the center of gaze beyond the present target projection on the retina, such that after the saccade the moving target remains inside the area centralis long enough to prepare and perform a shot. These results add to the growing body of knowledge on biological target tracking and may shed light on the mechanism underlying this behavior in other animals with no neural system for the generation of smooth pursuit eye movements.

Large-angle production of charged pions with 3-12.9 GeV/c incident protons on nuclear targets

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

Catanesi, M. G.; Radicioni, E.; Edgecock, R.

2008-05-15

Measurements of the double-differential {pi}{sup {+-}} production cross section in the momentum range 100{<=}p{<=}800 MeV/c and angle range 0.35{<=}{theta}{<=}2.15 rad in proton-beryllium, proton-carbon, proton-aluminium, proton-copper, proton-tin, proton-tantalum, and proton-lead collisions are presented. The data were taken with the large-acceptance HARP detector in the T9 beam line of the CERN PS. The pions were produced by proton beams in a momentum range from 3 to 12.9 GeV/c hitting a target with a thickness of 5% of a nuclear interaction length. Tracking and identification of the produced particles was performed by using a small-radius cylindrical Time Projection Chamber (TPC) placed inside amore » solenoidal magnet. Incident particles were identified by an elaborate system of beam detectors. Results are obtained for the double-differential cross sections d{sup 2}{sigma}/(dpd{theta}) at six incident proton beam momenta [3, 5, 8, and 8.9 GeV/c (Be only) and 12 and 12.9 GeV/c (Al only)]. They are based on a complete correction of static and dynamic distortions of tracks in the HARP TPC, which allows the complete statistics of the collected data set to be used. The results include and supersede our previously published results and are compatible with these. Results are compared with the GEANT4 and MARS Monte Carlo simulation.« less

The training and support needs of faculty and students using a health information technology system were significant: a case study in a dental school.

PubMed

Hill, Heather K; Stewart, Denice C L; Ash, Joan S

2010-11-13

Health Information Technology Systems (HITS) are becoming more widely integrated into patient care in the dental school setting. The purpose of this study was to evaluate the impact of a chairside HITS on users in the dental school setting. Qualitative techniques, including interviews, focus groups and observations, were used. Using grounded theory, we saw 9 themes emerge. One theme of particular interest was that "training and support needs of end-users were significant." This paper explores this theme in detail and discusses the implications.

Artificial Intelligence in Maintenance: Proceedings of the Joint Services Workshop Held at Boulder, Colorado on 4-6 October 1983.

DTIC Science & Technology

1984-06-01

intelligence . I strongly suspect that we’ll use data links to Rome so we can take advantage of both of the computer systems. Again, we see the need for close... data base indexing system would come up with a hit on those three key words I’ve just said. What is it? The hit is "artificial intelligence ." (This...pieces of data and is not classificatory in nature. In MDX there is S an intelligent data base component, called PATREC [6, 7], for doing such reasoning

Isolation and characterization of gallium resistant Pseudomonas aeruginosa mutants.

PubMed

García-Contreras, Rodolfo; Lira-Silva, Elizabeth; Jasso-Chávez, Ricardo; Hernández-González, Ismael L; Maeda, Toshinari; Hashimoto, Takahiro; Boogerd, Fred C; Sheng, Lili; Wood, Thomas K; Moreno-Sánchez, Rafael

2013-12-01

Pseudomonas aeruginosa PA14 cells resistant to the novel antimicrobial gallium nitrate (Ga) were developed using transposon mutagenesis and by selecting spontaneous mutants. The mutants showing the highest growth in the presence of Ga were selected for further characterization. These mutants showed 4- to 12-fold higher Ga minimal inhibitory growth concentrations and a greater than 8-fold increase in the minimum biofilm eliminating Ga concentration. Both types of mutants produced Ga resistant biofilms whereas the formation of wild-type biofilms was strongly inhibited by Ga. The gene interrupted in the transposon mutant was hitA, which encodes a periplasmic iron binding protein that delivers Fe³⁺ to the HitB iron permease; complementation of the mutant with the hitA gene restored the Ga sensitivity. This hitA mutant showed a 14-fold decrease in Ga internalization versus the wild-type strain, indicating that the HitAB system is also involved in the Ga uptake. Ga uptake in the spontaneous mutant was also lower, although no mutations were found in the hitAB genes. Instead, this mutant harbored 64 non-silent mutations in several genes including those of the phenazine pyocyanin biosynthesis. The spontaneous mutant produced 2-fold higher pyocyanin basal levels than the wild-type; the addition of this phenazine to wild-type cultures protected them from the Ga bacteriostatic effect. The present data indicate that mutations affecting Ga transport and probably pyocyanin biosynthesis enable cells to develop resistance to Ga. Copyright © 2013 Elsevier GmbH. All rights reserved.

42 CFR 495.344 - Approval of the State Medicaid HIT plan, the HIT PAPD and update, the HIT IAPD and update, and...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Approval of the State Medicaid HIT plan, the HIT... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Requirements Specific to the Medicaid Program § 495.344 Approval of the State Medicaid HIT plan, the HIT PAPD...

MYC/BCL2/BCL6 triple hit lymphoma: a study of 40 patients with a comparison to MYC/BCL2 and MYC/BCL6 double hit lymphomas.

PubMed

Huang, Wenting; Medeiros, L Jeffrey; Lin, Pei; Wang, Wei; Tang, Guilin; Khoury, Joseph; Konoplev, Sergej; Yin, C Cameron; Xu, Jie; Oki, Yasuhiro; Li, Shaoying

2018-05-21

High-grade B-cell lymphomas with MYC, BCL2, and BCL6 rearrangements (triple hit lymphoma) are uncommon. We studied the clinicopathologic features of 40 patients with triple hit lymphoma and compared them to 157 patients with MYC/BCL2 double hit lymphoma and 13 patients with MYC/BCL6 double hit lymphoma. The triple hit lymphoma group included 25 men and 15 women with a median age of 61 years (range, 34-85). Nine patients had a history of B-cell lymphoma. Histologically, 23 (58%) cases were diffuse large B-cell lymphoma and 17 cases had features of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Most cases of triple hit lymphoma were positive for CD10 (100%), BCL2 (95%), BCL6 (82%), MYC (74%), and 71% with MYC and BCL2 coexpression. P53 was overexpressed in 29% of triple hit lymphoma cases. The clinicopathological features of triple hit lymphoma patients were similar to patients with MYC/BCL2 and MYC/BCL6 double hit lymphoma, except that triple hit lymphoma cases were more often CD10 positive compared with MYC/BCL6 double hit lymphoma (p < 0.05). Induction chemotherapy used was similar for patients with triple hit lymphoma and double hit lymphoma and overall survival in triple hit lymphoma patients was 17.6 months, similar to the overall survival of patients with double hit lymphoma (p = 0.67). Patients with triple hit lymphoma showing P53 overexpression had significantly worse overall survival compared with those without P53 overexpression (p = 0.04). On the other hand, double expressor status and prior history of B-cell lymphoma did not correlate with overall survival. In conclusion, most patients with triple hit lymphoma have an aggressive clinical course and poor prognosis and these tumors have a germinal center B-cell immunophenotype, similar to patients with double hit lymphomas. P53 expression is a poor prognostic factor in patients with triple hit lymphoma.

Theoretical modeling of the MILES hit profiles in military weapon low-data rate simulators

NASA Astrophysics Data System (ADS)

Andrews, L. C.; Phillips, R. L.; Smith, C. A.; Belichki, S. B.; Crabbs, R.; Cofarro, J. T.; Fountain, W.; Tucker, F. M.; Parrish, B. J.

2016-09-01

Math modeling of a low-data-rate optical communication system is presented and compared with recent testing results over ranges up to 100 m in an indoor tunnel at Kennedy Space Center. Additional modeling of outdoor testing results at longer ranges in the open atmosphere is also presented. The system modeled is the Army's Multiple Integrated Laser Engagement System (MILES) that has been used as a tactical training system since the early 1980s. The objective of the current modeling and testing is to obtain target hit zone profiles for the M16A2/M4 rifles and establish a data baseline for MILES that will aid in its upgrade using more recently developed lasers and detectors.

Integrating unified medical language system and association mining techniques into relevance feedback for biomedical literature search.

PubMed

Ji, Yanqing; Ying, Hao; Tran, John; Dews, Peter; Massanari, R Michael

2016-07-19

Finding highly relevant articles from biomedical databases is challenging not only because it is often difficult to accurately express a user's underlying intention through keywords but also because a keyword-based query normally returns a long list of hits with many citations being unwanted by the user. This paper proposes a novel biomedical literature search system, called BiomedSearch, which supports complex queries and relevance feedback. The system employed association mining techniques to build a k-profile representing a user's relevance feedback. More specifically, we developed a weighted interest measure and an association mining algorithm to find the strength of association between a query and each concept in the article(s) selected by the user as feedback. The top concepts were utilized to form a k-profile used for the next-round search. BiomedSearch relies on Unified Medical Language System (UMLS) knowledge sources to map text files to standard biomedical concepts. It was designed to support queries with any levels of complexity. A prototype of BiomedSearch software was made and it was preliminarily evaluated using the Genomics data from TREC (Text Retrieval Conference) 2006 Genomics Track. Initial experiment results indicated that BiomedSearch increased the mean average precision (MAP) for a set of queries. With UMLS and association mining techniques, BiomedSearch can effectively utilize users' relevance feedback to improve the performance of biomedical literature search.

Spontaneous heparin-induced thrombocytopenia (HIT) syndrome: HIT without any heparin exposure.

PubMed

Miyata, Shigeki

2016-01-01

Heparin-induced thrombocytopenia (HIT) is a pro-thrombotic side effect of heparin therapy caused by HIT antibodies with platelet-activating properties. Recent advances in understanding of spontaneous HIT syndrome, which can occur even without any heparin exposure despite its clinical and serological characteristics being similar to those of HIT, reveal the following HIT clinical features atypical for an immune-mediated disease. Heparin-naïve patients can develop IgG antibodies as early as day 4, as in a secondary immune response. Evidence for an anamnestic response upon heparin re-exposure is lacking. In addition, HIT antibodies are relatively short-lived, unlike those in a secondary immune response. Antigen immunoassays are commonly used worldwide for serological diagnosis of HIT. However, such assays do not indicate whether HIT antibodies have platelet-activating properties, leading to low diagnostic specificity for HIT. The detection of platelet-activating antibodies using a washed platelet activation assay is crucial for making a HIT diagnosis. These atypical clinical and serological features should be carefully considered while appropriately diagnosing HIT, which leads to appropriate therapy such as immediate administration of an alternative anticoagulant for preventing thromboembolic events and re-administration of heparin during surgery involving cardiopulmonary bypass when HIT antibodies are no longer detectable.

An empirically-derived approach for investigating Health Information Technology: the Elementally Entangled Organisational Communication (EEOC) framework.

PubMed

Georgiou, Andrew; Westbrook, Johanna I; Braithwaite, Jeffrey

2012-07-12

The purpose of this paper is to illustrate the Elementally Entangled Organisational Communication (EEOC) framework by drawing on a set of three case studies which assessed the impact of new Health Information Technology (HIT) on a pathology service. The EEOC framework was empirically developed as a tool to tackle organisational communication challenges in the implementation and evaluation of health information systems. The framework was synthesised from multiple research studies undertaken across a major metropolitan hospital pathology service during the period 2005 to 2008. These studies evaluated the impact of new HIT systems in pathology departments (Laboratory Information System) and an Emergency Department (Computerised Provider Order Entry) located in Sydney, Australia. Key dimensions of EEOC are illustrated by the following case studies: 1) the communication infrastructure between the Blood Bank and the ward for the coordination and distribution of blood products; 2) the organisational environment in the Clinical Chemistry and Haematology departments and their attempts to organise, plan and control the processing of laboratory specimens; and 3) the temporal make up of the organisation as revealed in changes to the way the Central Specimen Reception allocated, sequenced and synchronised work tasks. The case studies not only highlight the pre-existing communication architecture within the organisation but also the constitutive role communication plays in the way organisations go about addressing their requirements. HIT implementation involves a mutual transformation of the organisation and the technology. This is a vital consideration because of the dangers associated with poor organisational planning and implementation of HIT, and the potential for unintended adverse consequences, workarounds and risks to the quality and safety of patient care. The EEOC framework aims to account for the complex range of contextual factors and triggers that play a role in the success or otherwise of new HITs, and in the realisation of their innovation potential.

An empirically-derived approach for investigating Health Information Technology: the Elementally Entangled Organisational Communication (EEOC) framework

PubMed Central

2012-01-01

Background The purpose of this paper is to illustrate the Elementally Entangled Organisational Communication (EEOC) framework by drawing on a set of three case studies which assessed the impact of new Health Information Technology (HIT) on a pathology service. The EEOC framework was empirically developed as a tool to tackle organisational communication challenges in the implementation and evaluation of health information systems. Methods The framework was synthesised from multiple research studies undertaken across a major metropolitan hospital pathology service during the period 2005 to 2008. These studies evaluated the impact of new HIT systems in pathology departments (Laboratory Information System) and an Emergency Department (Computerised Provider Order Entry) located in Sydney, Australia. Results Key dimensions of EEOC are illustrated by the following case studies: 1) the communication infrastructure between the Blood Bank and the ward for the coordination and distribution of blood products; 2) the organisational environment in the Clinical Chemistry and Haematology departments and their attempts to organise, plan and control the processing of laboratory specimens; and 3) the temporal make up of the organisation as revealed in changes to the way the Central Specimen Reception allocated, sequenced and synchronised work tasks. Conclusions The case studies not only highlight the pre-existing communication architecture within the organisation but also the constitutive role communication plays in the way organisations go about addressing their requirements. HIT implementation involves a mutual transformation of the organisation and the technology. This is a vital consideration because of the dangers associated with poor organisational planning and implementation of HIT, and the potential for unintended adverse consequences, workarounds and risks to the quality and safety of patient care. The EEOC framework aims to account for the complex range of contextual factors and triggers that play a role in the success or otherwise of new HITs, and in the realisation of their innovation potential. PMID:22788698

CHI during an ohmic discharge in HIT-II

NASA Astrophysics Data System (ADS)

Mueller, Dennis; Nelson, Brian A.; Redd, Aaron J.; Hamp, William T.

2004-11-01

Coaxial Helicity Injection (CHI) has been used on the National Spherical Torus Experiment (NSTX), the Helicity Injected Torus (HIT) and HIT-II to initiate plasma and to drive up to 400 kA of toroidal current. The primary goal of the CHI systems is to provide a start-up plasma with substantial toroidal current that can be heated and sustained with other methods. We have investigated the use of CHI systems to add current to an established, inductively driven plasma. This may be an attractive method to add edge current that may modify the stability characteristics of the discharge or modify the particle and energy transport in a spherical torus. For example, divertor biasing experiments have been successful in modifying particle and energy transport in the scrape-off layer of tokamaks. Use of IGBT power supplies to modulate the injector current makes analysis of current penetration feasible by comparisons of before and after CHI using EFIT analysis of the data.

Multimode drug inducible CRISPR/Cas9 devices for transcriptional activation and genome editing

PubMed Central

Lu, Jia; Zhao, Chen; Zhao, Yingze; Zhang, Jingfang; Zhang, Yue; Chen, Li; Han, Qiyuan; Ying, Yue; Peng, Shuai; Ai, Runna; Wang, Yu

2018-01-01

Abstract Precise investigation and manipulation of dynamic biological processes often requires molecular modulation in a controlled inducible manner. The clustered, regularly interspaced, short palindromic repeats (CRISPR)/CRISPR associated protein 9 (Cas9) has emerged as a versatile tool for targeted gene editing and transcriptional programming. Here, we designed and vigorously optimized a series of Hybrid drug Inducible CRISPR/Cas9 Technologies (HIT) for transcriptional activation by grafting a mutated human estrogen receptor (ERT2) to multiple CRISPR/Cas9 systems, which renders them 4-hydroxytamoxifen (4-OHT) inducible for the access of genome. Further, extra functionality of simultaneous genome editing was achieved with one device we named HIT2. Optimized terminal devices herein delivered advantageous performances in comparison with several existing designs. They exerted selective, titratable, rapid and reversible response to drug induction. In addition, these designs were successfully adapted to an orthogonal Cas9. HIT systems developed in this study can be applied for controlled modulation of potentially any genomic loci in multiple modes. PMID:29237052

Monte-Carlo Simulations of Heavy Ions Track Structures and Applications

NASA Technical Reports Server (NTRS)

Plante, Ianik; Cucinotta, Francia A.

2013-01-01

In space, astronauts are exposed to protons, high ]energy heavy (HZE) ions that have a high charge (Z) and energy (E), and secondary radiation, including neutrons and recoil nuclei produced by nuclear reactions in spacecraft walls or in tissue. The astronauts can only be partly shielded from these particles. Therefore, on travelling to Mars, it is estimated that every cell nucleus in an astronaut fs body would be hit by a proton or secondary electron (e.g., electrons of the target atoms ionized by the HZE ion) every few days and by an HZE ion about once a month. The risks related to these heavy ions are not well known and of concern for long duration space exploration missions. Medical ion therapy is another situation where human beings can be irradiated by heavy ions, usually to treat cancer. Heavy ions have a peculiar track structure characterized by high levels of energy ]deposition clustering, especially in near the track ends in the so ]called eBragg peak f region. In radiotherapy, these features of heavy ions can provide an improved dose conformation with respect to photons, also considering that the relative biological effectiveness (RBE) of therapeutic ions in the plateau region before the peak is sufficiently low. Therefore, several proton and carbon ion therapy facilities are under construction at this moment

Baseline monitoring using aircraft laser ranging. [spaceborne laser simulation and aircraft laser tracking

NASA Technical Reports Server (NTRS)

Krabill, W. B.; Hoge, F. E.; Martin, C. F.

1982-01-01

The use of aircraft laser ranging for the determination of baselines between ground based retroreflectors was investigated via simulations and with tests at Wallops Flight Center using the Airborne Oceanographic Lidar (AOL) on the Wallops C-54 aircraft ranging to a reflector array deployed around one of the Wallops runways. The aircraft altitude and reflector spacing were chosen on the basis of scaled down modeling of spacecraft tracking from 1000 km of reflectors separated by some 52 km, or of high altitude (10 km) aircraft tracking of reflectors separated by some 500 m. Aircraft altitudes flown for different passes across the runway reflector array varied from 800 m to 1350 m, with 32 reflectors deployed over an approximtely 300 m x 500 m ground pattern. The AOL transmitted 400 pulses/sec with a scan rate of 5/sec in a near circular pattern, so that the majority of the pulses were reflected by the runway surface or its environs rather than by retroreflectors. The return pulse characteristics clearly showed the high reflectivity of portions of the runway, with several returns indistinguishable in amplitude from reflector returns. For each pass across the reflector field, typically six to ten reflector hits were identified, consistent with that predicted by simulations and the observed transmitted elliptical pulse size.

Morphological feature detection for cervical cancer screening

NASA Astrophysics Data System (ADS)

Narayanswamy, Ramkumar; Sharpe, John P.; Duke, Heather J.; Stewart, Rosemary J.; Johnson, Kristina M.

1995-03-01

An optoelectronic system has been designed to pre-screen pap-smear slides and detect the suspicious cells using the hit/miss transform. Computer simulation of the algorithm tested on 184 pap-smear images detected 95% of the suspicious region as suspect while tagging just 5% of the normal regions as suspect. An optoelectronic implementation of the hit/miss transform using a 4f Vander-Lugt correlator architecture is proposed and demonstrated with experimental results.

Engineering Design Handbook: Recoilless Rifle Weapon Systems.

DTIC Science & Technology

1976-01-15

rifles also creates danger of physiological damage also exists. psychological factors which may be signifi- The extent and nature of the damage caused...the intensity of the bla&st, its disruption often cause psychological effects impulse, the position of the subject with of extreme lethargy and...General. 6. AD 3S 1 905, Capt. L. R. Creelman , A 2. David E. Walters and Edith F. Reilly, Parameiric Study of the Probability of Hit Hitting

Aligning health information technologies with effective service delivery models to improve chronic disease care.

PubMed

Bauer, Amy M; Thielke, Stephen M; Katon, Wayne; Unützer, Jürgen; Areán, Patricia

2014-09-01

Healthcare reforms in the United States, including the Affordable Care and HITECH Acts, and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology (HIT) and the integration of general medical and mental health services. These developments, which aim to improve chronic disease care, have largely occurred in parallel, with little attention to the need for coordination. In this article, the fundamental connections between HIT and improvements in chronic disease management are explored. We use the evidence-based collaborative care model as an example, with attention to health literacy improvement for supporting patient engagement in care. A review of the literature was conducted to identify how HIT and collaborative care, an evidence-based model of chronic disease care, support each other. Five key principles of effective collaborative care are outlined: care is patient-centered, evidence-based, measurement-based, population-based, and accountable. The potential role of HIT in implementing each principle is discussed. Key features of the mobile health paradigm are described, including how they can extend evidence-based treatment beyond traditional clinical settings. HIT, and particularly mobile health, can enhance collaborative care interventions, and thus improve the health of individuals and populations when deployed in integrated delivery systems. Copyright © 2014 Elsevier Inc. All rights reserved.

Aligning health information technologies with effective service delivery models to improve chronic disease care

PubMed Central

Bauer, Amy M.; Thielke, Stephen M.; Katon, Wayne; Unützer, Jürgen; Areán, Patricia

2014-01-01

Objective Healthcare reforms in the United States, including the Affordable Care and HITECH Acts, and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology (HIT) and the integration of general medical and mental health services. These developments, which aim to improve chronic disease care have largely occurred in parallel, with little attention to the need for coordination. In this article, the fundamental connections between HIT and improvements in chronic disease management are explored. We use the evidence-based collaborative care model as an example, with attention to health literacy improvement for supporting patient engagement in care. Method A review of the literature was conducted to identify how HIT and collaborative care, an evidence-based model of chronic disease care, support each other. Results Five key principles of effective collaborative care are outlined: care is patient-centered, evidence-based, measurement-based, population-based, and accountable. The potential role of HIT in implementing each principle is discussed. Key features of the mobile health paradigm are described, including how they can extend evidence-based treatment beyond traditional clinical settings. Conclusion HIT, and particularly mobile health, can enhance collaborative care interventions, and thus improve the health of individuals and populations when deployed in integrated delivery systems. PMID:24963895

High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence

PubMed Central

Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

2015-01-01

Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases. PMID:25833341

High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence.

PubMed

Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

2015-06-01

Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

The Helicity Injected Torus (HIT) Program

NASA Astrophysics Data System (ADS)

Jarboe, T. R.; Gu, P.; Hamp, W.; Izzo, V.; Jewell, P.; Liptac, J.; McCollam, K. J.; Nelson, B. A.; Raman, R.; Redd, A. J.; Shumlak, U.; Sieck, P. E.; Smith, R. J.; Jain, K. K.; Nagata, M.; Uyama, T.

2000-10-01

The purpose of the Helicity Injected Torus (HIT) program is to develop current drive techniques for low-aspect-ratio toroidal plasmas. The present HIT-II spherical tokamak experiment is capable of both Coaxial Helicity Injection (CHI) and transformer action current drive. The HIT-II device itself is modestly sized (major radius R = 0.3 m, minor radius a = 0.2 m, with an on-axis magnetic field of up to Bo = 0.5 T), but has demonstrated toroidal plasma currents of up to 200 kA, using either CHI or transformer drive. An overview of ongoing research on HIT-II plasmas, including recent results, will be presented. An electron-locking model has been developed for helicity injection current drive; a description of this model will be presented, as well as comparisons to experimental results from the HIT and HIT-II devices. Empirical results from both the HIT program and past spheromak research, buttressed by theoretical developments, have led to the design of the upcoming HIT-SI (Helicity Injected Torus with Steady Inductive helicity injection) device (T.R. Jarboe, Fusion Technology 36, p. 85, 1999). HIT-SI will be able to form a high-beta spheromak, a low aspect ratio RFP or a spherical tokamak using constant inductive helicity injection. The HIT-SI design and construction progress will be presented.

Model Checking for Verification of Interactive Health IT Systems

PubMed Central

Butler, Keith A.; Mercer, Eric; Bahrami, Ali; Tao, Cui

2015-01-01

Rigorous methods for design and verification of health IT systems have lagged far behind their proliferation. The inherent technical complexity of healthcare, combined with the added complexity of health information technology makes their resulting behavior unpredictable and introduces serious risk. We propose to mitigate this risk by formalizing the relationship between HIT and the conceptual work that increasingly typifies modern care. We introduce new techniques for modeling clinical workflows and the conceptual products within them that allow established, powerful modeling checking technology to be applied to interactive health IT systems. The new capability can evaluate the workflows of a new HIT system performed by clinicians and computers to improve safety and reliability. We demonstrate the method on a patient contact system to demonstrate model checking is effective for interactive systems and that much of it can be automated. PMID:26958166

Delta opioid peptide (D-Ala 2, D-Leu 5) enkephalin: linking hibernation and neuroprotection.

PubMed

Borlongan, Cesario V; Wang, Yun; Su, Tsung-Ping

2004-09-01

Hibernation is a potential protective strategy for the peripheral, as well as for the central nervous system. A protein factor termed hibernation induction trigger (HIT) was found to induce hibernation in summer-active ground squirrels. Purification of HIT yielded an 88-kD peptide that is enriched in winter hibernators. Partial sequence of the 88-kD protein indicates that it may be related to the inhibitor of metalloproteinase. Using opioid receptor antagonists to elucidate the mechanisms of HIT, it was found that HIT targeted the delta opioid receptors. Indeed, delta opioid (D-Ala 2, D-Leu 5) enkephalin (DADLE) was shown to induce hibernation. Specifically, HIT and DADLE were found to prolong survival of peripheral organs, such as the lung, the heart, liver, and kidney preserved en bloc or as a single preparation. In addition, DADLE has been recently demonstrated to promote survival of neurons in the central nervous system. Exposure to DADLE dose-dependently enhanced cell viability of cultured primary rat fetal dopaminergic cells. Subsequent transplantation of these DADLE-treated dopaminergic cells into the Parkinsonian rat brain resulted in a two-fold increase in surviving grafted cells. Interestingly, delivery of DADLE alone protected against dopaminergic depletion in a rodent model of Parkinson s disease. Similarly, DADLE blocked and reversed the dopaminergic terminal damage induced by methamphetamine (METH). Such neuroprotective effects of DADLE against METH neurotoxicity was accompanied by attenuation of mRNA expressions of a tumor necrosis factor p53 and an immediate early gene c-fos. In parallel to these beneficial effects of DADLE on the dopaminergic system, DADLE also ameliorated the neuronal damage induced by ischemia-reperfusion following a transient middle cerebral artery occlusion. In vitro replication of this ischemia cell death by serum-deprivation of PC12 cells revealed that DADLE exerted neuroprotection in a naltrexone-sensitive manner. These results taken together suggest that DADLE stands as a novel therapeutic agent. In this review paper, we present laboratory evidence supporting the use of DADLE for protection of peripheral and central nervous system.

Assessment of the performances of AcuStar HIT and the combination with heparin-induced multiple electrode aggregometry: a retrospective study.

PubMed

Minet, V; Bailly, N; Douxfils, J; Osselaer, J C; Laloy, J; Chatelain, C; Elalamy, I; Chatelain, B; Dogné, J M; Mullier, F

2013-09-01

Early diagnosis of immune heparin-induced thrombocytopenia (HIT) is challenging. HemosIL® AcuStar HIT and heparin-induced multiple electrode aggregometry (HIMEA) were recently proposed as rapid diagnostic methods. We conducted a study to assess performances of AcuStar HIT-IgG (PF4-H) and AcuStar HIT-Ab (PF4-H). The secondary objective was to compare the performances of the combination of Acustar HIT and HIMEA with standardised clinical diagnosis. Sera of 104 suspected HIT patients were retrospectively tested with AcuStar HIT. HIMEA was performed on available sera (n=81). The clinical diagnosis was established by analysing in a standardized manner the patient's medical records. These tests were also compared with PF4-Enhanced®, LTA, and SRA in subsets of patients. Thresholds were determined using ROC curve analysis with clinical outcome as reference. Using the recommended thresholds (1.00AU), the negative predictive value (NPV) of HIT-IgG and HIT-Ab were 100.0% (95% CI: 95.9%-100.0% and 95.7%-100.0%). The positive predictive value (PPV) were 64.3% (95% CI: 35.1%-87.2.2%) and 45.0% (95% CI: 23.2%-68.6%), respectively. Using our thresholds (HIT-IgG: 2.89AU, HIT-Ab: 9.41AU), NPV of HIT-IgG and HIT-Ab were 100.0% (95% CI: 96.0%-100.0% and 96.1%-100.0%). PPV were 75.0% (95% CI: 42.7%-94.5%) and 81.8% (95% CI: 48.3%-97.7%), respectively. Of the 79 patients with a medium-high pretest probability score, 67 were negative using HIT-IgG (PF4-H) test at our thresholds. HIMEA was performed on HIT-IgG positive patients. Using this combination, only one patient on 79 was incorrectly diagnosed. Acustar HIT showed good performances to exclude the diagnosis of HIT. Combination with HIMEA improves PPV. Copyright © 2013 Elsevier Ltd. All rights reserved.

A GEM readout with radial zigzag strips and linear charge-sharing response

DOE PAGES

Zhang, Aiwu; Hohlmann, Marcus; Azmoun, Babak; ...

2018-01-10

Here, we study the position sensitivity of radial zigzag strips intended to read out large GEM detectors for tracking at future experiments. Zigzag strips can cover a readout area with fewer strips than regular straight strips while maintaining good spatial resolution. Consequently, they can reduce the number of required electronic channels and related cost for large-area GEM detector systems. A non-linear relation between incident particle position and hit position measured from charge sharing among zigzag strips was observed in a previous study. We significantly reduce this non-linearity by improving the interleaving of adjacent physical zigzag strips. Zigzag readout structures aremore » implemented on PCBs and on a flexible foil and are tested using a 10 cm × 10 cm triple-GEM detector scanned with a strongly collimated X-ray gun on a 2D motorized stage. Lastly, angular resolutions of 60–84 μrad are achieved with a 1.37 mrad angular strip pitch at a radius of 784 mm. On a linear scale this corresponds to resolutions below 100 μm.« less

A GEM readout with radial zigzag strips and linear charge-sharing response

NASA Astrophysics Data System (ADS)

Zhang, Aiwu; Hohlmann, Marcus; Azmoun, Babak; Purschke, Martin L.; Woody, Craig

2018-04-01

We study the position sensitivity of radial zigzag strips intended to read out large GEM detectors for tracking at future experiments. Zigzag strips can cover a readout area with fewer strips than regular straight strips while maintaining good spatial resolution. Consequently, they can reduce the number of required electronic channels and related cost for large-area GEM detector systems. A non-linear relation between incident particle position and hit position measured from charge sharing among zigzag strips was observed in a previous study. We significantly reduce this non-linearity by improving the interleaving of adjacent physical zigzag strips. Zigzag readout structures are implemented on PCBs and on a flexible foil and are tested using a 10 cm × 10 cm triple-GEM detector scanned with a strongly collimated X-ray gun on a 2D motorized stage. Angular resolutions of 60-84 μrad are achieved with a 1.37 mrad angular strip pitch at a radius of 784 mm. On a linear scale this corresponds to resolutions below 100 μm.

Classifying health information technology patient safety related incidents - an approach used in Wales.

PubMed

Warm, D; Edwards, P

2012-01-01

Interest in the field of patient safety incident reporting and analysis with respect to Health Information Technology (HIT) has been growing over recent years as the development, implementation and reliance on HIT systems becomes ever more prevalent. One of the rationales for capturing patient safety incidents is to learn from failures in the delivery of care and must form part of a feedback loop which also includes analysis; investigation and monitoring. With the advent of new technologies and organizational programs of delivery the emphasis is increasingly upon analyzing HIT incidents. This thematic review had two objectives, to test the applicability of a framework specifically designed to categorize HIT incidents and to review the Welsh incidents as communicated via the national incident reporting system in order to understand their implications for healthcare. The incidents were those reported as IT/ telecommunications failure/ overload. Incidents were searched for within a national reporting system using a standardized search strategy for incidents occurring between 1(st) January 2009 and 31(st) May 2011. 149 incident reports were identified and classified. The majority (77%) of which were machine related (technical problems) such as access problems; computer system down/too slow; display issues; and software malfunctions. A further 10% (n = 15) of incidents were down to human-computer interaction issues and 13% (n = 19) incidents, mainly telephone related, could not be classified using the framework being tested. On the basis of this review of incidents, it is recommended that the framework be expanded to include hardware malfunctions and the wrong record retrieved/missing data associated with a machine output error (as opposed to human error). In terms of the implications for clinical practice, the incidents reviewed highlighted critical issues including the access problems particularly relating to the use of mobile technologies.

Heparin-induced thrombocytopenia: real-world issues.

PubMed

Linkins, Lori-Ann; Warkentin, Theodore E

2011-09-01

Heparin-induced thrombocytopenia (HIT) is a prothrombotic drug reaction caused by platelet-activating antibodies. HIT sera often activate platelets without needing heparin-such heparin-"independent" platelet activation can be associated with HIT beginning or worsening despite stopping heparin ("delayed-onset HIT"). We address important issues in HIT diagnosis and therapy, using a recent cohort of HIT patients to illustrate influences of heparin type; triggers for HIT investigation; serological features of heparin-independent platelet activation; and treatment. In our cohort of recent HIT cases ( N = 13), low-molecular-weight heparin (dalteparin) was a common causative agent ( N = 8, 62%); most patients were diagnosed after HIT-thrombosis had occurred; and danaparoid was the most frequently selected treatment. Heparin-independent platelet activation was common (7/13 [54%]) and predicted slower platelet count recovery (>1 week) among evaluable patients (5/5 vs 1/6; P = 0.015). In our experience with argatroban-treated patients, HIT-associated consumptive coagulopathy confounds anticoagulant monitoring. Our observations provide guidance on practical aspects of HIT diagnosis and management. Thieme Medical Publishers.

The immune imbalance in the second hit of pancreatitis is independent of IL-17A.

PubMed

Thomson, John-Edwin; Brand, Martin; Fonteh, Pascaline

2018-04-01

Severe acute pancreatitis (SAP) is characterised by two distinct clinical phases. Organ dysfunction and death is initially as a result of a systemic inflammatory response syndrome (SIRS). Systemic sepsis from infected pancreatic necrosis characterises the second phase, the so called 'second hit' of acute pancreatitis (AP). An immune imbalance during the second hit is postulated to contribute to the formation of the septic complications that occur in these patients. The pro-inflammatory T-helper (Th) 17 pathway has been shown to be an initiator of early SIRS in AP, however to date its role has not been established in the second hit in AP. Thirty-six patients with mild (n = 16), moderate (n = 10) and severe (n = 10) acute pancreatitis were enrolled. Peripheral blood samples were drawn on days 7, 9, 11 and 13 of illness for analysis of routine clinical markers as well as cytokine analysis. Flow cytometry and a IL-17A ELISA was performed to determine cytokine concentrations. There were no significant differences between days 7, 9, 11 and 13 for either the mild/moderate or SAP groups for IL-17A (CBA assay or ELISA), IFN-γ, TNF-α, IL-2 or IL-4. For each of the study days, the mean IL-6 and IL-10 concentrations were significantly higher in the SAP group compared to the mild/moderate group. WCC, CRP and PCT were all significantly higher in severe acute pancreatitis over the study days. An immune imbalance exists in patients with SAP, however secreted IL-17A is not responsible for the second hit in AP. Copyright © 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.

e-Health readiness assessment factors and measuring tools: A systematic review.

PubMed

Yusif, Salifu; Hafeez-Baig, Abdul; Soar, Jeffrey

2017-11-01

The evolving, adoption and high failure nature of health information technology (HIT)/IS/T systems requires effective readiness assessment to avert increasing failures while increasing system benefits. However, literature on HIT readiness assessment is myriad and fragmented. This review bares the contours of the available literature concluding in a set of manageable and usable recommendations for policymakers, researchers, individuals and organizations intending to assess readiness for any HIT implementation. Identify studies, analyze readiness factors and offer recommendations. Published articles 1995-2016 were searched using Medline/PubMed, Cinahl, Web of Science, PsychInfo, ProQuest. Studies were included if they were assessing IS/T/mHealth readiness in the context of HIT. Articles not written in English were excluded. Themes that emerged in the process of the data synthesis were thematically analysed and interpreted. Analyzed themes were found across 63 articles. In accordance with their prevalence of use, they included but not limited to "Technological readiness", 30 (46%); "Core/Need/Motivational readiness", 23 (37%); "Acceptance and use readiness", 19 (29%); "Organizational readiness", 20 (21%); "IT skills/Training/Learning readiness" (18%), "Engagement readiness", 16 (24%) and "Societal readiness" (14%). Despite their prevalence in use, "Technological readiness", "Motivational readiness" and "Engagement readiness" all had myriad and unreliable measuring tools. Core readiness had relatively reliable measuring tools, which repeatedly been used in various readiness assessment studies CONCLUSION: Thus, there is the need for reliable measuring tools for even the most commonly used readiness assessment factors/constructs: Core readiness, Engagement and buy-ins readiness, Technological readiness and IT Skills readiness as this could serve as an immediate step in conducting effective/reliable e-Health readiness assessment, which could lead to reduced HIT implementation failures. Copyright © 2017 Elsevier B.V. All rights reserved.

Student Use of Scaffolding Software: Relationships with Motivation and Conceptual Understanding

NASA Astrophysics Data System (ADS)

Butler, Kyle A.; Lumpe, Andrew

2008-10-01

This study was designed to theoretically articulate and empirically assess the role of computer scaffolds. In this project, several examples of educational software were developed to scaffold the learning of students performing high level cognitive activities. The software used in this study, Artemis, focused on scaffolding the learning of students as they performed information seeking activities. As 5th grade students traveled through a project-based science unit on photosynthesis, researchers used a pre-post design to test for both student motivation and student conceptual understanding of photosynthesis. To measure both variables, a motivation survey and three methods of concept map analysis were used. The student use of the scaffolding features was determined using a database that tracked students' movement between scaffolding tools. The gain scores of each dependent variable was then correlated to the students' feature use (time and hits) embedded in the Artemis Interface. This provided the researchers with significant relationships between the scaffolding features represented in the software and student motivation and conceptual understanding of photosynthesis. There were a total of three significant correlations in comparing the scaffolding use by hits (clicked on) with the dependent variables and only one significant correlation when comparing the scaffold use in time. The first significant correlation ( r = .499, p < .05) was between the saving/viewing features hits and the students' task value. This correlation supports the assumption that there is a positive relationship between the student use of the saving/viewing features and the students' perception of how interesting, how important, and how useful the task is. The second significant correlation ( r = 0.553, p < 0.01) was between the searching features hits and the students' self-efficacy for learning and performance. This correlation supports the assumption that there is a positive relationship between the student use of the searching features and the students' perception of their ability to accomplish a task as well as their confidence in their skills to perform that task. The third significant correlation ( r = 0.519, p < 0.05) was between the collaborative features hits and the students' essay performance scores. This correlation supports the assumption that there is a positive relationship between the student use of the collaborative features and the students' ability to perform high cognitive tasks. Finally, the last significant correlation ( r = 0.576, p < 0.01) was between the maintenance features time and the qualitative analysis of the concept maps. This correlation supports the assumption that there is a positive relationship between the student use of the maintenance features and student conceptual understanding of photosynthesis.

Biological effects of galactic radiation HZE particles in experiments on the orbital station Salyut 7

NASA Astrophysics Data System (ADS)

Miller, A. T.; Nevzgodina, L. V.

Lettuce (Lactuca sativa) seeds were flown on-board the orbital station Salyut 7 for 66-457 days. It was found that a single heavy charged particle (HZE) hitting a seed only slightly affects the subsequent plant growth. However, morphological anomalies of varying type in primordial leaves and roots were observed that show good correlation with the location of the particle track. The most severe damage detected by light and an electron microscopy were ``channels'' in dry and soaked seeds. The appearance of ``channels'' seems to be related to the LET of the incident particle. This finding is of considerable importance for assessment of space flight radiation hazard.

Hit identification and optimization in virtual screening: practical recommendations based on a critical literature analysis.

PubMed

Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B; Szukala, Richard; Johnson, Michael E; Hevener, Kirk E

2013-09-12

A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses, and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, druglike, and ADMET filters were applied to the reported hits to assess the quality of compounds reported, and a careful analysis of a subset of the studies that presented hit optimization was performed. These data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, definition of hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria.

Price performance following stock's IPO in different price limit systems

NASA Astrophysics Data System (ADS)

Wu, Ting; Wang, Yue; Li, Ming-Xia

2018-01-01

An IPO burst occurred in China's stock markets in 2015, while price limit trading rules usually help to reduce the short-term trading mania on individual stocks. It is interesting to make clear the function of the price limits after IPOs. We firstly make a statistical analysis based on all the IPO stocks listed from 1990 to 2015. A high dependency exists between the activities in stock's IPO and various market environment. We also focus on the price dynamics in the first 40 trading days after the stock listed. We find that price limit system will delay the price movement, especially for the up-trend movements, which may lead to longer continuous price limit hits. Similar to our previous work, many results such as ;W; shape can be also observed in the future daily return after the price limit open. At last, we find most IPO measures show evident correlations with the following price limit hits. IPO stocks with lower first-day turnover and earning per share will be followed with a longer continuous price limit hits and lower future daily return under the newest trading rules, which give us a good way to estimate the occurrence of price limit hits and the following price dynamics. Our analysis provides a better understanding of the price dynamics after IPO events and offers potential practical values for investors.

Differences in head impulse test results due to analysis techniques.

PubMed

Cleworth, Taylor W; Carpenter, Mark G; Honegger, Flurin; Allum, John H J

2017-01-01

Different analysis techniques are used to define vestibulo-ocular reflex (VOR) gain between eye and head angular velocity during the video head impulse test (vHIT). Comparisons would aid selection of gain techniques best related to head impulse characteristics and promote standardisation. Compare and contrast known methods of calculating vHIT VOR gain. We examined lateral canal vHIT responses recorded from 20 patients twice within 13 weeks of acute unilateral peripheral vestibular deficit onset. Ten patients were tested with an ICS Impulse system (GN Otometrics) and 10 with an EyeSeeCam (ESC) system (Interacoustics). Mean gain and variance were computed with area, average sample gain, and regression techniques over specific head angular velocity (HV) and acceleration (HA) intervals. Results for the same gain technique were not different between measurement systems. Area and average sample gain yielded equally lower variances than regression techniques. Gains computed over the whole impulse duration were larger than those computed for increasing HV. Gain over decreasing HV was associated with larger variances. Gains computed around peak HV were smaller than those computed around peak HA. The median gain over 50-70 ms was not different from gain around peak HV. However, depending on technique used, the gain over increasing HV was different from gain around peak HA. Conversion equations between gains obtained with standard ICS and ESC methods were computed. For low gains, the conversion was dominated by a constant that needed to be added to ESC gains to equal ICS gains. We recommend manufacturers standardize vHIT gain calculations using 2 techniques: area gain around peak HA and peak HV.

B-HIT - A Tool for Harvesting and Indexing Biodiversity Data

PubMed Central

Barker, Katharine; Braak, Kyle; Cawsey, E. Margaret; Coddington, Jonathan; Robertson, Tim; Whitacre, Jamie

2015-01-01

With the rapidly growing number of data publishers, the process of harvesting and indexing information to offer advanced search and discovery becomes a critical bottleneck in globally distributed primary biodiversity data infrastructures. The Global Biodiversity Information Facility (GBIF) implemented a Harvesting and Indexing Toolkit (HIT), which largely automates data harvesting activities for hundreds of collection and observational data providers. The team of the Botanic Garden and Botanical Museum Berlin-Dahlem has extended this well-established system with a range of additional functions, including improved processing of multiple taxon identifications, the ability to represent associations between specimen and observation units, new data quality control and new reporting capabilities. The open source software B-HIT can be freely installed and used for setting up thematic networks serving the demands of particular user groups. PMID:26544980

Health information technology needs help from primary care researchers.

PubMed

Krist, Alex H; Green, Lee A; Phillips, Robert L; Beasley, John W; DeVoe, Jennifer E; Klinkman, Michael S; Hughes, John; Puro, Jon; Fox, Chester H; Burdick, Tim

2015-01-01

While health information technology (HIT) efforts are beginning to yield measurable clinical benefits, more is needed to meet the needs of patients and clinicians. Primary care researchers are uniquely positioned to inform the evidence-based design and use of technology. Research strategies to ensure success include engaging patient and clinician stakeholders, working with existing practice-based research networks, and using established methods from other fields such as human factors engineering and implementation science. Policies are needed to help support primary care researchers in evaluating and implementing HIT into everyday practice, including expanded research funding, strengthened partnerships with vendors, open access to information systems, and support for the Primary Care Extension Program. Through these efforts, the goal of improved outcomes through HIT can be achieved. © Copyright 2015 by the American Board of Family Medicine.

B-HIT - A Tool for Harvesting and Indexing Biodiversity Data.

PubMed

Kelbert, Patricia; Droege, Gabriele; Barker, Katharine; Braak, Kyle; Cawsey, E Margaret; Coddington, Jonathan; Robertson, Tim; Whitacre, Jamie; Güntsch, Anton

2015-01-01

With the rapidly growing number of data publishers, the process of harvesting and indexing information to offer advanced search and discovery becomes a critical bottleneck in globally distributed primary biodiversity data infrastructures. The Global Biodiversity Information Facility (GBIF) implemented a Harvesting and Indexing Toolkit (HIT), which largely automates data harvesting activities for hundreds of collection and observational data providers. The team of the Botanic Garden and Botanical Museum Berlin-Dahlem has extended this well-established system with a range of additional functions, including improved processing of multiple taxon identifications, the ability to represent associations between specimen and observation units, new data quality control and new reporting capabilities. The open source software B-HIT can be freely installed and used for setting up thematic networks serving the demands of particular user groups.

Just-in-time Database-Driven Web Applications

PubMed Central

2003-01-01

"Just-in-time" database-driven Web applications are inexpensive, quickly-developed software that can be put to many uses within a health care organization. Database-driven Web applications garnered 73873 hits on our system-wide intranet in 2002. They enabled collaboration and communication via user-friendly Web browser-based interfaces for both mission-critical and patient-care-critical functions. Nineteen database-driven Web applications were developed. The application categories that comprised 80% of the hits were results reporting (27%), graduate medical education (26%), research (20%), and bed availability (8%). The mean number of hits per application was 3888 (SD = 5598; range, 14-19879). A model is described for just-in-time database-driven Web application development and an example given with a popular HTML editor and database program. PMID:14517109

Incorporating INTERACT II Clinical Decision Support Tools into Nursing Home Health Information Technology

PubMed Central

Handler, Steven M.; Sharkey, Siobhan S.; Hudak, Sandra; Ouslander, Joseph G.

2012-01-01

A substantial reduction in hospitalization rates has been associated with the implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement intervention using the accompanying paper-based clinical practice tools (INTERACT II). There is significant potential to further increase the impact of INTERACT by integrating INTERACT II tools into nursing home (NH) health information technology (HIT) via standalone or integrated clinical decision support (CDS) systems. This article highlights the process of translating INTERACT II tools from paper to NH HIT. The authors believe that widespread dissemination and integration of INTERACT II CDS tools into various NH HIT products could lead to sustainable improvement in resident and clinician process and outcome measures, including enhanced interclinician communication and a reduction in potentially avoidable hospitalizations. PMID:22267955

A trace-driven analysis of name and attribute caching in a distributed system

NASA Technical Reports Server (NTRS)

Shirriff, Ken W.; Ousterhout, John K.

1992-01-01

This paper presents the results of simulating file name and attribute caching on client machines in a distributed file system. The simulation used trace data gathered on a network of about 40 workstations. Caching was found to be advantageous: a cache on each client containing just 10 directories had a 91 percent hit rate on name look ups. Entry-based name caches (holding individual directory entries) had poorer performance for several reasons, resulting in a maximum hit rate of about 83 percent. File attribute caching obtained a 90 percent hit rate with a cache on each machine of the attributes for 30 files. The simulations show that maintaining cache consistency between machines is not a significant problem; only 1 in 400 name component look ups required invalidation of a remotely cached entry. Process migration to remote machines had little effect on caching. Caching was less successful in heavily shared and modified directories such as /tmp, but there weren't enough references to /tmp overall to affect the results significantly. We estimate that adding name and attribute caching to the Sprite operating system could reduce server load by 36 percent and the number of network packets by 30 percent.

Superior Effects of High-Intensity Interval Training vs. Moderate Continuous Training on Arterial Stiffness in Episodic Migraine: A Randomized Controlled Trial.

PubMed

Hanssen, Henner; Minghetti, Alice; Magon, Stefano; Rossmeissl, Anja; Papadopoulou, Athina; Klenk, Christopher; Schmidt-Trucksäss, Arno; Faude, Oliver; Zahner, Lukas; Sprenger, Till; Donath, Lars

2017-01-01

Background: Migraine is associated with increased cardiovascular risk and vascular dysfunction. Since aerobic exercise can reduce cardiovascular risk, the present randomized controlled trail aimed at investigating the effects of high-intensity interval training (HIT) vs. moderate continuous exercise training (MCT) on arterial stiffness in migraine patients. Methods: Forty-eight episodic migraineurs were initially enrolled in the study. 37 patients [female: 30; age: 37 ( SD : 10); BMI: 23.1 (5.2); Migraine days per month: 3.7 (2.5)] completed the intervention. Central blood pressure, pulse wave reflection, and aortic pulse wave velocity (PWV) were obtained by an oscillometric monitor. Incremental treadmill exercise testing yielded maximal and submaximal fitness parameters. Participants were randomly assigned to either HIT, MCT, or a control group (CON). The intervention groups trained twice a week over a 12-week intervention period. Results: After adjustment for between-group baseline differences, a moderate meaningful overall reduction of the augmentation index at 75 min -1 heart rate (AIx@75) was observed [partial eta squared ([Formula: see text]) = 0.16; p = 0.06]. With 91% likely beneficial effects, HIT was more effective in reducing AIx@75 than MCT [HIT: pre 22.0 (9.7), post 14.9 (13.0), standardized mean difference (SMD) = 0.62; MCT: pre 16.6 (8.5), post 21.3 (10.4), SMD -0.49]. HIT induced a relevant reduction in central systolic blood pressure [cSBP: pre 118 (23) mmHg, post 110 (16) mmHg, SMD = 0.42] with a 59% possibly beneficial effect compared to CON, while MCT showed larger effects in lowering central diastolic blood pressure [pre 78 (7) mmHg, post 74 (7) mmHg, SMD = 0.61], presenting 60% possibly beneficial effects compared to CON. Central aortic PWV showed no changes in any of the three groups. Migraine days were reduced more successfully by HIT than MCT (HIT: SMD = 1.05; MCT: SMD = 0.43). Conclusion: HIT but not MCT reduces AIx@75 as a measure of pulse wave reflection and indirect marker of systemic arterial stiffness. Both exercise modalities beneficially affect central blood pressure. HIT proved to be an effective complementary treatment option to reduce vascular dysfunction and blood pressure in migraineurs.

Near-optimal alternative generation using modified hit-and-run sampling for non-linear, non-convex problems

NASA Astrophysics Data System (ADS)

Rosenberg, D. E.; Alafifi, A.

2016-12-01

Water resources systems analysis often focuses on finding optimal solutions. Yet an optimal solution is optimal only for the modelled issues and managers often seek near-optimal alternatives that address un-modelled objectives, preferences, limits, uncertainties, and other issues. Early on, Modelling to Generate Alternatives (MGA) formalized near-optimal as the region comprising the original problem constraints plus a new constraint that allowed performance within a specified tolerance of the optimal objective function value. MGA identified a few maximally-different alternatives from the near-optimal region. Subsequent work applied Markov Chain Monte Carlo (MCMC) sampling to generate a larger number of alternatives that span the near-optimal region of linear problems or select portions for non-linear problems. We extend the MCMC Hit-And-Run method to generate alternatives that span the full extent of the near-optimal region for non-linear, non-convex problems. First, start at a feasible hit point within the near-optimal region, then run a random distance in a random direction to a new hit point. Next, repeat until generating the desired number of alternatives. The key step at each iterate is to run a random distance along the line in the specified direction to a new hit point. If linear equity constraints exist, we construct an orthogonal basis and use a null space transformation to confine hits and runs to a lower-dimensional space. Linear inequity constraints define the convex bounds on the line that runs through the current hit point in the specified direction. We then use slice sampling to identify a new hit point along the line within bounds defined by the non-linear inequity constraints. This technique is computationally efficient compared to prior near-optimal alternative generation techniques such MGA, MCMC Metropolis-Hastings, evolutionary, or firefly algorithms because search at each iteration is confined to the hit line, the algorithm can move in one step to any point in the near-optimal region, and each iterate generates a new, feasible alternative. We use the method to generate alternatives that span the near-optimal regions of simple and more complicated water management problems and may be preferred to optimal solutions. We also discuss extensions to handle non-linear equity constraints.

The Analysis of the Patterns of Radiation-Induced DNA Damage Foci by a Stochastic Monte Carlo Model of DNA Double Strand Breaks Induction by Heavy Ions and Image Segmentation Software

NASA Technical Reports Server (NTRS)

Ponomarev, Artem; Cucinotta, F.

2011-01-01

To create a generalized mechanistic model of DNA damage in human cells that will generate analytical and image data corresponding to experimentally observed DNA damage foci and will help to improve the experimental foci yields by simulating spatial foci patterns and resolving problems with quantitative image analysis. Material and Methods: The analysis of patterns of RIFs (radiation-induced foci) produced by low- and high-LET (linear energy transfer) radiation was conducted by using a Monte Carlo model that combines the heavy ion track structure with characteristics of the human genome on the level of chromosomes. The foci patterns were also simulated in the maximum projection plane for flat nuclei. Some data analysis was done with the help of image segmentation software that identifies individual classes of RIFs and colocolized RIFs, which is of importance to some experimental assays that assign DNA damage a dual phosphorescent signal. Results: The model predicts the spatial and genomic distributions of DNA DSBs (double strand breaks) and associated RIFs in a human cell nucleus for a particular dose of either low- or high-LET radiation. We used the model to do analyses for different irradiation scenarios. In the beam-parallel-to-the-disk-of-a-flattened-nucleus scenario we found that the foci appeared to be merged due to their high density, while, in the perpendicular-beam scenario, the foci appeared as one bright spot per hit. The statistics and spatial distribution of regions of densely arranged foci, termed DNA foci chains, were predicted numerically using this model. Another analysis was done to evaluate the number of ion hits per nucleus, which were visible from streaks of closely located foci. In another analysis, our image segmentaiton software determined foci yields directly from images with single-class or colocolized foci. Conclusions: We showed that DSB clustering needs to be taken into account to determine the true DNA damage foci yield, which helps to determine the DSB yield. Using the model analysis, a researcher can refine the DSB yield per nucleus per particle. We showed that purely geometric artifacts, present in the experimental images, can be analytically resolved with the model, and that the quantization of track hits and DSB yields can be provided to the experimentalists who use enumeration of radiation-induced foci in immunofluorescence experiments using proteins that detect DNA damage. An automated image segmentaiton software can prove useful in a faster and more precise object counting for colocolized foci images.

Impact of the track structure of heavy charged particles on cytogenetic damage in human blood lymphocytes

NASA Astrophysics Data System (ADS)

Lee, Ryonfa; Nasonova, Elena; Sommer, Sylwetster; Hartel, Carola; Durante, Marco; Ritter, Sylvia

In space, astronauts are unavoidably exposed to charged particles from protons to irons. For a better estimate of the health risks of astronauts, further knowledge on the biological effects of charged particles, in particular the induction of cytogenetic damage is required. One im-portant factor that determines the biological response is the track structure of particles, i.e. their microscopic dose deposition in cells. The aim of the present study was to assess the influence of track structure of heavy ions on the yield and the quality of cytogenetic damage in human peripheral blood lymphocytes representing normal tissue. Cells were irradiated with 9.5 MeV/u C-ions or 990 MeV/u Fe-ions which have a comparable LET (175 keV/µm and 155 keV/µm, respectively) but a different track radius (2.3 and 6200 µm, respectively). When aberrations were analyzed in first cycle metaphases collected at different post-irradiation times (48-84 h) following fluorescence plus Giemsa staining, an increase in the aberration yield with sampling time was observed for both radiation qualities reflecting a damage dependent cell cycle progression delay to mitosis. The pronounced differences in the aberration frequency per cell are attributable to the stochastic distribution of particle traversals per cell nucleus (radius: 2.8 µm). Following C-ion exposure we found a high fraction of non-aberrant cells in samples collected at 48 h which represent cells not directly hit by a particle and slightly damaged cells that successfully repaired the induced lesions. In addition, at higher C-ion fluences the aberra-tion yield saturated, suggesting that a fraction of lymphocytes receiving multiple particle hits is not able to reach mitosis. On the other hand, at 48 h after Fe-ion exposure the proportion of non-aberrant cells is lower than after C-ion irradiation clearly reflecting the track structure of high energy particles (i.e. more homogeneous dose deposition compared to low energy C-ions). Furthermore, the aberration yield increased linearly with Fe-ion fluence. When aberrations were analyzed in first cycle G2 -PCC cells to account for the prolonged G2 arrest of damaged cells, the same trend was detected. However, the increase in the aberration yield with time and the saturation effect were less pronounced compared to metaphase samples. Altogether, these data show that the aberration analysis with multiple samplings is necessary for a reliable estimate of cytogenetic damage induced by charged particles. In particular, when damage is measured at one early time-point the effectiveness of low energy particles will be considerably underestimated. When the aberration spectrum induced by low energy C-ions and high en-ergy Fe-ions was compared, we did not find a difference. Preliminary data obtained with the high resolution mFISH-technique confirm this observation. (Work supported by BMBF, Bonn, under contract 02S8497)

Development of monolithic pixel detector with SOI technology for the ILC vertex detector

NASA Astrophysics Data System (ADS)

Yamada, M.; Ono, S.; Tsuboyama, T.; Arai, Y.; Haba, J.; Ikegami, Y.; Kurachi, I.; Togawa, M.; Mori, T.; Aoyagi, W.; Endo, S.; Hara, K.; Honda, S.; Sekigawa, D.

2018-01-01

We have been developing a monolithic pixel sensor for the International Linear Collider (ILC) vertex detector with the 0.2 μm FD-SOI CMOS process by LAPIS Semiconductor Co., Ltd. We aim to achieve a 3 μm single-point resolution required for the ILC with a 20×20 μm2 pixel. Beam bunch crossing at the ILC occurs every 554 ns in 1-msec-long bunch trains with an interval of 200 ms. Each pixel must record the charge and time stamp of a hit to identify a collision bunch for event reconstruction. Necessary functions include the amplifier, comparator, shift register, analog memory and time stamp implementation in each pixel, and column ADC and Zero-suppression logic on the chip. We tested the first prototype sensor, SOFIST ver.1, with a 120 GeV proton beam at the Fermilab Test Beam Facility in January 2017. SOFIST ver.1 has a charge sensitive amplifier and two analog memories in each pixel, and an 8-bit Wilkinson-type ADC is implemented for each column on the chip. We measured the residual of the hit position to the reconstructed track. The standard deviation of the residual distribution fitted by a Gaussian is better than 3 μm.

Application of activity sensors for estimating behavioral patterns

USGS Publications Warehouse

Roberts, Caleb P.; Cain, James W.; Cox, Robert D.

2016-01-01

The increasing use of Global Positioning System (GPS) collars in habitat selection studies provides large numbers of precise location data points with reduced field effort. However, inclusion of activity sensors in many GPS collars also grants the potential to remotely estimate behavioral state. Thus, only using GPS collars to collect location data belies their full capabilities. Coupling behavioral state with location data would allow researchers and managers to refine habitat selection models by using diel behavioral state changes to partition fine-scale temporal shifts in habitat selection. We tested the capability of relatively unsophisticated GPS-collar activity sensors to estimate behavior throughout diel periods using free-ranging female elk (Cervus canadensis) in the Jemez Mountains of north-central New Mexico, USA, 2013–2014. Collars recorded cumulative number of movements (hits) per 15-min recording period immediately preceding GPS fixes at 0000, 0600, 1200, and 1800 hr. We measured diel behavioral patterns of focal elk, categorizing active (i.e., foraging, traveling, vigilant, grooming) and inactive (i.e., resting) states. Active behaviors (foraging, traveling) produced more average hits (0.87 ± 0.69 hits/min, 4.0 ± 2.2 hits/min, respectively; 95% CI) and inactive (resting) behavior fewer hits (−1.1 ± 0.61 95% CI). We differentiated active and inactive behavioral states with a bootstrapped threshold of 5.9 ± 3.9 hits/15-min recording period. Mean cumulative activity-sensor hits corresponded with observed diel behavioral patterns: hits increased during crepuscular (0600, 1800 hr) observations when elk were most active (0000–0600 hr: d = 0.19; 1200–1800 hr: d = 0.64) and decreased during midday and night (0000 hr, 1200 hr) when elk were least active (1800–0000 hr: d = −0.39; 0600–1200 hr: d = −0.43). Even using relatively unsophisticated GPS-collar activity sensors, managers can remotely estimate behavioral states, approximate diel behavioral patterns, and potentially complement location data in developing habitat selection models.

Hit Identification and Optimization in Virtual Screening: Practical Recommendations Based Upon a Critical Literature Analysis

PubMed Central

Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B.; Szukala, Richard; Johnson, Michael E.; Hevener, Kirk E.

2013-01-01

A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, drug-like, and ADMET filters were applied to the reported hits to assess the quality of compounds reported and a careful analysis of a subset of the studies which presented hit optimization was performed. This data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, defining hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria. PMID:23688234

The Helicity Injected Torus Program

NASA Astrophysics Data System (ADS)

Jarboe, T. R.; Nelson, B. A.; Jewell, P. D.; Liptac, J. E.; McCollam, K. J.; Raman, R.; Redd, A. J.; Rogers, J. A.; Sieck, P. E.; Shumlak, U.; Smith, R. J.; Nagata, M.; Uyama, T.

1999-11-01

The Helicity Injected Torus--II (HIT--II) spherical torus is capable of both Coaxial Helicity Injection (CHI) and transformer action current drive. HIT--II has a major radius R = 0.3, minor radius a = 0.2, aspect ratio A = R/a = 1.5, with an on axis magnetic field of up to Bo = 0.67 T. HIT--II provides equilibrium control, CHI flux boundary conditions, and transformer action using 28 poloidal field coils, using active flux feedback control. HIT--II has driven up to 200 kA of plasma current, using either CHI or transformer drive. An overview and recent results of the HIT--II program will be presented. The development of a locked-electron current drive model for HIT and HIT--II has led to the design of a constant inductive helicity injection method for spherical torii. This method is incorporated in the design of the Helicity Injected Torus -- Steady Inductive (HIT-- SI)(T.R. Jarboe, Fusion Technology, 36) (1), p. 85, 1999 experiment. HIT--SI can form a high-beta spheromak, a low aspect ratio RFP, or a spherical tokamak in a steady-state manner without using electrodes. The HIT--SI design and methodology will be presented.

Rapid exclusion of the diagnosis of immune HIT by AcuStar HIT and heparin-induced multiple electrode aggregometry.

PubMed

Minet, V; Baudar, J; Bailly, N; Douxfils, J; Laloy, J; Lessire, S; Gourdin, M; Devalet, B; Chatelain, B; Dogné, J M; Mullier, F

2014-06-01

Accurate diagnosis of heparin-induced thrombocytopenia (HIT) is essential but remains challenging. We have previously demonstrated, in a retrospective study, the usefulness of the combination of the 4Ts score, AcuStar HIT and heparin-induced multiple electrode aggregometry (HIMEA) with optimized thresholds. We aimed at exploring prospectively the performances of our optimized diagnostic algorithm on suspected HIT patients. The secondary objective is to evaluate performances of AcuStar HIT-Ab (PF4-H) in comparison with the clinical outcome. 116 inpatients with clinically suspected immune HIT were included. Our optimized diagnostic algorithm was applied to each patient. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) of the overall diagnostic strategy as well as AcuStar HIT-Ab (at manufacturer's thresholds and at our thresholds) were calculated using clinical diagnosis as the reference. Among 116 patients, 2 patients had clinically-diagnosed HIT. These 2 patients were positive on AcuStar HIT-Ab, AcuStar HIT-IgG and HIMEA. Using our optimized algorithm, all patients were correctly diagnosed. AcuStar HIT-Ab at our cut-off (>9.41 U/mL) and at manufacturer's cut-off (>1.00 U/mL) showed both a sensitivity of 100.0% and a specificity of 99.1% and 90.4%, respectively. The combination of the 4Ts score, the HemosIL® AcuStar HIT and HIMEA with optimized thresholds may be useful for the rapid and accurate exclusion of the diagnosis of immune HIT. Copyright © 2014 Elsevier Ltd. All rights reserved.

Inappropriate documentation of heparin allergy in the medical record because of misdiagnosis of heparin-induced thrombocytopenia: frequency and consequences.

PubMed

McMahon, C M; Tanhehco, Y C; Cuker, A

2017-02-01

Essentials Misdiagnosis of heparin-induced thrombocytopenia (HIT) may be associated with adverse outcomes. We conducted a study of patients with a heparin allergy in the chart due to misdiagnosis of HIT. 42% of patients with a heparin allergy due to suspected HIT were clearly HIT-negative. 68% were unnecessarily treated with an alternative anticoagulant, 66% of whom had major bleeding. Background It is recommended that heparin be added to the allergy list of patients with heparin-induced thrombocytopenia (HIT). Misdiagnosis of HIT could lead to inappropriate documentation of a heparin allergy and adverse outcomes. Objectives To determine the frequency and consequences of inappropriate documentation of a heparin allergy because of misdiagnosis of HIT. Methods We conducted a cohort study of patients with an inappropriate heparin allergy listed in the electronic medical record (EMR) because of misdiagnosis of HIT. We searched the EMR for patients with a new heparin allergy. Patients were eligible if the reason for allergy listing was suspected acute HIT and laboratory testing for HIT was performed within 60 days. Subjects were defined as 'HIT-negative' if they had a 4Ts score of ≤ 3 or negative laboratory test results. Results Of 239 subjects with a new heparin allergy documented because of concern regarding HIT, 100 (42%) met the prespecified definition of HIT-negative. Sixty-eight (68%) HIT-negative subjects unnecessarily received an alternative parenteral anticoagulant for a median duration of 10.5 days. Among these 68 patients, 45 (66%) met criteria for major bleeding. Sixty-eight (68%) of the 100 HIT-negative subjects had an inappropriate allergy to heparin documented that persisted in the EMR for > 3 years beyond the index hospitalization. Conclusions Inappropriate listing of heparin as an allergy in the EMR because of misdiagnosis of HIT is common, is associated with substantial rates of unnecessary alternative anticoagulant use and major bleeding, and tends to persist beyond the index admission. © 2016 International Society on Thrombosis and Haemostasis.

Imagining Counterfactual Worlds in Autism Spectrum Disorder.

PubMed

Black, Jo; Williams, David; Ferguson, Heather J

2018-02-01

Two experiments are presented that explore online counterfactual processing in autism spectrum disorder (ASD) using eye-tracking. Participants' eye movements were tracked while they read factual and counterfactual sentences in an anomaly detection task. In Experiment 1, the sentences depicted everyday counterfactual situations (e.g., If Joanne had remembered her umbrella, her hair would have been dry/wet when she arrived home). Sentences in Experiment 2 depicted counterfactual versions of real world events (e.g., If the Titanic had not hit an iceberg, it would have survived/sunk along with all the passengers). Results from both experiments suggest that counterfactual understanding is undiminished in adults with ASD. In fact, participants with ASD were faster than Typically Developing (TD) participants to detect anomalies within realistic, discourse-based counterfactuals (Experiment 1). Detection was comparable for TD and ASD groups when understanding could be grounded in knowledge about reality (Experiment 2), though the 2 groups used subtly different strategies for responding to and recovering from counterfactual inconsistent words. These data argue against general difficulties in global coherence and complex integration in ASD. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Tracking performance of a single-crystal and a polycrystalline diamond pixel-detector

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

Menasce, D.; et al.

2013-06-01

We present a comparative characterization of the performance of a single-crystal and a polycrystalline diamond pixel-detector employing the standard CMS pixel readout chips. Measurements were carried out at the Fermilab Test Beam Facility, FTBF, using protons of momentum 120 GeV/c tracked by a high-resolution pixel telescope. Particular attention was directed to the study of the charge-collection, the charge-sharing among adjacent pixels and the achievable position resolution. The performance of the single-crystal detector was excellent and comparable to the best available silicon pixel-detectors. The measured average detection-efficiency was near unity, ε = 0.99860±0.00006, and the position-resolution for shared hits was aboutmore » 6 μm. On the other hand, the performance of the polycrystalline detector was hampered by its lower charge collection distance and the readout chip threshold. A new readout chip, capable of operating at much lower threshold (around 1 ke $-$), would be required to fully exploit the potential performance of the polycrystalline diamond pixel-detector.« less

Defense Travel System (DTS) Airline Ticket Price Analysis: Do DTS Ticket Prices Differ From Other Online Tickets Available for Naval Postgraduate School Travelers

DTIC Science & Technology

2007-12-01

price dispersion at least as large as dispersion for traditional retailers for books, music CDs, and software offered through 52 Internet and...dispersion differences. For instance, for 22 old-hit albums , average price percentage differences are 31% on-line, compared to 11% off-line. But for 21...current-hit albums , differences are smaller at 18% on-line and 19% off-line. This suggests price dispersion levels are related to product

High-intensity training reduces intermittent hypoxia-induced ER stress and myocardial infarct size.

PubMed

Bourdier, Guillaume; Flore, Patrice; Sanchez, Hervé; Pepin, Jean-Louis; Belaidi, Elise; Arnaud, Claire

2016-01-15

Chronic intermittent hypoxia (IH) is described as the major detrimental factor leading to cardiovascular morbimortality in obstructive sleep apnea (OSA) patients. OSA patients exhibit increased infarct size after a myocardial event, and previous animal studies have shown that chronic IH could be the main mechanism. Endoplasmic reticulum (ER) stress plays a major role in the pathophysiology of cardiovascular disease. High-intensity training (HIT) exerts beneficial effects on the cardiovascular system. Thus, we hypothesized that HIT could prevent IH-induced ER stress and the increase in infarct size. Male Wistar rats were exposed to 21 days of IH (21-5% fraction of inspired O2, 60-s cycle, 8 h/day) or normoxia. After 1 wk of IH alone, rats were submitted daily to both IH and HIT (2 × 24 min, 15-30m/min). Rat hearts were either rapidly frozen to evaluate ER stress by Western blot analysis or submitted to an ischemia-reperfusion protocol ex vivo (30 min of global ischemia/120 min of reperfusion). IH induced cardiac proapoptotic ER stress, characterized by increased expression of glucose-regulated protein kinase 78, phosphorylated protein kinase-like ER kinase, activating transcription factor 4, and C/EBP homologous protein. IH-induced myocardial apoptosis was confirmed by increased expression of cleaved caspase-3. These IH-associated proapoptotic alterations were associated with a significant increase in infarct size (35.4 ± 3.2% vs. 22.7 ± 1.7% of ventricles in IH + sedenary and normoxia + sedentary groups, respectively, P < 0.05). HIT prevented both the IH-induced proapoptotic ER stress and increased myocardial infarct size (28.8 ± 3.9% and 21.0 ± 5.1% in IH + HIT and normoxia + HIT groups, respectively, P = 0.28). In conclusion, these findings suggest that HIT could represent a preventive strategy to limit IH-induced myocardial ischemia-reperfusion damages in OSA patients. Copyright © 2016 the American Physiological Society.

Biosensor-based small molecule fragment screening with biolayer interferometry

NASA Astrophysics Data System (ADS)

Wartchow, Charles A.; Podlaski, Frank; Li, Shirley; Rowan, Karen; Zhang, Xiaolei; Mark, David; Huang, Kuo-Sen

2011-07-01

Biosensor-based fragment screening is a valuable tool in the drug discovery process. This method is advantageous over many biochemical methods because primary hits can be distinguished from non-specific or non-ideal interactions by examining binding profiles and responses, resulting in reduced false-positive rates. Biolayer interferometry (BLI), a technique that measures changes in an interference pattern generated from visible light reflected from an optical layer and a biolayer containing proteins of interest, is a relatively new method for monitoring small molecule interactions. The BLI format is based on a disposable sensor that is immersed in 96-well or 384-well plates. BLI has been validated for small molecule detection and fragment screening with model systems and well-characterized targets where affinity constants and binding profiles are generally similar to those obtained with surface plasmon resonsance (SPR). Screens with challenging targets involved in protein-protein interactions including BCL-2, JNK1, and eIF4E were performed with a fragment library of 6,500 compounds, and hit rates were compared for these targets. For eIF4E, a protein containing a PPI site and a nucleotide binding site, results from a BLI fragment screen were compared to results obtained in biochemical HTS screens. Overlapping hits were observed for the PPI site, and hits unique to the BLI screen were identified. Hit assessments with SPR and BLI are described.

Phosphoproteome and transcriptome analyses of ErbB ligand-stimulated MCF-7 cells.

PubMed

Nagashima, Takeshi; Oyama, Masaaki; Kozuka-Hata, Hiroko; Yumoto, Noriko; Sakaki, Yoshiyuki; Hatakeyama, Mariko

2008-01-01

Cellular signal transduction pathways and gene expression are tightly regulated to accommodate changes in response to physiological environments. In the current study, molecules were identified that are activated as a result of intracellular signaling and immediately expressed as mRNA in MCF-7 breast cancer cells shortly after stimulation of ErbB receptor ligands, epidermal growth factor (EGF) or heregulin (HRG). For the identification of tyrosine-phosphorylated proteins and expressed genes, a SILAC (stable isotopic labeling using amino acids in cell culture) method and Affymetrix gene expression array system, respectively, were used. Unexpectedly, the overlapping of genes appeared in two experimental datasets was very low for HRG (43 hits in the proteome data, 1,655 in the transcriptome data, and 5 hits common to both datasets), while no overlapping gene was detected for EGF (15 hits in the proteome data, 211 hits in the transcriptome data, and no hits common to both datasets). The HRG overlapping genes included ERBB2, NEDD9, MAPK3, JUP and EPHA2. Biological pathway analysis indicated that HRG-stimulated molecular activation is significantly related to cancer pathways including bladder cancer, chronic myeloid leukemia and pancreatic cancer (p < 0.05). The proteome datasets of EGF and HRG contain molecules that are related to Axon guidance, ErbB signaling and VEGF signaling at a high rate.

Poisson Statistics of Combinatorial Library Sampling Predict False Discovery Rates of Screening

PubMed Central

2017-01-01

Microfluidic droplet-based screening of DNA-encoded one-bead-one-compound combinatorial libraries is a miniaturized, potentially widely distributable approach to small molecule discovery. In these screens, a microfluidic circuit distributes library beads into droplets of activity assay reagent, photochemically cleaves the compound from the bead, then incubates and sorts the droplets based on assay result for subsequent DNA sequencing-based hit compound structure elucidation. Pilot experimental studies revealed that Poisson statistics describe nearly all aspects of such screens, prompting the development of simulations to understand system behavior. Monte Carlo screening simulation data showed that increasing mean library sampling (ε), mean droplet occupancy, or library hit rate all increase the false discovery rate (FDR). Compounds identified as hits on k > 1 beads (the replicate k class) were much more likely to be authentic hits than singletons (k = 1), in agreement with previous findings. Here, we explain this observation by deriving an equation for authenticity, which reduces to the product of a library sampling bias term (exponential in k) and a sampling saturation term (exponential in ε) setting a threshold that the k-dependent bias must overcome. The equation thus quantitatively describes why each hit structure’s FDR is based on its k class, and further predicts the feasibility of intentionally populating droplets with multiple library beads, assaying the micromixtures for function, and identifying the active members by statistical deconvolution. PMID:28682059

77 FR 32639 - HIT Standards Committee and HIT Policy Committee; Call for Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... with the implementation of the Federal Health IT Strategic Plan, and in accordance with policies... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee and HIT Policy Committee; Call for... Health Information Technology Policy Committee (HITPC). Name of Committees: HIT Standards Committee and...

An Investigation of the Relationship Between Automated Machine Translation Evaluation Metrics and User Performance on an Information Extraction Task

DTIC Science & Technology

2007-01-01

parameter dimension between the two models). 93 were tested.3 Model 1 log( pHits 1− pHits ) = α + β1 ∗ MetricScore (6.6) The results for each of the...505.67 oTERavg .357 .13 .007 log( pHits 1− pHits ), that is, log-odds of correct task performance, of 2.79 over the intercept only model. All... pHits 1− pHits ) = −1.15− .418× I[MT=2] − .527× I[MT=3] + 1.78×METEOR+ 1.28×METEOR × I[MT=2] + 1.86×METEOR × I[MT=3] (6.7) Model 3 log( pHits 1− pHits

Review of Social and Organizational Issues in Health Information Technology.

PubMed

Kuziemsky, Craig E

2015-07-01

This paper reviews organizational and social issues (OSIs) in health information technology (HIT). A review and synthesis of the literature on OSIs in HIT was conducted. Five overarching themes with respect to OSIs in HIT were identified and discussed: scope and frameworks for defining OSIs in HIT, context matters, process immaturity and complexity, trade-offs will happen and need to be discussed openly, and means of studying OSIs in HIT. There is a wide body of literature that provides insight into OSIs in HIT, even if many of the studies are not explicitly labelled as such. The two biggest research needs are more explicit and theoretical studies of OSI in HITs and more research on integrating micro and macro perspectives of HIT use in organizations.

Health information technology and dynamic capabilities.

PubMed

Leung, Ricky C

2012-01-01

Health information technology (HIT) purports to increase quality and efficiency in health care organizations. However, health care organizations are situated in constantly changing environments. They need dynamic capabilities to implement HIT effectively. This article builds on the dynamic capabilities perspective and generates propositions about implementing HIT in dynamic environments. Specifically, I identify the (1) the necessary resources and capabilities for organizations to implement HIT; (2) the organizational capabilities and benefits that can be enhanced by HIT; and (3) the similarities and differences between three distinct forms of HIT. I synthesized the literature on dynamic capabilities and HIT to identify dynamic capabilities that are associated with (1) electronic medical records, (2) telemedicine, and (3) social media. In addition, I discuss the benefits of these HITs for improving the dynamic capabilities of health care organizations. PROPOSITIONS/FINDINGS: This article generates three sets of propositions that can be tested empirically. First, I am concerned with how organizational size and human resources affect successful implementation of HIT. In addition, I argue that three technology-specific factors--hospital type, medical specialty, and socially desirable technical features--may affect the implementation of HIT. To cope with constantly changing environmental pressures, health administrators need to deploy, modify, and/or acquire organizational resources skillfully. Practitioners need to identify dynamic capabilities to support specific forms of HIT and understand how HIT enables health care organizations in turn. The concept of evolutionary fitness in the dynamic capabilities perspective may be developed to measure HIT implementation.

The influence of the great Hanshin earthquake on human response to environmental vibration due to the Shinkansen.

PubMed

Sumitomo, S; Tsujimoto, S; Maeda, S; Kitamura, Y

1998-07-01

A severe earthquake of magnitude 7.2 hit the west part of Japan on January 17, 1995. A part of the Shinkansen railway, which is one of the most popular high-speed mass transportation systems in Japan, was seriously damaged by the earthquake. About 80 days later, the Shinkansen service was resumed but complaints about vibration due to the passing Shinkansen increased rapidly among residents near the tracks. This paper reports the results of two investigations that were carried out in both stricken and non-stricken areas to determine the cause of complaint. In the first investigation, the ground vibration propagation induced by passing trains was measured. In the second investigation, questionnaires were distributed to the people living near the Shinkansen tracks. As a result, it was found out that the vibration levels before and after the earthquake were almost the same at most measured points in the stricken area. It was also found that the vibration levels in the stricken area and a non-stricken area were almost the same within 50 m from the Shinkansen tracks. However the results of the questionnaire survey showed that people's nuisance due to the vibration in the stricken area was clearly greater than that in the non-stricken area. This inconsistency was explained using the "category judgment method", which is generally used to determine the relationship between a physical stimulus and psychological reaction. According to the results of this analysis, the vibration level, at which 50% of the inhabitants complained about Shinkansen vibration, was approximately 54 dB in the non-stricken area and 50 dB in the stricken area. This result suggests that the people who experienced the severe earthquake became 4 dB more sensitive to the Shinkansen vibration than the people living in a non-stricken area despite the fact that this investigation was carried out 10 months after the earthquake struck.

Evaluation of two new automated chemiluminescent assays (HemosIL® AcuStar HIT-IgG and HemosIL® AcuStar HIT-Ab) for the detection of heparin-induced antibodies in the diagnosis of heparin-induced thrombocytopenia.

PubMed

Van Hoecke, F; Devreese, K

2012-08-01

Recently, two new, fully automated quantitative chemiluminescent immunoassays, the HemosIL(®) AcuStar HIT-IgG (PF4-H), specific for IgG anti-PF4/H antibodies, and the HemosIL(®) AcuStar HIT-Ab(PF4-H), detecting IgG, IgM and IgA anti-PF4/H antibodies, were introduced into the market. In this study, their performance was compared mutually and with the Zymutest HIA IgG and HIA IgGAM ELISA. Citrated plasmas from 87 patients with clinical suspicion of heparin-induced thrombocytopenia (HIT) were analyzed with all four assays and with a functional confirmation assay. Apart from the manufacturer's cutoffs, optimalized cutoffs were evaluated as well. Sensitivities of all assays were 100%. The Acustar HIT-IgG assay showed a higher specificity compared with the HIT-Ab assay (85%vs. 73%), using the manufacturer's cutoffs. Specificities of all assays, except for the AcuStar HIT-IgG, could be significantly improved when altering the cutoff. Titers were significantly higher for the HIT-Ab assay compared with the HIT-IgG assay (P = 0.0001). This was also the case for the patients with confirmed HIT (P = 0.0495), indicating that the one cutoff (1.0 OD) for both Acustar assays, as proposed by the manufacturer, can be adapted for the AcuStar Hit-Ab assay resulting in an increased specificity. Performance characteristics of the Acustar HIT-IgG and HIT-Ab assay are comparable to the Zymutest HIA IgG and HIA IgGAM. © 2012 Blackwell Publishing Ltd.

Cerebral High-Intensity Transient Signals during Pediatric Cardiac Catheterization: A Pilot Study Using Transcranial Doppler Ultrasonography.

PubMed

LaRovere, Kerri L; Kapur, Kush; McElhinney, Doff B; Razumovsky, Alexander; Kussman, Barry D

2017-07-01

Cerebral emboli are one potential cause of acute brain injury in children with congenital heart disease (CHD) undergoing cardiac catheterization. In this pilot study using transcranial Doppler (TCD) ultrasonography, we sought to evaluate the incidence, burden, and circumstances of cerebral high-intensity transient signals (HITS), presumably representing emboli, during pediatric cardiac catheterization. Emboli monitoring of the right middle cerebral artery was performed in five children. HITS, counted offline, were defined as unidirectional signals associated with audible "chirp" and sinusoidal correlation. HITS were grouped as single, >10 HITS ("cluster"), or HITS "with curtain effect" per 3-5 cardiac cycles. Cerebral blood flow velocity (CBFV) and pulsatility index (PI) were recorded after anesthetic induction (baseline). Total HITS in the cohort was 1,697 (790 single HITS, 606 HITS within clusters, and 301 HITS within curtains). HITS in clusters and curtains comprised 53% (907/1,697) of total HITS, and occurred in 44 clusters/curtains. Events associated with clusters/curtains included left ventricular angiography (39%; 17/44), right ventricular angiography (16%; 7/44), device placement (16%; 7/44), heparin bolus (9%; 4/44), pulmonary artery angiography (9%; 4/44), venous access (5%; 2/44), right atrial angiography (2%; 1/44), arterial access (2%; 1/44), and hemodynamic measurements (2%; 1/44). No patient had clinically detectable neurologic injury. HITS are common during pediatric cardiac catheterization, and associated with procedural factors. Whether curtains/clusters are worse than single, repetitive HITS is unknown. Larger studies are needed to determine whether HITS are a marker of risk of neurologic injury from emboli during pediatric cardiac catheterization. Copyright © 2017 by the American Society of Neuroimaging.

Platelet count recovery and seroreversion in immune HIT despite continuation of heparin: further observations and literature review.

PubMed

Shih, Andrew W; Sheppard, Jo-Ann I; Warkentin, Theodore E

2017-10-05

One of the standard distinctions between type 1 (non-immune) and type 2 (immune-mediated) heparin-induced thrombocytopenia (HIT) is the transience of thrombocytopenia: type 1 HIT is viewed as early-onset and transient thrombocytopenia, with platelet count recovery despite continuing heparin administration. In contrast, type 2 HIT is viewed as later-onset (i. e., 5 days or later) thrombocytopenia in which it is generally believed that platelet count recovery will not occur unless heparin is discontinued. However, older reports of type 2 HIT sometimes did include the unexpected observation that platelet counts could recover despite continued heparin administration, although without information provided regarding changes in HIT antibody levels in association with platelet count recovery. In recent years, some reports of type 2 HIT have confirmed the observation that platelet count recovery can occur despite continuing heparin administration, with serological evidence of waning levels of HIT antibodies ("seroreversion"). We now report two additional patient cases of type 2 HIT with platelet count recovery despite ongoing therapeutic-dose (1 case) or prophylactic-dose (1 case) heparin administration, in which we demonstrate concomitant waning of HIT antibody levels. We further review the literature describing this phenomenon of HIT antibody seroreversion and platelet count recovery despite continuing heparin administration. Our observations add to the concept that HIT represents a remarkably transient immune response, including sometimes even when heparin is continued.

Novel HIT antibody detection method using Sonoclot® coagulation analyzer.

PubMed

Wanaka, Keiko; Asada, Reiko; Miyashita, Kumiko; Kaneko, Makoto; Endo, Hirokazu; Yatomi, Yutaka

2015-01-01

Since heparin-induced thrombocytopenia (HIT), caused by the generation of antibodies against platelet factor 4 (PF4)/heparin complexes (HIT antibodies), may induce serious complications due to thrombosis, a prompt diagnosis is desirable. Functional tests with platelet activation to detect HIT antibodies are useful for diagnosis of HIT, in particular (14)C-selotonin release assay (SRA). However, they are complicated and so can be performed only in limited laboratories. We tested if a blood coagulation test using Sonoclot® analyzer can serve for the detection of HIT antibodies. A murine monoclonal antibody (HIT-MoAb) against PF4/heparin complexes was used as an alternative to human HIT antibodies. To the mixture of HIT-MoAb and heparin (0.5 U/mL, final), whole blood obtained from a healthy volunteer was added, and then the activated clotting time (ACT), clot rate (CR), and area under the curve (AUC) were measured with Sonoclot® analyzer for 30minutes. The HIT-MoAb (30 to 100μg/mL, final) concentration dependently suppressed the anticoagulation activity (prolongation of ACT and decrease of CR and AUC) of heparin. The suppression of anticoagulation effect of heparin by HIT-MoAb was demonstrated by measurements using Sonoclot® analyzer. This method may provide a new tool for screening of HIT antibodies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Controlled replication: reduce the capacity occupied by redundant replicas in tiled chip multiprocessors

NASA Astrophysics Data System (ADS)

Li, Hao; Xie, Lunguo

2013-03-01

The design of cache system for Chip Multiprocessor (CMP) face many challenges because future CMPs will have more cores and greater on-chip cache capacity. There are two base design schemes about L2 cache: private scheme in which each L2 slice is treated as a private L2 cache and shared scheme in which all L2 slices are treated as a large L2 cache shared by all cores. Private caches provide the lowest hit latency but reduce the total effective cache capacity. A shared L2 cache increases the effective cache capacity but has long hit latencies when data is on a remote tile. This paper present a new Controlled Replication (CR) policy to reduce the capacities occupied by redundant shared replicas. the new CR policy increases the effective capacity than victim replication scheme and has lower hit latency than shared scheme. We evaluate the various schemes using full-system simulation of parallel applications. Results show that CR reduces the average memory access latency of shared scheme by an average of 13%, providing better overall performance than victim replication and shared schemes.

Traumatic Brain Injury: Effects on the Endocrine System

MedlinePlus

Fact Sheet BTrarainumInajutircy: Effects on the Endocrine System What is traumatic brain injury? Traumatic brain injury, also called TBI, is sudden damage to the brain. It happens when the head hits ...

Review of Social and Organizational Issues in Health Information Technology

PubMed Central

2015-01-01

Objectives This paper reviews organizational and social issues (OSIs) in health information technology (HIT). Methods A review and synthesis of the literature on OSIs in HIT was conducted. Results Five overarching themes with respect to OSIs in HIT were identified and discussed: scope and frameworks for defining OSIs in HIT, context matters, process immaturity and complexity, trade-offs will happen and need to be discussed openly, and means of studying OSIs in HIT. Conclusions There is a wide body of literature that provides insight into OSIs in HIT, even if many of the studies are not explicitly labelled as such. The two biggest research needs are more explicit and theoretical studies of OSI in HITs and more research on integrating micro and macro perspectives of HIT use in organizations. PMID:26279951

A comparison of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the endoscopic treatment of primary vesicoureteral reflux.

PubMed

Akin, Melih; Erginel, Basak; Karadag, Cetin Ali; Yildiz, Abdullah; Ozçelik, Gül Sumru; Sever, Nihat; Genc, Nimetullah Mete; Dokucu, Ali Ihsan

2014-11-01

We aimed to compare the success rates of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the treatment of primary vesicoureteral reflux (VUR) with a new nonbiodegradable tissue-augmenting substance (Vantris, Promedon, Cordoba, Argentina). Between January 2011 and December 2012, fifty-two children who underwent subureteric injection for primary VUR are included. The children were randomly separated into two groups, the HIT and the double HIT groups, according to the type of injection. Success was defined as no reflux on a follow-up voiding cystourethrogram (VCUG) after 6 months. The patients were evaluated according to sex, age, grade of reflux, number of injections, and injected volume, and the radiological success rates were compared. Fifty-two patients underwent an endoscopic injection for primary grade III-V VUR. The HIT group consisted of 26 patients with 33 ureters, and the double HIT group consisted of 26 patients with 35 ureters. There were no significant differences in terms of the sex, ages, VUR grades, bilaterality between the two groups. The mean injected volumes were ml 1.12 (1.02-1.22) in the HIT group and 1.24 ml (95 % CI 1.10-1.38) in the double HIT group. The reflux was resolved in 21/33 (63.6 %) ureters in the HIT group and in 30/35 (85.7 %) ureters in the double HIT group, (p < 0.05). We had only one complication. This patient in the double HIT group, developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month. We observed successful results double HIT method with PPC in Grade III-V reflux, but the long-term follow-up of patients is needed for hydronephrosis. As the double HIT treatment leads to a higher success rate, its use is preferable.

A multi-method pilot evaluation of an online diabetes exercise system.

PubMed

Schaarup, Clara; Hejlesen, Ole K

2015-01-01

The American Diabetes Association and The European Association of The Study of Diabetes recommend people with Type 2 diabetes to do moderate to vigorous aerobic exercise for 150 min per week to avoid late diabetic complications. However, most people with diabetes do not follow the recommendation. Consumer health information technology (CHIT) might play a role in supporting behavior changes that promote health and well-being. A CHIT prototype of an online diabetes exercise system, which contained the newest research of low volume high-intensity interval training (HIT), was developed. To test the system we used a multi-method pilot evaluation that includes; interviews, paper prototyping, heuristic evaluation, and test with patients. The patients expressed satisfaction with HIT and appreciated that the system was web-based. The findings from this pilot study inspire to further development and evaluation of online CHIT systems to diabetics.

Car suspension system monitoring under road conditions

NASA Astrophysics Data System (ADS)

Fedotov, A. I.; Kuznetsov, N. Y.; Lysenko, A. V.; Vlasov, V. G.

2017-12-01

The paper describes an advanced gyro-based measuring system comprising a CGV-4K central vertical gyro and a G-3M gyrocompass. The advanced system provides additional functions that help measure unsprung mass rotation angles about a vertical axis, rolling angles, trim angles and movements of the unsprung masses of the front (ap and al) and rear b axes when a car wheel hits a single obstruction. The paper also describes the operation of the system, which measures movements of unsprung masses about the body of a car when it hits a single obstruction. The paper presents the dependency diagrams ap = f(t) and al = f(t) for front and rear wheels respectively, as well as b = f(t) for a rear left wheel, which were determined experimentally. Test results for a car equipped with an advanced gyro-based measuring system moving around a circle can form a basis for developing a mathematical model of the process.

Microbeam studies of the sensitivity of structures within living cells

NASA Technical Reports Server (NTRS)

Braby, L. A.

1992-01-01

Determining the biological effects of low doses of radiation with high linear energy transfer (LET) is complicated by the stochastic nature of charged-particle interactions. Populations of cells exposed to very low radiation doses contain a few cells which have been hit by a charged particle, while the majority of the cells receive no radiation damage. At somewhat higher doses, a few cells receive two or more events. Because the effects of damage produced by separate events can interact in the cell, we have had to make assumptions about the nature of these interactions in order to interpret the results of the experiments. Many of those assumptions can be tested if we can be sure of the number of charged-particle events which occur in individual cells, and correlate this number with the biological effect. We have developed a special irradiation facility at Pacific Northwest Laboratory (PNL) to control the actual number of charged particle tracks that pass through cell nuclei. The beam from a 2 MeV tandem accelerator is collimated to approximately 5 microns. Cells, grown in special dishes with 1.5 microns thick plastic bottoms, are positioned so that the desired portion of the cell aligns with the collimator. A shutter in the beam line is opened and closed after the desired number of particle tracks has been counted. This approach can be used to investigate the effects of the interaction between irradiated and unirradiated cells in an organized system, as well as to study the effects of spatial and temporal distribution of radiation damage within single cells.(ABSTRACT TRUNCATED AT 250 WORDS).

First tests of a novel radiation hard CMOS sensor process for Depleted Monolithic Active Pixel Sensors

NASA Astrophysics Data System (ADS)

Pernegger, H.; Bates, R.; Buttar, C.; Dalla, M.; van Hoorne, J. W.; Kugathasan, T.; Maneuski, D.; Musa, L.; Riedler, P.; Riegel, C.; Sbarra, C.; Schaefer, D.; Schioppa, E. J.; Snoeys, W.

2017-06-01

The upgrade of the ATLAS [1] tracking detector for the High-Luminosity Large Hadron Collider (LHC) at CERN requires novel radiation hard silicon sensor technologies. Significant effort has been put into the development of monolithic CMOS sensors but it has been a challenge to combine a low capacitance of the sensing node with full depletion of the sensitive layer. Low capacitance brings low analog power. Depletion of the sensitive layer causes the signal charge to be collected by drift sufficiently fast to separate hits from consecutive bunch crossings (25 ns at the LHC) and to avoid losing the charge by trapping. This paper focuses on the characterization of charge collection properties and detection efficiency of prototype sensors originally designed in the framework of the ALICE Inner Tracking System (ITS) upgrade [2]. The prototypes are fabricated both in the standard TowerJazz 180nm CMOS imager process [3] and in an innovative modification of this process developed in collaboration with the foundry, aimed to fully deplete the sensitive epitaxial layer and enhance the tolerance to non-ionizing energy loss. Sensors fabricated in standard and modified process variants were characterized using radioactive sources, focused X-ray beam and test beams before and after irradiation. Contrary to sensors manufactured in the standard process, sensors from the modified process remain fully functional even after a dose of 1015neq/cm2, which is the the expected NIEL radiation fluence for the outer pixel layers in the future ATLAS Inner Tracker (ITk) [4].

The Challenges and Issues Regarding E-Health and Health Information Technology Trends in the Healthcare Sector

NASA Astrophysics Data System (ADS)

Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

Like other industries, the utilization of the internet and Information Technology (IT) has increased in the health sector. Different applications attributed to the internet and IT in healthcare practice. It includes a range of services that intersect the edge of medicine, computer and information science. The presence of the internet helps healthcare practice with the use of electronic processes and communication. Also, health IT (HIT) deals with the devices, clinical guidelines and methods required to improve the management of information in healthcare. Although the internet and HIT has been considered as an influential means to enhance health care delivery, it is completely naive to imagine all new tools and mechanisms supported by the internet and HIT systems are simply adopted and used by all organizational members. As healthcare professionals play an important role in the healthcare sector, there is no doubt that mechanism of newly introduced HIT and new application of the internet in medical practice should be coupled with healthcare professionals' acceptance. Therefore, with great resistance by healthcare professionals new mechanism and tools supported by IT and the internet cannot be used properly and subsequently may not improve the quality of medical care services. However, factors affecting the healthcare professionals' adoption behavior concerning new e-health and HIT mechanism are still not conclusively identified. This research (as a theoretical study) tries to propose the source of resistance in order to handle the challenges over new e-technology in the health industry. This study uses the involved concepts and develops a conceptual framework to improve overall acceptance of e-health and HIT by healthcare professionals.

Environmental factors and health information technology management strategy.

PubMed

Menachemi, Nir; Shin, Dong Yeong; Ford, Eric W; Yu, Feliciano

2011-01-01

: Previous studies have provided theoretical and empirical evidence that environmental forces influence hospital strategy. : Rooted in resource dependence theory and the information uncertainty perspective, this study examined the relationship between environmental market characteristics and hospitals' selection of a health information technology (HIT) management strategy. : A cross-sectional design is used to analyze secondary data from the American Hospital Association Annual Survey, the Healthcare Information and Management Systems Society Analytics Database, and the Area Resource File. Univariate and multinomial logistic regression analyses are used. : Overall, 3,221 hospitals were studied, of which 60.9% pursed a single-vendor HIT management strategy, 28.9% pursued a best-of-suite strategy, and 10.2% used a best-of-breed strategy. Multivariate analyses controlling for hospital characteristics found that measures of environmental factors representing munificence, dynamism, and/or complexity were systematically associated with various hospital HIT management strategy use. Specifically, the number of generalist physicians per capita was positively associated with the single-vendor strategy (B = -5.64, p = .10). Hospitals in urban markets were more likely to pursue the best-of-suite strategy (B = 0.622, p < .001). Dynamism, measured as the number of managed care contracts for a given hospital, was negatively associated with the single-vendor strategy (B = 0.004, p = .049). Lastly, complexity, measured as market competition, was positively associated with the best-of-breed strategy (B = 0.623, p = .042). : By and large, environmental factors are associated with hospital HIT management strategies in mostly theoretically supported ways. Hospital leaders and policy makers interested in influencing the adoption of hospital HIT should consider how market conditions influence HIT management decisions as part of programs to promote meaningful use.

Evaluating the effect of online data compression on the disk cache of a mass storage system

NASA Technical Reports Server (NTRS)

Pentakalos, Odysseas I.; Yesha, Yelena

1994-01-01

A trace driven simulation of the disk cache of a mass storage system was used to evaluate the effect of an online compression algorithm on various performance measures. Traces from the system at NASA's Center for Computational Sciences were used to run the simulation and disk cache hit ratios, number of files and bytes migrating to tertiary storage were measured. The measurements were performed for both an LRU and a size based migration algorithm. In addition to seeing the effect of online data compression on the disk cache performance measure, the simulation provided insight into the characteristics of the interactive references, suggesting that hint based prefetching algorithms are the only alternative for any future improvements to the disk cache hit ratio.

New paradigms for measuring clinical performance using electronic health records.

PubMed

Weiner, Jonathan P; Fowles, Jinnet B; Chan, Kitty S

2012-06-01

Measures of provider success are the centerpiece of quality improvement and pay-for-performance programs around the globe. In most nations, these measures are derived from administrative records, paper charts and consumer surveys; increasingly, electronic patient record systems are also being used. We use the term 'e-QMs' to describe quality measures that are based on data found within electronic health records and other related health information technology (HIT). We offer a framework or typology for e-QMs and describe opportunities and impediments associated with the transition from old to new If public and private systems of care are to effectively use HIT to support and evaluate health-care system quality and safety, the quality measurement field must embrace new paradigms and strategically address a series of technical, conceptual and practical challenges.

Parallel selection of antibody libraries on phage and yeast surfaces via a cross-species display.

PubMed

Patel, Chirag A; Wang, Jinqing; Wang, Xinwei; Dong, Feng; Zhong, Pingyu; Luo, Peter P; Wang, Kevin C

2011-09-01

We created a cross-species display system that allows the display of the same antibody libraries on both prokaryotic phage and eukaryotic yeast without the need for molecular cloning. Using this cross-display system, a large, diverse library can be constructed once and subsequently used for display and selection in both phage and yeast systems. In this article, we performed the parallel phage and yeast selection of an antibody maturation library using this cross-display platform. This parallel selection allowed us to isolate more unique hits than single-species selection, with 162 unique clones from phage and 107 unique clones from yeast. In addition, we were able to shuttle yeast hits back to Escherichia coli cells for affinity characterization at a higher throughput.

Social organization of self-management support of persons with diabetes: a health systems comparison.

PubMed

Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-09-01

Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

Forensic Evidence and Criminal Investigations: The Impact of Ballistics Information on the Investigation of Violent Crime in Nine Cities.

PubMed

King, William R; Campbell, Bradley A; Matusiak, Matthew C; Katz, Charles M

2017-07-01

We explore the impact of information from ballistics imaging hit reports on the investigation into violent crimes. Ballistics imaging hits link two crimes involving the same firearm by forensically matching tool marks on the fired bullets or cartridge cases. Interview data collected from detectives who received a hit report were used to explore the relationship between the presence of a hit report and outcomes in 65 gun-related violent crime investigations in nine U.S. police agencies. Findings indicate hit reports rarely contribute to identification, arrest, charging, or sentencing of suspects, because of delays in producing hit reports. On average, hit reports were completed 181.4 days after the focal crime. This delay forces investigations to proceed without the benefit of information from ballistics analysis. Additionally, hit reports rarely contained detailed information that was immediately useful to investigators. Instead, hit reports required additional research by the investigator to unlock useful information. © 2017 American Academy of Forensic Sciences.

Dynamical structure and risk assessment of 20th Century Windstorms

NASA Astrophysics Data System (ADS)

Varino, Filipa; Philippe, Arbogast; Bruno, Joly; Gwendal, Rivière; Marie-Laure, Fandeur; Henry, Bovy; Jean-Baptiste, Granier; Mitchell-Wallace, Kirsten

2017-04-01

Windstorms play an important role in weather variability over western Europe. Strong winds associated with fronts and sting jets can lead to several social and economic damages. However, in addition to wind intensity, the displacement speed of the storm, its area and position are also important factors in determining loss. In this study we focus on windstorms associated with the highest damages of the 20th century, and we analyse whether the dynamical structure of the storm is related to its impact. First, we apply an extra-tropical storm tracking algorithm to the ECMWF ERA-20C reanalysis that covers the whole twentieth century and for the whole Northern Hemisphere. Secondly, using the same data, we compute the 3-hourly Loss and Meteorological index for 18 different European countries as in Pinto et al. (2012) with a 25km grid resolution. Thirdly, we develop a High-Loss Tracking Method that matches information from the Loss Index results and the trajectories tracked to systematically associate damages over a particular country to a particular storm. Such a combination provides information on the typical life cycle of storms that create strong damages over a particular country. Finally, only storms hitting France are considered. More than 1500 storms are detected over the whole period and their evolution is analyzed by performing various composites depending on their position relative to the jet stream and their region of impact.

Smoked Cannabis' Psychomotor and Neurocognitive Effects in Occasional and Frequent Smokers

PubMed Central

Desrosiers, Nathalie A.; Ramaekers, Johannes G.; Chauchard, Emeline; Gorelick, David A.; Huestis, Marilyn A.

2015-01-01

Δ9-Tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, impairs psychomotor performance, cognition and driving ability; thus, driving under the influence of cannabis is a public safety concern. We documented cannabis' psychomotor, neurocognitive, subjective and physiological effects in occasional and frequent smokers to investigate potential differences between these smokers. Fourteen frequent (≥4x/week) and 11 occasional (<2x/week) cannabis smokers entered a secure research unit ∼19 h prior to smoking one 6.8% THC cigarette. Cognitive and psychomotor performance was evaluated with the critical tracking (CTT), divided attention (DAT), n-back (working memory) and Balloon Analog Risk (BART) (risk-taking) tasks at −1.75, 1.5, 3.5, 5.5 and 22.5 h after starting smoking. GLM (General Linear Model) repeated measures ANOVA was utilized to compare scores. Occasional smokers had significantly more difficulty compensating for CTT tracking error compared with frequent smokers 1.5 h after smoking. Divided attention performance declined significantly especially in occasional smokers, with session × group effects for tracking error, hits, false alarms and reaction time. Cannabis smoking did not elicit session × group effects on the n-back or BART. Controlled cannabis smoking impaired psychomotor function, more so in occasional smokers, suggesting some tolerance to psychomotor impairment in frequent users. These data have implications for cannabis-associated impairment in driving under the influence of cannabis cases. PMID:25745105

Statistical Study of Eruptive Filaments using Automated Detection and Tracking Technique

NASA Astrophysics Data System (ADS)

Joshi, Anand D.; Hanaoka, Yoichiro

2017-08-01

Solar filaments are dense and cool material suspended in the low solar corona. They are found to be on the Sun for periods up to a few weeks, and they end their lifetime either as a gradual disappearance or an eruption. We have developed an automated detection and tracking technique to study such filament eruptions using full-disc Hα images. Various processing steps are used before subjecting an image to segmentation, that would extract only the filaments. Further steps track the filaments between successive images, label them uniquely, and generate output that can be used for a comparative study. In this poster, we would use this technique to carry out a statistical study of several erupting filaments through which the common underlying properties of such eruptions can be derived. Details of the technique will also be discussed in brief. Filament eruptions are found to be closely associated with coronal mass ejections (CMEs) wherein a large mass from corona is ejected into the interplanetary space. If such a CME hits the Earth with a favourable orientation of magnetic field a geomagnetic storm can result adversely affecting electronic infrastructure in space as well as ground. The properties of filament eruptions derived can be used in future to predict an eruption in an almost real-time basis, thereby giving a warning of imminent storm.

Co-visualization of DNA damage and ion traversals in live mammalian cells using a fluorescent nuclear track detector

PubMed Central

Kodaira, Satoshi; Konishi, Teruaki; Kobayashi, Alisa; Maeda, Takeshi; Ahmad, Tengku Ahbrizal Farizal Tengku; Yang, Gen; Akselrod, Mark S.; Furusawa, Yoshiya; Uchihori, Yukio

2015-01-01

Abstract The geometric locations of ion traversals in mammalian cells constitute important information in the study of heavy ion-induced biological effect. Single ion traversal through a cellular nucleus produces complex and massive DNA damage at a nanometer level, leading to cell inactivation, mutations and transformation. We present a novel approach that uses a fluorescent nuclear track detector (FNTD) for the simultaneous detection of the geometrical images of ion traversals and DNA damage in single cells using confocal microscopy. HT1080 or HT1080–53BP1-GFP cells were cultured on the surface of a FNTD and exposed to 5.1-MeV/n neon ions. The positions of the ion traversals were obtained as fluorescent images of a FNTD. Localized DNA damage in cells was identified as fluorescent spots of γ-H2AX or 53BP1-GFP. These track images and images of damaged DNA were obtained in a short time using a confocal laser scanning microscope. The geometrical distribution of DNA damage indicated by fluorescent γ-H2AX spots in fixed cells or fluorescent 53BP1-GFP spots in living cells was found to correlate well with the distribution of the ion traversals. This method will be useful for evaluating the number of ion hits on individual cells, not only for micro-beam but also for random-beam experiments. PMID:25324538

LncRNA-HIT Functions as an Epigenetic Regulator of Chondrogenesis through Its Recruitment of p100/CBP Complexes.

PubMed

Carlson, Hanqian L; Quinn, Jeffrey J; Yang, Yul W; Thornburg, Chelsea K; Chang, Howard Y; Stadler, H Scott

2015-12-01

Gene expression profiling in E 11 mouse embryos identified high expression of the long noncoding RNA (lncRNA), LNCRNA-HIT in the undifferentiated limb mesenchyme, gut, and developing genital tubercle. In the limb mesenchyme, LncRNA-HIT was found to be retained in the nucleus, forming a complex with p100 and CBP. Analysis of the genome-wide distribution of LncRNA-HIT-p100/CBP complexes by ChIRP-seq revealed LncRNA-HIT associated peaks at multiple loci in the murine genome. Ontological analysis of the genes contacted by LncRNA-HIT-p100/CBP complexes indicate a primary role for these loci in chondrogenic differentiation. Functional analysis using siRNA-mediated reductions in LncRNA-HIT or p100 transcripts revealed a significant decrease in expression of many of the LncRNA-HIT-associated loci. LncRNA-HIT siRNA treatments also impacted the ability of the limb mesenchyme to form cartilage, reducing mesenchymal cell condensation and the formation of cartilage nodules. Mechanistically the LncRNA-HIT siRNA treatments impacted pro-chondrogenic gene expression by reducing H3K27ac or p100 activity, confirming that LncRNA-HIT is essential for chondrogenic differentiation in the limb mesenchyme. Taken together, these findings reveal a fundamental epigenetic mechanism functioning during early limb development, using LncRNA-HIT and its associated proteins to promote the expression of multiple genes whose products are necessary for the formation of cartilage.

LncRNA-HIT Functions as an Epigenetic Regulator of Chondrogenesis through Its Recruitment of p100/CBP Complexes

PubMed Central

Carlson, Hanqian L.; Quinn, Jeffrey J.; Yang, Yul W.; Thornburg, Chelsea K.; Chang, Howard Y.; Stadler, H. Scott

2015-01-01

Gene expression profiling in E 11 mouse embryos identified high expression of the long noncoding RNA (lncRNA), LNCRNA-HIT in the undifferentiated limb mesenchyme, gut, and developing genital tubercle. In the limb mesenchyme, LncRNA-HIT was found to be retained in the nucleus, forming a complex with p100 and CBP. Analysis of the genome-wide distribution of LncRNA-HIT-p100/CBP complexes by ChIRP-seq revealed LncRNA-HIT associated peaks at multiple loci in the murine genome. Ontological analysis of the genes contacted by LncRNA-HIT-p100/CBP complexes indicate a primary role for these loci in chondrogenic differentiation. Functional analysis using siRNA-mediated reductions in LncRNA-HIT or p100 transcripts revealed a significant decrease in expression of many of the LncRNA-HIT-associated loci. LncRNA-HIT siRNA treatments also impacted the ability of the limb mesenchyme to form cartilage, reducing mesenchymal cell condensation and the formation of cartilage nodules. Mechanistically the LncRNA-HIT siRNA treatments impacted pro-chondrogenic gene expression by reducing H3K27ac or p100 activity, confirming that LncRNA-HIT is essential for chondrogenic differentiation in the limb mesenchyme. Taken together, these findings reveal a fundamental epigenetic mechanism functioning during early limb development, using LncRNA-HIT and its associated proteins to promote the expression of multiple genes whose products are necessary for the formation of cartilage. PMID:26633036

Reviews

NASA Astrophysics Data System (ADS)

2008-11-01

WE RECOMMEND Ideas, Evidence and Argument in Science Fantastic DVD packed with classroom activities LabQuest Datalogger hits all the right buttons The Complete Idiot's Guide to String Theory A book that is better than its title lets on Light Strip SEP proves yet again that simple equipment is best Teaching Radioactivity Multimedia resource gets hands-on with radioactivity WORTH A LOOK Sunshine DVD of the sci-fi film includes insightful commentary track Peltier Cell Unit SEP equipment is useful but unusually pricey 100 Things to Spot in the Night Sky Data cards are packed with astronomical facts Light Sensor SEP unit is only useful for one specific experiment Windmill Generator Classroom-sized windmill does not sell wind power The Number Devil A 'mathematical adventure' book for young children

Apollo-Soyuz pamphlet no. 6: Cosmic ray dosage. [experimental designiradiation hazards and dosage

NASA Technical Reports Server (NTRS)

Page, L. W.; From, T. P.

1977-01-01

The radiation hazard inside spacecraft is discussed with emphasis on its effects on the crew, biological specimens, and spacecraft instruments. The problem of light flash sensations in the eyes of astronauts is addressed and experiment MA-106 is described. In this experiment, light flashes seen by blindfolded astronauts were counted and high energy cosmic ray intensity in the command module cabin were measured. The damage caused by cosmic ray hits on small living organisms was investigated in the Biostack 3 experiment (MA-107). Individual cosmic rays were tracked through layers of bacterial spores, small seeds, and eggs interleaved with layers of AgCl-crystal wafers, special plastic, and special photographic film that registered each cosmic ray particle passed.

Hyperinsulin therapy for calcium channel antagonist poisoning: a seven-year retrospective study.

PubMed

Espinoza, Tamara R; Bryant, Sean M; Aks, Steve E

2013-01-01

The use of hyperinsulin therapy (HIT) in severe calcium channel antagonist (CCA) poisoning has become a more common therapy within the last decade. The objective of this study is to report 7 years of experience recommending HIT. This was a retrospective chart review utilizing our regional poison center (RPC) data from January 1, 2002, through December 31, 2008. All cases of CCA poisoning receiving HIT were searched. Endpoints included the number of CCA cases utilizing HIT, insulin dose, time of initiation of HIT, patient outcome, adverse events, age, glucose concentration, and lowest systolic blood pressure recorded. Forty-six cases of CCA poisoning were managed with HIT over 7 years. All the patients received standard antidotal therapy (= intravenous fluids, calcium salts, glucagon, and pressors). HIT administration followed our RPC recommendation 23 times (50%), and no hypoglycemic events occurred. Means (age, highest glucose measured, and lowest systolic blood pressure measured) were 51 years, 282 mg/dL, and 74 mm Hg, respectively. Our RPC recommendations for HIT were followed 50% of the time over the last 7 years. In light of the lack of hypoglycemia associated with HIT in our study population, we recommend HIT as an early and safe antidote in significant CCA poisoning.

Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review.

PubMed

Warkentin, Theodore E; Pai, Menaka; Linkins, Lori-Ann

2017-08-31

Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, ON, Canada, since January 1, 2015 (when we completed our prospective study of rivaroxaban for HIT), using rivaroxaban for serologically confirmed HIT (4Ts score ≥4 points; positive platelet factor 4 [PF4]/heparin immunoassay, positive serotonin-release assay). We also performed a literature review of HIT treatment using DOACs (rivaroxaban, apixaban, dabigatran, edoxaban). We focused on patients who received DOAC therapy for acute HIT as either primary therapy (group A) or secondary therapy (group B; initial treatment using a non-DOAC/non-heparin anticoagulant with transition to a DOAC during HIT-associated thrombocytopenia). Our primary end point was occurrence of objectively documented thrombosis during DOAC therapy for acute HIT. We found that recovery without new, progressive, or recurrent thrombosis occurred in all 10 Hamilton patients with acute HIT treated with rivaroxaban. Data from the literature review plus these new data identified a thrombosis rate of 1 of 46 patients (2.2%; 95% CI, 0.4%-11.3%) in patients treated with rivaroxaban during acute HIT (group A, n = 25; group B, n = 21); major hemorrhage was seen in 0 of 46 patients. Similar outcomes in smaller numbers of patients were observed with apixaban (n = 12) and dabigatran (n = 11). DOACs offer simplified management of selected patients, as illustrated by a case of persisting (autoimmune) HIT (>2-month platelet recovery with inversely parallel waning of serum-induced heparin-independent serotonin release) with successful outpatient rivaroxaban management of HIT-associated thrombosis. Evidence supporting efficacy and safety of DOACs for acute HIT is increasing, with the most experience reported for rivaroxaban. © 2017 by The American Society of Hematology.

Evaluation of a new nanoparticle-based lateral-flow immunoassay for the exclusion of heparin-induced thrombocytopenia (HIT).

PubMed

Sachs, Ulrich J; von Hesberg, Jakob; Santoso, Sentot; Bein, Gregor; Bakchoul, Tamam

2011-12-01

Heparin-induced thrombocytopenia (HIT) is an adverse complication of heparin caused by HIT antibodies (abs) that recognise platelet factor 4-heparin (PF4/hep) complexes. Several laboratory tests are available for the confirmation and/or refutation of HIT. A reliable and rapid single-sample test is still pending. It was the objective of this study to evaluate a new lateral-flow immunoassay based on nanoparticle technology. A cohort of 452 surgical and medical patients suspected of having HIT was evaluated. All samples were tested in two IgG-specific ELISAs, in a particle gel immunoassay (PaGIA) and in a newly developed lateral-flow immunoassay (LFI-HIT) as well as in a functional test (HIPA). Clinical pre-test probability was determined using 4T's score. Platelet-activating antibodies were present in 34/452 patients, all of whom had intermediate to high clinical probability. PF4/hep abs were detected in 79, 87, 86, and 63 sera using the four different immunoassays. The negative predictive values (NPV) were 100% for both ELISA tests and LFI-HIT but only 99.2% for PaGIA. There were less false positives (n=29) in the LFI-HIT compared to any other test. Additionally, significantly less time was required to perform LFI-HIT than to perform the other immunoassays. In conclusion, a newly developed lateral-flow assay, LFI-HIT, was capable of identifying all HIT patients in a cohort in a short period of time. Beside an NPV of 100%, the rate of false-positive signals is significantly lower with LFI-HIT than with other immunoassay(s). These performance characteristics suggest a high potency in reducing the risk and costs in patients suspected of having HIT.

Elevated circulating IGF-I promotes mammary gland development and proliferation.

PubMed

Cannata, Dara; Lann, Danielle; Wu, Yingjie; Elis, Sebastien; Sun, Hui; Yakar, Shoshana; Lazzarino, Deborah A; Wood, Teresa L; Leroith, Derek

2010-12-01

Animal studies have shown that IGF-I is essential for mammary gland development. Previous studies have suggested that local IGF-I rather than circulating IGF-I is the major mediator of mammary gland development. In the present study we used the hepatic IGF-I transgenic (HIT) and IGF-I knockout/HIT (KO-HIT) mouse models to examine the effects of enhanced circulating IGF-I on mammary development in the presence and absence of local IGF-I. HIT mice express the rat IGF-I transgene under the transthyretin promoter in the liver and have elevated circulating IGF-I and normal tissue IGF-I levels. The KO-HIT mice have no tissue IGF-I and increased circulating IGF-I. Analysis of mammary gland development reveals a greater degree of complexity in HIT mice as compared to control and KO-HIT mice, which demonstrate similar degrees of mammary gland complexity. Immunohistochemical evaluation of glands of HIT mice also suggests an enhanced degree of proliferation of the mammary gland, whereas KO-HIT mice exhibit mammary gland proliferation similar to control mice. In addition, HIT mice have a higher percentage of proliferating myoepithelial and luminal cells than control mice, whereas KO-HIT mice have an equivalent percentage of proliferating myoepithelial and luminal cells as control mice. Thus, our findings show that elevated circulating IGF-I levels are sufficient to promote normal pubertal mammary epithelial development. However, HIT mice demonstrate more pronounced mammary gland development when compared to control and KO-HIT mice. This suggests that both local and endocrine IGF-I play roles in mammary gland development and that elevated circulating IGF-I accelerates mammary epithelial proliferation.

Biological characterization of adult MYC-translocation-positive mature B-cell lymphomas other than molecular Burkitt lymphoma.

PubMed

Aukema, Sietse M; Kreuz, Markus; Kohler, Christian W; Rosolowski, Maciej; Hasenclever, Dirk; Hummel, Michael; Küppers, Ralf; Lenze, Dido; Ott, German; Pott, Christiane; Richter, Julia; Rosenwald, Andreas; Szczepanowski, Monika; Schwaenen, Carsten; Stein, Harald; Trautmann, Heiko; Wessendorf, Swen; Trümper, Lorenz; Loeffler, Markus; Spang, Rainer; Kluin, Philip M; Klapper, Wolfram; Siebert, Reiner

2014-04-01

Chromosomal translocations affecting the MYC oncogene are the biological hallmark of Burkitt lymphomas but also occur in a subset of other mature B-cell lymphomas. If accompanied by a chromosomal break targeting the BCL2 and/or BCL6 oncogene these MYC translocation-positive (MYC(+)) lymphomas are called double-hit lymphomas, otherwise the term single-hit lymphomas is applied. In order to characterize the biological features of these MYC(+) lymphomas other than Burkitt lymphoma we explored, after exclusion of molecular Burkitt lymphoma as defined by gene expression profiling, the molecular, pathological and clinical aspects of 80 MYC-translocation-positive lymphomas (31 single-hit, 46 double-hit and 3 MYC(+)-lymphomas with unknown BCL6 status). Comparison of single-hit and double-hit lymphomas revealed no difference in MYC partner (IG/non-IG), genomic complexity, MYC expression or gene expression profile. Double-hit lymphomas more frequently showed a germinal center B-cell-like gene expression profile and had higher IGH and MYC mutation frequencies. Gene expression profiling revealed 130 differentially expressed genes between BCL6(+)/MYC(+) and BCL2(+)/MYC(+) double-hit lymphomas. BCL2(+)/MYC(+) double-hit lymphomas more frequently showed a germinal center B-like gene expression profile. Analysis of all lymphomas according to MYC partner (IG/non-IG) revealed no substantial differences. In this series of lymphomas, in which immunochemotherapy was administered in only a minority of cases, single-hit and double-hit lymphomas had a similar poor outcome in contrast to the outcome of molecular Burkitt lymphoma and lymphomas without the MYC break. Our data suggest that, after excluding molecular Burkitt lymphoma and pediatric cases, MYC(+) lymphomas are biologically quite homogeneous with single-hit and double-hit lymphomas as well as IG-MYC and non-IG-MYC(+) lymphomas sharing various molecular characteristics.

Obstacles in the diagnostics and therapy of heparin-induced thrombocytopenia.

PubMed

Antonijević, Nebojsa M; Radovanović, Nebojsa; Obradović, Slobodan; Vucelić, Dragica; Stojanović, Bojan; Miković, Danijela; Kovac, Mirjana; Kocica, Tina; Tadić, Svetlana; Antonijević, Irina; Drasković, Snezana; Djordjević, Valentina; Calija, Branko; Perunicić, Jovan; Vasiljević, Zorana

2010-01-01

An immune-mediated, severe, acquired prothrombotic disorder, heparin-induced thrombocytopenia type II (HIT II) occurs in 0.5-5% of patients exposed to unfractionated heparin longer than 5-7 days. Arterial and venous thromboses are induced by HIT II in about 35-50% of patients. Typical death rate for HIT is about 29%, while 21% of HIT patients result in amputation of a limb. The trend towards the occurrence of HIT due to the administration of low molecular weight heparins (LMWH) taking ever conspicuous place in the standard venous thromboembolism (VTE) prophylaxis has been more frequently observed recently. It is considered that LMWH may cause HIT II in about 0.25-1%. The need for further modification of HIPA assays with LMWH has been imposed in the HIT laboratory diagnostics, heretofore overburdened with complexity. There are several constantly opposing problems arising in HIT laboratory diagnostics, one of which is that in a certain number of patients immunologic assays detect nonpathogenic antibodies (mainly IgM or IgA heparin-PF4 antibodies) while, on the other hand, the occurrence of HIT pathogenetically mediated by minor antigens (neutrophil-activating peptide 2 or interleukin 8) may be neglected in certain cases. The following factors play an important role in the interpretation of each laboratory HIT assays performed: 1. correlation with HIT clinical probability test, the best known of which is 4T'score, 2. the interpretation of the laboratory findings dependent on the time of the thrombocytopenia onset, as well as 3. the sensitivity and specificity of each test respectively. The HIT diagnostics in the presence of other comorbid states which may also induce thrombocytopenia, more precisely known as pseudo HIT (cancer, sepsis, disseminated intravascular coagulation, pulmonary embolism, antiphospholipid syndrome, etc), represents a specific clinical problem.

NMR screening in fragment-based drug design: a practical guide.

PubMed

Kim, Hai-Young; Wyss, Daniel F

2015-01-01

Fragment-based drug design (FBDD) comprises both fragment-based screening (FBS) to find hits and elaboration of these hits to lead compounds. Typical fragment hits have lower molecular weight (<300-350 Da) and lower initial potency but higher ligand efficiency when compared to those from high-throughput screening. NMR spectroscopy has been widely used for FBDD since it identifies and localizes the binding site of weakly interacting hits on the target protein. Here we describe ligand-based NMR methods for hit identification from fragment libraries and for functional cross-validation of primary hits.

Beneficial effects of Houttuynia cordata polysaccharides on "two-hit" acute lung injury and endotoxic fever in rats associated with anti-complementary activities.

PubMed

Lu, Yan; Jiang, Yun; Ling, Lijun; Zhang, Yunyi; Li, Hong; Chen, Daofeng

2018-03-01

Houttuynia cordata Thunb. is a traditional herb used for clearing heat and eliminating toxins, and has also been used for the treatment of severe acute respiratory syndrome (SARS). In vitro, the crude H. cordata polysaccharides (CHCP) exhibited potent anti-complementary activity through both the classical and alternative pathways by acting on components C3 and C4 of the complement system without interfering with the coagulation system. This study was to investigate the preventive effects of CHCP on acute lung injury (ALI) induced by hemorrhagic shock plus lipopolysaccharide (LPS) instillation (two-hit) and LPS-induced fever in rats. CHCP significantly attenuated pulmonary injury in the "two-hit" ALI model by reducing pulmonary edema and protein exudation in bronchoalveolar lavage fluid (BALF). In addition, it reduced the deposit of complement activation products in the lung and improved oxidant-antioxidant imbalance. Moreover, CHCP administration inhibited fever in rats, reduced the number of leukocytes and restored serum complement levels. The inhibition on the inappropriate activation of complement system by CHCP may play an important role in its beneficial effects on inflammatory diseases. The anti-complementary polysaccharides are likely to be among the key substances for the heat-clearing function of H. cordata .

[Diagnosis and treatment of heparin-induced thrombocytopenia (HIT) based on its atypical immunological features].

PubMed

Miyata, Shigeki; Maeda, Takuma

2016-03-01

Heparin-induced thrombocytopenia (HIT) is a prothrombotic side effect of heparin therapy caused by HIT antibodies, i.e., anti-platelet factor 4 (PF4)/heparin IgG with platelet-activating properties. For serological diagnosis, antigen immunoassays are commonly used worldwide. However, such assays do not indicate their platelet-activating properties, leading to low specificity for the HIT diagnosis. Therefore, over-diagnosis is currently the most serious problem associated with HIT. The detection of platelet-activating antibodies using a washed platelet activation assay is crucial for appropriate HIT diagnosis. Recent advances in our understanding of the pathogenesis of HIT include it having several clinical features atypical for an immune-mediated disease. Heparin-naïve patients can develop IgG antibodies as early as day 4, as in a secondary immune response. Evidence for an anamnestic response on heparin re-exposure is lacking. In addition, HIT antibodies are relatively short-lived, unlike those in a secondary immune response. These lines of evidence suggest that the mechanisms underlying HIT antibody formation may be compatible with a non-T cell-dependent immune reaction. These atypical clinical and serological features should be carefully considered while endeavoring to accurately diagnose HIT, which leads to appropriate therapies such as immediate administration of an alternative anticoagulant to prevent thromboembolic events and re-administration of heparin during surgery involving cardiopulmonary bypass when HIT antibodies are no longer detectable.

Health information technology knowledge and skills needed by HIT employers.

PubMed

Fenton, S H; Gongora-Ferraez, M J; Joost, E

2012-01-01

To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey.

Early phase drug discovery: cheminformatics and computational techniques in identifying lead series.

PubMed

Duffy, Bryan C; Zhu, Lei; Decornez, Hélène; Kitchen, Douglas B

2012-09-15

Early drug discovery processes rely on hit finding procedures followed by extensive experimental confirmation in order to select high priority hit series which then undergo further scrutiny in hit-to-lead studies. The experimental cost and the risk associated with poor selection of lead series can be greatly reduced by the use of many different computational and cheminformatic techniques to sort and prioritize compounds. We describe the steps in typical hit identification and hit-to-lead programs and then describe how cheminformatic analysis assists this process. In particular, scaffold analysis, clustering and property calculations assist in the design of high-throughput screening libraries, the early analysis of hits and then organizing compounds into series for their progression from hits to leads. Additionally, these computational tools can be used in virtual screening to design hit-finding libraries and as procedures to help with early SAR exploration. Copyright © 2012 Elsevier Ltd. All rights reserved.

Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination

PubMed Central

Bruns, Eric J.; Hyde, Kelly L.; Sather, April; Hook, Alyssa; Lyon, Aaron R.

2015-01-01

Health information technology (HIT) and care coordination for individuals with complex needs are high priorities for quality improvement in health care. However, there is little empirical guidance about how best to design electronic health record systems and related technologies to facilitate implementation of care coordination models in behavioral health, or how best to apply user input to the design and testing process. In this paper, we describe an iterative development process that incorporated user/stakeholder perspectives at multiple points and resulted in an electronic behavioral health information system (EBHIS) specific to the wraparound care coordination model for youth with serious emotional and behavioral disorders. First, we review foundational HIT research on how EBHIS can enhance efficiency and outcomes of wraparound that was used to inform development. After describing the rationale for and functions of a prototype EBHIS for wraparound, we describe methods and results for a series of six small studies that informed system development across four phases of effort – predevelopment, development, initial user testing, and commercialization – and discuss how these results informed system design and refinement. Finally, we present next steps, challenges to dissemination, and guidance for others aiming to develop specialized behavioral health HIT. The research team's experiences reinforce the opportunity presented by EBHIS to improve care coordination for populations with complex needs, while also pointing to a litany of barriers and challenges to be overcome to implement such technologies. PMID:26060099

Robust statistical methods for hit selection in RNA interference high-throughput screening experiments.

PubMed

Zhang, Xiaohua Douglas; Yang, Xiting Cindy; Chung, Namjin; Gates, Adam; Stec, Erica; Kunapuli, Priya; Holder, Dan J; Ferrer, Marc; Espeseth, Amy S

2006-04-01

RNA interference (RNAi) high-throughput screening (HTS) experiments carried out using large (>5000 short interfering [si]RNA) libraries generate a huge amount of data. In order to use these data to identify the most effective siRNAs tested, it is critical to adopt and develop appropriate statistical methods. To address the questions in hit selection of RNAi HTS, we proposed a quartile-based method which is robust to outliers, true hits and nonsymmetrical data. We compared it with the more traditional tests, mean +/- k standard deviation (SD) and median +/- 3 median of absolute deviation (MAD). The results suggested that the quartile-based method selected more hits than mean +/- k SD under the same preset error rate. The number of hits selected by median +/- k MAD was close to that by the quartile-based method. Further analysis suggested that the quartile-based method had the greatest power in detecting true hits, especially weak or moderate true hits. Our investigation also suggested that platewise analysis (determining effective siRNAs on a plate-by-plate basis) can adjust for systematic errors in different plates, while an experimentwise analysis, in which effective siRNAs are identified in an analysis of the entire experiment, cannot. However, experimentwise analysis may detect a cluster of true positive hits placed together in one or several plates, while platewise analysis may not. To display hit selection results, we designed a specific figure called a plate-well series plot. We thus suggest the following strategy for hit selection in RNAi HTS experiments. First, choose the quartile-based method, or median +/- k MAD, for identifying effective siRNAs. Second, perform the chosen method experimentwise on transformed/normalized data, such as percentage inhibition, to check the possibility of hit clusters. If a cluster of selected hits are observed, repeat the analysis based on untransformed data to determine whether the cluster is due to an artifact in the data. If no clusters of hits are observed, select hits by performing platewise analysis on transformed data. Third, adopt the plate-well series plot to visualize both the data and the hit selection results, as well as to check for artifacts.

Biophysics Representation of the Two-Hit Model of Alzheimer's Disease for the Exploration of Late CNS Risks from Space Radiation

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Ponomarev, Artem

2009-01-01

A concern for long-term space travel outside the Earth s magnetic field is the late effects to the central nervous system (CNS) from galactic cosmic ray (GCR) or solar particle events (SPE). Human epidemiology data is severely limited for making CNS risk estimates and it is not clear such effects occur following low LET exposures. We are developing systems biology models based on biological information on specific diseases, and experimental data for proton and heavy ion radiation. A two-hit model of Alzheimer s disease (AD) has been proposed by Zhu et al.(1), which is the framework of our model. Of importance is that over 50% of the US population over the age of 75-y have mild to severe forms of AD. Therefore we recommend that risk assessment for a potential AD risk from space radiation should focus on the projection of an earlier age of onset of AD and the prevention of this possible acceleration through countermeasures. In the two-hit model, oxidative stress and aberrant cell cycle-related abnormalities leading to amyloid-beta plaques and neurofibrillary tangles are necessary and invariant steps in AD. We have formulated a stochastic cell kinetics model of the two-hit AD model. In our model a population of neuronal cells is allowed to undergo renewal through neurogenesis and is susceptible to oxidative stress or cell cycle abnormalities with age-specific accumulation of damage. Baseline rates are fitted to AD population data for specific ages, gender, and for persons with an apolipoprotein 4 allele. We then explore how low LET or heavy ions may increase either of the two-hits or neurogenesis either through persistent oxidative stress, direct mutation, or through changes to the micro-environment, and suggest possible ways to develop accurate quantitative estimates of these processes for predicting AD risks following long-term space travel.

Lead generation and examples opinion regarding how to follow up hits.

PubMed

Orita, Masaya; Ohno, Kazuki; Warizaya, Masaichi; Amano, Yasushi; Niimi, Tatsuya

2011-01-01

In fragment-based drug discovery (FBDD), not only identifying the starting fragment hit to be developed but also generating a drug lead from that starting fragment hit is important. Converting fragment hits to leads is generally similar to a high-throughput screening (HTS) hits-to-leads approach in that properties associated with activity for a target protein, such as selectivity against other targets and absorption, distribution, metabolism, excretion, and toxicity (ADME/Tox), and physicochemical properties should be taken into account. However, enhancing the potency of the fragment hit is a key requirement in FBDD, unlike HTS, because initial fragment hits are generally weak. This enhancement is presently achieved by adding additional chemical groups which bind to additional parts of the target protein or by joining or combining two or more hit fragments; however, strategies for effecting greater improvements in effective activity are needed. X-ray analysis is a key technology attractive for converting fragments to drug leads. This method makes it clear whether a fragment hit can act as an anchor and provides insight regarding introduction of functional groups to improve fragment activity. Data on follow-up chemical synthesis of fragment hits has allowed for the differentiation of four different strategies: fragment optimization, fragment linking, fragment self-assembly, and fragment evolution. Here, we discuss our opinion regarding how to follow up on fragment hits, with a focus on the importance of fragment hits as an anchor moiety to so-called hot spots in the target protein using crystallographic data. Copyright © 2011 Elsevier Inc. All rights reserved.

External validation of the HIT Expert Probability (HEP) score.

PubMed

Joseph, Lee; Gomes, Marcelo P V; Al Solaiman, Firas; St John, Julie; Ozaki, Asuka; Raju, Manjunath; Dhariwal, Manoj; Kim, Esther S H

2015-03-01

The diagnosis of heparin-induced thrombocytopenia (HIT) can be challenging. The HIT Expert Probability (HEP) Score has recently been proposed to aid in the diagnosis of HIT. We sought to externally and prospectively validate the HEP score. We prospectively assessed pre-test probability of HIT for 51 consecutive patients referred to our Consultative Service for evaluation of possible HIT between August 1, 2012 and February 1, 2013. Two Vascular Medicine fellows independently applied the 4T and HEP scores for each patient. Two independent HIT expert adjudicators rendered a diagnosis of HIT likely or unlikely. The median (interquartile range) of 4T and HEP scores were 4.5 (3.0, 6.0) and 5 (3.0, 8.5), respectively. There were no significant differences between area under receiver-operating characteristic curves of 4T and HEP scores against the gold standard, confirmed HIT [defined as positive serotonin release assay and positive anti-PF4/heparin ELISA] (0.74 vs 0.73, p = 0.97). HEP score ≥ 2 was 100 % sensitive and 16 % specific for determining the presence of confirmed HIT while a 4T score > 3 was 93 % sensitive and 35 % specific. In conclusion, the HEP and 4T scores are excellent screening pre-test probability models for HIT, however, in this prospective validation study, test characteristics for the diagnosis of HIT based on confirmatory laboratory testing and expert opinion are similar. Given the complexity of the HEP scoring model compared to that of the 4T score, further validation of the HEP score is warranted prior to widespread clinical acceptance.

Lessons from the Canadian national health information technology plan for the United States: opinions of key Canadian experts.

PubMed

Zimlichman, Eyal; Rozenblum, Ronen; Salzberg, Claudia A; Jang, Yeona; Tamblyn, Melissa; Tamblyn, Robyn; Bates, David W

2012-01-01

To summarize the Canadian health information technology (HIT) policy experience and impart lessons learned to the US as it determines its policy in this area. Qualitative analysis of interviews with identified key stakeholders followed by an electronic survey. We conducted semi-structured interviews with 29 key Canadian HIT policy and opinion leaders and used a grounded theory approach to analyze the results. The informant sample was chosen to provide views from different stakeholder groups including national representatives and regional representatives from three Canadian provinces. Canadian informants believed that much of the current US direction is positive, especially regarding incentives and meaningful use, but that there are key opportunities for the US to emphasize direct engagement with providers, define a clear business case for them, sponsor large scale evaluations to assess HIT impact in a broad array of settings, determine standards but also enable access to resources needed for mid-course corrections of standards when issues are identified, and, finally, leverage implementation of digital imaging systems. Not all stakeholder groups were included, such as providers or patients. In addition, as in all qualitative research, a selection bias could be present due to the relatively small sample size. Based on Canadian experience with HIT policy, stakeholders identified as lessons for the US the need to increase direct engagement with providers and the importance of defining the business case for HIT, which can be achieved through large scale evaluations, and of recognizing and leveraging successes as they emerge.

Health information technology and implementation science: partners in progress in the VHA.

PubMed

Hynes, Denise M; Whittier, Erika R; Owens, Arika

2013-03-01

The Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has demonstrated how implementation science can enhance the quality of health care. During this time an increasing number of implementation research projects have developed or utilized health information technology (HIT) innovations to leverage the VA's electronic health record and information systems. To describe the HIT approaches used and to characterize the facilitators and barriers to progress within implementation research projects in the VA QUERI program. Nine case studies were selected from among 88 projects and represented 8 of 14 HIT categories identified. Each case study included key informants whose roles on the project were principal investigator, implementation science and informatics development. We conducted documentation analysis and semistructured in-person interviews with key informants for each of the 9 case studies. We used qualitative analysis software to identify and thematically code information and interview responses. : Thematic analyses revealed 3 domains or pathways critical to progression through the QUERI steps. These pathways addressed: (1) compliance and collaboration with information technology policies and procedures; (2) operating within organizational policies and building collaborations with end users, clinicians, and administrators; and (3) obtaining and maintaining research resources and approvals. Sustained efforts in HIT innovation and in implementation science in the Veterans Health Administration demonstrates the interdependencies of these initiatives and the critical pathways that can contribute to progress. Other health care quality improvement efforts that rely on HIT can learn from the Veterans Health Administration experience.

The economics of health information technology in medication management: a systematic review of economic evaluations.

PubMed

O'Reilly, Daria; Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann

2012-01-01

To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.

A highly optimized vectorized code for Monte Carlo simulations of SU(3) lattice gauge theories

NASA Technical Reports Server (NTRS)

Barkai, D.; Moriarty, K. J. M.; Rebbi, C.

1984-01-01

New methods are introduced for improving the performance of the vectorized Monte Carlo SU(3) lattice gauge theory algorithm using the CDC CYBER 205. Structure, algorithm and programming considerations are discussed. The performance achieved for a 16(4) lattice on a 2-pipe system may be phrased in terms of the link update time or overall MFLOPS rates. For 32-bit arithmetic, it is 36.3 microsecond/link for 8 hits per iteration (40.9 microsecond for 10 hits) or 101.5 MFLOPS.

The One-on-One Stochastic Duel. Parts I and II

DTIC Science & Technology

1979-04-15

called the fundamental marksman problem (FM). From this we may solve the duel problem by considering each marksman to be firing independ- ently of the...other. The first to hit his passive target wins. This is entirely equivalent to the fundamental duel, a the model described above in no way links the...fire another round at t it muot fail, in order fo’" the system to be in the state of having just fired th a round which vas the n one, and no hits

The Coast Artillery Journal. Volume 68, Number 3, March 1928

DTIC Science & Technology

1928-03-01

therefor. Although the system of observation and computation of hits contemplated by the regulations were devised for the former semi-cubical target-area...so greatly simplifies his observations. It is also a fact that if hits are to he computed , as described below, the range observer must regard only...have been computed , the 3’s and 4’s are divided definitely into s’s and h’s, and the 10-20’s definitely into h’s and outs. It need not be fancied that

Current insights into the laboratory diagnosis of HIT.

PubMed

Bakchoul, T; Zöllner, H; Greinacher, A

2014-06-01

Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction and prothrombotic disorder caused by immunization against platelet factor 4 (PF4) after complex formation with heparin or other polyanions. After antibody binding to PF4/heparin complexes, HIT antibodies are capable of intravascular platelet activation by cross-linking Fc gamma receptor IIa (FcγRIIa) on the platelet surface leading to a platelet count decrease and/or thrombosis. In contrast to most other immune-mediated disorders, the currently available laboratory tests for anti-PF4/heparin antibodies show a high sensitivity also for clinically irrelevant antibodies. This makes the diagnosis of HIT challenging and bears the risk to substantially overdiagnose HIT. The strength of the antigen assays for HIT is in ruling out HIT when the test is negative. Functional assays have a higher specificity for clinically relevant antibodies, but they are restricted to specialized laboratories. Currently, a Bayesian approach combining the clinical likelihood estimation for HIT with laboratory tests is the most appropriate approach to diagnose HIT. In this review, we give an overview on currently available diagnostic procedures and discuss their limitations. © 2014 John Wiley & Sons Ltd.