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  1. Nutritional deficiency in Dutch primary care: data from general practice research and registration networks

    NARCIS (Netherlands)

    Wayenburg, van C.A.M.; Laar, van de F.A.; Waal, de M.W.M.; Okkes, I.M.; Akker, van den M.; Veen, van der W.J.; Schellevis, F.G.; Staveren, van W.A.; Binsbergen, van J.J.; Weel, van C.

    2005-01-01

    Objective: To explore incidence and prevalence rates of nutritional deficiency in adults in general practice. Methods: Six Dutch general practice research and registration networks supplied incidence and prevalence rates of nutritional deficiency by the International Classification of Primary Care

  2. Nutritional deficiency in Dutch primary care : data from general practice research and registration networks

    NARCIS (Netherlands)

    van Wayenburg, CAM; van de Laar, FA; de Waal, MWM; Okkes, IM; van den Akker, M; van der Veen, WJ; Schellevis, FG; van Staveren, WA; van Binsbergen, JJ; van Weel, C

    Objective: To explore incidence and prevalence rates of nutritional deficiency in adults in general practice. Methods: Six Dutch general practice research and registration networks supplied incidence and prevalence rates of nutritional deficiency by the International Classification of Primary Care

  3. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners

    Directory of Open Access Journals (Sweden)

    van der Sande Marianne AB

    2011-07-01

    Full Text Available Abstract Background Chlamydia is the most common curable sexually transmitted infection (STI in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs. Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening in the Netherlands. The aim of this study was to assess the usefulness of electronic medical records for monitoring the incidence of chlamydia cases diagnosed in primary care in the Netherlands. Methods In the electronic records of two regional and two national networks, we identified chlamydia diagnoses by means of ICPC codes (International Classification of Primary Care, laboratory results in free text and the prescription of antibiotics. The year of study was 2007 for the two regional networks and one national network, for the other national network the year of study was 2005. We calculated the incidence of diagnosed chlamydia cases per sex, age group and degree of urbanization. Results A large diversity was observed in the way chlamydia episodes were coded in the four different GP networks and how easily information concerning chlamydia diagnoses could be extracted. The overall incidence ranged from 103.2/100,000 to 590.2/100,000. Differences were partly related to differences between patient populations. Nevertheless, we observed similar trends in the incidence of chlamydia diagnoses in all networks and findings were in line with earlier reports. Conclusions Electronic patient records, originally intended for individual patient care in general practice, can be an additional source of data for monitoring chlamydia incidence in primary care and can be of use in assessing the future impact of population-based chlamydia screening programs. To increase the usefulness of data we recommend more efforts to standardize registration by (specific ICPC code and laboratory results across the existing GP networks.

  4. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners.

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; Broek, I.V.F. van den; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; Sande, M.A.B. van der; Kretzschmar, M.E.E.

    2011-01-01

    BACKGROUND: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

  5. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; van den Broek, I.V.F.; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; van der Sande, M.A.B.; Kretzschmar, M.E.E.

    2011-01-01

    Background: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

  6. Primary health care and general practice attachment: establishing an undergraduate teaching network in rural Greek health centers.

    Science.gov (United States)

    Smyrnakis, Emmanouil; Gavana, Magda; Kondilis, Elias; Giannakopoulos, Stathis; Panos, Alexandros; Chainoglou, Athanasia; Stardeli, Thomai; Kavaka, Niki; Benos, Alexis

    2013-01-01

    Exposure of undergraduate medical students to general practice and community healthcare services is common practice in the international medical curricula. Nevertheless, proponents of the hospital and biotechnology based paradigm, which is still dominant within the medical academic environment, question both the scope and the setting of this training procedure. Regarding the latter, the quality of teaching is often questioned in settings such as rural primary health centers, where health professionals have neither incentives nor accredited training skills. Therefore, the success of community based medical education depends substantially on the procedures implemented to involve non-academic staff as clinical teachers. This report describes the steps taken by the Aristotle University of Thessaloniki (AUTH) Medical School to establish and maintain a Rural Primary Health Care (PHC) Teaching Network in order to implement community oriented PHC and GP undergraduate medical education. A multi-professional teachers' network of healthcare staff, working in Rural Primary Health Centers, has been chosen, in order to expose students to the holistic approach of PHC. The enrollment of teachers to the Teaching Network was solely on a voluntary basis. The novelty of this procedure is that each professional is approached personally, instead through the Health Center (HC) that usually offers this service as a package in similar activities. In an attempt to attract health professionals committed to medical education, a self-selection procedure was adopted. Collaboration with the medical school was established but it was characterized by the School's inability to compensate teachers. A series of 'Training the Trainers' seminars were completed during the first implementation period in order to enhance the awareness of health professionals regarding undergraduate teaching in PHC; to present the educational needs of medical students; to expose them to the principles of medical teaching

  7. The historical development of the Dutch Sentinel General Practice Network from a paper based into a digital primary care monitoring system.

    NARCIS (Netherlands)

    Schweikardt, C.; Verheij, R.A.; Donker, G.A.; Coppieters, Y.

    2016-01-01

    Aim: The Dutch Sentinel General Practice Network (SGPN) was founded in 1970 for disease surveillance in primary care, based on paper questionnaires. Advances in information technology offered new prospects of data collection from electronic health records (EHRs). This study investigates the

  8. General Purpose (office) Network reorganisation

    CERN Multimedia

    IT Department

    2016-01-01

    On Saturday 27 August, the IT Department’s Communication Systems group will perform a major reorganisation of CERN’s General Purpose Network.   This reorganisation will cause network interruptions on Saturday 27 August (and possibly Sunday 28 August) and will be followed by a change to the IP addresses of connected systems that will come into effect on Monday 3 October. For further details and information about the actions you may need to take, please see: https://information-technology.web.cern.ch/news/general-purpose-office-network-reorganisation.

  9. Generalization performance of regularized neural network models

    DEFF Research Database (Denmark)

    Larsen, Jan; Hansen, Lars Kai

    1994-01-01

    Architecture optimization is a fundamental problem of neural network modeling. The optimal architecture is defined as the one which minimizes the generalization error. This paper addresses estimation of the generalization performance of regularized, complete neural network models. Regularization...

  10. Generalized Double Ring Network Structures

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Patel, A.; Knudsen, Thomas Phillip

    2004-01-01

    ) structures. Results on the Generalized Petersen Graphs provide necessary and sufficient conditions for a N2R(p; q) structure to be node or edge symmetric, and a table free routing scheme always determining a shortest path between any pair of nodes is presented. Next, the performance in terms of average...

  11. Random walks on generalized Koch networks

    International Nuclear Information System (INIS)

    Sun, Weigang

    2013-01-01

    For deterministically growing networks, it is a theoretical challenge to determine the topological properties and dynamical processes. In this paper, we study random walks on generalized Koch networks with features that include an initial state that is a globally connected network to r nodes. In each step, every existing node produces m complete graphs. We then obtain the analytical expressions for first passage time (FPT), average return time (ART), i.e. the average of FPTs for random walks from node i to return to the starting point i for the first time, and average sending time (AST), defined as the average of FPTs from a hub node to all other nodes, excluding the hub itself with regard to network parameters m and r. For this family of Koch networks, the ART of the new emerging nodes is identical and increases with the parameters m or r. In addition, the AST of our networks grows with network size N as N ln N and also increases with parameter m. The results obtained in this paper are the generalizations of random walks for the original Koch network. (paper)

  12. Generalized network improvement and packing problems

    CERN Document Server

    Holzhauser, Michael

    2016-01-01

    Michael Holzhauser discusses generalizations of well-known network flow and packing problems by additional or modified side constraints. By exploiting the inherent connection between the two problem classes, the author investigates the complexity and approximability of several novel network flow and packing problems and presents combinatorial solution and approximation algorithms. Contents Fractional Packing and Parametric Search Frameworks Budget-Constrained Minimum Cost Flows: The Continuous Case Budget-Constrained Minimum Cost Flows: The Discrete Case Generalized Processing Networks Convex Generalized Flows Target Groups Researchers and students in the fields of mathematics, computer science, and economics Practitioners in operations research and logistics The Author Dr. Michael Holzhauser studied computer science at the University of Kaiserslautern and is now a research fellow in the Optimization Research Group at the Department of Mathematics of the University of Kaiserslautern.

  13. Continuous Road Network Generalization throughout All Scales

    Directory of Open Access Journals (Sweden)

    Radan Šuba

    2016-08-01

    Full Text Available Until now, road network generalization has mainly been applied to the task of generalizing from one fixed source scale to another fixed target scale. These actions result in large differences in content and representation, e.g., a sudden change of the representation of road segments from areas to lines, which may confuse users. Therefore, we aim at the continuous generalization of a road network for the whole range, from the large scale, where roads are represented as areas, to mid- and small scales, where roads are represented progressively more frequently as lines. As a consequence of this process, there is an intermediate scale range where at the same time some roads will be represented as areas, while others will be represented as lines. We propose a new data model together with a specific data structure where for all map objects, a range of valid map scales is stored. This model is based on the integrated and explicit representation of: (1 a planar area partition; and (2 a linear road network. This enables the generalization process to include the knowledge and understanding of a linear network. This paper further discusses the actual generalization options and algorithms for populating this data structure with high quality vario-scale cartographic content.

  14. Generalized instantly decodable network coding for relay-assisted networks

    KAUST Repository

    Elmahdy, Adel M.

    2013-09-01

    In this paper, we investigate the problem of minimizing the frame completion delay for Instantly Decodable Network Coding (IDNC) in relay-assisted wireless multicast networks. We first propose a packet recovery algorithm in the single relay topology which employs generalized IDNC instead of strict IDNC previously proposed in the literature for the same relay-assisted topology. This use of generalized IDNC is supported by showing that it is a super-set of the strict IDNC scheme, and thus can generate coding combinations that are at least as efficient as strict IDNC in reducing the average completion delay. We then extend our study to the multiple relay topology and propose a joint generalized IDNC and relay selection algorithm. This proposed algorithm benefits from the reception diversity of the multiple relays to further reduce the average completion delay in the network. Simulation results show that our proposed solutions achieve much better performance compared to previous solutions in the literature. © 2013 IEEE.

  15. Primary generalized glucocorticoid resistance and hypersensitivity.

    Science.gov (United States)

    Charmandari, Evangelia

    2011-01-01

    The human glucocorticoid receptor (hGR) is a ubiquitously expressed intracellular, ligand-dependent transcription factor, which mediates the action of glucocorticoids and influences physiological functions essential for life. Alterations in the molecular mechanisms of hGR action impair glucocorticoid signal transduction and alter tissue sensitivity to glucocorticoids. This review summarizes the pathophysiology, molecular mechanisms and clinical aspects of primary generalized glucocorticoid resistance (PGGR) and hypersensitivity (PGGH). A systematic review of the published, peer-reviewed medical literature (PubMed: 1975 through May 2011) was conducted to identify original articles and reviews on this topic. Evidence synthesis was relied upon the experience of a number of experts in the field, including our extensive personal experience. The molecular basis of PGGR and PGGH has been ascribed to mutations in the hGR gene, which alter tissue sensitivity to glucocorticoids. The stochastic nature of glucocorticoid signaling pathways in association with the variable effect that hGR gene mutations/polymorphisms might have on glucocorticoid signal transduction indicates that alterations in hGR action may have important implications for many critical biological processes, such as the behavioral and physiological responses to stress, the immune and inflammatory reaction, as well as growth and reproduction. Copyright © 2011 S. Karger AG, Basel.

  16. A generalized and parameterized interference model for cognitive radio networks

    KAUST Repository

    Mahmood, Nurul Huda

    2011-06-01

    For meaningful co-existence of cognitive radios with primary system, it is imperative that the cognitive radio system is aware of how much interference it generates at the primary receivers. This can be done through statistical modeling of the interference as perceived at the primary receivers. In this work, we propose a generalized model for the interference generated by a cognitive radio network, in the presence of small and large scale fading, at a primary receiver located at the origin. We then demonstrate how this model can be used to estimate the impact of cognitive radio transmission on the primary receiver in terms of different outage probabilities. Finally, our analytical findings are validated through some selected computer-based simulations. © 2011 IEEE.

  17. Empirical generalization assessment of neural network models

    DEFF Research Database (Denmark)

    Larsen, Jan; Hansen, Lars Kai

    1995-01-01

    competing models. Since all models are trained on the same data, a key issue is to take this dependency into account. The optimal split of the data set of size N into a cross-validation set of size Nγ and a training set of size N(1-γ) is discussed. Asymptotically (large data sees), γopt→1......This paper addresses the assessment of generalization performance of neural network models by use of empirical techniques. We suggest to use the cross-validation scheme combined with a resampling technique to obtain an estimate of the generalization performance distribution of a specific model....... This enables the formulation of a bulk of new generalization performance measures. Numerical results demonstrate the viability of the approach compared to the standard technique of using algebraic estimates like the FPE. Moreover, we consider the problem of comparing the generalization performance of different...

  18. The Generalized Fixed-Charge Network Design Problem

    DEFF Research Database (Denmark)

    Thomadsen, Tommy; Stidsen, Thomas K.

    2007-01-01

    In this paper we present the generalized fixed-charge network design (GFCND) problem. The GFCND problem is an instance of the so-called generalized network design problems. In such problems, clusters instead of nodes have to be interconnected by a network. The network interconnecting the clusters...... is a fixed-charge network, and thus the GFCND problem generalizes the fixed-charge network design problem. The GFCND problem is related to the more general problem of designing hierarchical telecommunication networks. A mixed integer programming model is described and a branch-cut-and-price algorithm...

  19. Generalized networking engineering: optimal pricing and routing in multiservice networks

    Science.gov (United States)

    Mitra, Debasis; Wang, Qiong

    2002-07-01

    One of the functions of network engineering is to allocate resources optimally to forecasted demand. We generalize the mechanism by incorporating price-demand relationships into the problem formulation, and optimizing pricing and routing jointly to maximize total revenue. We consider a network, with fixed topology and link bandwidths, that offers multiple services, such as voice and data, each having characteristic price elasticity of demand, and quality of service and policy requirements on routing. Prices, which depend on service type and origin-destination, determine demands, that are routed, subject to their constraints, so as to maximize revenue. We study the basic properties of the optimal solution and prove that link shadow costs provide the basis for both optimal prices and optimal routing policies. We investigate the impact of input parameters, such as link capacities and price elasticities, on prices, demand growth, and routing policies. Asymptotic analyses, in which network bandwidth is scaled to grow, give results that are noteworthy for their qualitative insights. Several numerical examples illustrate the analyses.

  20. Impulsive generalized function synchronization of complex dynamical networks

    International Nuclear Information System (INIS)

    Zhang, Qunjiao; Chen, Juan; Wan, Li

    2013-01-01

    This Letter investigates generalized function synchronization of continuous and discrete complex networks by impulsive control. By constructing the reasonable corresponding impulsively controlled response networks, some criteria and corollaries are derived for the generalized function synchronization between the impulsively controlled complex networks, continuous and discrete networks are both included. Furthermore, the generalized linear synchronization and nonlinear synchronization are respectively illustrated by several examples. All the numerical simulations demonstrate the correctness of the theoretical results

  1. Equivalence of Conventional and Modified Network of Generalized Neural Elements

    Directory of Open Access Journals (Sweden)

    E. V. Konovalov

    2016-01-01

    Full Text Available The article is devoted to the analysis of neural networks consisting of generalized neural elements. The first part of the article proposes a new neural network model — a modified network of generalized neural elements (MGNE-network. This network developes the model of generalized neural element, whose formal description contains some flaws. In the model of the MGNE-network these drawbacks are overcome. A neural network is introduced all at once, without preliminary description of the model of a single neural element and method of such elements interaction. The description of neural network mathematical model is simplified and makes it relatively easy to construct on its basis a simulation model to conduct numerical experiments. The model of the MGNE-network is universal, uniting properties of networks consisting of neurons-oscillators and neurons-detectors. In the second part of the article we prove the equivalence of the dynamics of the two considered neural networks: the network, consisting of classical generalized neural elements, and MGNE-network. We introduce the definition of equivalence in the functioning of the generalized neural element and the MGNE-network consisting of a single element. Then we introduce the definition of the equivalence of the dynamics of the two neural networks in general. It is determined the correlation of different parameters of the two considered neural network models. We discuss the issue of matching the initial conditions of the two considered neural network models. We prove the theorem about the equivalence of the dynamics of the two considered neural networks. This theorem allows us to apply all previously obtained results for the networks, consisting of classical generalized neural elements, to the MGNE-network.

  2. General acteoside of rehmanniae leaves in the treatment of primary ...

    African Journals Online (AJOL)

    A total of 400 patients diagnosed with primary chronic glomerulonephritis were recruited from outpatient clinics and were randomly assigned to the treatment group (general acteoside of Rehmanniae leaves, two 200mg tablets, bid) or the control group (piperazine ferulate, four 50-mg tablets, bid ). The primary outcome

  3. Networks In ACA Marketplaces Are Narrower For Mental Health Care Than For Primary Care.

    Science.gov (United States)

    Zhu, Jane M; Zhang, Yuehan; Polsky, Daniel

    2017-09-01

    There is increasing concern about the extent to which narrow-network plans, generally defined as those including fewer than 25 percent of providers in a given health insurance market, affect consumers' choice of and access to specialty providers-particularly in mental health care. Using data for 2016 from 531 unique provider networks in the Affordable Care Act Marketplaces, we evaluated how network size and the percentage of providers who participate in any network differ between mental health care providers and a control group of primary care providers. Compared to primary care networks, participation in mental health networks was low, with only 42.7 percent of psychiatrists and 19.3 percent of nonphysician mental health care providers participating in any network. On average, plan networks included 24.3 percent of all primary care providers and 11.3 percent of all mental health care providers practicing in a given state-level market. These findings raise important questions about provider-side barriers to meeting the goal of mental health parity regulations: that insurers cover mental health services on a par with general medical and surgical services. Concerted efforts to increase network participation by mental health care providers, along with greater regulatory attention to network size and composition, could improve consumer choice and complement efforts to achieve mental health parity. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Primary health eye care knowledge among general practitioners ...

    African Journals Online (AJOL)

    Primary health eye care knowledge among general practitioners working in the Cape Town metropole. M Van Zyl, N Fernandes, G Rogers, N Du Toit. Abstract. Aim: The main purpose of this study was to determine whether general practitioners (GPs) in the Cape Town metropole have sufficient knowledge to diagnose and ...

  5. Generalized Network Psychometrics : Combining Network and Latent Variable Models

    NARCIS (Netherlands)

    Epskamp, S.; Rhemtulla, M.; Borsboom, D.

    2017-01-01

    We introduce the network model as a formal psychometric model, conceptualizing the covariance between psychometric indicators as resulting from pairwise interactions between observable variables in a network structure. This contrasts with standard psychometric models, in which the covariance between

  6. Primary prevention in psychiatry in general hospitals in South Asia

    Science.gov (United States)

    Sood, Mamta; Chadda, Rakesh Kumar; Kallivayalil, Roy Abraham

    2017-01-01

    The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions. All the functional components of the general hospital psychiatric units (GHPUs) offer scope for introducing primary preventive psychiatry services. Psychiatrists in GHPUs can lead efforts for primary prevention in mental health in the hospital by employing strategies in the framework of universal, selective, and indicated prevention. The preventive strategies could be targeted at the patients visiting the hospital for various health services and their caregivers, employees, and the trainees. Similar principles can be employed in teaching and training. PMID:29497199

  7. Primary Cilia, Signaling Networks and Cell Migration

    DEFF Research Database (Denmark)

    Veland, Iben Rønn

    Primary cilia are microtubule-based, sensory organelles that emerge from the centrosomal mother centriole to project from the surface of most quiescent cells in the human body. Ciliary entry is a tightly controlled process, involving diffusion barriers and gating complexes that maintain a unique...... and cytoskeletal organization. Further, cell migration and polarization in are impaired in Invs MEFs. In two-dimensional cell migration, the centrosome is positioned between the nucleus and the leading edge with the primary cilium directed towards the direction of migration. PDGFRα is activated in the primary......, which leads to uncontrolled cell movements. Together, the results obtained from my PhD studies reflect the high level of complexity within signaling systems regulated by the primary cilium that control cellular processes during embryonic development and in tissue homeostasis. As such, this dissertation...

  8. Collaborative Network Management for Enhancing Quality Education of Primary Schools

    Science.gov (United States)

    Chaikoed, Wisithsak; Sirisuthi, Chaiyuth; Numnaphol, Kochaporn

    2017-01-01

    This research aims to study the network and collaborative factors that enhance quality education of primary schools. Different methods were used in this research work: (1) Related approaches, theories, and research literatures and (2) Scholars were interviewed on 871 issues in the form of questionnaire, and the collaborative network factors were…

  9. GENERAL: Epidemic spreading on networks with vaccination

    Science.gov (United States)

    Shi, Hong-Jing; Duan, Zhi-Sheng; Chen, Guan-Rong; Li, Rong

    2009-08-01

    In this paper, a new susceptible-infected-susceptible (SIS) model on complex networks with imperfect vaccination is proposed. Two types of epidemic spreading patterns (the recovered individuals have or have not immunity) on scale-free networks are discussed. Both theoretical and numerical analyses are presented. The epidemic thresholds related to the vaccination rate, the vaccination-invalid rate and the vaccination success rate on scale-free networks are demonstrated, showing different results from the reported observations. This reveals that whether or not the epidemic can spread over a network under vaccination control is determined not only by the network structure but also by the medicine's effective duration. Moreover, for a given infective rate, the proportion of individuals to vaccinate can be calculated theoretically for the case that the recovered nodes have immunity. Finally, simulated results are presented to show how to control the disease prevalence.

  10. Structural Behavioral Study on the General Aviation Network Based on Complex Network

    Science.gov (United States)

    Zhang, Liang; Lu, Na

    2017-12-01

    The general aviation system is an open and dissipative system with complex structures and behavioral features. This paper has established the system model and network model for general aviation. We have analyzed integral attributes and individual attributes by applying the complex network theory and concluded that the general aviation network has influential enterprise factors and node relations. We have checked whether the network has small world effect, scale-free property and network centrality property which a complex network should have by applying degree distribution of functions and proved that the general aviation network system is a complex network. Therefore, we propose to achieve the evolution process of the general aviation industrial chain to collaborative innovation cluster of advanced-form industries by strengthening network multiplication effect, stimulating innovation performance and spanning the structural hole path.

  11. Networking among Libraries in the General Electric Company.

    Science.gov (United States)

    King, Maryde

    1988-01-01

    Describes the growth of library networking activities in the General Electric Company. Topics discussed include complications resulting from the decentralized nature of the company; information services offered through the network; memberships in local networks; and plans for the creation of an online union catalog. (CLB)

  12. Primary Cilia, Signaling Networks and Cell Migration

    DEFF Research Database (Denmark)

    Veland, Iben Rønn

    Primary cilia are microtubule-based, sensory organelles that emerge from the centrosomal mother centriole to project from the surface of most quiescent cells in the human body. Ciliary entry is a tightly controlled process, involving diffusion barriers and gating complexes that maintain a unique...

  13. Topology Identification of General Dynamical Network with Distributed Time Delays

    International Nuclear Information System (INIS)

    Zhao-Yan, Wu; Xin-Chu, Fu

    2009-01-01

    General dynamical networks with distributed time delays are studied. The topology of the networks are viewed as unknown parameters, which need to be identified. Some auxiliary systems (also called the network estimators) are designed to achieve this goal. Both linear feedback control and adaptive strategy are applied in designing these network estimators. Based on linear matrix inequalities and the Lyapunov function method, the sufficient condition for the achievement of topology identification is obtained. This method can also better monitor the switching topology of dynamical networks. Illustrative examples are provided to show the effectiveness of this method. (general)

  14. Large scale road network generalization for vario-scale map

    NARCIS (Netherlands)

    Suba, R.; Meijers, B.M.; Van Oosterom, P.J.M.

    2015-01-01

    The classical approach for road network generalization consists of producing multiple maps, for a different scale or purpose, from a single detailed data source and quite often roads are represented by line objects. Our target is the generalization of a road network for the whole scale range from

  15. One pass learning for generalized classifier neural network.

    Science.gov (United States)

    Ozyildirim, Buse Melis; Avci, Mutlu

    2016-01-01

    Generalized classifier neural network introduced as a kind of radial basis function neural network, uses gradient descent based optimized smoothing parameter value to provide efficient classification. However, optimization consumes quite a long time and may cause a drawback. In this work, one pass learning for generalized classifier neural network is proposed to overcome this disadvantage. Proposed method utilizes standard deviation of each class to calculate corresponding smoothing parameter. Since different datasets may have different standard deviations and data distributions, proposed method tries to handle these differences by defining two functions for smoothing parameter calculation. Thresholding is applied to determine which function will be used. One of these functions is defined for datasets having different range of values. It provides balanced smoothing parameters for these datasets through logarithmic function and changing the operation range to lower boundary. On the other hand, the other function calculates smoothing parameter value for classes having standard deviation smaller than the threshold value. Proposed method is tested on 14 datasets and performance of one pass learning generalized classifier neural network is compared with that of probabilistic neural network, radial basis function neural network, extreme learning machines, and standard and logarithmic learning generalized classifier neural network in MATLAB environment. One pass learning generalized classifier neural network provides more than a thousand times faster classification than standard and logarithmic generalized classifier neural network. Due to its classification accuracy and speed, one pass generalized classifier neural network can be considered as an efficient alternative to probabilistic neural network. Test results show that proposed method overcomes computational drawback of generalized classifier neural network and may increase the classification performance. Copyright

  16. Generalized routing protocols for multihop relay networks

    KAUST Repository

    Khan, Fahd Ahmed

    2011-07-01

    Performance of multihop cooperative networks depends on the routing protocols employed. In this paper we propose the last-n-hop selection protocol, the dual path protocol, the forward-backward last-n-hop selection protocol and the forward-backward dual path protocol for the routing of data through multihop relay networks. The average symbol error probability performance of the schemes is analysed by simulations. It is shown that close to optimal performance can be achieved by using the last-n-hop selection protocol and its forward-backward variant. Furthermore we also compute the complexity of the protocols in terms of number of channel state information required and the number of comparisons required for routing the signal through the network. © 2011 IEEE.

  17. Functional Network Connectivity Patterns between Idiopathic Generalized Epilepsy with Myoclonic and Absence Seizures

    Directory of Open Access Journals (Sweden)

    Qifu Li

    2017-05-01

    Full Text Available The extensive cerebral cortex and subcortical structures are considered as the major regions related to the generalized epileptiform discharges in idiopathic generalized epilepsy. However, various clinical syndromes and electroencephalogram (EEG signs exist across generalized seizures, such as the loss of consciousness during absence seizures (AS and the jerk of limbs during myoclonic seizures (MS. It is presumed that various functional systems affected by discharges lead to the difference in syndromes of these seizures. Twenty epileptic patients with MS, 21 patients with AS, and 21 healthy controls were recruited in this study. The functional network connectivity was analyzed based on the resting-state functional magnetic resonance imaging scans. The statistical analysis was performed in three groups to assess the difference in the functional brain networks in two types of generalized seizures. Twelve resting-state networks were identified in three groups. Both patient groups showed common abnormalities, including decreased functional connectivity in salience network (SN, cerebellum network, and primary perceptional networks and decreased connection between SN and visual network, compared with healthy controls. Interestingly, the frontal part of high-level cognitive resting-state networks showed increased functional connectivity (FC in patients with MS, but decreased FC in patients with AS. Moreover, patients with MS showed decreased negative connections between high-level cognitive networks and primary system. The common alteration in both patient groups, including SN, might reflect a similar mechanism associated with the loss of consciousness during generalized seizures. This study provided the evidence of brain network in generalized epilepsy to understand the difference between MS and AS.

  18. Current state of information technology use in a US primary care practice-based research network

    Directory of Open Access Journals (Sweden)

    James Andrews

    2004-02-01

    Conclusion While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.

  19. Nutritional status, brain network organization, and general intelligence.

    Science.gov (United States)

    Zamroziewicz, Marta K; Talukdar, M Tanveer; Zwilling, Chris E; Barbey, Aron K

    2017-11-01

    The high energy demands of the brain underscore the importance of nutrition in maintaining brain health and further indicate that aspects of nutrition may optimize brain health, in turn enhancing cognitive performance. General intelligence represents a critical cognitive ability that has been well characterized by cognitive neuroscientists and psychologists alike, but the extent to which a driver of brain health, namely nutritional status, impacts the neural mechanisms that underlie general intelligence is not understood. This study therefore examined the relationship between the intrinsic connectivity networks supporting general intelligence and nutritional status, focusing on nutrients known to impact the metabolic processes that drive brain function. We measured general intelligence, favorable connective architecture of seven intrinsic connectivity networks, and seventeen plasma phospholipid monounsaturated and saturated fatty acids in a sample of 99 healthy, older adults. A mediation analysis was implemented to investigate the relationship between empirically derived patterns of fatty acids, general intelligence, and underlying intrinsic connectivity networks. The mediation analysis revealed that small world propensity within one intrinsic connectivity network supporting general intelligence, the dorsal attention network, was promoted by a pattern of monounsaturated fatty acids. These results suggest that the efficiency of functional organization within a core network underlying general intelligence is influenced by nutritional status. This report provides a novel connection between nutritional status and functional network efficiency, and further supports the promise and utility of functional connectivity metrics in studying the impact of nutrition on cognitive and brain health. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Operational performance of the primary transport telecommunication network of Ukraine

    Directory of Open Access Journals (Sweden)

    Bondarenko O. V.

    2013-12-01

    Full Text Available The paper presents statistical data on the number, nature and causes of the damage to underground fiber-optic communication lines, on which the transport telecommunication primary network is based, using an example of Donetsk and Lugansk regions for the period between 2001 and 2010. Comparison of these characteristics with the values of similar parameters over 2001—2005 allows to develop recommendations for the improvement of the reliability of telecommunication networks.

  1. Magnetoencephalography Reveals a Widespread Increase in Network Connectivity in Idiopathic/Genetic Generalized Epilepsy.

    Directory of Open Access Journals (Sweden)

    Adham Elshahabi

    Full Text Available Idiopathic/genetic generalized epilepsy (IGE/GGE is characterized by seizures, which start and rapidly engage widely distributed networks, and result in symptoms such as absences, generalized myoclonic and primary generalized tonic-clonic seizures. Although routine magnetic resonance imaging is apparently normal, many studies have reported structural alterations in IGE/GGE patients using diffusion tensor imaging and voxel-based morphometry. Changes have also been reported in functional networks during generalized spike wave discharges. However, network function in the resting-state without epileptiforme discharges has been less well studied. We hypothesize that resting-state networks are more representative of the underlying pathophysiology and abnormal network synchrony. We studied functional network connectivity derived from whole-brain magnetoencephalography recordings in thirteen IGE/GGE and nineteen healthy controls. Using graph theoretical network analysis, we found a widespread increase in connectivity in patients compared to controls. These changes were most pronounced in the motor network, the mesio-frontal and temporal cortex. We did not, however, find any significant difference between the normalized clustering coefficients, indicating preserved gross network architecture. Our findings suggest that increased resting state connectivity could be an important factor for seizure spread and/or generation in IGE/GGE, and could serve as a biomarker for the disease.

  2. [Primary Health Care in Austria - Tu Felix Austria nube - Concept for networking in the primary care of Upper Austria].

    Science.gov (United States)

    Kriegel, Johannes; Rebhandl, Erwin; Hockl, Wolfgang; Stöbich, Anna-Maria

    2017-10-01

    The primary health care in rural areas in Austria is currently determined by challenges such as ageing of the population, the shift towards chronic and age-related illnesses, the specialist medical and hospital-related education and training of physicians' as well growing widespread difficulty of staffing doctor's office. The objective is to realize a general practitioner centered and team-oriented primary health care (PHC) approach by establishing networked primary health care in rural areas of Austria. Using literature research, online survey, expert interviews and expert workshops, we identified different challenges in terms of primary health care in rural areas. Further, current resources and capacities of primary health care in rural areas were identified using the example of the district of Rohrbach. Twelve design dimensions and 51 relevant measurement indicators of a PHC network were delineated and described. Based on this, 12 design approaches of PHC concept for the GP-centered and team-oriented primary health care in rural areas have been developed.

  3. Networks and social capital: a relational approach to primary healthcare reform

    Directory of Open Access Journals (Sweden)

    Scott Catherine

    2007-09-01

    Full Text Available Abstract Collaboration among health care providers and across systems is proposed as a strategy to improve health care delivery the world over. Over the past two decades, health care providers have been encouraged to work in partnership and build interdisciplinary teams. More recently, the notion of networks has entered this discourse but the lack of consensus and understanding about what is meant by adopting a network approach in health services limits its use. Also crucial to this discussion is the work of distinguishing the nature and extent of the impact of social relationships – generally referred to as social capital. In this paper, we review the rationale for collaboration in health care systems; provide an overview and synthesis of key concepts; dispel some common misconceptions of networks; and apply the theory to an example of primary healthcare network reform in Alberta (Canada. Our central thesis is that a relational approach to systems change, one based on a synthesis of network theory and social capital can provide the fodation for a multi-focal approach to primary healthcare reform. Action strategies are recommended to move from an awareness of 'networks' to fully translating knowledge from existing theory to guide planning and practice innovations. Decision-makers are encouraged to consider a multi-focal approach that effectively incorporates a network and social capital approach in planning and evaluating primary healthcare reform.

  4. Networks and social capital: a relational approach to primary healthcare reform.

    Science.gov (United States)

    Scott, Catherine; Hofmeyer, Anne

    2007-09-25

    Collaboration among health care providers and across systems is proposed as a strategy to improve health care delivery the world over. Over the past two decades, health care providers have been encouraged to work in partnership and build interdisciplinary teams. More recently, the notion of networks has entered this discourse but the lack of consensus and understanding about what is meant by adopting a network approach in health services limits its use. Also crucial to this discussion is the work of distinguishing the nature and extent of the impact of social relationships - generally referred to as social capital. In this paper, we review the rationale for collaboration in health care systems; provide an overview and synthesis of key concepts; dispel some common misconceptions of networks; and apply the theory to an example of primary healthcare network reform in Alberta (Canada). Our central thesis is that a relational approach to systems change, one based on a synthesis of network theory and social capital can provide the fodation for a multi-focal approach to primary healthcare reform. Action strategies are recommended to move from an awareness of 'networks' to fully translating knowledge from existing theory to guide planning and practice innovations. Decision-makers are encouraged to consider a multi-focal approach that effectively incorporates a network and social capital approach in planning and evaluating primary healthcare reform.

  5. How primary care networks can help integrate academic and service initiatives in primary care.

    Science.gov (United States)

    Thomas, Paul; Graffy, Jonathan; Wallace, Paul; Kirby, Mike

    2006-01-01

    Theory of effective network operation in primary care is underdeveloped. This study aimed to identify how primary care networks can best integrate academic and service initiatives. We performed a comparative case study of 4 primary care research networks in North London, England, for the years 1998-2002. Indicators were selected to assess changes in (1) research capacity, (2) multidisciplinary collaboration, and (3) research productivity. We compared the profiles of network outcome with descriptions of their contexts and organizational types from a previous evaluation. Together, the networks supported 133 viable projects and 30 others; 399 practitioners, managers, and academics participated in the research teams. How the networks organized themselves was influenced by the circumstances in which they were formed. Different ways of organizing were associated with different outcome profiles. Shared projects and learning spaces helped participants to develop trusted relationships. A top-down, hierarchical approach based on institutional alliances and academic expertise attracted more funding and appeared to be stable. The bottom-up, individualistic network with research practices was good at reflecting on practical primary care concerns. Whole-system methods brought together stakeholder contributions from all parts of the system. Networks can help integrate academic research and service development initiatives by facilitating interorganizational interactions and in shared leadership of projects. Researchers and practitioners stand to gain considerably from an integrated approach in both the short and the long term. Success requires agreement about a set of pathways, learning spaces, and feedback mechanisms to harness the insights and efforts of stakeholders throughout the whole system.

  6. Adolescent Social Networks: General and Smoking-Specific Characteristics Associated With Smoking

    Science.gov (United States)

    Roberts, Megan E.; Nargiso, Jessica E.; Gaitonde, Linda Brazil; Stanton, Cassandra A.; Colby, Suzanne M.

    2015-01-01

    Objective: Converging lines of research suggest that adolescents’ smoking behaviors are strongly influenced by the characteristics of their social network and the social processes their network facilitates. The primary goal of this study was to conduct a detailed comparison of the social networks of adolescent smokers and nonsmokers to determine what aspects relate the most to smoking status. A secondary goal was to conduct within-group analyses to examine relationships between key measures of behavior-specific social support and (a) smoking susceptibility among nonsmokers, and (b) readiness to quit smoking among smokers. Method: A matched sample of 190 adolescent smokers and nonsmokers (Mage = 16.8 years; 51% female) completed a questionnaire in which they nominated and reported on up to 10 important people in their lives. This measure allowed us to examine adolescents’ overall networks (both peers and family) and to investigate numerous aspects, including general network characteristics (e.g., size of network, average contact with network members), social support (e.g., importance of people in the network), and the pervasiveness of smoking in the network (e.g., percentage of smoking peers). Results: The pervasiveness of smoking in adolescents’ social network was the strongest distinguisher of smokers versus nonsmokers. In addition, behavior-specific social support was strongly associated with susceptibility to initiate smoking among nonsmokers and readiness to quit among smokers. Conclusions: This research offers insight into potential targets for prevention and early intervention by demonstrating how social networks can both promote and attenuate risk for smoking. PMID:25785800

  7. Net one, net two: the primary care network income statement.

    Science.gov (United States)

    Halley, M D; Little, A W

    1999-10-01

    Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses.

  8. Moving image compression and generalization capability of constructive neural networks

    Science.gov (United States)

    Ma, Liying; Khorasani, Khashayar

    2001-03-01

    To date numerous techniques have been proposed to compress digital images to ease their storage and transmission over communication channels. Recently, a number of image compression algorithms using Neural Networks NNs have been developed. Particularly, several constructive feed-forward neural networks FNNs have been proposed by researchers for image compression, and promising results have been reported. At the previous SPIE AeroSense conference 2000, we proposed to use a constructive One-Hidden-Layer Feedforward Neural Network OHL-FNN for compressing digital images. In this paper, we first investigate the generalization capability of the proposed OHL-FNN in the presence of additive noise for network training and/ or generalization. Extensive experimental results for different scenarios are presented. It is revealed that the constructive OHL-FNN is not as robust to additive noise in input image as expected. Next, the constructive OHL-FNN is applied to moving images, video sequences. The first, or other specified frame in a moving image sequence is used to train the network. The remaining moving images that follow are then generalized/compressed by this trained network. Three types of correlation-like criteria measuring the similarity of any two images are introduced. The relationship between the generalization capability of the constructed net and the similarity of images is investigated in some detail. It is shown that the constructive OHL-FNN is promising even for changing images such as those extracted from a football game.

  9. Team effectiveness in primary care networks in Alberta.

    Science.gov (United States)

    Drew, Peter; Jones, Brad; Norton, Douglas

    2010-01-01

    Primary care networks (PCNs) are interdisciplinary programs in a geographical area that are designed to improve patient care, team collaboration and appropriate resource allocation. They are one of government's approaches to delivering quality healthcare with finite resources. The primary objective of this study was to explore the level of perceived team effectiveness in PCNs within three former health regions in Alberta. A descriptive, cross-sectional, exploratory, semi-structured questionnaire study design was employed. Respondents identified five themes for strategies to improve team effectiveness. Although many factors and strategies were identified, more work is needed to explore the study's findings.

  10. Factors with regard to computerisation of the Dutch and the Belgian national general practitioner sentinel networks: a comparative analysis.

    NARCIS (Netherlands)

    Schweikardt, C.; Casteren, V. van; Verheij, R.A.; Coppieters, Y.

    2013-01-01

    Background: A general practitioner (GP) sentinel network observes a sample of the population by supplying reports on the incidence and epidemiological characteristics of specific diseases and on procedures in primary health care. In the 1970s, the Dutch and the Belgian national GP sentinel networks

  11. Performance of an opportunistic multi-user cognitive network with multiple primary users

    KAUST Repository

    Khan, Fahd Ahmed

    2014-04-01

    Consider a multi-user underlay cognitive network where multiple cognitive users, having limited peak transmit power, concurrently share the spectrum with a primary network with multiple users. The channel between the secondary network is assumed to have independent but not identical Nakagami-m fading. The interference channel between the secondary users and the primary users is assumed to have Rayleigh fading. The uplink scenario is considered where a single secondary user is selected for transmission. This opportunistic selection depends on the transmission channel power gain and the interference channel power gain as well as the power allocation policy adopted at the users. Exact closed form expressions for the momentgenerating function, outage performance and the symbol-error-rate performance are derived. The outage performance is also studied in the asymptotic regimes and the generalized diversity gain of this scheduling scheme is derived. Numerical results corroborate the derived analytical results.

  12. Optimizing Neural Network Architectures Using Generalization Error Estimators

    DEFF Research Database (Denmark)

    Larsen, Jan

    1994-01-01

    This paper addresses the optimization of neural network architectures. It is suggested to optimize the architecture by selecting the model with minimal estimated averaged generalization error. We consider a least-squares (LS) criterion for estimating neural network models, i.e., the associated...... neural network applications, it is impossible to suggest a perfect model, and consequently the ability to handle incomplete models is urgent. A concise derivation of the GEN-estimator is provided, and its qualities are demonstrated by comparative numerical studies...

  13. Detection of generalized synchronization using echo state networks

    Science.gov (United States)

    Ibáñez-Soria, D.; Garcia-Ojalvo, J.; Soria-Frisch, A.; Ruffini, G.

    2018-03-01

    Generalized synchronization between coupled dynamical systems is a phenomenon of relevance in applications that range from secure communications to physiological modelling. Here, we test the capabilities of reservoir computing and, in particular, echo state networks for the detection of generalized synchronization. A nonlinear dynamical system consisting of two coupled Rössler chaotic attractors is used to generate temporal series consisting of time-locked generalized synchronized sequences interleaved with unsynchronized ones. Correctly tuned, echo state networks are able to efficiently discriminate between unsynchronized and synchronized sequences even in the presence of relatively high levels of noise. Compared to other state-of-the-art techniques of synchronization detection, the online capabilities of the proposed Echo State Network based methodology make it a promising choice for real-time applications aiming to monitor dynamical synchronization changes in continuous signals.

  14. Seismic noise filtering based on Generalized Regression Neural Networks

    Science.gov (United States)

    Djarfour, Nouredine; Ferahtia, Jalal; Babaia, Foudel; Baddari, Kamel; Said, El-adj; Farfour, Mohammed

    2014-08-01

    This paper deals with the application of Generalized Regression Neural Networks to the seismic data filtering. The proposed system is a class of neural networks widely used for the continuous function mapping. They are based on the well known nonparametric kernel statistical estimators. The main advantages of this neural network include adaptability, simplicity and rapid training. Several synthetic tests are performed in order to highlight the merit of the proposed topology of neural network. In this work, the filtering strategy has been applied to remove random noises as well as source-related noises from real seismic data extracted from a field in the South of Algeria. The obtained results are very promising and indicate the high performance of the proposed filter in comparison to the well known frequency-wavenumber filter.

  15. Optimal Design of Gravitational Sewer Networks with General Cellular Automata

    Directory of Open Access Journals (Sweden)

    Mohammad Hadi Afshar

    2014-05-01

    Full Text Available In this paper, a Cellular Automata method is applied for the optimal design of sewer networks. The solution of sewer network optimization problems requires the determination of pipe diameters and average pipe cover depths, minimizing the total cost of the sewer network subject to operational constraints. In this paper, the network nodes and upstream and downstream pipe cover depths are considered as CA cells and cell states, respectively, and the links around each cell are taken into account as neighborhood. The proposed method is a general and flexible method for the optimization of sewer networks as it can be used to optimally design both gravity and pumped network due to the use of pipe nodal cover depths as the decision variables. The proposed method is tested against two  gravitational sewer networks and the  comparison of results with other methods such as  Genetic algorithm, Cellular Automata, Ant Colony Optimization Algorithm and Particle Swarm Optimization show the efficiency and effectiveness of the proposed method.

  16. SNAP: A General Purpose Network Analysis and Graph Mining Library

    Science.gov (United States)

    Leskovec, Jure; Sosič, Rok

    2016-01-01

    Large networks are becoming a widely used abstraction for studying complex systems in a broad set of disciplines, ranging from social network analysis to molecular biology and neuroscience. Despite an increasing need to analyze and manipulate large networks, only a limited number of tools are available for this task. Here, we describe Stanford Network Analysis Platform (SNAP), a general-purpose, high-performance system that provides easy to use, high-level operations for analysis and manipulation of large networks. We present SNAP functionality, describe its implementational details, and give performance benchmarks. SNAP has been developed for single big-memory machines and it balances the trade-off between maximum performance, compact in-memory graph representation, and the ability to handle dynamic graphs where nodes and edges are being added or removed over time. SNAP can process massive networks with hundreds of millions of nodes and billions of edges. SNAP offers over 140 different graph algorithms that can efficiently manipulate large graphs, calculate structural properties, generate regular and random graphs, and handle attributes and meta-data on nodes and edges. Besides being able to handle large graphs, an additional strength of SNAP is that networks and their attributes are fully dynamic, they can be modified during the computation at low cost. SNAP is provided as an open source library in C++ as well as a module in Python. We also describe the Stanford Large Network Dataset, a set of social and information real-world networks and datasets, which we make publicly available. The collection is a complementary resource to our SNAP software and is widely used for development and benchmarking of graph analytics algorithms. PMID:28344853

  17. SNAP: A General Purpose Network Analysis and Graph Mining Library.

    Science.gov (United States)

    Leskovec, Jure; Sosič, Rok

    2016-10-01

    Large networks are becoming a widely used abstraction for studying complex systems in a broad set of disciplines, ranging from social network analysis to molecular biology and neuroscience. Despite an increasing need to analyze and manipulate large networks, only a limited number of tools are available for this task. Here, we describe Stanford Network Analysis Platform (SNAP), a general-purpose, high-performance system that provides easy to use, high-level operations for analysis and manipulation of large networks. We present SNAP functionality, describe its implementational details, and give performance benchmarks. SNAP has been developed for single big-memory machines and it balances the trade-off between maximum performance, compact in-memory graph representation, and the ability to handle dynamic graphs where nodes and edges are being added or removed over time. SNAP can process massive networks with hundreds of millions of nodes and billions of edges. SNAP offers over 140 different graph algorithms that can efficiently manipulate large graphs, calculate structural properties, generate regular and random graphs, and handle attributes and meta-data on nodes and edges. Besides being able to handle large graphs, an additional strength of SNAP is that networks and their attributes are fully dynamic, they can be modified during the computation at low cost. SNAP is provided as an open source library in C++ as well as a module in Python. We also describe the Stanford Large Network Dataset, a set of social and information real-world networks and datasets, which we make publicly available. The collection is a complementary resource to our SNAP software and is widely used for development and benchmarking of graph analytics algorithms.

  18. Hybrid-source impedance network and its generalized cascading concepts

    DEFF Research Database (Denmark)

    Li, Ding; Gao, Feng; Loh, Poh Chiang

    2009-01-01

    for current-type inverters. These impedance networks can in principle be combined into a single generic network entity, before generalized cascading concepts are proposed for connecting multiple of them together to form energy converters with a higher output voltage gain and other unique advantages....... It is anticipated that these concepts and their formed inverters can find applications in photovoltaic and other renewable systems, which in turn motivate the investigation initiated here on two-level and three-level generalized cascading concepts. In addition to their theoretical performance merits, practical...... shortcomings and relevant transient phenomena exhibited by the generalized concepts are discussed to provide a comprehensive knowledge base needed for weighing relevant tradeoffs before deciding on a particular application....

  19. Generalized Hybrid Constructive Learning Algorithm for Multioutput RBF Networks.

    Science.gov (United States)

    Qian, Xusheng; Huang, He; Chen, Xiaoping; Huang, Tingwen

    2017-11-01

    An efficient generalized hybrid constructive (GHC) learning algorithm for multioutput radial basis function (RBF) networks is proposed to obtain a compact network with good generalization capability. By this algorithm, one can train the adjustable parameters and determine the optimal network structure simultaneously. First, an initialization method based on the growing and pruning algorithm is utilized to select the important initial hidden neurons and candidate ones. Then, by introducing a generalized hidden matrix, a structured parameter optimization algorithm is presented to train multioutput RBF network with fixed size, which combines Levenberg-Marquardt (LM) algorithm with least-square method together. Beginning from an appropriate number of hidden neurons, new neurons chosen from the candidates are added one by one each time when the training entraps into local minima. By incorporating an improved incremental constructive scheme, the training is built on previous results after adding new neurons such that the GHC learning algorithm avoids a trial-and-error procedure. Furthermore, based on the improved computation for LM training, the memory limitation problem is solved. The computational complexity analysis and experimental results demonstrate that better performance is efficiently achieved by this algorithm.

  20. Exact Solutions of a Generalized Weighted Scale Free Network

    Directory of Open Access Journals (Sweden)

    Li Tan

    2013-01-01

    Full Text Available We investigate a class of generalized weighted scale-free networks, where the new vertex connects to m pairs of vertices selected preferentially. The key contribution of this paper is that, from the standpoint of random processes, we provide rigorous analytic solutions for the steady state distributions, including the vertex degree distribution, the vertex strength distribution and the edge weight distribution. Numerical simulations indicate that this network model yields three power law distributions for the vertex degrees, vertex strengths and edge weights, respectively.

  1. Generalized memory associativity in a network model for the neuroses

    Science.gov (United States)

    Wedemann, Roseli S.; Donangelo, Raul; de Carvalho, Luís A. V.

    2009-03-01

    We review concepts introduced in earlier work, where a neural network mechanism describes some mental processes in neurotic pathology and psychoanalytic working-through, as associative memory functioning, according to the findings of Freud. We developed a complex network model, where modules corresponding to sensorial and symbolic memories interact, representing unconscious and conscious mental processes. The model illustrates Freud's idea that consciousness is related to symbolic and linguistic memory activity in the brain. We have introduced a generalization of the Boltzmann machine to model memory associativity. Model behavior is illustrated with simulations and some of its properties are analyzed with methods from statistical mechanics.

  2. Primary health eye care knowledge among general practitioners ...

    African Journals Online (AJOL)

    2010-05-10

    May 10, 2010 ... Responding GPs felt that there is a need for ophthalmology up-skilling courses and 99.9% of them would attend such courses. Also, 82% of GPs felt that primary care doctors, not optometrists, should deliver primary eye care. Conclusion: GPs appear to lack sufficient knowledge to manage primary health ...

  3. Performance analysis of an opportunistic multi-user cognitive network with multiple primary users

    KAUST Repository

    Khan, Fahd Ahmed

    2014-03-01

    Consider a multi-user underlay cognitive network where multiple cognitive users concurrently share the spectrum with a primary network with multiple users. The channel between the secondary network is assumed to have independent but not identical Nakagami-m fading. The interference channel between the secondary users (SUs) and the primary users is assumed to have Rayleigh fading. A power allocation based on the instantaneous channel state information is derived when a peak interference power constraint is imposed on the secondary network in addition to the limited peak transmit power of each SU. The uplink scenario is considered where a single SU is selected for transmission. This opportunistic selection depends on the transmission channel power gain and the interference channel power gain as well as the power allocation policy adopted at the users. Exact closed form expressions for the moment-generating function, outage performance, symbol error rate performance, and the ergodic capacity are derived. Numerical results corroborate the derived analytical results. The performance is also studied in the asymptotic regimes, and the generalized diversity gain of this scheduling scheme is derived. It is shown that when the interference channel is deeply faded and the peak transmit power constraint is relaxed, the scheduling scheme achieves full diversity and that increasing the number of primary users does not impact the diversity order. © 2014 John Wiley & Sons, Ltd.

  4. Measuring social networks in British primary schools through scientific engagement

    Science.gov (United States)

    Conlan, A. J. K.; Eames, K. T. D.; Gage, J. A.; von Kirchbach, J. C.; Ross, J. V.; Saenz, R. A.; Gog, J. R.

    2011-01-01

    Primary schools constitute a key risk group for the transmission of infectious diseases, concentrating great numbers of immunologically naive individuals at high densities. Despite this, very little is known about the social patterns of mixing within a school, which are likely to contribute to disease transmission. In this study, we present a novel approach where scientific engagement was used as a tool to access school populations and measure social networks between young (4–11 years) children. By embedding our research project within enrichment activities to older secondary school (13–15) children, we could exploit the existing links between schools to achieve a high response rate for our study population (around 90% in most schools). Social contacts of primary school children were measured through self-reporting based on a questionnaire design, and analysed using the techniques of social network analysis. We find evidence of marked social structure and gender assortativity within and between classrooms in the same school. These patterns have been previously reported in smaller studies, but to our knowledge no study has attempted to exhaustively sample entire school populations. Our innovative approach facilitates access to a vitally important (but difficult to sample) epidemiological sub-group. It provides a model whereby scientific communication can be used to enhance, rather than merely complement, the outcomes of research. PMID:21047859

  5. Neural network for nonsmooth pseudoconvex optimization with general convex constraints.

    Science.gov (United States)

    Bian, Wei; Ma, Litao; Qin, Sitian; Xue, Xiaoping

    2018-05-01

    In this paper, a one-layer recurrent neural network is proposed for solving a class of nonsmooth, pseudoconvex optimization problems with general convex constraints. Based on the smoothing method, we construct a new regularization function, which does not depend on any information of the feasible region. Thanks to the special structure of the regularization function, we prove the global existence, uniqueness and "slow solution" character of the state of the proposed neural network. Moreover, the state solution of the proposed network is proved to be convergent to the feasible region in finite time and to the optimal solution set of the related optimization problem subsequently. In particular, the convergence of the state to an exact optimal solution is also considered in this paper. Numerical examples with simulation results are given to show the efficiency and good characteristics of the proposed network. In addition, some preliminary theoretical analysis and application of the proposed network for a wider class of dynamic portfolio optimization are included. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Current state of information technology use in a US primary care practice-based research network.

    Science.gov (United States)

    Andrews, James E; Pearce, Kevin A; Sydney, Carey; Ireson, Carol; Love, Margaret

    2004-01-01

    To examine the current levels of information technology (IT) use in a primary care practice-based research network (PBRN) in order to inform future development of its infrastructure. Every primary care practitioner who is a member of the Kentucky Ambulatory Network (KAN),as well as the office managers of each practice. Practitioners included family practitioners, general practitioners, nurse practitioners and physician assistants. A cross-sectional study using two survey instruments: one for office managers and one for practitioners. The office manager survey included questions related to the current state of IT within the practice, plans for enhancement and general IT issues from the perspective of managing a practice. The practitioner survey was designed to measure current IT use and attitudes of primary care practitioners. Response rates for the surveys were 46% (n = 68) for the office managers and 51% (n = 116) for practitioners. All but one practice had internet access; however, 43% had only dial-up service. Only 21% of practitioners use an electronic medical record (EMR), with dollar cost being the barrier reported most frequently (58%). More than half of the office managers were either 'somewhat interested' (45%) or 'very interested' (17%) in a low-cost, standardised EMR that was, at the time, to be sponsored by the American Academy of Family Physicians. For practitioners, 71% were either 'somewhat' or 'very' interested in such a system. Responses to other IT issues are reported. While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.

  7. Primary non-adherence to prescribed medication in general practice

    DEFF Research Database (Denmark)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

    2013-01-01

    prescriptions issued electronically by 140 physicians at 16 primary health care centres in the Reykjavik capital area during two periods before and after increases in copayment were matched with those dispensed in pharmacies, the difference constituting primary non-adherence (population: 200&emsp14...

  8. Generalized Fluid System Simulation Program (GFSSP) Version 6 - General Purpose Thermo-Fluid Network Analysis Software

    Science.gov (United States)

    Majumdar, Alok; Leclair, Andre; Moore, Ric; Schallhorn, Paul

    2011-01-01

    GFSSP stands for Generalized Fluid System Simulation Program. It is a general-purpose computer program to compute pressure, temperature and flow distribution in a flow network. GFSSP calculates pressure, temperature, and concentrations at nodes and calculates flow rates through branches. It was primarily developed to analyze Internal Flow Analysis of a Turbopump Transient Flow Analysis of a Propulsion System. GFSSP development started in 1994 with an objective to provide a generalized and easy to use flow analysis tool for thermo-fluid systems.

  9. Medicare Local-Local Health Network partnerships in South Australia: lessons for Primary Health Networks.

    Science.gov (United States)

    Javanparast, Sara; Baum, Fran; Barton, Elsa; Freeman, Toby; Lawless, Angela; Fuller, Jeffrey; Reed, Richard L; Kidd, Michael R

    2015-09-07

    To examine the partnerships in population health planning between Medicare Locals (MLs) and Local Health Networks (LHNs) in South Australia, and the factors that facilitated or constrained collaborations, to offer lessons for LHNs and Primary Health Networks. We conducted a qualitative study using individual interviews with key informants (executive or program leader staff) from the five South Australian MLs and the five South Australian LHNs. A total of 34 interviews were conducted between March and July 2014. Significant work was undertaken by MLs in the process of population health planning and needs assessment. Participants from both MLs and LHNs described examples of collaborative work, including data sharing and synthesis, program implementation and community consultation. The focus of LHNs on acute and intermediate care, the lack of system-level strategies to support collaboration, and constant policy and structural changes leading to uncertainty in the primary health care landscape were perceived as key barriers to collaboration. The experience of MLs and their achievements in building relationships and trust with stakeholders in their regions, including LHNs, provide valuable lessons for the new Primary Health Networks in Australia.

  10. The influential role of personal advice networks on general practitioners' performance: a social capital perspective.

    Science.gov (United States)

    Calciolari, Stefano; González-Ortiz, Laura G; Lega, Federico

    2017-08-08

    In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning the influence of the resources embedded in the GPs' personal advice networks (i.e., social capital) on GPs' capacity to meet defined objectives. The present study has two goals: (a) to assess the GPs' personal advice networks according to the social capital framework and (b) to test the influence of such relationships on GPs' capacity to accomplish organizational goals. The data collection relied on administrative data provided by an Italian local health authority (LHA) and a survey administered to the GPs of the selected LHA. The GPs' personal advice networks were assessed through an ad-hoc instrument and interpreted as egocentric networks. Multivariate regression analyses assessed two different performance measures. Social capital may influence the GPs' capacity to meet targets, though the influence differs according to the objective considered. In particular, the higher the professional heterogeneity of a GP personal advice network, the lower her/his capacity is to meet targets of prescriptive appropriateness. Our findings might help to design more effective primary care reforms depending on the pursued goals. However, further research is needed.

  11. General Information About Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

    Science.gov (United States)

    ... Inherited risk Hormone replacement therapy Weight and height Endometriosis The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer: Oral contraceptives Tubal ligation Giving birth Salpingectomy ...

  12. Primary Health Care: care coordinator in regionalized networks?

    Science.gov (United States)

    Almeida, Patty Fidelis de; Santos, Adriano Maia Dos

    2016-12-22

    To analyze the breadth of care coordination by Primary Health Care in three health regions. This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries. Analisar o alcance da coordenação do cuidado pela Atenção Primária à Saúde em três regiões de saúde. Trata-se de estudo de caso, com abordagem quantitativa e qualitativa. Foram realizadas 31 entrevistas semiestruturadas com gestores municipais, regionais e estaduais e estudo transversal com aplicação de questionários para médicos (74), enfermeiros (127) e amostra representativa de usuários (1.590) da Estratégia Saúde da Família em três municípios-sede de regiões de saúde do estado da Bahia. A função de porta de entrada preferencial pela Atenção Primária à Saúde deparava-se com forte concorrência de servi

  13. Vehicle Sideslip Angle Estimation Based on General Regression Neural Network

    Directory of Open Access Journals (Sweden)

    Wang Wei

    2016-01-01

    Full Text Available Aiming at the accuracy of estimation of vehicle’s mass center sideslip angle, an estimation method of slip angle based on general regression neural network (GRNN and driver-vehicle closed-loop system has been proposed: regarding vehicle’s sideslip angle as time series mapping of yaw speed and lateral acceleration; using homogeneous design project to optimize the training samples; building the mapping relationship among sideslip angle, yaw speed, and lateral acceleration; at the same time, using experimental method to measure vehicle’s sideslip angle to verify validity of this method. Estimation results of neural network and real vehicle experiment show the same changing tendency. The mean of error is within 10% of test result’s amplitude. Results show GRNN can estimate vehicle’s sideslip angle correctly. It can offer a reference to the application of vehicle’s stability control system on vehicle’s state estimation.

  14. Primary health care teams and the patient perspective: a social network analysis.

    Science.gov (United States)

    Cheong, Lynn H M; Armour, Carol L; Bosnic-Anticevich, Sinthia Z

    2013-01-01

    Multidisciplinary care (MDC) has been proposed as a potential strategy to address the rising challenges of modern health issues. However, it remains unclear as to how patients' health connections may impact on multidisciplinary processes and outcomes. This research aims to gain a deeper understanding of patients' potential role in MDC: i) describe patients' health networks, ii) compare different care groups, iii) gain an understanding of the nature and extent of their interactions, and iv) identify the role of pharmacists within patient networks. In-depth, semi-structured interviews were conducted with asthma patients from Sydney, Australia. Participants were recruited from a range of standard asthma health care access points (community group) and a specialized multidisciplinary asthma clinic (clinic group). Quantitative social network analysis provided structural insight into asthma networks while qualitative social network analysis assisted in interpretation of network data. A total of 47 interviews were conducted (26 community group participants and 21 clinic group participants). Although participants' asthma networks consisted of a range of health care professionals (HCPs), these did not reflect or encourage MDC. Not only did participants favor minimal interaction with any HCP, they preferred sole-charge care and were found to strongly rely on lay individuals such as family and friends. While general practitioners and respiratory specialists were participants' principal choice of HCP, community pharmacists were less regarded. Limited opportunities were presented for HCPs to collaborate, particularly pharmacists. As patients' choices of HCPs may strongly influence collaborative processes and outcomes, this research highlights the need to consider patient perspectives in the development of MDC models in primary care. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Primary immunodeficiency diseases: practice among primary care providers and awareness among the general public, United States, 2008.

    Science.gov (United States)

    Waltenburg, Rachel; Kobrynski, Lisa; Reyes, Michele; Bowen, Scott; Khoury, Muin J

    2010-12-01

    Primary immunodeficiency disorders (PIDDs) represent a class of genetic diseases of the immune system. Delayed primary immunodeficiency disorder diagnosis leads to increased morbidity and mortality. This study assessed current primary immunodeficiency disorder practice among physicians and awareness among the public. Primary immunodeficiency disorder practice and awareness data were collected using national surveys of physicians (DocStyles) and the public (HealthStyles). Physician respondents (n = 1250) were family practitioners (41%), internists (39%), and pediatricians (20%). Overall, 32% of physicians had diagnosed, treated, or referred a patient with primary immunodeficiency disorder in the last 5 years. Physician specialty was the only significant predictor of having a patient with primary immunodeficiency disorder in unconditional logistic modeling (pediatrician odds ratio = 4.4; internist odds ratio = 1.5; and family practitioner odds ratio = referent). When a possible primary immunodeficiency disorder case presented, 81% of physicians performed laboratory testing and 77% referred the patient to a specialist. Of the general population surveyed (n = 5399), 40% were aware of primary immunodeficiency disorder. Those respondents were more likely to be older, female, white, married (ever), more highly educated, with a higher income level. Most people learned about primary immunodeficiency disorder from media outlets (64% television/radio and 41% magazine/newspaper). Additional primary immunodeficiency disorder educational efforts, which target both physicians and the public, may be needed because increased primary immunodeficiency disorder awareness may lead to earlier diagnosis and less morbidity and mortality.

  16. The cyclical social choice of primary vs. general election candidates

    DEFF Research Database (Denmark)

    Kurrild-Klitgaard, Peter

    The manner in which US presidential elections are organized make them ripe for empirical manifestations of the “voting paradoxes” identified by social choice theorists. This note illustrates the general point with polling data involving the two leading Democrats and the three leading Republicans ...

  17. Some general rules governing huge power networks; Quelques regles generales gouvernant les grands reseaux electriques

    Energy Technology Data Exchange (ETDEWEB)

    Clade, J. [Electricite de France (EDF), 75 - Paris (France)

    2010-12-15

    The very large networks operate on vast territories, on the scale not only of countries, but of continents. Their aim is twofold: transmitting electrical energy from the power plants - nuclear or thermal power plants, hydraulic, wind power plants etc. - to consumption areas (that is the transmission function); pooling the power plants, so as to operate at any time those which are the less expensive (interconnection of energy production) and to guarantee a safe continuous supply to the users (interconnection of power). However, the transmission of electrical energy is more costly than transmission, when possible, of primary energy sources, either fossil fuels or nuclear. When the sources are not chiefly hydraulic, it is pertinent to limit the transmission of electricity by siting the power plants as close as possible to the consumption areas. On the contrary, interconnection may allow significant savings in the way of power plant investments and fuel expenses. Therein is the main economical justification for very large electrical systems and networks, except in cases where distant hydraulic sources are operated. We must then think over large electrical networks mainly as tools for cooperation between power producers, aiming at an electrical supply to customers which is safe, continuous and as inexpensive as possible. (author)

  18. Complex Environmental Data Modelling Using Adaptive General Regression Neural Networks

    Science.gov (United States)

    Kanevski, Mikhail

    2015-04-01

    The research deals with an adaptation and application of Adaptive General Regression Neural Networks (GRNN) to high dimensional environmental data. GRNN [1,2,3] are efficient modelling tools both for spatial and temporal data and are based on nonparametric kernel methods closely related to classical Nadaraya-Watson estimator. Adaptive GRNN, using anisotropic kernels, can be also applied for features selection tasks when working with high dimensional data [1,3]. In the present research Adaptive GRNN are used to study geospatial data predictability and relevant feature selection using both simulated and real data case studies. The original raw data were either three dimensional monthly precipitation data or monthly wind speeds embedded into 13 dimensional space constructed by geographical coordinates and geo-features calculated from digital elevation model. GRNN were applied in two different ways: 1) adaptive GRNN with the resulting list of features ordered according to their relevancy; and 2) adaptive GRNN applied to evaluate all possible models N [in case of wind fields N=(2^13 -1)=8191] and rank them according to the cross-validation error. In both cases training were carried out applying leave-one-out procedure. An important result of the study is that the set of the most relevant features depends on the month (strong seasonal effect) and year. The predictabilities of precipitation and wind field patterns, estimated using the cross-validation and testing errors of raw and shuffled data, were studied in detail. The results of both approaches were qualitatively and quantitatively compared. In conclusion, Adaptive GRNN with their ability to select features and efficient modelling of complex high dimensional data can be widely used in automatic/on-line mapping and as an integrated part of environmental decision support systems. 1. Kanevski M., Pozdnoukhov A., Timonin V. Machine Learning for Spatial Environmental Data. Theory, applications and software. EPFL Press

  19. Health promotion, primary prevention and secondary prevention in general practice

    OpenAIRE

    Karl, Tatjana

    2013-01-01

    The WHO´s aims regarding healthcare for the European region are mainly based on health promotion and preventive as well as supporting health education. The Ottawa Charta declares health promotion as a process to provide all people with a higher degree of self-determination regarding their health and thereby enabling them to increase it. General practitioners are of major importance regarding the medical area of behaviour oriented prevention by promoting health and acting preventive. ...

  20. Interpretive medicine: Supporting generalism in a changing primary care world.

    Science.gov (United States)

    Reeve, Joanne

    2010-01-01

    Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

  1. Model of Learning Organizational Development of Primary School Network under the Office of Basic Education Commission

    Science.gov (United States)

    Sai-rat, Wipa; Tesaputa, Kowat; Sriampai, Anan

    2015-01-01

    The objectives of this study were 1) to study the current state of and problems with the Learning Organization of the Primary School Network, 2) to develop a Learning Organization Model for the Primary School Network, and 3) to study the findings of analyses conducted using the developed Learning Organization Model to determine how to develop the…

  2. Generalized constraint neural network regression model subject to linear priors.

    Science.gov (United States)

    Qu, Ya-Jun; Hu, Bao-Gang

    2011-12-01

    This paper is reports an extension of our previous investigations on adding transparency to neural networks. We focus on a class of linear priors (LPs), such as symmetry, ranking list, boundary, monotonicity, etc., which represent either linear-equality or linear-inequality priors. A generalized constraint neural network-LPs (GCNN-LPs) model is studied. Unlike other existing modeling approaches, the GCNN-LP model exhibits its advantages. First, any LP is embedded by an explicitly structural mode, which may add a higher degree of transparency than using a pure algorithm mode. Second, a direct elimination and least squares approach is adopted to study the model, which produces better performances in both accuracy and computational cost over the Lagrange multiplier techniques in experiments. Specific attention is paid to both "hard (strictly satisfied)" and "soft (weakly satisfied)" constraints for regression problems. Numerical investigations are made on synthetic examples as well as on the real-world datasets. Simulation results demonstrate the effectiveness of the proposed modeling approach in comparison with other existing approaches.

  3. Peramalan Kunjungan Wisatawan Mancanegara Menggunakan Generalized Regression Neural Networks

    Directory of Open Access Journals (Sweden)

    Sri Herawati

    2016-05-01

    Full Text Available Peramalan kunjungan wisatawan mancanegara (wisman sangat penting bagi pemerintah dan industri, karena peramalan menjadi dasar dalam perencanaan kebijakan yang efektif. Penelitian ini menggunakan Generalized Regression Neural Network (GRNN untuk meramalkan kunjungan wisman menurut 19 pintu masuk utama dan kebangsaan, seperti: Ngurah Rai, Soekarno-Hatta, Batam, Tanjung Uban, Polonia, Juanda, Husein Sastranegara, Tanjung Balai Karimun, Tanjung Pinang, Tanjung Priok, Adi Sucipto, Minangkabau, Entikong, Adi Sumarmo, Sultan Syarif Kasim II, Sepinggan, Sam Ratulangi, Bandara Internasional Lombok, dan Makassar. GRNN memiliki kelebihan tidak memerlukan estimasi jumlah bobot jaringan untuk mendapatkan arsitektur jaringan optimal, sehingga tidak memerlukan pengaturan parameter bebas. Uji coba penelitian dilakukan dengan menggunakan spread dari 0,1 sampai 1,0. Hasil uji coba menunjukkan bahwa kinerja Peramalan terbaik dengan menggunakan spread 0,1 baik untuk data latih maupun data uji

  4. A generalized network representation of twist-reflectors

    International Nuclear Information System (INIS)

    Rebuffi, L.

    1986-06-01

    A general network representation of different kinds of Twist-Reflector (T.R.) is presented. By mean of a TM- and TE-type modal representation of the fields, using a double equivalent circuit it is possible to describe a strip, parallel plate or corrugated surface T.R. Modal reflection coefficients GAMMA' and GAMMA'' are derived starting from Marcuvitz formulations [1 ] and adapting them to different tested mirrors. Theoretic-empirical circuit parameters are thus deduced to satisfy the two basic conditions for an optimal design. The strip and the plate thickness is considered to be finite, thus reducing the degree of approximation. Using this model, predicted theoretical values for the reflector efficiency are in close agreement with experimental results, thus permitting a correct design of different kinds of Twist-Reflector

  5. General practitioners' views on leadership roles and challenges in primary health care: a qualitative study

    OpenAIRE

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

    2017-01-01

    Objective To explore general practitioners? (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical...

  6. Throughput Analysis of Primary and Secondary Networks in a Shared IEEE 802.11 System

    OpenAIRE

    Kumar, Santhosh; Shende, Nirmal; Murthy, Chandra R.; Ayyagari, Arun

    2012-01-01

    In this paper, we analyze the coexistence of a primary and a secondary (cognitive) network when both networks use the IEEE 802.11 based distributed coordination function for medium access control. Specifically, we consider the problem of channel capture by a secondary network that uses spectrum sensing to determine the availability of the channel, and its impact on the primary throughput. We integrate the notion of transmission slots in Bianchi's Markov model with the physical time slots, to ...

  7. Generalized single-hidden layer feedforward networks for regression problems.

    Science.gov (United States)

    Wang, Ning; Er, Meng Joo; Han, Min

    2015-06-01

    In this paper, traditional single-hidden layer feedforward network (SLFN) is extended to novel generalized SLFN (GSLFN) by employing polynomial functions of inputs as output weights connecting randomly generated hidden units with corresponding output nodes. The significant contributions of this paper are as follows: 1) a primal GSLFN (P-GSLFN) is implemented using randomly generated hidden nodes and polynomial output weights whereby the regression matrix is augmented by full or partial input variables and only polynomial coefficients are to be estimated; 2) a simplified GSLFN (S-GSLFN) is realized by decomposing the polynomial output weights of the P-GSLFN into randomly generated polynomial nodes and tunable output weights; 3) both P- and S-GSLFN are able to achieve universal approximation if the output weights are tuned by ridge regression estimators; and 4) by virtue of the developed batch and online sequential ridge ELM (BR-ELM and OSR-ELM) learning algorithms, high performance of the proposed GSLFNs in terms of generalization and learning speed is guaranteed. Comprehensive simulation studies and comparisons with standard SLFNs are carried out on real-world regression benchmark data sets. Simulation results demonstrate that the innovative GSLFNs using BR-ELM and OSR-ELM are superior to standard SLFNs in terms of accuracy, training speed, and structure compactness.

  8. General practice and primary health care in Denmark

    DEFF Research Database (Denmark)

    Møller Pedersen, Kjeld; Andersen, John Sahl; Søndergård, Jens

    2012-01-01

    ) an after-hours system staffed by GPs on a rota basis; (4) a mixed capitation and fee-for-service system; and (5) GPs are self-employed, working on contract for the public funder based on a national agreement that details not only services and reimbursement but also opening hours and required postgraduate...... by 5 key components: (1) a list system, with an average of close to 1600 persons on the list of a typical GP; (2) the GP as gatekeeper and first-line provider in the sense that a referral from a GP is required for most office-based specialists and always for in- and outpatient hospital treatment; (3...... education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges...

  9. Network nestedness as generalized core-periphery structures

    OpenAIRE

    Lee, Sang Hoon

    2016-01-01

    The concept of nestedness, in particular for ecological and economical networks, has been introduced as a structural characteristic of real interacting systems. We suggest that the nestedness is in fact another way to express a mesoscale network property called the core-periphery structure. With real ecological mutualistic networks and synthetic model networks, we reveal the strong correlation between the nestedness and core-periphery-ness (likeness to the core-periphery structure), by defini...

  10. Network nestedness as generalized core-periphery structures.

    Science.gov (United States)

    Lee, Sang Hoon

    2016-02-01

    The concept of nestedness, in particular for ecological and economical networks, has been introduced as a structural characteristic of real interacting systems. We suggest that the nestedness is in fact another way to express a mesoscale network property called the core-periphery structure. With real ecological mutualistic networks and synthetic model networks, we reveal the strong correlation between the nestedness and core-periphery-ness (likeness to the core-periphery structure), by defining the network-level measures for nestedness and core-periphery-ness in the case of weighted and bipartite networks. However, at the same time, via more sophisticated null-model analysis, we also discover that the degree (the number of connected neighbors of a node) distribution poses quite severe restrictions on the possible nestedness and core-periphery parameter space. Therefore, there must exist structurally interwoven properties in more fundamental levels of network formation, behind this seemingly obvious relation between nestedness and core-periphery structures.

  11. Social support network, mental health and quality of life: a cross-sectional study in primary care

    OpenAIRE

    Portugal, Flávia Batista; Campos, Mônica Rodrigues; Correia, Celina Ragoni; Gonçalves, Daniel Almeida; Ballester, Dinarte; Tófoli, Luis Fernando; Mari, Jair de Jesus; Gask, Linda; Dowrick, Christopher; Bower, Peter; Fortes, Sandra

    2016-01-01

    The objective of this study was to identify the association between emotional distress and social support networks with quality of life in primary care patients. This was a cross-sectional study involving 1,466 patients in the cities of São Paulo and Rio de Janeiro, Brazil, in 2009/2010. The General Health Questionnaire, the Hospital Anxiety and Depression Scale and the brief version of the World Health Organization Quality of Life Instrument were used. The Social Support Network Index classi...

  12. Altered structural and functional thalamocortical networks in secondarily generalized extratemporal lobe seizures

    Directory of Open Access Journals (Sweden)

    Syu-Jyun Peng

    2017-01-01

    Full Text Available Structural and functional abnormalities in the thalamocortical network in primary generalized epilepsies or mesial temporal lobe epilepsy have recently been identified by voxel-wise analyses of neuroimaging. However, evidence is needed regarding the profiles of the thalamocortical network in patients with secondarily generalized seizures from focal neocortical sources. We used high-resolution T1-weighted, diffusion-tensor and resting-state functional MR imaging (rs-fMRI to examine 16 patients with secondarily generalized extratemporal lobe seizures and 16 healthy controls. All the patients were medically effective and MRI-negative. Using whole brain voxel-based morphometry (VBM to compare the patients with the normal controls, we observed significantly decreased gray matter (GM density in the thalamus and 3 frontal gyri and significantly reduced white matter (WM fractional anisotropy (FA in the bilateral anterior corona radiata of the patients. Alterations in the thalamocortical functional connectivity with different cortices were identified by the rs-fMRI analysis seeding of the whole thalamus. The prefrontal gyri with the greatest functional connectivity were also traced by seeding a sub-thalamic region that is demarcated in an atlas, in which the thalamic parcellation is based on the WM connectivity to the cortices. This sub-thalamic region anatomically contains the mediodorsal thalamic nucleus where, concordantly, there was a significant decrease in thalamic GM density in the VBM study. In contrast to the negative correlation between the disease duration and reduced thalamic densities and subcortical FA values, the strength of the functional thalamocortical connectivity had a paradoxical correlation. Our results conclusively indicate that generalized seizures with a focal cortical source are associated with structural and functional alterations in the thalamocortical network.

  13. Classification of mammographic masses using generalized dynamic fuzzy neural networks

    International Nuclear Information System (INIS)

    Lim, Wei Keat; Er, Meng Joo

    2004-01-01

    In this article, computer-aided classification of mammographic masses using generalized dynamic fuzzy neural networks (GDFNN) is presented. The texture parameters, derived from first-order gradient distribution and gray-level co-occurrence matrices, were computed from the regions of interest. A total of 343 images containing 180 benign masses and 163 malignant masses from the Digital Database for Screening Mammography were analyzed. A fast approach of automatically generating fuzzy rules from training samples was implemented to classify tumors. This work is novel in that it alleviates the problem of requiring a designer to examine all the input-output relationships of a training database in order to obtain the most appropriate structure for the classifier in a conventional computer-aided diagnosis. In this approach, not only the connection weights can be adjusted, but also the structure can be self-adaptive during the learning process. By virtue of the automatic generation of the classifier by the GDFNN learning algorithm, the area under the receiver-operating characteristic curve, A z , attains 0.868±0.020, which corresponds to a true-positive fraction of 95.0% at a false positive fraction of 52.8%. The corresponding accuracy is 70.0%, the positive predictive value is 62.0%, and the negative predictive value is 91.4%

  14. Group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder: an effectiveness trial.

    Science.gov (United States)

    McEvoy, Peter M; Erceg-Hurn, David M; Anderson, Rebecca A; Campbell, Bruce N C; Swan, Amanda; Saulsman, Lisa M; Summers, Mark; Nathan, Paula R

    2015-04-01

    Generalized anxiety disorder (GAD) is a common and highly comorbid anxiety disorder characterized by repetitive negative thinking (RNT). Treatment trials tend to exclude individuals with non-primary GAD, despite this being a common presentation in real world clinics. RNT is also associated with multiple emotional disorders, suggesting that it should be targeted regardless of the primary disorder. This study evaluated the acceptability and effectiveness of brief group metacognitive therapy (MCT) for primary or non-primary GAD within a community clinic. Patients referred to a specialist community clinic attended six, two-hour weekly sessions plus a one-month follow-up (N=52). Measures of metacognitive beliefs, RNT, symptoms, positive and negative affect, and quality of life were completed at the first, last, and follow-up sessions. Attrition was low and large intent-to-treat effects were observed on most outcomes, particularly for negative metacognitive beliefs and RNT. Treatment gains increased further to follow-up. Benchmarking comparisons demonstrated that outcomes compared favorably to longer disorder-specific protocols for primary GAD. No control group or independent assessment of protocol adherence. Brief metacognitive therapy is an acceptable and powerful treatment for patients with primary or non-primary GAD. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Structure identification and adaptive synchronization of uncertain general complex dynamical networks

    International Nuclear Information System (INIS)

    Xu Yuhua; Zhou Wuneng; Fang Jian'an; Lu Hongqian

    2009-01-01

    This Letter proposes an approach to identify the topological structure and unknown parameters for uncertain general complex networks simultaneously. By designing effective adaptive controllers, we achieve synchronization between two complex networks. The unknown network topological structure and system parameters of uncertain general complex dynamical networks are identified simultaneously in the process of synchronization. Several useful criteria for synchronization are given. Finally, an illustrative example is presented to demonstrate the application of the theoretical results.

  16. Structure identification and adaptive synchronization of uncertain general complex dynamical networks

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yuhua, E-mail: yuhuaxu2004@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teacher' s College, Hubei 442000 (China); Zhou Wuneng, E-mail: wnzhou@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Fang Jian' an [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Lu Hongqian [Shandong Institute of Light Industry, Shandong Jinan 250353 (China)

    2009-12-28

    This Letter proposes an approach to identify the topological structure and unknown parameters for uncertain general complex networks simultaneously. By designing effective adaptive controllers, we achieve synchronization between two complex networks. The unknown network topological structure and system parameters of uncertain general complex dynamical networks are identified simultaneously in the process of synchronization. Several useful criteria for synchronization are given. Finally, an illustrative example is presented to demonstrate the application of the theoretical results.

  17. A recurrent neural network based on projection operator for extended general variational inequalities.

    Science.gov (United States)

    Liu, Qingshan; Cao, Jinde

    2010-06-01

    Based on the projection operator, a recurrent neural network is proposed for solving extended general variational inequalities (EGVIs). Sufficient conditions are provided to ensure the global convergence of the proposed neural network based on Lyapunov methods. Compared with the existing neural networks for variational inequalities, the proposed neural network is a modified version of the general projection neural network existing in the literature and capable of solving the EGVI problems. In addition, simulation results on numerical examples show the effectiveness and performance of the proposed neural network.

  18. Optogenetic analysis of a nociceptor neuron and network reveals ion channels acting downstream of primary sensors

    Science.gov (United States)

    Husson, Steven J.; Costa, Wagner Steuer; Wabnig, Sebastian; Stirman, Jeffrey N.; Watson, Joseph D.; Spencer, W. Clay; Akerboom, Jasper; Looger, Loren L.; Treinin, Millet; Miller, David M.; Lu, Hang; Gottschalk, Alexander

    2012-01-01

    Summary Background Nociception generally evokes rapid withdrawal behavior in order to protect the tissue from harmful insults. Most nociceptive neurons responding to mechanical insults display highly branched dendrites, an anatomy shared by Caenorhabditis elegans FLP and PVD neurons, which mediate harsh touch responses. Although several primary molecular nociceptive sensors have been characterized, less is known about modulation and amplification of noxious signals within nociceptor neurons. First, we analyzed the FLP/PVD network by optogenetics and studied integration of signals from these cells in downstream interneurons. Second, we investigated which genes modulate PVD function, based on prior single neuron mRNA profiling of PVD. Results Selectively photoactivating PVD, FLP and downstream interneurons using Channelrhodopsin-2 (ChR2) enabled functionally dissecting this nociceptive network, without interfering signals by other mechanoreceptors. Forward or reverse escape behaviors were determined by PVD and FLP, via integration by command interneurons. To identify mediators of PVD function, acting downstream of primary nocisensor molecules, we knocked down PVD-specific transcripts by RNAi and quantified light-evoked PVD-dependent behavior. Cell-specific disruption of synaptobrevin or voltage-gated Ca2+-channels (VGCCs) showed that PVD signals chemically to command interneurons. Knocking down the DEG/ENaC channel ASIC-1 and the TRPM channel GTL-1 indicated that ASIC-1 may extend PVD’s dynamic range and that GTL-1 may amplify its signals. These channels act cell-autonomously in PVD, downstream of primary mechanosensory molecules. Conclusions Our work implicates TRPM channels in modifying excitability of, and DEG/ENaCs in potentiating signal output from a mechano-nociceptor neuron. ASIC-1 and GTL-1 homologues, if functionally conserved, may denote valid targets for novel analgesics. PMID:22483941

  19. Towards Device-Independent Information Processing on General Quantum Networks

    Science.gov (United States)

    Lee, Ciarán M.; Hoban, Matty J.

    2018-01-01

    The violation of certain Bell inequalities allows for device-independent information processing secure against nonsignaling eavesdroppers. However, this only holds for the Bell network, in which two or more agents perform local measurements on a single shared source of entanglement. To overcome the practical constraints that entangled systems can only be transmitted over relatively short distances, large-scale multisource networks have been employed. Do there exist analogs of Bell inequalities for such networks, whose violation is a resource for device independence? In this Letter, the violation of recently derived polynomial Bell inequalities will be shown to allow for device independence on multisource networks, secure against nonsignaling eavesdroppers.

  20. Synchronization of general complex networks via adaptive control ...

    Indian Academy of Sciences (India)

    2014-03-07

    Mar 7, 2014 ... networks with derivative coupling and time-delay coupling was investigated by adaptive control schemes [42]. However ... [41], the synchronization of complex dynamical networks with non-derivative coupling and derivative coupling .... For any symmetric positive definite matrix. M ∈ Rn×n and x,y ∈ Rn, ...

  1. European primary care surveillance networks: an overview of structure and operation.

    NARCIS (Netherlands)

    Deckers, J.G.M.; Paget, W.J.; Schellevis, F.G.; Fleming, D.M.

    2004-01-01

    In many European countries, primary care networks have a important role in public health surveillance. The networks are organised and function differently in EU member states. Their information is a potential source for a European health information and monitoring system as envisaged in the European

  2. A neural network for locating the primary vertex in a pixel detector

    International Nuclear Information System (INIS)

    Kantowski, R.; Marzban, C.

    1995-01-01

    Using simulated collider data for p+p→2Jets interactions in a two-barrel pixel detector, a neural network is trained to construct the coordinate of the primary vertex to a high degree of accuracy. Three other estimates of this coordinate are also considered and compared to that of the neural network. It is shown that the network can match the best of the traditional estimates. ((orig.))

  3. Information-seeking behaviors of practitioners in a primary care practice-based research network (PBRN)*

    OpenAIRE

    Andrews, James E.; Pearce, Kevin A.; Ireson, Carol; Love, Margaret M.

    2005-01-01

    Objective: The aim of this study was to examine the information-seeking behaviors (e.g., information resource usage patterns, access to types of sources and to medical libraries, and use of particular information technologies) of members in a primary care practice-based research network (PBRN) to inform future efforts supporting primary care practitioners in their daily care of patients.

  4. A General Framework for Flow Control in Wireless Networks

    National Research Council Canada - National Science Library

    Chen, Minghua

    2006-01-01

    .... Current widely accepted solutions assume that congestion is the only cause of packet loss and are not applicable to wireless networks in which the bulk of packet loss is due to errors at the physical layer...

  5. Family practices registration networks contributed to primary care research.

    NARCIS (Netherlands)

    Weel, C. van; Grauw, W.J.C. de

    2006-01-01

    BACKGROUND AND OBJECTIVE: Family physicians (FP) play a key role in the diagnosis and treatment of health problems in the community and for evidence-based guidance clinical research must be based on primary care data. This paper analyses the state-of-the-art approaches to collection of data and the

  6. Spaces of phylogenetic networks from generalized nearest-neighbor interchange operations.

    Science.gov (United States)

    Huber, Katharina T; Linz, Simone; Moulton, Vincent; Wu, Taoyang

    2016-02-01

    Phylogenetic networks are a generalization of evolutionary or phylogenetic trees that are used to represent the evolution of species which have undergone reticulate evolution. In this paper we consider spaces of such networks defined by some novel local operations that we introduce for converting one phylogenetic network into another. These operations are modeled on the well-studied nearest-neighbor interchange operations on phylogenetic trees, and lead to natural generalizations of the tree spaces that have been previously associated to such operations. We present several results on spaces of some relatively simple networks, called level-1 networks, including the size of the neighborhood of a fixed network, and bounds on the diameter of the metric defined by taking the smallest number of operations required to convert one network into another. We expect that our results will be useful in the development of methods for systematically searching for optimal phylogenetic networks using, for example, likelihood and Bayesian approaches.

  7. General practice registration networks in the Netherlands: a brief report

    NARCIS (Netherlands)

    H.E. Hart (Bertien); J.C. van der Wouden (Hans); P. Hoppener; G.J. van Schendel; J.A. Knottnerus (André)

    1999-01-01

    textabstractIn the Netherlands, several general practice registrations exist. Groups of general practitioners register elements of patient care according to agreed-upon criteria, and these data are collected in a central database. By means of a questionnaire the

  8. Managing RFID sensors networks with a general purpose RFID middleware.

    Science.gov (United States)

    Abad, Ismael; Cerrada, Carlos; Cerrada, Jose A; Heradio, Rubén; Valero, Enrique

    2012-01-01

    RFID middleware is anticipated to one of the main research areas in the field of RFID applications in the near future. The Data EPC Acquisition System (DEPCAS) is an original proposal designed by our group to transfer and apply fundamental ideas from System and Data Acquisition (SCADA) systems into the areas of RFID acquisition, processing and distribution systems. In this paper we focus on how to organize and manage generic RFID sensors (edge readers, readers, PLCs, etc…) inside the DEPCAS middleware. We denote by RFID Sensors Networks Management (RSNM) this part of DEPCAS, which is built on top of two new concepts introduced and developed in this work: MARC (Minimum Access Reader Command) and RRTL (RFID Reader Topology Language). MARC is an abstraction layer used to hide heterogeneous devices inside a homogeneous acquisition network. RRTL is a language to define RFID Reader networks and to describe the relationship between them (concentrator, peer to peer, master/submaster).

  9. Managing RFID Sensors Networks with a General Purpose RFID Middleware

    Science.gov (United States)

    Abad, Ismael; Cerrada, Carlos; Cerrada, Jose A.; Heradio, Rubén; Valero, Enrique

    2012-01-01

    RFID middleware is anticipated to one of the main research areas in the field of RFID applications in the near future. The Data EPC Acquisition System (DEPCAS) is an original proposal designed by our group to transfer and apply fundamental ideas from System and Data Acquisition (SCADA) systems into the areas of RFID acquisition, processing and distribution systems. In this paper we focus on how to organize and manage generic RFID sensors (edge readers, readers, PLCs, etc…) inside the DEPCAS middleware. We denote by RFID Sensors Networks Management (RSNM) this part of DEPCAS, which is built on top of two new concepts introduced and developed in this work: MARC (Minimum Access Reader Command) and RRTL (RFID Reader Topology Language). MARC is an abstraction layer used to hide heterogeneous devices inside a homogeneous acquisition network. RRTL is a language to define RFID Reader networks and to describe the relationship between them (concentrator, peer to peer, master/submaster). PMID:22969370

  10. Comparison of Five Major Guidelines for Statin Use in Primary Prevention in a Contemporary General Population

    DEFF Research Database (Denmark)

    Mortensen, Martin Bødtker; Nordestgaard, Børge Grønne

    2018-01-01

    : Observational study of actual ASCVD events during 10 years, followed by a modeling study to estimate the effectiveness of different guidelines. Setting: The Copenhagen General Population Study. Participants: 45 750 Danish persons aged 40 to 75 years who did not use statins and did not have ASCVD at baseline...... recommending that more persons use statins for primary prevention of ASCVD should prevent more events than guidelines recommending use by fewer persons. Primary Funding Source: Copenhagen University Hospital....

  11. General practitioners' views on leadership roles and challenges in primary health care: a qualitative study.

    Science.gov (United States)

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

    2017-03-01

    To explore general practitioners' (GPs) views on leadership roles and leadership challenges in general practice and primary health care. We conducted focus groups (FGs) with 17 GPs. Norwegian primary health care. 17 GPs who attended a 5 d course on leadership in primary health care. Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. KEY POINTS Little is known about doctors' experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

  12. Generalized versus non-generalized neural network model for multi-lead inflow forecasting at Aswan High Dam

    Directory of Open Access Journals (Sweden)

    A. El-Shafie

    2011-03-01

    Full Text Available Artificial neural networks (ANN have been found efficient, particularly in problems where characteristics of the processes are stochastic and difficult to describe using explicit mathematical models. However, time series prediction based on ANN algorithms is fundamentally difficult and faces problems. One of the major shortcomings is the search for the optimal input pattern in order to enhance the forecasting capabilities for the output. The second challenge is the over-fitting problem during the training procedure and this occurs when ANN loses its generalization. In this research, autocorrelation and cross correlation analyses are suggested as a method for searching the optimal input pattern. On the other hand, two generalized methods namely, Regularized Neural Network (RNN and Ensemble Neural Network (ENN models are developed to overcome the drawbacks of classical ANN models. Using Generalized Neural Network (GNN helped avoid over-fitting of training data which was observed as a limitation of classical ANN models. Real inflow data collected over the last 130 years at Lake Nasser was used to train, test and validate the proposed model. Results show that the proposed GNN model outperforms non-generalized neural network and conventional auto-regressive models and it could provide accurate inflow forecasting.

  13. Training doctors for primary care in China: Transformation of general practice education.

    Science.gov (United States)

    Li, Donald

    2016-01-01

    China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.

  14. Primary prevention of cardio-metabolic diseases in general practice: a Dutch survey of attitudes and working methods of general practitioners.

    NARCIS (Netherlands)

    Nielen, M.M.J.; Assendelft, W.J.J.; Drenthen, A.J.M.; Hombergh, P. van den; Dis, I. van; Schellevis, F.G.

    2010-01-01

    BACKGROUND: To study the attitudes and working methods of general practitioners (GPs) in primary prevention of cardiovascular diseases, diabetes mellitus and chronic kidney diseases. METHODS: A questionnaire with questions about attitude and working methods in the primary prevention of

  15. Cooperative Detection for Primary User in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Zhu Jia

    2009-01-01

    Full Text Available We propose two novel cooperative detection schemes based on the AF (Amplify and Forward and DF (Decode and Forward protocols to achieve spatial diversity gains for cognitive radio networks, which are referred to as the AF-CDS, (AF-based Cooperative Detection Scheme and DF-CDS (DF-based Cooperative Detection Scheme, respectively. Closed-form expressions of detection probabilities for the noncooperation scheme, AND-CDS (AND-based Cooperative Detection Scheme, AF-CDS and DF-CDS, are derived over Rayleigh fading channels. Also, we analyze the overall agility for the proposed cooperative detection schemes and show that our schemes can further reduce the detection time. In addition, we compare the DF-CDS with the AF-CDS in terms of detection probability and agility gain, depicting the advantage of DF-CDS at low SNR region and high false alarm probability region.

  16. Using Social Network Theory to Influence the Development of State and Local Primary Prevention Capacity-Building Teams

    Science.gov (United States)

    Cook-Craig, Patricia G.

    2010-01-01

    This article examines the role that social network theory and social network analysis has played in assessing and developing effective primary prevention networks across a southeastern state. In 2004 the state began an effort to develop a strategic plan for the primary prevention of violence working with local communities across the state. The…

  17. Basic ICT adoption and use by general practitioners: an analysis of primary care systems in 31 European countries.

    Science.gov (United States)

    De Rosis, Sabina; Seghieri, Chiara

    2015-08-22

    There is general consensus that appropriate development and use of information and communication technologies (ICT) are crucial in the delivery of effective primary care (PC). Several countries are defining policies to support and promote a structural change of the health care system through the introduction of ICT. This study analyses the state of development of basic ICT in PC systems of 31 European countries with the aim to describe the extent of, and main purposes for, computer use by General Practitioners (GPs) across Europe. Additionally, trends over time have been analysed. Descriptive statistical analysis was performed on data from the QUALICOPC (Quality and Costs of Primary Care in Europe) survey, to describe the geographic differences in the general use of computer, and in specific computerized clinical functions for different health-related purposes such as prescribing, medication checking, generating health records and research for medical information on the Internet. While all the countries have achieved a near-universal adoption of a computer in their primary care practices, with only a few countries near or under the boundary of 90 %, the computerisation of primary care clinical functions presents a wide variability of adoption within and among countries and, in several cases (such as in the southern and central-eastern Europe), a large room for improvement. At European level, more efforts could be done to support southern and central-eastern Europe in closing the gap in adoption and use of ICT in PC. In particular, more attention seems to be need on the current usages of the computer in PC, by focusing policies and actions on the improvement of the appropriate usages that can impact on quality and costs of PC and can facilitate an interconnected health care system. However, policies and investments seem necessary but not sufficient to achieve these goals. Organizational, behavioural and also networking aspects should be taken in consideration.

  18. A Decentralized VPN Service over Generalized Mobile Ad-Hoc Networks

    Science.gov (United States)

    Fujita, Sho; Shima, Keiichi; Uo, Yojiro; Esaki, Hiroshi

    We present a decentralized VPN service that can be built over generalized mobile ad-hoc networks (Generalized MANETs), in which topologies can be represented as a time-varying directed multigraph. We address wireless ad-hoc networks and overlay ad-hoc networks as instances of Generalized MANETs. We first propose an architecture to operate on various kinds of networks through a single set of operations. Then, we design and implement a decentralized VPN service on the proposed architecture. Through the development and operation of a prototype system we implemented, we found that the proposed architecture makes the VPN service applicable to each instance of Generalized MANETs, and that the VPN service makes it possible for unmodified applications to operate on the networks.

  19. Primary generalized familial and sporadic glucocorticoid resistance (Chrousos syndrome) and hypersensitivity.

    Science.gov (United States)

    Charmandari, Evangelia; Kino, Tomoshige; Chrousos, George P

    2013-01-01

    Familial or sporadic primary generalized glucocorticoid resistance or Chrousos syndrome is a rare genetic condition characterized by generalized, partial, target-tissue insensitivity to glucocorticoids and a consequent hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis. Primary generalized glucocorticoid hypersensitivity (PGGH) represents the mirror image of the former, and is characterized by generalized, partial, target-tissue hypersensitivity to glucocorticoids, and compensatory hypoactivation of the HPA axis. The molecular basis of both conditions has been ascribed to mutations in the human glucocorticoid receptor (hGR) gene, which impair the molecular mechanisms of hGR action and alter tissue sensitivity to glucocorticoids. This review summarizes the pathophysiology, molecular mechanisms and clinical aspects of Chrousos syndrome and PGGH. Copyright © 2013 S. Karger AG, Basel.

  20. Medication incidents in primary care medicine: a prospective study in the Swiss Sentinel Surveillance Network (Sentinella).

    Science.gov (United States)

    Gnädinger, Markus; Conen, Dieter; Herzig, Lilli; Puhan, Milo A; Staehelin, Alfred; Zoller, Marco; Ceschi, Alessandro

    2017-07-26

    To describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Prospective surveillance study. Swiss primary healthcare, Swiss Sentinel Surveillance Network. Patients with drug treatment who experienced any erroneous event related to the medication process and interfering with normal treatment course, as judged by their physician. The 180 physicians in the study were general practitioners or paediatricians participating in the Swiss Federal Sentinel reporting system in 2015. Primary: medication incidents; secondary: potential risk factors like age, gender, polymedication, morbidity, care-dependency, previous hospitalisation. The mean rates of detected medication incidents were 2.07 per general practitioner per year (46.5 per 1 00 000 contacts) and 0.15 per paediatrician per year (2.8 per 1 00 000 contacts), respectively. The following factors were associated with medication incidents (OR, 95% CI): higher age 1.004 per year (1.001; 1.006), care by community nurse 1.458 (1.025; 2.073) and care by an institution 1.802 (1.399; 2.323), chronic conditions 1.052 (1.029; 1.075) per condition, medications 1.052 (1.030; 1.074) per medication, as well as Thurgau Morbidity Index for stage 4: 1.292 (1.004; 1.662), stage 5: 1.420 (1.078; 1.868) and stage 6: 1.680 (1.178; 2.396), respectively. Most cases were linked to an incorrect dosage for a given patient, while prescription of an erroneous medication was the second most common error. Medication incidents are common in adult primary care, whereas they rarely occur in paediatrics. Older and multimorbid patients are at a particularly high risk for medication incidents. Reasons for medication incidents are diverse but often seem to be linked to communication problems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  1. Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations.

    Science.gov (United States)

    Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant

    2017-05-01

    Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally

  2. Efficient network-matrix architecture for general flow transport inspired by natural pinnate leaves.

    Science.gov (United States)

    Hu, Liguo; Zhou, Han; Zhu, Hanxing; Fan, Tongxiang; Zhang, Di

    2014-11-14

    Networks embedded in three dimensional matrices are beneficial to deliver physical flows to the matrices. Leaf architectures, pervasive natural network-matrix architectures, endow leaves with high transpiration rates and low water pressure drops, providing inspiration for efficient network-matrix architectures. In this study, the network-matrix model for general flow transport inspired by natural pinnate leaves is investigated analytically. The results indicate that the optimal network structure inspired by natural pinnate leaves can greatly reduce the maximum potential drop and the total potential drop caused by the flow through the network while maximizing the total flow rate through the matrix. These results can be used to design efficient networks in network-matrix architectures for a variety of practical applications, such as tissue engineering, cell culture, photovoltaic devices and heat transfer.

  3. Construction of road network vulnerability evaluation index based on general travel cost

    Science.gov (United States)

    Leng, Jun-qiang; Zhai, Jing; Li, Qian-wen; Zhao, Lin

    2018-03-01

    With the development of China's economy and the continuous improvement of her urban road network, the vulnerability of the urban road network has attracted increasing attention. Based on general travel cost, this work constructs the vulnerability evaluation index for the urban road network, and evaluates the vulnerability of the urban road network from the perspective of user generalised travel cost. Firstly, the generalised travel cost model is constructed based on vehicle cost, travel time, and traveller comfort. Then, the network efficiency index is selected as an evaluation index of vulnerability: the network efficiency index is composed of the traffic volume and the generalised travel cost, which are obtained from the equilibrium state of the network. In addition, the research analyses the influence of traffic capacity decrease, road section attribute value, and location of road section, on vulnerability. Finally, the vulnerability index is used to analyse the local area network of Harbin and verify its applicability.

  4. Partnerships in primary care in Australia: network structure, dynamics and sustainability.

    Science.gov (United States)

    Lewis, Jenny M; Baeza, Juan I; Alexander, Damon

    2008-07-01

    Partnerships represent a prescriptive form of network governance, based on the idea of cooperation. This article has four aims. The first is to describe why network governance and partnerships are important now, and what one particular example - Primary Care Partnerships - is addressing. The second is to analyse the network structure of two of these partnerships, and the third is to examine network dynamics. The fourth aim is to explore relationships and sustainability over the longer term. Two government-funded and steered partnerships, which were established to increase coordination between primary care services in Victoria, Australia, were examined. Annual interviews at three points in time between 2002 and 2005 were used to explore relationships between organizations within these two partnerships. The structure of two different communication networks, based on contacts for work and contacts for strategic information, were examined using social network analysis. Tracing network structures over time highlighted partnership dynamics. The network structures changed over the three years of the study, but an important constant was the continuing centrality of the independent staff employed to manage the partnerships. Over the longer term, it seems to be more important to fund independent partnership staff, rather than people who connect partnerships to the funding agency. If partnerships are seen as valuable in improving service coordination and health outcomes, then long term rather than just start-up funding support is required.

  5. A Simple Network Architecture Accounts for Diverse Reward Time Responses in Primary Visual Cortex.

    Science.gov (United States)

    Huertas, Marco A; Hussain Shuler, Marshall G; Shouval, Harel Z

    2015-09-16

    Many actions performed by animals and humans depend on an ability to learn, estimate, and produce temporal intervals of behavioral relevance. Exemplifying such learning of cued expectancies is the observation of reward-timing activity in the primary visual cortex (V1) of rodents, wherein neural responses to visual cues come to predict the time of future reward as behaviorally experienced in the past. These reward-timing responses exhibit significant heterogeneity in at least three qualitatively distinct classes: sustained increase or sustained decrease in firing rate until the time of expected reward, and a class of cells that reach a peak in firing at the expected delay. We elaborate upon our existing model by including inhibitory and excitatory units while imposing simple connectivity rules to demonstrate what role these inhibitory elements and the simple architectures play in sculpting the response dynamics of the network. We find that simply adding inhibition is not sufficient for obtaining the different distinct response classes, and that a broad distribution of inhibitory projections is necessary for obtaining peak-type responses. Furthermore, although changes in connection strength that modulate the effects of inhibition onto excitatory units have a strong impact on the firing rate profile of these peaked responses, the network exhibits robustness in its overall ability to predict the expected time of reward. Finally, we demonstrate how the magnitude of expected reward can be encoded at the expected delay in the network and how peaked responses express this reward expectancy. Heterogeneity in single-neuron responses is a common feature of neuronal systems, although sometimes, in theoretical approaches, it is treated as a nuisance and seldom considered as conveying a different aspect of a signal. In this study, we focus on the heterogeneous responses in the primary visual cortex of rodents trained with a predictable delayed reward time. We describe under what

  6. Managing RFID Sensors Networks with a General Purpose RFID Middleware

    Directory of Open Access Journals (Sweden)

    Enrique Valero

    2012-06-01

    Full Text Available RFID middleware is anticipated to one of the main research areas in the field of RFID applications in the near future. The Data EPC Acquisition System (DEPCAS is an original proposal designed by our group to transfer and apply fundamental ideas from System and Data Acquisition (SCADA systems into the areas of RFID acquisition, processing and distribution systems. In this paper we focus on how to organize and manage generic RFID sensors (edge readers, readers, PLCs, etc… inside the DEPCAS middleware. We denote by RFID Sensors Networks Management (RSNM this part of DEPCAS, which is built on top of two new concepts introduced and developed in this work: MARC (Minimum Access Reader Command and RRTL (RFID Reader Topology Language. MARC is an abstraction layer used to hide heterogeneous devices inside a homogeneous acquisition network. RRTL is a language to define RFID Reader networks and to describe the relationship between them (concentrator, peer to peer, master/submaster.

  7. Identifying generalities in data sets using periodic Hopfield networks : initial status report.

    Energy Technology Data Exchange (ETDEWEB)

    Link, Hamilton E.; Backer, Alejandro

    2004-12-01

    We present a novel class of dynamic neural networks that is capable of learning, in an unsupervised manner, attractors that correspond to generalities in a data set. Upon presentation of a test stimulus, the networks follow a sequence of attractors that correspond to subsets of increasing size or generality in the original data set. The networks, inspired by those of the insect antennal lobe, build upon a modified Hopfield network in which nodes are periodically suppressed, global inhibition is gradually strengthened, and the weight of input neurons is gradually decreased relative to recurrent connections. This allows the networks to converge on a Hopfield network's equilibrium within each suppression cycle, and to switch between attractors in between cycles. The fast mutually reinforcing excitatory connections that dominate dynamics within cycles ensures the robust error-tolerant behavior that characterizes Hopfield networks. The cyclic inhibition releases the network from what would otherwise be stable equilibriums or attractors. Increasing global inhibition and decreasing dependence on the input leads successive attractors to differ, and to display increasing generality. As the network is faced with stronger inhibition, only neurons connected with stronger mutually excitatory connections will remain on; successive attractors will consist of sets of neurons that are more strongly correlated, and will tend to select increasingly generic characteristics of the data. Using artificial data, we were able to identify configurations of the network that appeared to produce a sequence of increasingly general results. The next logical steps are to apply these networks to suitable real-world data that can be characterized by a hierarchy of increasing generality and observe the network's performance. This report describes the work, data, and results, the current understanding of the results, and how the work could be continued. The code, data, and preliminary

  8. Engineering the Mechanical Properties of Polymer Networks with Precise Doping of Primary Defects.

    Science.gov (United States)

    Chan, Doreen; Ding, Yichuan; Dauskardt, Reinhold H; Appel, Eric A

    2017-12-06

    Polymer networks are extensively utilized across numerous applications ranging from commodity superabsorbent polymers and coatings to high-performance microelectronics and biomaterials. For many applications, desirable properties are known; however, achieving them has been challenging. Additionally, the accurate prediction of elastic modulus has been a long-standing difficulty owing to the presence of loops. By tuning the prepolymer formulation through precise doping of monomers, specific primary network defects can be programmed into an elastomeric scaffold, without alteration of their resulting chemistry. The addition of these monomers that respond mechanically as primary defects is used both to understand their impact on the resulting mechanical properties of the materials and as a method to engineer the mechanical properties. Indeed, these materials exhibit identical bulk and surface chemistry, yet vastly different mechanical properties. Further, we have adapted the real elastic network theory (RENT) to the case of primary defects in the absence of loops, thus providing new insights into the mechanism for material strength and failure in polymer networks arising from primary network defects, and to accurately predict the elastic modulus of the polymer system. The versatility of the approach we describe and the fundamental knowledge gained from this study can lead to new advancements in the development of novel materials with precisely defined and predictable chemical, physical, and mechanical properties.

  9. International Classification of Primary Care-2 coding of primary care data at the general out-patients' clinic of General Hospital, Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Olawunmi Abimbola Olagundoye

    2016-01-01

    Full Text Available Background: Primary care serves as an integral part of the health systems of nations especially the African continent. It is the portal of entry for nearly all patients into the health care system. Paucity of accurate data for health statistics remains a challenge in the most parts of Africa because of inadequate technical manpower and infrastructure. Inadequate quality of data systems contributes to inaccurate data. A simple-to-use classification system such as the International Classification of Primary Care (ICPC may be a solution to this problem at the primary care level. Objectives: To apply ICPC-2 for secondary coding of reasons for encounter (RfE, problems managed and processes of care in a Nigerian primary care setting. Furthermore, to analyze the value of selected presented symptoms as predictors of the most common diagnoses encountered in the study setting. Materials and Methods: Content analysis of randomly selected patients' paper records for data collection at the end of clinic sessions conducted by family physicians at the general out-patients' clinics. Contents of clinical consultations were secondarily coded with the ICPC-2 and recorded into excel spreadsheets with fields for sociodemographic data such as age, sex, occupation, religion, and ICPC elements of an encounter: RfE/complaints, diagnoses/problems, and interventions/processes of care. Results: Four hundred and one encounters considered in this study yielded 915 RfEs, 546 diagnoses, and 1221 processes. This implies an average of 2.3 RfE, 1.4 diagnoses, and 3.0 processes per encounter. The top 10 RfE, diagnoses/common illnesses, and processes were determined. Through the determination of the probability of the occurrence of certain diseases beginning with a RfE/complaint, the top five diagnoses that resulted from each of the top five RfE were also obtained. The top five RfE were: headache, fever, pain general/multiple sites, visual disturbance other and abdominal pain

  10. A general strategy to superstructured networks and nested self-similar networks of bismuth compounds.

    Science.gov (United States)

    Guo, Chuan Fei; Zhang, Jianming; Tian, Ye; Liu, Qian

    2012-10-23

    We have reported the synthesis of superstructured nanonetworks of BiOCl and nested nanonetworks of Bi(2)S(3) in a series of lattice-directed topotactic transformations [C. F. Guo et al. J. Am. Chem. Soc. 2011, 138, 8211-8215]. Here we extend the transformations to a much broader system including ordered nanowall networks of BiOCl, BiOBr, Bi(2)O(2)CO(3), β-Bi(2)O(3), and Bi(2)S(3), as well as nested self-similar networks of Bi(2)S(3) and amorphous BiO(x). We suggest even more superstructured networks and nested self-similar networks of bismuth compounds with a lattice parameter of ~2(n/2) × 3.9 Å (n = 0, 1, 2, 3, 4), might also be obtained. The superstructured networks and nested networks are novel architectures that may find applications in electronic devices, sensors, filters, and photocatalysts.

  11. Altered brain network measures in patients with primary writing tremor

    International Nuclear Information System (INIS)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant; Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn; Yadav, Ravi; Pal, Pramod Kumar

    2017-01-01

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results. (orig.)

  12. Altered brain network measures in patients with primary writing tremor

    Energy Technology Data Exchange (ETDEWEB)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant [National Institute of Mental Health and Neurosciences, Department of Clinical Neurosciences, Bangalore, Karnataka (India); National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India); Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn [National Institute of Mental Health and Neurosciences, Department of Neuroimaging and Interventional Radiology, Bangalore, Karnataka (India); Yadav, Ravi; Pal, Pramod Kumar [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India)

    2017-10-15

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results. (orig.)

  13. Cognitive Multiple-Antenna Network with Outage and Rate Margins at the Primary System

    DEFF Research Database (Denmark)

    Maham, Behrouz; Popovski, Petar

    2015-01-01

    interference from the downlink MISO cognitive radio, also called secondary system. We derive exact expressions for outage probability of the primary user under Rayleigh fading, when the primary system is exposed to interference from a secondary base station. We treat three different operating modes......In the common model for spectrum sharing, cognitive users can access the spectrum as long as the target performance in the legitimate primary system is not violated. In this paper, we consider a downlink primary multiple-inputsingle- output (MISO) system which operates under a controlled...... BS and introduce a suitable rate margin and a consistent requirement for primary throughput, for which we determine the outage probability. To be able to accommodate the secondary network, a rate margin is assumed at the primary link. We calculate the exact outage probabilities and average throughput...

  14. [The possibilities of congenital pathology primary prophylaxis as responsibility of general practitioner in Ukraine].

    Science.gov (United States)

    Hoĭda, N H; Protsiuk, O V; Iashchenko, O B; Lynchak, O V; Tymchenko, O I

    2014-01-01

    The aim was to study some tendencies of congenital pathology primary prophylaxis in context of Governmental measures and general practitioner's activity. The information basis of investigation was made up from foreign and home publications, lawmaking documents and data of questioners. Questioners were filled in by doctors who obtained general practitioner qualification (152 persons). The questioner contained information about sex, age, marital status of future general practitioners. It also contained questions about progress in studies at Medical University, healthy way of life maintenance during pregnancy, understanding of possibility to prevent child birth with congenital malformation, ways of congenital malformations prophylaxis in general practitioner's activity. System approaches to congenital pathology burden reduce started forming. State possibilities are not applied effectively in congenital pathology primary prophylaxis. Doctors who obtain general practitioner qualification understand the importance of healthy way of life and medical and genetic consultation for birth child with congenital malformations preventing. Future general practitioners consider that it is possible to carry out complex of steps for decreasing congenital pathology burden. It is impossible to carry out special congenital malformations prophylaxis programs because of economic situation in Ukraine. At the same time some results could be achieved due to professional activity of general practitioners and carrying out specific preventive measures on the way to decrease of congenital malformations burden.

  15. On the existence of a generalized non-specific task-dependent network

    Directory of Open Access Journals (Sweden)

    Kenneth eHugdahl

    2015-08-01

    Full Text Available In this paper we suggest the existence of a generalized task-related cortical network that is up-regulated whenever the task to be performed requires the allocation of generalized non-specific cognitive resources, independent of the specifics of the task to be performed. We have labelled this general purpose network, the extrinsic mode network (EMN as complementary to the default mode network (DMN, such that the EMN is down-regulated during periods of task-absence, when the DMN is up-regulated, and vice versa. We conceptualize the EMN as a cortical network for extrinsic neuronal activity, similar to the DMN as being a cortical network for intrinsic neuronal activity. The EMN has essentially a fronto-temporo-parietal spatial distribution, including the inferior and middle frontal gyri, inferior parietal lobule, supplementary motor area, inferior temporal gyrus, We further hypothesize that this network is always active regardless of the cognitive task being performed. We suggest that failure of network up- and down-regulation dynamics may provide neuronal underpinnings for cognitive impairments seen in many mental disorders, such as e.g. schizophrenia. We start by describing a common observation in functional imaging, the close overlap in fronto-parietal activations in healthy individuals to tasks that denote very different cognitive processes. We now suggest that this is because the brain utilizes the EMN network as a generalized response to tasks that exceeds a cognitive demand threshold and/or requires the processing of novel information. We further discuss how the EMN is related to the DMN, and how a network for extrinsic activity is related to a network for intrinsic activity. Finally we discuss whether the EMN and DMN networks interact in a common single brain system, rather than being two separate and independent brain systems.

  16. Practice-based research networks: the laboratories of primary care research.

    Science.gov (United States)

    Lindbloom, Erik J; Ewigman, Bernard G; Hickner, John M

    2004-04-01

    Medical research has traditionally been based in academic centers, and the findings are frequently not applicable in community primary care settings. The result is a large gap between the possible and the practical in delivering high-quality primary medical care in the United States. Practice-based research networks (PBRNs), laboratories for primary care clinical research, are the appropriate vehicles for uniting the worlds of community primary care practice and clinical research. Although they have received little attention in the mainstream of clinical and health services research, PBRNs have already reported a variety of findings useful for primary care providers, and these networks have helped to identify key issues in healthcare delivery that affect important outcomes. In this report, we outline the rationale for and history of PBRNs. We describe the organization and work of several productive PBRNs, giving examples of their studies that have changed the standards of modern primary care practice. Finally, we describe a developing electronic process for identifying research questions obtained directly from primary care providers that can be used to focus the national primary care research agenda on questions of clinical relevance and importance. As electronic technologies are fully developed and tested, they will facilitate communication between clinicians and researchers, thereby improving the effectiveness and efficiency of practice-based research.

  17. Continuous Morbidity Registration at Dutch Sentinel General Practice Network 2009.

    NARCIS (Netherlands)

    Donker, G.A.

    2011-01-01

    The Mexican flu pandemic was limited to a mild pandemic, although the flu incidence rate was higher than in the previous three seasons. At the peak of the epidemic 189 per 100.000 registered patients consulted their general practitioner (GP). The sentinel GP’s of NIVEL registered the number of new

  18. General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care

    Directory of Open Access Journals (Sweden)

    Rasmussen Finn

    2011-02-01

    Full Text Available Abstract Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men and 10 district nurses (7 women, 3 men from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and

  19. The general critical analysis for continuous-time UPPAM recurrent neural networks.

    Science.gov (United States)

    Qiao, Chen; Jing, Wen-Feng; Fang, Jian; Wang, Yu-Ping

    2016-01-29

    The uniformly pseudo-projection-anti-monotone (UPPAM) neural network model, which can be considered as the unified continuous-time neural networks (CNNs), includes almost all of the known CNNs individuals. Recently, studies on the critical dynamics behaviors of CNNs have drawn special attentions due to its importance in both theory and applications. In this paper, we will present the analysis of the UPPAM network under the general critical conditions. It is shown that the UPPAM network possesses the global convergence and asymptotical stability under the general critical conditions if the network satisfies one quasi-symmetric requirement on the connective matrices, which is easy to be verified and applied. The general critical dynamics have rarely been studied before, and this work is an attempt to gain an meaningful assurance of general critical convergence and stability of CNNs. Since UPPAM network is the unified model for CNNs, the results obtained here can generalize and extend the existing critical conclusions for CNNs individuals, let alone those non-critical cases. Moreover, the easily verified conditions for general critical convergence and stability can further promote the applications of CNNs.

  20. Mechanisms of change during group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder.

    Science.gov (United States)

    McEvoy, Peter M; Erceg-Hurn, David M; Anderson, Rebecca A; Campbell, Bruce N C; Nathan, Paula R

    2015-10-01

    Repetitive negative thinking (RNT) is a transdiagnostic process that serves to maintain emotional disorders. Metacognitive theory suggests that positive and negative metacognitive beliefs guide the selection of RNT as a coping strategy which, in turn, increases psychological distress. The aim of this study was to test the indirect effect of metacognitive beliefs on psychological distress via RNT. Patients (N=52) with primary and non-primary generalized anxiety disorder attended a brief, six-week group metacognitive therapy program and completed measures of metacognitive beliefs, RNT, and symptoms at the first and final treatment sessions, and at a one-month follow-up. Prospective indirect effects models found that negative metacognitive beliefs (but not positive metacognitive beliefs) had a significant indirect effect on psychological distress via RNT. As predicted by metacognitive theory, targeting negative metacognitions in treatment appears to reduce RNT and, in turn, emotional distress. Further research using alternative measures at multiple time points during therapy is required to determine whether the absence of a relationship with positive metacognitive beliefs in this study was a consequence of (a) psychometric issues, (b) these beliefs only being relevant to a subgroup of patients, or (c) a lack of awareness early in treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Patterns of Discursive Interactions in Primary Classrooms: An Application of Social Network Analysis

    Science.gov (United States)

    Mameli, Consuelo; Mazzoni, Elvis; Molinari, Luisa

    2015-01-01

    This study aimed to investigate whether social network analysis (SNA) is a useful method for identifying different discursive patterns in everyday classroom activities. The material analysed came from 20 teacher-led lessons that were video-recorded in small-size classes in Italian public primary schools. SNA was used to measure classroom relations…

  2. Co-evolution of networks and quantum dynamics: a generalization of preferential attachment

    International Nuclear Information System (INIS)

    Nicosia, Vincenzo; Latora, Vito; Machida, Takuya; Wilson, Richard; Hancock, Edwin; Konno, Norio; Severini, Simone

    2013-01-01

    We propose a model of network growth in which the network is co-evolving together with the dynamics of a quantum mechanical system, namely a quantum walk taking place over the network. The model naturally generalizes the Barabási–Albert model of preferential attachment and it has a rich set of tunable parameters, such as the initial conditions of the dynamics or the interaction of the system with its environment. We show that the model produces networks with two-modal power-law degree distributions, super-hubs, finite clustering coefficient, small-world behaviour and non-trivial degree–degree correlations. (paper)

  3. Autoassociative memory design using interconnected generalized brain-state-in-a-box neural networks.

    Science.gov (United States)

    Oh, Cheolhwan; Zak, Stanislaw H; Zhai, Guisheng

    2005-06-01

    A class of interconnected neural networks composed of generalized Brain-State-in-a-Box (gBSB) neural subnetworks is considered. Interconnected gBSB neural network architectures are proposed along with their stability conditions. The design of the interconnected neural networks is reduced to the problem of solving linear matrix inequalities (LMIs) to determine the interconnection parameters. A method for solving LMIs is devised generating the solutions that, in general, are further away from zero than the corresponding solutions obtained using MATLAB's LMI toolbox, thus resulting in stronger interconnections between the subnetworks. The proposed architectures are then used to construct neural associative memories. Simulations are performed to illustrate the results obtained.

  4. Altered resting state connectivity in right side frontoparietal network in primary insomnia patients

    International Nuclear Information System (INIS)

    Li, Shumei; Tian, Junzhang; Li, Meng; Wang, Tianyue; Lin, Chulan; Yin, Yi; Jiang, Guihua; Zeng, Luxian; Li, Cheng

    2018-01-01

    This study investigated alterations of resting-state networks (RSNs) in primary insomnia patients as well as relationships between these changes and clinical features. Fifty-nine primary insomnia patients and 53 healthy control subjects underwent a resting-state fMRI scan (rs-fMRI). Ten RSNs were identified using independent component analysis of rs-fMRI data. To assess significant differences between the two groups, voxel-wise analysis of ten RSNs was conducted using dual regression with FSL randomised non-parametric permutation testing and a threshold-free cluster enhanced technique to control for multiple comparisons. Relationships between abnormal functional connectivity and clinical variables were then investigated with Pearson's correlation analysis. Primary insomnia patients showed decreased connectivity in regions of the right frontoparietal network (FPN), including the superior parietal lobule and superior frontal gyrus. Moreover, decreased connectivity in the right middle temporal gyrus and right lateral occipital cortex with the FPN showed significant positive correlations with disease duration and self-rated anxiety, respectively. Our study suggests that primary insomnia patients are characterised by abnormal organisation of the right FPN, and dysfunction of the FPN is correlated with disease duration and anxiety. The results enhance our understanding of neural substrates underlying symptoms of primary insomnia from the viewpoint of resting-state networks. (orig.)

  5. A generalized electro-elastic theory of polymer networks

    Science.gov (United States)

    Cohen, Noy

    2018-01-01

    A rigorous multi-scale analysis of the electromechanical coupling in dielectric polymers is conducted. The body couples stemming from a misalignment between the electric field and the electric-dipole density vector are studied and the conservation laws for polymer networks are derived. Using variational principles, expressions for the polarization and the stress are determined. Interestingly, it is found that the stress tensor resulting from coupled loadings in which the electric field is misaligned with the principal stretch directions is not symmetric and the asymmetry arises from the body couples. Next, the electro-mechanical response of a chain is analyzed. The deformations of the individual polymer chains are related to the macroscopic deformation via two highly non-linear constraints - the first pertaining to the compatibility of the local deformations with the imposed macroscopic one and the second stems from the symmetric part of the stress at equilibrium. In accord with the proposed framework, an amended three-chains model is introduced. The predictions of this model are found to be in excellent agreement with experimental findings. Lastly, the behavior of a polymer subjected to a simple shear and an electric field is studied. The offset between the electric field and the principal directions gives rise to body couples, a polarization that is not aligned with the electric field, and an asymmetric stress tensor.

  6. Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study.

    Science.gov (United States)

    Calleo, Jessica S; Bush, Amber L; Cully, Jeffrey A; Wilson, Nancy L; Kraus-Schuman, Cynthia; Rhoades, Howard M; Novy, Diane M; Masozera, Nicholas; Williams, Susan; Horsfield, Matthew; Kunik, Mark E; Stanley, Melinda A

    2013-05-01

    To increase the sustainability of cognitive behavior therapy (CBT) in primary care for late-life anxiety, we incorporated nonexpert counselors, options for telephone meetings, and integration with primary care clinicians. This open trial examines the feasibility, satisfaction, and clinical outcomes of CBT delivered by experienced and nonexperienced counselors for older adults with generalized anxiety disorder (GAD). Clinical outcomes assessed worry (Penn State Worry Questionnaire), GAD (Generalized Anxiety Disorder Severity Scale), and anxiety (Beck Anxiety Inventory and Structured Interview Guide for Hamilton Anxiety Scale). After 3 months of treatment, Cohen's d effect sizes for worry and anxiety ranged from 0.48 to 0.78. Patients treated by experienced and nonexperienced counselors had similar reductions in worry and anxiety, although treatment outcomes were more improved on the Beck Anxiety Inventory for experienced therapists. Preliminary results suggest that adapted CBT can effectively reduce worry. The piloted modifications can provide acceptable and feasible evidence-based care.

  7. Bifurcation analysis on a generalized recurrent neural network with two interconnected three-neuron components

    International Nuclear Information System (INIS)

    Hajihosseini, Amirhossein; Maleki, Farzaneh; Rokni Lamooki, Gholam Reza

    2011-01-01

    Highlights: → We construct a recurrent neural network by generalizing a specific n-neuron network. → Several codimension 1 and 2 bifurcations take place in the newly constructed network. → The newly constructed network has higher capabilities to learn periodic signals. → The normal form theorem is applied to investigate dynamics of the network. → A series of bifurcation diagrams is given to support theoretical results. - Abstract: A class of recurrent neural networks is constructed by generalizing a specific class of n-neuron networks. It is shown that the newly constructed network experiences generic pitchfork and Hopf codimension one bifurcations. It is also proved that the emergence of generic Bogdanov-Takens, pitchfork-Hopf and Hopf-Hopf codimension two, and the degenerate Bogdanov-Takens bifurcation points in the parameter space is possible due to the intersections of codimension one bifurcation curves. The occurrence of bifurcations of higher codimensions significantly increases the capability of the newly constructed recurrent neural network to learn broader families of periodic signals.

  8. General and specialized media routinely employed for primary isolation of bacterial pathogens of fishes

    Science.gov (United States)

    Starliper, C.E.

    2008-01-01

    There are a number of significant diseases among cultured and free-ranging freshwater fishes that have a bacterial etiology; these represent a variety of gram-negative and gram-positive genera. Confirmatory diagnosis of these diseases involves primary isolation of the causative bacterium on bacteriologic media. Frequently used "general" bacteriologic media simply provide the essential nutrients for growth. For most of the major pathogens, however, there are differential and/or selective media that facilitate primary recovery. Some specialized media are available as "ready-to-use" from suppliers, while others must be prepared. Differential media employ various types of indicator systems, such as pH indicators, that allow diagnosticians to observe assimilation of selected substrates. An advantage to the use of differential media for primary isolation is that they hasten bacterial characterization by yielding the appropriate positive or negative result for a particular substrate, often leading to a presumptive identification. Selective media also incorporate agent(s) that inhibit the growth of contaminants typically encountered with samples from aquatic environments. Media that incorporate differential and/or selective components are ideally based on characters that are unique to the targeted bacterium, and their use can reduce the time associated with diagnosis and facilitate early intervention in affected fish populations. In this review, the concepts of general and differential/selective bacteriologic media and their use and development for fish pathogens are discussed. The media routinely employed for primary isolation of the significant bacterial pathogens of fishes are presented. ?? Wildlife Disease Association 2008.

  9. An Approach to Optical Network Design using General Heuristic Optimization Framework

    Directory of Open Access Journals (Sweden)

    Marko Lacković

    2010-12-01

    Full Text Available The article tackles the problem of optimization methods in optical network design process, based on optimal traffic routing with the goal to minimize the utilized network resources for given topology and traffic demands. An optimization framework Nyx has been developed with the focus on flexibility in solving optimization problems by implementing general heuristic search techniques. Nyx modular organization has been described, including coding types for solutions and genetic algorithm as the optimization method. Optimal routing has been implemented to demonstrate the use of Nyx in the optical network design process. Optimal routing procedure has been applied to Pan-European optical network with variations of routing procedures and the number of wavelengths. The analysis included no protection scenario, 1+1 protection and path restoration. The routing was performed using shortest path routing and optimal routing which minimizes the use of optical network resources, being network multiplexers, amplifiers and fibers.  

  10. An analogue of Morse theory for planar linear networks and the generalized Steiner problem

    International Nuclear Information System (INIS)

    Karpunin, G A

    2000-01-01

    A study is made of the generalized Steiner problem: the problem of finding all the locally minimal networks spanning a given boundary set (terminal set). It is proposed to solve this problem by using an analogue of Morse theory developed here for planar linear networks. The space K of all planar linear networks spanning a given boundary set is constructed. The concept of a critical point and its index is defined for the length function l of a planar linear network. It is shown that locally minimal networks are local minima of l on K and are critical points of index 1. The theorem is proved that the sum of the indices of all the critical points is equal to χ(K)=1. This theorem is used to find estimates for the number of locally minimal networks spanning a given boundary set

  11. Partnership effectiveness in primary community care networks: A national empirical analysis of partners' coordination infrastructure designs.

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Lin, Yung-Kai; Lin, Cheng-Chieh

    2010-01-01

    Previous empirical and managerial studies have ignored the effectiveness of integrated health networks. It has been argued that the varying definitions and strategic imperatives of integrated organizations may have complicated the assessment of the outcomes/performance of varying models, particularly when their market structures and contexts differed. This study aimed to empirically verify a theoretical perspective on the coordination infrastructure designs and the effectiveness of the primary community care networks (PCCNs) formed and funded by the Bureau of National Health Insurance since March 2003. The PCCNs present a model to replace the traditional fragmented providers in Taiwan's health care. The study used a cross-sectional mailed survey designed to ascertain partnership coordination infrastructure and integration of governance, clinical care, bonding, finances, and information. The outcome indicators were PCCNs' perceived performance and willingness to remain within the network. Structural equation modeling examined the causal relationships, controlling for organizational and environmental factors. Primary data collection occurred from February through December 2005, via structured questionnaires sent to 172 PCCNs. Using the individual PCCN as the unit of analysis, the results found that a network's efforts regarding coordination infrastructures were positively related to the PCCN's perceived performance and willingness to remain within the network. In addition, PCCNs practicing in rural areas and in areas with higher density of medical resources had better perceived effectiveness and willingness to cooperate in the network.Practical Implication: The lack of both an operational definition and an information about system-wide integration may have obstructed understanding of integrated health networks' organizational dynamics. This study empirically examined individual PCCNs and offers new insights on how to improve networks' organizational design and

  12. Clinical and neuropsychological characteristics of general paresis misdiagnosed as primary psychiatric disease.

    Science.gov (United States)

    Yanhua, Wang; Haishan, Shi; Le, Hou; Xiaomei, Zhong; Xinru, Chen; Ling, Li; Zhangying, Wu; Dong, Zheng; Yuefen, Zhang; Yan, Tan; Xinni, Luo; Sha, Liu; Yuping, Ning

    2016-07-11

    Neurosyphilis is caused by the invasion of Treponema pallidum into the central nervous system. General paresis (GP) is a type of neurosyphilis. The main manifestation of general paresis is dementia; however, this is different from the other types of dementia, which can be cured by adequate doses of penicillin in the early stage. Neurosyphilis is the "great imitator" because it can mimic many types of medical disorders. In addition, the manifestations of neurosyphilis are not typical. Psychiatric disorders as a cause of general paresis have become more common due to the use of antibiotics. Patients with a psychiatric manifestation are often misdiagnosed. The purpose of this study was to explore the differences in the clinical and neuropsychological characteristics of general paresis between patients misdiagnosed as having a primary psychiatric disease and patients diagnosed correctly upon seeing a doctor. The results may assist clinicians in the early identification of neurosyphilis with a mental disorder. The demographic and clinical manifestations, laboratory tests, and neuroimaging and neuropsychological characteristics were analysed in 55 general paresis patients with psychiatric disorders, including 29 patients misdiagnosed as primary psychiatric disease and 26 patients diagnosed as having general paresis after being seen once by a doctor. All of the patients had positive assay results for cerebral spinal fluid (CSF) Treponema pallidum hemagglutination (TPHA). Only 43.3 % of misdiagnosed patients and 30.8 % of general paresis patients had positive results for the CSF rapid plasma reagin (RPR) test; 96.4 % patients had abnormal neuroimaging. Mood disturbances were the most common psychiatric disorder in the general paresis patients, especially agitation, between the two groups (patients with general paresis who were misdiagnosed as having primary psychiatric disease and patients who had never been misdiagnosed) (p = 0.011). Our findings reinforce the

  13. Development of a general method for obtaining the geometry of microfluidic networks

    International Nuclear Information System (INIS)

    Razavi, Mohammad Sayed; Salimpour, M. R.; Shirani, Ebrahim

    2014-01-01

    In the present study, a general method for geometry of fluidic networks is developed with emphasis on pressure-driven flows in the microfluidic applications. The design method is based on general features of network's geometry such as cross-sectional area and length of channels. Also, the method is applicable to various cross-sectional shapes such as circular, rectangular, triangular, and trapezoidal cross sections. Using constructal theory, the flow resistance, energy loss and performance of the network are optimized. Also, by this method, practical design strategies for the fabrication of microfluidic networks can be improved. The design method enables rapid prediction of fluid flow in the complex network of channels and is very useful for improving proper miniaturization and integration of microfluidic networks. Minimization of flow resistance of the network of channels leads to universal constants for consecutive cross-sectional areas and lengths. For a Y-shaped network, the optimal ratios of consecutive cross-section areas (A i+1 /A i ) and lengths (L i+1 /L i ) are obtained as A i+1 /A i = 2 −2/3 and L i+1 /L i = 2 −1/3 , respectively. It is shown that energy loss in the network is proportional to the volume of network. It is also seen when the number of channels is increased both the hydraulic resistance and the volume occupied by the network are increased in a similar manner. Furthermore, the method offers that fabrication of multi-depth and multi-width microchannels should be considered as an integral part of designing procedures. Finally, numerical simulations for the fluid flow in the network have been performed and results show very good agreement with analytic results

  14. Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education.

    Science.gov (United States)

    Hallinan, Christine M; Hegarty, Kelsey L

    2016-01-01

    The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the

  15. Recent advances in the molecular mechanisms causing primary generalized glucocorticoid resistance.

    Science.gov (United States)

    Nicolaides, Nicolas; Lamprokostopoulou, Agaristi; Sertedaki, Amalia; Charmandari, Evangelia

    2016-01-01

    Primary Generalized Glucocorticoid Resistance is a rare condition characterized by generalized, partial, target tissue insensitivity to glucocorticoids owing to inactivating mutations, insertions or deletions in the human glucocorticoid receptor (hGR) gene (NR3C1). Recent advances in molecular and structural biology have enabled us to elucidate the molecular mechanisms of action of the mutant receptors and to understand how certain conformational alterations of the defective hGRs result in generalized glucocorticoid resistance. Furthermore, our ever-increasing understanding of the molecular mechanisms of glucocorticoid action indicates that the glucocorticoid signaling pathway is a stochastic system that plays a fundamental role in maintaining both basal and stress-related homeostasis. In this review, we summarize the clinical manifestations and molecular pathogenesis of Primary Generalized Glucocorticoid Resistance, we present our recent findings from the functional characterization of three novel heterozygous point mutations in the NR3C1 gene, and we discuss the diagnostic approach and therapeutic management of the condition. When the condition is suspected, we recommend sequencing analysis of the NR3C1 gene as well as of other genes encoding proteins involved in the glucocorticoid signal transduction. The tremendous progress of next-generation sequencing will undoubtedly uncover novel hGR partners or cofactors.

  16. [Primary Health Care in the coordination of health care networks: an integrative review].

    Science.gov (United States)

    Rodrigues, Ludmila Barbosa Bandeira; Silva, Patricia Costa Dos Santos; Peruhype, Rarianne Carvalho; Palha, Pedro Fredemir; Popolin, Marcela Paschoal; Crispim, Juliane de Almeida; Pinto, Ione Carvalho; Monroe, Aline Aparecida; Arcêncio, Ricardo Alexandre

    2014-02-01

    Health systems organized in health care networks and coordinated by Primary Health Care can contribute to an improvement in clinical quality with a positive impact on health outcomes and user satisfaction (by improving access and resolubility) and a reduction in the costs of local health systems. Thus, the scope of this paper is to analyze the scientific output about the evidence, potential, challenges and prospects of Primary Health Care in the coordination of Health Care Networks. To achieve this, the integrative review method was selected covering the period between 2000 and 2011. The databases selected were Medline (Medical Literature Analysis and Retrieval System online), Lilacs (Latin American Literature in Health Sciences) and SciELO (Scientific Electronic Library Online). Eighteen articles fulfilled the selection criteria. It was seen that the potential impacts of primary care services supersede the inherent weaknesses. However, the results revealed the need for research with a higher level of classification of the scientific evidence about the role of Primary Healh Care in the coordination of Health Care Networks.

  17. Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran.

    Science.gov (United States)

    Golkari, Ali; Sabokseir, Aira; Sheiham, Aubrey; Watt, Richard G

    2016-01-01

    Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran. This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom's Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment.  Height (Poral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas.

  18. Generalized anxiety disorder in primary care: mental health services use and treatment adequacy.

    Science.gov (United States)

    Roberge, Pasquale; Normand-Lauzière, François; Raymond, Isabelle; Luc, Mireille; Tanguay-Bernard, Marie-Michèle; Duhoux, Arnaud; Bocti, Christian; Fournier, Louise

    2015-10-22

    Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model of Health Care Use. A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12 months took part in this study. Data were drawn from the "Dialogue" project, a large primary care study conducted in 67 primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n = 14833), patients at risk of anxiety or depression completed the Composite International Diagnostic Interview-Simplified (CIDIS). Multilevel logistic regression models were developed to examine correlates of treatment adequacy for pharmacological and psychological treatments. Results indicate that 52.5 % of participants were recognized as having GAD by a healthcare professional in the past 12 months, and 36.2 % of the sample received a pharmacological (24.4 %) and/or psychological treatment (19.2 %) meeting indicators based on clinical practice guidelines recommendations. The detection of GAD by a health professional and the presence of comorbid depression were associated with overall treatment adequacy. This study suggests that further efforts towards GAD detection could lead to an increase in the delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow up of patients with a GAD medication and access to psychotherapy from the primary care setting.

  19. Habitat variability does not generally promote metabolic network modularity in flies and mammals.

    Science.gov (United States)

    Takemoto, Kazuhiro

    2016-01-01

    The evolution of species habitat range is an important topic over a wide range of research fields. In higher organisms, habitat range evolution is generally associated with genetic events such as gene duplication. However, the specific factors that determine habitat variability remain unclear at higher levels of biological organization (e.g., biochemical networks). One widely accepted hypothesis developed from both theoretical and empirical analyses is that habitat variability promotes network modularity; however, this relationship has not yet been directly tested in higher organisms. Therefore, I investigated the relationship between habitat variability and metabolic network modularity using compound and enzymatic networks in flies and mammals. Contrary to expectation, there was no clear positive correlation between habitat variability and network modularity. As an exception, the network modularity increased with habitat variability in the enzymatic networks of flies. However, the observed association was likely an artifact, and the frequency of gene duplication appears to be the main factor contributing to network modularity. These findings raise the question of whether or not there is a general mechanism for habitat range expansion at a higher level (i.e., above the gene scale). This study suggests that the currently widely accepted hypothesis for habitat variability should be reconsidered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. The existence of generalized synchronization of chaotic systems in complex networks.

    Science.gov (United States)

    Hu, Aihua; Xu, Zhenyuan; Guo, Liuxiao

    2010-03-01

    The paper studies the existence of generalized synchronization in complex networks, which consist of chaotic systems. When a part of modified nodes are chaotic, and the others have asymptotically stable equilibriums or orbital asymptotically stable periodic solutions, under certain conditions, the existence of generalized synchronization can be turned to the problem of contractive fixed point in the family of Lipschitz functions. In addition, theoretical proofs are proposed to the exponential attractive property of generalized synchronization manifold. Numerical simulations validate the theory.

  1. A general model for metabolic scaling in self-similar asymmetric networks.

    Directory of Open Access Journals (Sweden)

    Alexander Byers Brummer

    2017-03-01

    Full Text Available How a particular attribute of an organism changes or scales with its body size is known as an allometry. Biological allometries, such as metabolic scaling, have been hypothesized to result from selection to maximize how vascular networks fill space yet minimize internal transport distances and resistances. The West, Brown, Enquist (WBE model argues that these two principles (space-filling and energy minimization are (i general principles underlying the evolution of the diversity of biological networks across plants and animals and (ii can be used to predict how the resulting geometry of biological networks then governs their allometric scaling. Perhaps the most central biological allometry is how metabolic rate scales with body size. A core assumption of the WBE model is that networks are symmetric with respect to their geometric properties. That is, any two given branches within the same generation in the network are assumed to have identical lengths and radii. However, biological networks are rarely if ever symmetric. An open question is: Does incorporating asymmetric branching change or influence the predictions of the WBE model? We derive a general network model that relaxes the symmetric assumption and define two classes of asymmetrically bifurcating networks. We show that asymmetric branching can be incorporated into the WBE model. This asymmetric version of the WBE model results in several theoretical predictions for the structure, physiology, and metabolism of organisms, specifically in the case for the cardiovascular system. We show how network asymmetry can now be incorporated in the many allometric scaling relationships via total network volume. Most importantly, we show that the 3/4 metabolic scaling exponent from Kleiber's Law can still be attained within many asymmetric networks.

  2. A convenient tool to profile patients for generalized cardiovascular disease risk in primary care.

    Science.gov (United States)

    Wickramasinghe, S Rasika; DeFilippis, Andrew P; Lloyd-Jones, Donald M; Blumenthal, Roger S

    2009-04-15

    The early identification of and intervention in patients with increased risk factors for generalized cardiovascular disease greatly reduces their long-term mortality from hard coronary artery disease (CAD) events and other related co-morbidities. Thus, a number of multivariate risk factor analyses based on large-scale population studies have led to various risk-scoring models aimed at screening for those at high risk for CAD. These assessment systems, by virtue of novel diagnostic markers and better population data, have become increasingly adept at accurately predicting CAD risk in individual patients. Nevertheless, their practical application in the setting of primary care has lagged, because of a reluctance of many primary care physicians to adopt these methods. An effective risk assessment system should not only encompass the risk for hard CAD events but also include risks for related co-morbid conditions, such as stroke and heart failure, and be simple and accurate enough to be efficiently used in primary care clinics. In conclusion, in an attempt to simplify 1 of the more effective risk assessment devices for generalized cardiovascular disease risk that meets all these requirements, the investigators strongly support the model proposed by D'Agostino and colleagues and provide here a commentary on its utility in identifying patients at high risk for cardiovascular disease.

  3. The role of the General Practitioner in weight management in primary care – a cross sectional study in General Practice

    Directory of Open Access Journals (Sweden)

    Young Doris

    2008-12-01

    Full Text Available Abstract Background Obesity has become a global pandemic, considered the sixth leading cause of mortality by the WHO. As gatekeepers to the health system, General Practitioners are placed in an ideal position to manage obesity. Yet, very few consultations address weight management. This study aims to explore reasons why patients attending General Practice appointments are not engaging with their General Practitioner (GP for weight management and their perception of the role of the GP in managing their weight. Methods In February 2006, 367 participants aged between 17 and 64 were recruited from three General Practices in Melbourne to complete a waiting room self – administered questionnaire. Questions included basic demographics, the role of the GP in weight management, the likelihood of bringing up weight management with their GP and reasons why they would not, and their nominated ideal person to consult for weight management. Physical measurements to determine weight status were then completed. The statistical methods included means and standard deviations to summarise continuous variables such as weight and height. Sub groups of weight and questionnaire answers were analysed using the χ2 test of significant differences taking p as Results The population sample had similar obesity co-morbidity rates to the National Heart Foundation data. 74% of patients were not likely to bring up weight management when they visit their GP. Negative reasons were time limitation on both the patient's and doctor's part and the doctor lacking experience. The GP was the least likely person to tell a patient to lose weight after partner, family and friends. Of the 14% that had been told by their GP to lose weight, 90% had cardiovascular obesity related co-morbidities. GPs (15% were 4th in the list of ideal persons to manage weight after personal trainer Conclusion Patients do not have confidence in their GPs for weight management, preferring other health

  4. Synchronization stability of general complex dynamical networks with time-varying delays

    International Nuclear Information System (INIS)

    Li Kun; Guan Shuguang; Gong Xiaofeng; Lai, C.-H.

    2008-01-01

    The synchronization problem of some general complex dynamical networks with time-varying delays is investigated. Both time-varying delays in the network couplings and time-varying delays in the dynamical nodes are considered. The novel delay-dependent criteria in terms of linear matrix inequalities (LMI) are derived based on free-weighting matrices technique and appropriate Lyapunov functional proposed recently. Numerical examples are given to illustrate the effectiveness and advantage of the proposed synchronization criteria

  5. General-Purpose Computation with Neural Networks: A Survey of Complexity Theoretic Results

    Czech Academy of Sciences Publication Activity Database

    Šíma, Jiří; Orponen, P.

    2003-01-01

    Roč. 15, č. 12 (2003), s. 2727-2778 ISSN 0899-7667 R&D Projects: GA AV ČR IAB2030007; GA ČR GA201/02/1456 Institutional research plan: AV0Z1030915 Keywords : computational power * computational complexity * perceptrons * radial basis functions * spiking neurons * feedforward network s * reccurent network s * probabilistic computation * analog computation Subject RIV: BA - General Mathematics Impact factor: 2.747, year: 2003

  6. The Primary Care Obesity Network: Translating Expert Committee Guidelines on Childhood Obesity Into Practice.

    Science.gov (United States)

    Eneli, Ihuoma U; Howell, Candace; Rose, Megan E; Pratt, Keeley; Lovegrove, Ericca L; Domrose, Erica L; Polas, Phyllis J

    2017-12-01

    Childhood obesity remains a serious public health threat. There is an urgent need for innovative, effective, and sustainable interventions for childhood obesity that are multisector, integrated, and pragmatic. Using the 2007 Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity as a guide, a tertiary care obesity program at a children's hospital established the Primary Care Obesity Network (PCON). This article describes the structure, implementation, resources, and outcome measures of the PCON, a network of primary care practices and a tertiary care obesity center established to prevent and treat childhood obesity in Central Ohio. This program offers an opportunity to assess how and whether the expert committee guidelines can be translated into practice. As Accountable Care Organizations strive to provide services through the lens of improving population health, the PCON can serve as an example for addressing childhood obesity.

  7. Generalized Projective Synchronization between Two Different Neural Networks with Mixed Time Delays

    Directory of Open Access Journals (Sweden)

    Xuefei Wu

    2012-01-01

    Full Text Available The generalized projective synchronization (GPS between two different neural networks with nonlinear coupling and mixed time delays is considered. Several kinds of nonlinear feedback controllers are designed to achieve GPS between two different such neural networks. Some results for GPS of these neural networks are proved theoretically by using the Lyapunov stability theory and the LaSalle invariance principle. Moreover, by comparison, we determine an optimal nonlinear controller from several ones and provide an adaptive update law for it. Computer simulations are provided to show the effectiveness and feasibility of the proposed methods.

  8. Using information and communication technologies to consult with patients in Victorian primary care: the views of general practitioners.

    Science.gov (United States)

    Hanna, Lisa; Fairhurst, Karen

    2013-01-01

    Information and communication technologies such as email, text messaging and video messaging are commonly used by the general population. However, international research has shown that they are not used routinely by GPs to communicate or consult with patients. Investigating Victorian GPs' perceptions of doing so is timely given Australia's new National Broadband Network, which may facilitate web-based modes of doctor-patient interaction. This study therefore aimed to explore Victorian GPs' experiences of, and attitudes toward, using information and communication technologies to consult with patients. Qualitative telephone interviews were carried out with a maximum variation sample of 36GPs from across Victoria. GPs reported a range of perspectives on using new consultation technologies within their practice. Common concerns included medico-legal and remuneration issues and perceived patient information technology literacy. Policy makers should incorporate GPs' perspectives into primary care service delivery planning to promote the effective use of information and communication technologies in improving accessibility and quality of general practice care.

  9. Switch Based Opportunistic Spectrum Access for General Primary User Traffic Model

    KAUST Repository

    Gaaloul, Fakhreddine

    2012-06-18

    This letter studies cognitive radio transceiver that can opportunistically use the available channels of primary user (PU). Specifically, we investigate and compare two different opportunistic channel access schemes. The first scheme applies when the secondary user (SU) has access to only one channel. The second scheme, based on channel switching mechanism, applies when the SU has access to multiple channels but can at a given time monitor and access only one channel. For these access schemes, we derive the exact analytical results for the novel performance metrics of average access time and average waiting time under general PU traffic models.

  10. A comparison of back propagation and generalized regression neural networks performance in neutron spectrometry

    International Nuclear Information System (INIS)

    Ortiz R, J. M.; Martinez B, M. R.; Solis S, L. O.; Castaneda M, R.; Vega C, H. R.

    2015-10-01

    The process of unfolding the neutron energy spectrum has been the subject of research for many years. Monte Carlo, iterative methods, the bayesian theory, the principle of maximum entropy are some of the methods used. The drawbacks associated with traditional unfolding procedures have motivated the need of complementary approaches. Back Propagation Neural Networks (BPNN), have been applied with success in the neutron spectrometry and dosimetry domains, however, the structure and the learning parameters are factors that contribute in a significant way in the networks performance. In artificial neural network domain, Generalized Regression Neural Network (GRNN) is one of the simplest neural networks in term of network architecture and learning algorithm. The learning is instantaneous, which mean require no time for training. Opposite to BPNN, a GRNN would be formed instantly with just a 1-pass training with the development data. In the network development phase, the only hurdle is to tune the hyper parameter, which is known as sigma, governing the smoothness of the network. The aim of this work was to compare the performance of BPNN and GRNN in the solution of the neutron spectrometry problem. From results obtained can be observed that despite the very similar results, GRNN performs better than BPNN. (Author)

  11. A comparison of back propagation and generalized regression neural networks performance in neutron spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz R, J. M.; Martinez B, M. R.; Solis S, L. O.; Castaneda M, R. [Universidad Autonoma de Zacatecas, Unidad Academica de Ingenieria Electrica, Av. Ramon Lopez Velarde 801, Col. Centro, 98000 Zacatecas, Zac. (Mexico); Vega C, H. R., E-mail: morvymm@yahoo.com.mx [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas, Zac. (Mexico)

    2015-10-15

    The process of unfolding the neutron energy spectrum has been the subject of research for many years. Monte Carlo, iterative methods, the bayesian theory, the principle of maximum entropy are some of the methods used. The drawbacks associated with traditional unfolding procedures have motivated the need of complementary approaches. Back Propagation Neural Networks (BPNN), have been applied with success in the neutron spectrometry and dosimetry domains, however, the structure and the learning parameters are factors that contribute in a significant way in the networks performance. In artificial neural network domain, Generalized Regression Neural Network (GRNN) is one of the simplest neural networks in term of network architecture and learning algorithm. The learning is instantaneous, which mean require no time for training. Opposite to BPNN, a GRNN would be formed instantly with just a 1-pass training with the development data. In the network development phase, the only hurdle is to tune the hyper parameter, which is known as sigma, governing the smoothness of the network. The aim of this work was to compare the performance of BPNN and GRNN in the solution of the neutron spectrometry problem. From results obtained can be observed that despite the very similar results, GRNN performs better than BPNN. (Author)

  12. [Out-of-hours primary care in Germany: general practitioners' views on the current situation].

    Science.gov (United States)

    Frankenhauser-Mannuß, J; Goetz, K; Scheuer, M; Szescenyi, J; Leutgeb, R

    2014-07-01

    The aim of this study was to explore views, experiences und perspectives of German GPs related to current out-of-hours service provision covering both urban and rural settings. In the context of the international project EurOOHnet (European Research Network for Out-of-Hours Primary Health Care) the German members (of EurOOHnet) developed a questionnaire about organisational structures, infrastructure requirements and the procedures of information flow between regular care and out-of-hours care in 2011. This questionnaire was adopted in every participating country. A comprehensive postal questionnaire was sent to 410 feneral practice cooperatives in Germany. Qualitative content analysis and an inductive reasoning process, supported by the use of Atlas.ti, were used to identify key themes from responses to open-ended questions in the survey. Results were grouped into 3 overarching categories and each of these were grouped into 3 sub-categories. The questionnaire response rate was 44% (181/410). The analysis identified organisational issues (e. g., financing) and infrastructure barriers (e. g., lack of motivated GPs for out-of-hours care) as key themes. Significantly, different priorities between rural and urban GPs were identified. In particular, rural GPs highlighted shortages of GPs and distance between the GP practice and patients' residence as concerning factors impacting on out-of-hours care. Based on reported views from survey respondents, urban and rural primary care service needs vary significantly and, therefore, different solutions are needed to improve out-of-hours primary care and optimise service quality. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Qualities and Inequalities in Online Social Networks through the Lens of the Generalized Friendship Paradox.

    Science.gov (United States)

    Momeni, Naghmeh; Rabbat, Michael

    2016-01-01

    The friendship paradox is the phenomenon that in social networks, people on average have fewer friends than their friends do. The generalized friendship paradox is an extension to attributes other than the number of friends. The friendship paradox and its generalized version have gathered recent attention due to the information they provide about network structure and local inequalities. In this paper, we propose several measures of nodal qualities which capture different aspects of their activities and influence in online social networks. Using these measures we analyse the prevalence of the generalized friendship paradox over Twitter and we report high levels of prevalence (up to over 90% of nodes). We contend that this prevalence of the friendship paradox and its generalized version arise because of the hierarchical nature of the connections in the network. This hierarchy is nested as opposed to being star-like. We conclude that these paradoxes are collective phenomena not created merely by a minority of well-connected or high-attribute nodes. Moreover, our results show that a large fraction of individuals can experience the generalized friendship paradox even in the absence of a significant correlation between degrees and attributes.

  14. Improving outcomes for people with COPD by developing networks of general practices: evaluation of a quality improvement project in east London.

    Science.gov (United States)

    Hull, Sally; Mathur, Rohini; Lloyd-Owen, Simon; Round, Thomas; Robson, John

    2014-10-16

    Structured care for people with chronic obstructive pulmonary disease (COPD) can improve outcomes. Delivering care in a deprived ethnically diverse area can prove challenging. Evaluation of a system change to enhance COPD care delivery in a primary care setting between 2010 and 2013 using observational data. All 36 practices in one inner London primary care trust were grouped geographically into eight networks of 4-5 practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary group, including a respiratory specialist and the community respiratory team, developed a 'care package' for COPD management, with financial incentives based on network achievements of clinical targets and supported case management and education. Monthly electronic dashboards enabled networks to track and improve performance. The size of network COPD registers increased by 10% in the first year. Between 2010 and 2013 completed care plans increased from 53 to 86.5%, pulmonary rehabilitation referrals rose from 45 to 70% and rates of flu immunisation from 81 to 83%, exceeding London and England figures. Hospital admissions decreased in Tower Hamlets from a historic high base. Investment of financial, organisational and educational resource into general practice networks was associated with clinically important improvements in COPD care in socially deprived, ethnically diverse communities. Key behaviour change included the following: collaborative working between practices driven by high-quality information to support performance review; shared financial incentives; and engagement between primary and secondary care clinicians.

  15. PRIMARY IMMUNODEFICIENCY: STATUS OF A PROBLEM TODAY. RUSSIAN NETWORK OF JMF-CENTERS

    Directory of Open Access Journals (Sweden)

    E. A. Latysheva

    2013-01-01

    Full Text Available The problems of primary immunodeficiency in Russia and the ways of solving of them are discussed in the article. Primary immunodeficiency is a group of rare diseases, so awareness of this pathology in the medical community and among patients is very low. This leads to late diagnosis and inadequate treatment of patients with such conditions. The result of the late beginning of treatment is early development of disability, and the high mortality rate of patients, as well as the high costs of the treatment of complications of primary immunodeficiency and sick-leave certificates for the government. Today in time and adequate therapy allows patients not only to reach adulthood without signs of disability, and to lead an active way of life, but to have healthy children. Given the high cost of therapy in many countries, the issue of providing patients with life-saving drugs remains unresolved. The global practice is to involve social organizations and funds. One of the foundations supporting educational programs, development of laboratories and research in the field of primary immunodeficiency is the Foundation of the Jeffrey Modell. A network of centres for primary immunodeficiency supported by the Jeffrey Modell Foundation (JMF-centers has started its functioning over the territory of the Russian Federation since 2011 in order to improve diagnostics and treatment of patients with primary immunodeficiency. A brief description of activity of these centers is presented in the article.

  16. Security risk assessment of the primary layer of wavelength division multiplexing passive optical network

    Science.gov (United States)

    Koudelka, Petr; Siska, Petr; Latal, Jan; Poboril, Radek; Hajek, Lukas; Kepak, Stanislav; Vasinek, Vladimir

    2015-01-01

    Next-generation passive optical access networks come to the fore nowadays. These optical next-generation networks are the response to the increasing qualitative requirements from end users. Technologies using Time Division Multiplexing include NG-PON (XG-PON 1 and XG-PON 2) and 10GEPON. Their advantage is the applicability to older topologies, which are operated by the original technology of passive optical access networks. Wavelength Division Multiplexing Passive Optical Network (WDM-PON) is an alternative also belonging to next-generation networks. Time Division Multiplexing is in this case replaced by Wavelength Division Multiplexing. Certain variants of WDM-PON use a combination of broadband light source, optical circulator, optical phased array and tunable FP laser. Construction of the terminal units (ONU) is advantageous because it can always tune in to the appropriate wavelength in the given optical DWDM channel (100 GHz). The disadvantage is the increased security risk on the primary layer due to channel crosstalk in an optical phased array (AWG). The aim of this paper is to assess the degree of security risk in real conditions. The article includes both simulation and real measurements in C + L bands with 100 GHz DWDM spacing.

  17. Robust general N user authentication scheme in a centralized quantum communication network via generalized GHZ states

    Science.gov (United States)

    Farouk, Ahmed; Batle, J.; Elhoseny, M.; Naseri, Mosayeb; Lone, Muzaffar; Fedorov, Alex; Alkhambashi, Majid; Ahmed, Syed Hassan; Abdel-Aty, M.

    2018-04-01

    Quantum communication provides an enormous advantage over its classical counterpart: security of communications based on the very principles of quantum mechanics. Researchers have proposed several approaches for user identity authentication via entanglement. Unfortunately, these protocols fail because an attacker can capture some of the particles in a transmitted sequence and send what is left to the receiver through a quantum channel. Subsequently, the attacker can restore some of the confidential messages, giving rise to the possibility of information leakage. Here we present a new robust General N user authentication protocol based on N-particle Greenberger-Horne-Zeilinger (GHZ) states, which makes eavesdropping detection more effective and secure, as compared to some current authentication protocols. The security analysis of our protocol for various kinds of attacks verifies that it is unconditionally secure, and that an attacker will not obtain any information about the transmitted key. Moreover, as the number of transferred key bits N becomes larger, while the number of users for transmitting the information is increased, the probability of effectively obtaining the transmitted authentication keys is reduced to zero.

  18. Not lost in translation: generalization of the primary systems hypothesis to Japanese-specific language processes.

    Science.gov (United States)

    Ueno, Taiji; Saito, Satoru; Saito, Akie; Tanida, Yuki; Patterson, Karalyn; Lambon Ralph, Matthew A

    2014-02-01

    The emergentist-connectionist approach assumes that language processing reflects interaction between primary neural systems (Primary Systems Hypothesis). This idea offers an overarching framework that generalizes to various kinds of (English) language and nonverbal cognitive activities. The current study advances this approach with respect to language in two new and important ways. The first is the provision of a neuroanatomically constrained implementation of the theory. The second is a test of its ability to generalize to a language other than English (in this case Japanese) and, in particular, to a feature of that language (pitch accent) for which there is no English equivalent. A corpus analysis revealed the presence and distribution of typical and atypical accent forms in Japanese vocabulary, forming a quasiregular domain. Consequently, according to the Primary Systems Hypothesis, there should be a greater semantic impact on the processing of words with an atypical pitch accent. In turn, when word meaning is intrinsically less rich (e.g., abstract words), speakers should be prone to regularization errors of pitch accent. We explored these semantic-phonological interactions, first, in a neuroanatomically constrained, parallel-distributed processing model of spoken language processing. This model captured the accent typicality effect observed in nonword repetition in Japanese adults and children and exhibited the predicted semantic impact on repetition of words with atypical accent patterns. Second, also as predicted, in word repetition and immediate serial recall of spoken words, human participants exhibited reduced pitch-accent accuracy and/or slower RT for low imageability words with atypical accent patterns, and they generated accent errors reflecting the more typical accent patterns found in Japanese.

  19. Development of a Scale for Domain General Perceived Control Scale Primary School ChildrensAND#8217;

    Directory of Open Access Journals (Sweden)

    Esra Dereli

    2012-06-01

    Full Text Available SUMMARY AIM: This study aimed to develop a scale to measure domain general perceived control scale for elementary age children. METHOD: Participants were a total of 341 primary school children, 4th and f4th grade for 152 students, 6th, 7th and 8th grade for 162 students aged between 10-14.Skinner (1996, perceived control based on the theory is created 12-item scale of perceived control of the general form of the trial for primary education children and this form, within the scope of the research subjects, are given in order to make the validity and reliability studies. In order to test the validity of the scale developed, Satisfaction with Life was used. This scale was developed by Diener et al. (1985 and adapted into Turkish by Yetim (1993. RESULTS:Exploratory and confirmatory factor analysises and certain reliability analyses were used in the study. As a result of the analysis, four Likert-type five items scale were obtained. The findings revealed one -dimensional scale, 46.35% of whose variance was explained. Cronbach’s coefficient alpha provided evidence for the internal consistency of the exploratory the Scale. The reliability of the scale was 0.70 and indicated that the 5 item scale had good internal consistency for the sample. CONCLUSION: The scale that resulted was given the title “Scale for Primary School Children’ Time Orientation during Classroom Disengagement”. This instrument may be used in various studies in the future, thus contributing to the development of the field. [TAF Prev Med Bull 2012; 11(3.000: 331-338

  20. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

    Directory of Open Access Journals (Sweden)

    Judith McLenan

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  1. The Rationality of Four Metrics of Network Robustness: A Viewpoint of Robust Growth of Generalized Meshes.

    Directory of Open Access Journals (Sweden)

    Xiaofan Yang

    Full Text Available There are quite a number of different metrics of network robustness. This paper addresses the rationality of four metrics of network robustness (the algebraic connectivity, the effective resistance, the average edge betweenness, and the efficiency by investigating the robust growth of generalized meshes (GMs. First, a heuristic growth algorithm (the Proximity-Growth algorithm is proposed. The resulting proximity-optimal GMs are intuitively robust and hence are adopted as the benchmark. Then, a generalized mesh (GM is grown up by stepwise optimizing a given measure of network robustness. The following findings are presented: (1 The algebraic connectivity-optimal GMs deviate quickly from the proximity-optimal GMs, yielding a number of less robust GMs. This hints that the rationality of the algebraic connectivity as a measure of network robustness is still in doubt. (2 The effective resistace-optimal GMs and the average edge betweenness-optimal GMs are in line with the proximity-optimal GMs. This partly justifies the two quantities as metrics of network robustness. (3 The efficiency-optimal GMs deviate gradually from the proximity-optimal GMs, yielding some less robust GMs. This suggests the limited utility of the efficiency as a measure of network robustness.

  2. Generalized network modeling of capillary-dominated two-phase flow.

    Science.gov (United States)

    Raeini, Ali Q; Bijeljic, Branko; Blunt, Martin J

    2018-02-01

    We present a generalized network model for simulating capillary-dominated two-phase flow through porous media at the pore scale. Three-dimensional images of the pore space are discretized using a generalized network-described in a companion paper [A. Q. Raeini, B. Bijeljic, and M. J. Blunt, Phys. Rev. E 96, 013312 (2017)2470-004510.1103/PhysRevE.96.013312]-which comprises pores that are divided into smaller elements called half-throats and subsequently into corners. Half-throats define the connectivity of the network at the coarsest level, connecting each pore to half-throats of its neighboring pores from their narrower ends, while corners define the connectivity of pore crevices. The corners are discretized at different levels for accurate calculation of entry pressures, fluid volumes, and flow conductivities that are obtained using direct simulation of flow on the underlying image. This paper discusses the two-phase flow model that is used to compute the averaged flow properties of the generalized network, including relative permeability and capillary pressure. We validate the model using direct finite-volume two-phase flow simulations on synthetic geometries, and then present a comparison of the model predictions with a conventional pore-network model and experimental measurements of relative permeability in the literature.

  3. Learning the Relationship between the Primary Structure of HIV Envelope Glycoproteins and Neutralization Activity of Particular Antibodies by Using Artificial Neural Networks

    Science.gov (United States)

    Buiu, Cătălin; Putz, Mihai V.; Avram, Speranta

    2016-01-01

    The dependency between the primary structure of HIV envelope glycoproteins (ENV) and the neutralization data for given antibodies is very complicated and depends on a large number of factors, such as the binding affinity of a given antibody for a given ENV protein, and the intrinsic infection kinetics of the viral strain. This paper presents a first approach to learning these dependencies using an artificial feedforward neural network which is trained to learn from experimental data. The results presented here demonstrate that the trained neural network is able to generalize on new viral strains and to predict reliable values of neutralizing activities of given antibodies against HIV-1. PMID:27727189

  4. Learning the Relationship between the Primary Structure of HIV Envelope Glycoproteins and Neutralization Activity of Particular Antibodies by Using Artificial Neural Networks.

    Science.gov (United States)

    Buiu, Cătălin; Putz, Mihai V; Avram, Speranta

    2016-10-11

    The dependency between the primary structure of HIV envelope glycoproteins (ENV) and the neutralization data for given antibodies is very complicated and depends on a large number of factors, such as the binding affinity of a given antibody for a given ENV protein, and the intrinsic infection kinetics of the viral strain. This paper presents a first approach to learning these dependencies using an artificial feedforward neural network which is trained to learn from experimental data. The results presented here demonstrate that the trained neural network is able to generalize on new viral strains and to predict reliable values of neutralizing activities of given antibodies against HIV-1.

  5. Generalized anxiety disorder in primary care: emerging issues in management and treatment.

    Science.gov (United States)

    Culpepper, Larry

    2002-01-01

    Generalized anxiety disorder (GAD) is highly prevalent in primary care patients and is a source of major morbidity. The low rate of recognition and diagnosis of GAD is often the result of insufficient knowledge on the part of primary care physicians, time pressures, and competing demands during patients' visits. Patient attribution of symptoms and the stigma related to mental illness also contribute to underrecognition. Other contributing factors include the natural history of GAD, the bimodal age of presentation, a chronic but waxing and waning course, frequent comorbidity with other anxiety and depressive disorders, and the controversy regarding the best diagnostic criteria. However, proper diagnosis is critical to appropriate management. Primary care management of GAD and associated comorbidities includes education about the nature of GAD as a medical disorder that is amenable to treatment and counseling about treatment alternatives and coping strategies. Most patients with GAD suffer from insomnia, and treating insomnia can be of great benefit to them. While cognitive-behavioral therapy and relaxation therapy are effective in treating GAD, most patients in primary care settings are likely to require pharmacologic treatment. Although commonly used, benzodiazepines and their short-term benefits are overshadowed by their decreased long-term effectiveness, their minimal treatment of psychic symptoms, and their degradation of patient performance. The selective serotonin reuptake inhibitor (SSRI) paroxetine is indicated for the short-term treatment of GAD, although adequate data supporting the use of most SSRIs for GAD are not yet available. The serotonin-norepinephrine reuptake inhibitor venlafaxine provides a treatment option resulting in both short- and long-term improvement of symptoms, attaining not only a response but also remission from GAD and prevention of relapse.

  6. Raising the topic of weight in general practice: perspectives of GPs and primary care nurses.

    Science.gov (United States)

    Blackburn, Maxine; Stathi, Afroditi; Keogh, Edmund; Eccleston, Christopher

    2015-08-07

    To explore general practitioners' (GPs) and primary care nurses' perceived barriers to raising the topic of weight in general practice. A qualitative study using the Theoretical Domains Framework (TDF). 34 semistructured interviews were conducted to explore views, opinions and experiences of initiating a discussion about weight. Content and thematic analyses were used to analyse the interview transcripts. General practices located in one primary care trust in the South West of England. 17 GPs and 17 nurses aged between 32 and 66 years. The modal age range for GPs was 30-39 years and for nurses, 40-49 years. Barriers were synthesised into three main themes: (1) limited understanding about obesity care, (2) concern about negative consequences, and (3) having time and resources to raise a sensitive topic. Most barriers were related to raising the topic in more routine settings, rather than when dealing with an associated medical condition. GPs were particularly worried about damaging their relationship with patients and emphasised the need to follow their patient's agenda. Uncertainty about obesity, concerns about alienating patients and feeling unable to raise the topic within the constraints of a 10 min consultation, is adding to the reluctance of GPs and nurses to broach the topic of weight. Addressing these concerns through training or by providing evidence of effective interventions that are feasible to deliver within consultations may lead to greater practitioner engagement and willingness to raise the topic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. SNR Wall Effect Alleviation by Generalized Detector Employed in Cognitive Radio Networks.

    Science.gov (United States)

    Shbat, Modar Safir; Tuzlukov, Vyacheslav

    2015-07-03

    The most commonly used spectrum sensing techniques in cognitive radio (CR) networks, such as the energy detector (ED), matched filter (MF), and others, suffer from the noise uncertainty and signal-to-noise ratio (SNR) wall phenomenon. These detectors cannot achieve the required signal detection performance regardless of the sensing time. In this paper, we explore a signal processing scheme, namely, the generalized detector (GD) constructed based on the generalized approach to signal processing (GASP) in noise, in spectrum sensing of CR network based on antenna array with the purpose to alleviate the SNR wall problem and improve the signal detection robustness under the low SNR. The simulation results confirm our theoretical issues and effectiveness of GD implementation in CR networks based on antenna array.

  8. SNR Wall Effect Alleviation by Generalized Detector Employed in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Modar Safir Shbat

    2015-07-01

    Full Text Available The most commonly used spectrum sensing techniques in cognitive radio (CR networks, such as the energy detector (ED, matched filter (MF, and others, suffer from the noise uncertainty and signal-to-noise ratio (SNR wall phenomenon. These detectors cannot achieve the required signal detection performance regardless of the sensing time. In this paper, we explore a signal processing scheme, namely, the generalized detector (GD constructed based on the generalized approach to signal processing (GASP in noise, in spectrum sensing of CR network based on antenna array with the purpose to alleviate the SNR wall problem and improve the signal detection robustness under the low SNR. The simulation results confirm our theoretical issues and effectiveness of GD implementation in CR networks based on antenna array.

  9. General rules for managing and surveying networks of pests, diseases, and endangered species.

    Science.gov (United States)

    Chadès, Iadine; Martin, Tara G; Nicol, Samuel; Burgman, Mark A; Possingham, Hugh P; Buckley, Yvonne M

    2011-05-17

    The efficient management of diseases, pests, or endangered species is an important global issue faced by agencies constrained by limited resources. The management challenge is even greater when organisms are difficult to detect. We show how to prioritize management and survey effort across time and space for networks of susceptible-infected-susceptible subpopulations. We present simple and robust rules of thumb for protecting desirable, or eradicating undesirable, subpopulations connected in typical network patterns (motifs). We further demonstrate that these rules can be generalized to larger networks when motifs are combined in more complex formations. Results show that the best location to manage or survey a pest or a disease on a network is also the best location to protect or survey an endangered species. The optimal starting point in a network is the fastest motif to manage, where line, star, island, and cluster motifs range from fast to slow. Managing the most connected node at the right time and maintaining the same management direction provide advantages over previously recommended outside-in strategies. When a species or disease is not detected and our belief in persistence decreases, our results recommend shifting resources toward management or surveillance of the most connected nodes. Our analytic approximation provides guidance on how long we should manage or survey networks for hard-to-detect organisms. Our rules take into account management success, dispersal, economic cost, and imperfect detection and offer managers a practical basis for managing networks relevant to many significant environmental, biosecurity, and human health issues.

  10. A comparison of back propagation and Generalized Regression Neural Networks performance in neutron spectrometry

    International Nuclear Information System (INIS)

    Martínez-Blanco, Ma. del Rosario

    2016-01-01

    The process of unfolding the neutron energy spectrum has been subject of research for many years. Monte Carlo, iterative methods, the bayesian theory, the principle of maximum entropy are some of the methods used. The drawbacks associated with traditional unfolding procedures have motivated the research of complementary approaches. Back Propagation Neural Networks (BPNN), have been applied with success in neutron spectrometry and dosimetry domains, however, the structure and learning parameters are factors that highly impact in the networks performance. In ANN domain, Generalized Regression Neural Network (GRNN) is one of the simplest neural networks in term of network architecture and learning algorithm. The learning is instantaneous, requiring no time for training. Opposite to BPNN, a GRNN would be formed instantly with just a 1-pass training on the development data. In the network development phase, the only hurdle is to optimize the hyper-parameter, which is known as sigma, governing the smoothness of the network. The aim of this work was to compare the performance of BPNN and GRNN in the solution of the neutron spectrometry problem. From results obtained it can be observed that despite the very similar results, GRNN performs better than BPNN.

  11. A generalized LSTM-like training algorithm for second-order recurrent neural networks.

    Science.gov (United States)

    Monner, Derek; Reggia, James A

    2012-01-01

    The long short term memory (LSTM) is a second-order recurrent neural network architecture that excels at storing sequential short-term memories and retrieving them many time-steps later. LSTM's original training algorithm provides the important properties of spatial and temporal locality, which are missing from other training approaches, at the cost of limiting its applicability to a small set of network architectures. Here we introduce the generalized long short-term memory(LSTM-g) training algorithm, which provides LSTM-like locality while being applicable without modification to a much wider range of second-order network architectures. With LSTM-g, all units have an identical set of operating instructions for both activation and learning, subject only to the configuration of their local environment in the network; this is in contrast to the original LSTM training algorithm, where each type of unit has its own activation and training instructions. When applied to LSTM architectures with peephole connections, LSTM-g takes advantage of an additional source of back-propagated error which can enable better performance than the original algorithm. Enabled by the broad architectural applicability of LSTM-g, we demonstrate that training recurrent networks engineered for specific tasks can produce better results than single-layer networks. We conclude that LSTM-g has the potential to both improve the performance and broaden the applicability of spatially and temporally local gradient-based training algorithms for recurrent neural networks. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Fuzzy modeling based on generalized neural networks and fuzzy clustering objective functions

    Science.gov (United States)

    Sun, Chuen-Tsai; Jang, Jyh-Shing

    1991-01-01

    An approach to the formulation of fuzzy if-then rules based on clustering objective functions is proposed. The membership functions are then calibrated with the generalized neural networks technique to achieve a desired input-output mapping. The learning procedure is basically a gradient-descent algorithm. A Kalman filter algorithm is used to improve the overall performance.

  13. Relay-Assisted Primary and Secondary Transmissions in Cognitive Radio Networks

    KAUST Repository

    Shafie, Ahmed El

    2016-09-27

    We assume a set of cognitive relay nodes that assists both primary and secondary transmissions in a time-slotted cognitive radio networks. To regulate the channel access of the various nodes in the network, we propose an overlapped spectrum sensing strategy for channel sensing, where the secondary source node senses the channel from the beginning of the time slot and the cognitive relay nodes sense the channel for double the sensing time used by the secondary source node to detect the activities of both the primary and secondary source nodes. Hence, the secondary source node has an intrinsic priority over the relay nodes. The relay nodes help both the primary user and the secondary user to deliver their unsuccessfully decoded packets at their destinations. In a given time slot, the scheduled relay node for data transmission starts its transmission when both the primary and secondary users are sensed to be inactive (i.e. have no data to transmit). We propose two optimization-based formulations with quality-of-service (QoS) constraints involving average queueing delay and average service rate requirements. We investigate both cases of perfect and imperfect spectrum sensing. To further enhance the users\\' QoS requirements, we propose three packet decoding strategies at the relay nodes and compare their performance. We derive an upper bound on the secondary queue average service rate to determine which decoding strategy can achieve that bound. Our numerical results show the benefits of relaying and its ability to enhance the performance of both the primary and secondary users. Moreover, the performance of the proposed schemes is close to the derived upper bound.

  14. Medical overuse and quaternary prevention in primary care - A qualitative study with general practitioners.

    Science.gov (United States)

    Alber, Kathrin; Kuehlein, Thomas; Schedlbauer, Angela; Schaffer, Susann

    2017-12-08

    Medical overuse is a topic of growing interest in health care systems and especially in primary care. It comprises both over investigation and overtreatment. Quaternary prevention strategies aim at protecting patients from unnecessary or harmful medicine. The objective of this study was to gain a deeper understanding of relevant aspects of medical overuse in primary care from the perspective of German general practitioners (GPs). We focused on the scope, consequences and drivers of medical overuse and strategies to reduce it (=quaternary prevention). We used the qualitative Grounded Theory approach. Theoretical sampling was carried out to recruit GPs in Bavaria, Germany. We accessed the field of research through GPs with academic affiliation, recommendations by interview partners and personal contacts. They differed in terms of primary care experience, gender, region, work experience abroad, academic affiliation, type of specialist training, practice organisation and position. Qualitative in-depth face-to-face interviews with a semi-structured interview guide were conducted (n = 13). The interviews were audiotaped and transcribed verbatim. Data analysis was carried out using open and axial coding. GPs defined medical overuse as unnecessary investigations and treatment that lack patient benefit or bear the potential to cause harm. They observed that medical overuse takes place in all three German reimbursement categories: statutory health insurance, private insurance and individual health services (direct payment). GPs criticised the poor acceptance of gate-keeping in German primary care. They referred to a low-threshold referral policy and direct patient access to outpatient secondary care, leading to specialist treatment without clear medical indication. The GPs described various direct drivers of medical overuse within their direct area of influence. They also emphasised indirect drivers related to system or societal processes. The proposed strategies for

  15. Dysregulation of Microtubule Stability Impairs Morphofunctional Connectivity in Primary Neuronal Networks.

    Science.gov (United States)

    Verstraelen, Peter; Detrez, Jan R; Verschuuren, Marlies; Kuijlaars, Jacobine; Nuydens, Rony; Timmermans, Jean-Pierre; De Vos, Winnok H

    2017-01-01

    Functionally related neurons assemble into connected networks that process and transmit electrochemical information. To do this in a coordinated manner, the number and strength of synaptic connections is tightly regulated. Synapse function relies on the microtubule (MT) cytoskeleton, the dynamics of which are in turn controlled by a plethora of MT-associated proteins, including the MT-stabilizing protein Tau. Although mutations in the Tau-encoding MAPT gene underlie a set of neurodegenerative disorders, termed tauopathies, the exact contribution of MT dynamics and the perturbation thereof to neuronal network connectivity has not yet been scrutinized. Therefore, we investigated the impact of targeted perturbations of MT stability on morphological (e.g., neurite- and synapse density) and functional (e.g., synchronous calcium bursting) correlates of connectivity in networks of primary hippocampal neurons. We found that treatment with MT-stabilizing or -destabilizing compounds impaired morphofunctional connectivity in a reversible manner. We also discovered that overexpression of MAPT induced significant connectivity defects, which were accompanied by alterations in MT dynamics and increased resistance to pharmacological MT depolymerization. Overexpression of a MAPT variant harboring the P301L point mutation in the MT-binding domain did far less, directly linking neuronal connectivity with Tau's MT binding affinity. Our results show that MT stability is a vulnerable node in tauopathies and that its precise pharmacological tuning may positively affect neuronal network connectivity. However, a critical balance in MT turnover causes it to be a difficult therapeutic target with a narrow operating window.

  16. Millisecond-timescale local network coding in the rat primary somatosensory cortex.

    Directory of Open Access Journals (Sweden)

    Seif Eldawlatly

    Full Text Available Correlation among neocortical neurons is thought to play an indispensable role in mediating sensory processing of external stimuli. The role of temporal precision in this correlation has been hypothesized to enhance information flow along sensory pathways. Its role in mediating the integration of information at the output of these pathways, however, remains poorly understood. Here, we examined spike timing correlation between simultaneously recorded layer V neurons within and across columns of the primary somatosensory cortex of anesthetized rats during unilateral whisker stimulation. We used bayesian statistics and information theory to quantify the causal influence between the recorded cells with millisecond precision. For each stimulated whisker, we inferred stable, whisker-specific, dynamic bayesian networks over many repeated trials, with network similarity of 83.3±6% within whisker, compared to only 50.3±18% across whiskers. These networks further provided information about whisker identity that was approximately 6 times higher than what was provided by the latency to first spike and 13 times higher than what was provided by the spike count of individual neurons examined separately. Furthermore, prediction of individual neurons' precise firing conditioned on knowledge of putative pre-synaptic cell firing was 3 times higher than predictions conditioned on stimulus onset alone. Taken together, these results suggest the presence of a temporally precise network coding mechanism that integrates information across neighboring columns within layer V about vibrissa position and whisking kinetics to mediate whisker movement by motor areas innervated by layer V.

  17. Dysregulation of Microtubule Stability Impairs Morphofunctional Connectivity in Primary Neuronal Networks

    Directory of Open Access Journals (Sweden)

    Peter Verstraelen

    2017-06-01

    Full Text Available Functionally related neurons assemble into connected networks that process and transmit electrochemical information. To do this in a coordinated manner, the number and strength of synaptic connections is tightly regulated. Synapse function relies on the microtubule (MT cytoskeleton, the dynamics of which are in turn controlled by a plethora of MT-associated proteins, including the MT-stabilizing protein Tau. Although mutations in the Tau-encoding MAPT gene underlie a set of neurodegenerative disorders, termed tauopathies, the exact contribution of MT dynamics and the perturbation thereof to neuronal network connectivity has not yet been scrutinized. Therefore, we investigated the impact of targeted perturbations of MT stability on morphological (e.g., neurite- and synapse density and functional (e.g., synchronous calcium bursting correlates of connectivity in networks of primary hippocampal neurons. We found that treatment with MT-stabilizing or -destabilizing compounds impaired morphofunctional connectivity in a reversible manner. We also discovered that overexpression of MAPT induced significant connectivity defects, which were accompanied by alterations in MT dynamics and increased resistance to pharmacological MT depolymerization. Overexpression of a MAPT variant harboring the P301L point mutation in the MT-binding domain did far less, directly linking neuronal connectivity with Tau's MT binding affinity. Our results show that MT stability is a vulnerable node in tauopathies and that its precise pharmacological tuning may positively affect neuronal network connectivity. However, a critical balance in MT turnover causes it to be a difficult therapeutic target with a narrow operating window.

  18. Neural networks with multiple general neuron models: a hybrid computational intelligence approach using Genetic Programming.

    Science.gov (United States)

    Barton, Alan J; Valdés, Julio J; Orchard, Robert

    2009-01-01

    Classical neural networks are composed of neurons whose nature is determined by a certain function (the neuron model), usually pre-specified. In this paper, a type of neural network (NN-GP) is presented in which: (i) each neuron may have its own neuron model in the form of a general function, (ii) any layout (i.e network interconnection) is possible, and (iii) no bias nodes or weights are associated to the connections, neurons or layers. The general functions associated to a neuron are learned by searching a function space. They are not provided a priori, but are rather built as part of an Evolutionary Computation process based on Genetic Programming. The resulting network solutions are evaluated based on a fitness measure, which may, for example, be based on classification or regression errors. Two real-world examples are presented to illustrate the promising behaviour on classification problems via construction of a low-dimensional representation of a high-dimensional parameter space associated to the set of all network solutions.

  19. [The new postgraduate training program in general internal medicine: implications for the primary care physician].

    Science.gov (United States)

    Monti, Matteo; Gachoud, David

    2010-11-03

    The Swiss postgraduate training program in general internal medicine is now designed as a competency-based curriculum. In other words, by the end of their training, the residents should demonstrate a set of predefined competences. Many of those competences have to be learnt in outpatient settings. Thus, the primary care physicians have more than ever an important role to play in educating tomorrows doctors. A competency-based model of training requires a regular assessment of the residents. The mini-CEX (mini-Clinical Evaluation eXercise) is the assessment tool proposed by the Swiss institute for postgraduate and continuing education. The mini-CEX is based on the direct observation of the trainees performing a specific task, as well as on the ensuing feedback. This article aims at introducing our colleagues in charge of residents to the mini-CEX, which is a useful tool promoting the culture of feedback in medical education.

  20. Diagnosis and treatment of panic disorder and generalized anxiety in primary care.

    Science.gov (United States)

    Valente, S M

    1996-08-01

    Anxiety is one of the common yet underdiagnosed mental health problems of Americans; as many as 20% of people seeking primary care have symptoms of treatable anxiety disorders. Untreated anxiety increases costly visits to urgent care. Clinicians need to screen for anxiety among patients at risk who have physical symptoms such as shortness of breath, nervousness, gastrointestinal upset, palpitations, muscle aches, tension, and insomnia. Other diagnostic clues include restlessness, nervousness, phobias, trembling, fatigue, and shaking. Onset typically occurs in the 20s but may occur at any age. Symptoms of two anxiety disorders, generalized anxiety disorder (GAD) and panic disorder, are discussed. A combination of treatments including antidepressant and anxiolytic medications, behavioral treatments, education (e.g., self-management, relaxation), and counseling (e.g., coping strategies) have high success rates; psychiatric consultations or referrals are useful.

  1. Gambling problems among patients in primary care: a cross-sectional study of general practices.

    Science.gov (United States)

    Cowlishaw, Sean; Gale, Lone; Gregory, Alison; McCambridge, Jim; Kessler, David

    2017-04-01

    Primary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems. To indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability. Cross-sectional study of patients attending 11 general practices in Bristol, South West England. Adult patients ( n = 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced. There were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1-4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression. There is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention. © British Journal of General Practice 2017.

  2. Generalized network modeling of capillary-dominated two-phase flow

    Science.gov (United States)

    Raeini, Ali Q.; Bijeljic, Branko; Blunt, Martin J.

    2018-02-01

    We present a generalized network model for simulating capillary-dominated two-phase flow through porous media at the pore scale. Three-dimensional images of the pore space are discretized using a generalized network—described in a companion paper [A. Q. Raeini, B. Bijeljic, and M. J. Blunt, Phys. Rev. E 96, 013312 (2017), 10.1103/PhysRevE.96.013312]—which comprises pores that are divided into smaller elements called half-throats and subsequently into corners. Half-throats define the connectivity of the network at the coarsest level, connecting each pore to half-throats of its neighboring pores from their narrower ends, while corners define the connectivity of pore crevices. The corners are discretized at different levels for accurate calculation of entry pressures, fluid volumes, and flow conductivities that are obtained using direct simulation of flow on the underlying image. This paper discusses the two-phase flow model that is used to compute the averaged flow properties of the generalized network, including relative permeability and capillary pressure. We validate the model using direct finite-volume two-phase flow simulations on synthetic geometries, and then present a comparison of the model predictions with a conventional pore-network model and experimental measurements of relative permeability in the literature.

  3. Dynamical influence processes on networks: general theory and applications to social contagion.

    Science.gov (United States)

    Harris, Kameron Decker; Danforth, Christopher M; Dodds, Peter Sheridan

    2013-08-01

    We study binary state dynamics on a network where each node acts in response to the average state of its neighborhood. By allowing varying amounts of stochasticity in both the network and node responses, we find different outcomes in random and deterministic versions of the model. In the limit of a large, dense network, however, we show that these dynamics coincide. We construct a general mean-field theory for random networks and show this predicts that the dynamics on the network is a smoothed version of the average response function dynamics. Thus, the behavior of the system can range from steady state to chaotic depending on the response functions, network connectivity, and update synchronicity. As a specific example, we model the competing tendencies of imitation and nonconformity by incorporating an off-threshold into standard threshold models of social contagion. In this way, we attempt to capture important aspects of fashions and societal trends. We compare our theory to extensive simulations of this "limited imitation contagion" model on Poisson random graphs, finding agreement between the mean-field theory and stochastic simulations.

  4. Probabilistic Inference in General Graphical Models through Sampling in Stochastic Networks of Spiking Neurons

    Science.gov (United States)

    Pecevski, Dejan; Buesing, Lars; Maass, Wolfgang

    2011-01-01

    An important open problem of computational neuroscience is the generic organization of computations in networks of neurons in the brain. We show here through rigorous theoretical analysis that inherent stochastic features of spiking neurons, in combination with simple nonlinear computational operations in specific network motifs and dendritic arbors, enable networks of spiking neurons to carry out probabilistic inference through sampling in general graphical models. In particular, it enables them to carry out probabilistic inference in Bayesian networks with converging arrows (“explaining away”) and with undirected loops, that occur in many real-world tasks. Ubiquitous stochastic features of networks of spiking neurons, such as trial-to-trial variability and spontaneous activity, are necessary ingredients of the underlying computational organization. We demonstrate through computer simulations that this approach can be scaled up to neural emulations of probabilistic inference in fairly large graphical models, yielding some of the most complex computations that have been carried out so far in networks of spiking neurons. PMID:22219717

  5. Reconstructing Generalized Logical Networks of Transcriptional Regulation in Mouse Brain from Temporal Gene Expression Data

    Directory of Open Access Journals (Sweden)

    Lodowski Kerrie H

    2009-01-01

    Full Text Available Gene expression time course data can be used not only to detect differentially expressed genes but also to find temporal associations among genes. The problem of reconstructing generalized logical networks to account for temporal dependencies among genes and environmental stimuli from transcriptomic data is addressed. A network reconstruction algorithm was developed that uses statistical significance as a criterion for network selection to avoid false-positive interactions arising from pure chance. The multinomial hypothesis testing-based network reconstruction allows for explicit specification of the false-positive rate, unique from all extant network inference algorithms. The method is superior to dynamic Bayesian network modeling in a simulation study. Temporal gene expression data from the brains of alcohol-treated mice in an analysis of the molecular response to alcohol are used for modeling. Genes from major neuronal pathways are identified as putative components of the alcohol response mechanism. Nine of these genes have associations with alcohol reported in literature. Several other potentially relevant genes, compatible with independent results from literature mining, may play a role in the response to alcohol. Additional, previously unknown gene interactions were discovered that, subject to biological verification, may offer new clues in the search for the elusive molecular mechanisms of alcoholism.

  6. A General Model for Representing Arbitrary Unsymmetries in Various Types of Network Analysis

    DEFF Research Database (Denmark)

    Rønne-Hansen, Jan

    1997-01-01

    When dealing with unsymmetric faults various proposals have been put forward. In general they have been characterized by specific treatment of the single fault in accordance with the structure and impedances involved. The model presented is based on node equations and was originally developed...... for transient stability studies in order to allow for an arbitrary fault representation as seen from the positive sequence network. The method results in impedances -or admittances-combining the negative sequence and zero sequence representation for the symmetrical network with the structure and electrical...

  7. Organizational factors influencing inter-professional team functioning in primary care networks.

    Science.gov (United States)

    Hepp, Shelanne; Misfeldt, Renee; Lait, Jana; Armitage, Gail D; Suter, Esther

    2014-01-01

    This study examined organizational factors influencing the functioning of inter-professional teams in select primary care networks (PCNs) in Alberta. Seven PCNs participated, each identifying two teams to be interviewed. The study used an exploratory qualitative approach to collect information from 118 physicians, managers and other clinical and non-clinical staff. Organizational factors affecting these teams included leadership and workplace culture, physical infrastructure, information technology infrastructure, organizational supports and employment models. The authors offer organizational strategies that enhance inter-professional team functioning based on interviewee recommendations and the existing literature. Further research is needed to link the strategies to measureable outcomes. Copyright © 2014 Longwoods Publishing.

  8. Cognitive Multiple Access Network with Outage Margin in the Primary System

    DEFF Research Database (Denmark)

    Maham, Behrouz; Popovski, Petar; Zhou, Xiangyun

    2011-01-01

    This paper investigates the problem of spectrally efficient operation of a multiuser uplink cognitive radio system in the presence of a single primary link. The secondary system applies opportunistic interference cancelation (OIC) and decodes the primary signal when such an opportunity is created...... the accuracy of the analysis, and the fact that the spectral-efficient, low-complexity, flexible, and high-performing cognitive radio can be designed based on the proposed schemes....... system is exposed to interference from secondary users. Moreover, approximated formulas and tight lower and upper bounds for the ergodic sum-rate capacity of the secondary network are found. Next, the power allocation is investigated in the secondary system for maximizing the sum-rate under an outage...

  9. Performance modeling of a two-tier primary-secondary network with IEEE 802.11 broadcast scheme

    KAUST Repository

    Khabazian, Mehdi

    2011-03-01

    In this paper, we study the performance of a two-tier primary-secondary network based on IEEE 802.11 broadcast scheme. We assume that a number of primary and secondary users coexist in the radio environment and share a single band. To protect the primary users\\' priority, the secondary users are allowed to contend for the channel only if they sense it idle for a certain sensing time. Considering an exponential packet inter-arrival time for the primary network, we model each primary user as an independent M/G/1 queue. Subsequently, we determine the primary users\\' average medium access delay in the presence of secondary users as well as the hybrid network\\'s throughput. Numerical results and discussions show the effects of parameters pertaining to the secondary users, such as as sensing time, packet payload size and population size, on the performance of the primary network. Furthermore, we provide simulation results which confirm the accuracy of the proposed analysis. © 2011 IEEE.

  10. Management of dental trauma in primary care: a postal survey of general dental practitioners.

    Science.gov (United States)

    Jackson, N G; Waterhouse, P J; Maguire, A

    2005-03-12

    To determine the self-perceived knowledge and attitudes of general dental practitioners (GDPs) concerning management of dental trauma in primary care. To identify potential barriers to the management of dental trauma in primary care. A self-completion postal questionnaire survey of 417 GDPs in six local health authority districts in northeast England. Likert scale responses to 20 statements designed to test self-perceived knowledge and attitudes. Following descriptive statistical analysis. Factor analysis with principle components analysis was undertaken to identify areas of correlation in questionnaire responses, followed by Chi squared test, Spearman's Rank Correlation and analysis of variance (ANOVA) to measure association between variables. The response rate was 74%. Enamel and dentine fractures were the most common injury, with 45% of GDPs responding seeing more than 10 cases of dental trauma in the preceding year and 53% of respondents seeing one to three cases of complicated crown fracture. Seventy-eight per cent believed that NHS remuneration was inadequate, but only 8% would refer patients with dental trauma to secondary care for this reason. Half of the GDPs believed that trauma could be treated more effectively in practice if NHS payments were greater. GDPs were significantly more likely to agree with this statement if they had previously undertaken a postgraduate course in the treatment of dental trauma (p=0.002). Single handed GDPs were statistically significantly more likely to agree with the statements 'I would not treat dental trauma cases at my practice because the NHS payment is inadequate' (p=0.008) and 'Treating dental trauma at my practice requires too much of my clinical time to be worthwhile' (p=0.002). Ninety-six per cent of GDPs disagreed that treatment of dental trauma rested solely within secondary care. Ninety-six per cent of GDPs agreed that they had a responsibility to provide initial emergency treatment for trauma patients prior to

  11. Agreement among dentists’ restorative treatment planning thresholds for primary occlusal caries, primary proximal caries, and existing restorations: Findings from The National Dental Practice-Based Research Network

    Science.gov (United States)

    Heaven, Tim J.; Gordan, Valeria V.; Litaker, Mark S.; Fellows, Jeffrey L.; Rindal, D. Brad; Firestone, Allen R.; Gilbert, Gregg H.

    2013-01-01

    Objectives The aim of this study was to quantify the agreement among individual National Dental Practice-Based Research Network dentists’ self-reported treatment decisions for primary occlusal caries, primary proximal caries, and existing restorations. Methods Five hypothetical clinical scenarios were presented: primary occlusal caries; primary proximal caries; and whether three existing restorations should be repaired or replaced. We quantified the probability that dentists who recommended later restorative intervention for primary caries were the same ones who recommended that existing restorations be repaired instead of replaced. Results Dentists who recommended later restorative treatment of primary occlusal caries and proximal caries at a more-advanced stage were significantly more likely to recommend repair instead of replacement. Agreement among dentists on a threshold stage for the treatment of primary caries ranged from 40 to 68%, while that for repair or replacement of existing restorations was 36 to 43%. Conclusions Dentists who recommended repair rather than replacement of existing restorations were significantly more likely to recommend later treatment of primary caries. Conversely, dentists who recommended treatment of primary caries at an earlier stage were significantly more likely to recommend replacement of the entire restoration. Between-dentist agreement for primary caries treatment was better than between-dentist agreement for repair or replacement of existing restorations. Clinical implications These findings suggest consistency in how individual dentists approach the treatment of primary caries and existing restorations. However, substantial variation was found between dentists in their treatment decisions about the same teeth. PMID:23743181

  12. Agreement among dentists' restorative treatment planning thresholds for primary occlusal caries, primary proximal caries, and existing restorations: findings from The National Dental Practice-Based Research Network.

    Science.gov (United States)

    Heaven, Tim J; Gordan, Valeria V; Litaker, Mark S; Fellows, Jeffrey L; Brad Rindal, D; Firestone, Allen R; Gilbert, Gregg H

    2013-08-01

    The aim of this study was to quantify the agreement among individual National Dental Practice-Based Research Network dentists' self-reported treatment decisions for primary occlusal caries, primary proximal caries, and existing restorations. Five hypothetical clinical scenarios were presented: primary occlusal caries; primary proximal caries; and whether three existing restorations should be repaired or replaced. We quantified the probability that dentists who recommended later restorative intervention for primary caries were the same ones who recommended that existing restorations be repaired instead of replaced. Dentists who recommended later restorative treatment of primary occlusal caries and proximal caries at a more-advanced stage were significantly more likely to recommend repair instead of replacement. Agreement among dentists on a threshold stage for the treatment of primary caries ranged from 40 to 68%, while that for repair or replacement of existing restorations was 36 to 43%. Dentists who recommended repair rather than replacement of existing restorations were significantly more likely to recommend later treatment of primary caries. Conversely, dentists who recommended treatment of primary caries at an earlier stage were significantly more likely to recommend replacement of the entire restoration. Between-dentist agreement for primary caries treatment was better than between-dentist agreement for repair or replacement of existing restorations. These findings suggest consistency in how individual dentists approach the treatment of primary caries and existing restorations. However, substantial variation was found between dentists in their treatment decisions about the same teeth. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis.

    Science.gov (United States)

    Pires, Carine Weber; Pedrotti, Djessica; Lenzi, Tathiane Larissa; Soares, Fabio Zovico Maxnuck; Ziegelmann, Patricia Klarmann; Rocha, Rachel de Oliveira

    2018-03-01

    This study aimed to compare the longevity of different conventional restorative materials placed in posterior primary teeth. This systematic review was conducted following the PRISMA statement and registered in PROSPERO (CRD42016035775). A comprehensive electronic search without date or language restrictions was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, Turning Research Into Practice (TRIP) and Clinical Trials databases up to January 2017, selecting randomized clinical trials that assessed the longevity of at least two different conventional restorative materials performed in primary molars. Seventeen studies were included in this systematic review. Pairwise and network meta-analyses were performed and relative risks and 95% confidence intervals (CI) calculated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer, resin-modified glass ionomer cement, amalgam, and composite resin. Risk of bias was low in most studies (45.38% of all items across studies). Pediatric dentists should avoid conventional glass ionomer cement for restoring primary molars.

  14. Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis

    Directory of Open Access Journals (Sweden)

    Carine Weber Pires

    2018-03-01

    Full Text Available Abstract This study aimed to compare the longevity of different conventional restorative materials placed in posterior primary teeth. This systematic review was conducted following the PRISMA statement and registered in PROSPERO (CRD42016035775. A comprehensive electronic search without date or language restrictions was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, Turning Research Into Practice (TRIP and Clinical Trials databases up to January 2017, selecting randomized clinical trials that assessed the longevity of at least two different conventional restorative materials performed in primary molars. Seventeen studies were included in this systematic review. Pairwise and network meta-analyses were performed and relative risks and 95% confidence intervals (CI calculated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer, resin-modified glass ionomer cement, amalgam, and composite resin. Risk of bias was low in most studies (45.38% of all items across studies. Pediatric dentists should avoid conventional glass ionomer cement for restoring primary molars.

  15. Gambling problems among patients in primary care: a cross-sectional study of general practices

    Science.gov (United States)

    Cowlishaw, Sean; Gale, Lone; Gregory, Alison; McCambridge, Jim; Kessler, David

    2017-01-01

    Background Primary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems. Aim To indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability. Design and setting Cross-sectional study of patients attending 11 general practices in Bristol, South West England. Method Adult patients (n = 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced. Results There were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1–4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression. Conclusion There is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention. PMID:28289016

  16. Reliability and Efficiency of Generalized Rumor Spreading Model on Complex Social Networks

    International Nuclear Information System (INIS)

    Naimi, Yaghoob; Naimi, Mohammad

    2013-01-01

    We introduce the generalized rumor spreading model and investigate some properties of this model on different complex social networks. Despite pervious rumor models that both the spreader-spreader (SS) and the spreader-stifler (SR) interactions have the same rate α, we define α (1) and α (2) for SS and SR interactions, respectively. The effect of variation of α (1) and α (2) on the final density of stiflers is investigated. Furthermore, the influence of the topological structure of the network in rumor spreading is studied by analyzing the behavior of several global parameters such as reliability and efficiency. Our results show that while networks with homogeneous connectivity patterns reach a higher reliability, scale-free topologies need a less time to reach a steady state with respect the rumor. (interdisciplinary physics and related areas of science and technology)

  17. Reliability and Efficiency of Generalized Rumor Spreading Model on Complex Social Networks

    Science.gov (United States)

    Yaghoob, Naimi; Mohammad, Naimi

    2013-07-01

    We introduce the generalized rumor spreading model and investigate some properties of this model on different complex social networks. Despite pervious rumor models that both the spreader-spreader (SS) and the spreader-stifler (SR) interactions have the same rate α, we define α(1) and α(2) for SS and SR interactions, respectively. The effect of variation of α(1) and α(2) on the final density of stiflers is investigated. Furthermore, the influence of the topological structure of the network in rumor spreading is studied by analyzing the behavior of several global parameters such as reliability and efficiency. Our results show that while networks with homogeneous connectivity patterns reach a higher reliability, scale-free topologies need a less time to reach a steady state with respect the rumor.

  18. Reconstructing Generalized Logical Networks of Transcriptional Regulation in Mouse Brain from Temporal Gene Expression Data

    Energy Technology Data Exchange (ETDEWEB)

    Song, Mingzhou (Joe) [New Mexico State University, Las Cruces; Lewis, Chris K. [New Mexico State University, Las Cruces; Lance, Eric [New Mexico State University, Las Cruces; Chesler, Elissa J [ORNL; Kirova, Roumyana [Bristol-Myers Squibb Pharmaceutical Research & Development, NJ; Langston, Michael A [University of Tennessee, Knoxville (UTK); Bergeson, Susan [Texas Tech University, Lubbock

    2009-01-01

    The problem of reconstructing generalized logical networks to account for temporal dependencies among genes and environmental stimuli from high-throughput transcriptomic data is addressed. A network reconstruction algorithm was developed that uses the statistical significance as a criterion for network selection to avoid false-positive interactions arising from pure chance. Using temporal gene expression data collected from the brains of alcohol-treated mice in an analysis of the molecular response to alcohol, this algorithm identified genes from a major neuronal pathway as putative components of the alcohol response mechanism. Three of these genes have known associations with alcohol in the literature. Several other potentially relevant genes, highlighted and agreeing with independent results from literature mining, may play a role in the response to alcohol. Additional, previously-unknown gene interactions were discovered that, subject to biological verification, may offer new clues in the search for the elusive molecular mechanisms of alcoholism.

  19. Multi-Destination Cognitive Radio Relay Network with SWIPT and Multiple Primary Receivers

    KAUST Repository

    Al-Habob, Ahmed A.

    2017-05-12

    In this paper, we study the performance of simultaneous wireless information and power transfer (SWIPT) technique in a multi-destination dual-hop underlay cognitive relay network with multiple primary receivers. Information transmission from the secondary source to destinations is performed entirely via a decode- and-forward (DF) relay. The relay is assumed to have no embedded power source and to harvest energy from the source signal using a power splitting (PS) protocol and employing opportunistic scheduling to forward the information to the selected destination. We derive analytical expressions for the outage probability assuming Rayleigh fading channels and considering the energy harvesting efficiency at relay, the source maximum transmit power and primary receivers interference constraints. The system performance is also studied at high signal-to-noise ratio (SNR) values where approximate expressions for the outage probability are provided and analyzed in terms of diversity order and coding gain. Monte-Carlo simulations and some numerical examples are provided to validate the derived expressions and to illustrate the effect of various system parameters on the system performance. In contrast to their conventional counterparts where a multi- destination diversity is usually achieved, the results show that the multi-destination cognitive radio relay networks with the SWIPT technique achieve a constant diversity order of one.

  20. [The Telehealth Network of the Americas and its role in primary health care].

    Science.gov (United States)

    Bill, Guillermo; Crisci, Carlos D; Canet, Tomislav

    2014-01-01

    The need to guarantee equitable access to health regardless of geographic, economic, or technological barriers motivated the Member States of the Organization of American States to create the Telehealth Network of the Americas, coordinated by the Inter-American Telecommunication Committee. The Network focuses on the use of new information and communications technology applied to health, based on the values of respect, equity, and solidarity and mandated by the philosophy of primary health. Its members include government agencies, nongovernmental organizations, university forums, hospital federations, and telecommunications companies, and it has already extended its reach to other continents and to different fields in which telemedicine is being used. Among its first achievements, it has implemented an innovative tool to be used in cases of disaster or limited geographic access. This mobile telemedicine station is housed in a portable case that includes a computer, various digital devices (otoscope, ophthalmoscope, microscope, dermatoscope), a high-resolution digital camera, an X-ray film viewer, and a satellite antenna. With this tool, it is possible to provide specialized support for rural physicians and primary health care workers located far from large urban centers.

  1. Analytical bounds on the area spectral efficiency of uplink heterogeneous networks over generalized fading channels

    KAUST Repository

    Shakir, Muhammad

    2014-06-01

    Heterogeneous networks (HetNets) are envisioned to enable next-generation cellular networks by providing higher spectral and energy efficiency. A HetNet is typically composed of multiple radio access technologies where several low-power low-cost operators or user-deployed small-cell base stations (SBSs) complement the macrocell network. In this paper, we consider a two-tier HetNet where the SBSs are arranged around the edge of the reference macrocell such that the resultant configuration is referred to as cell-on-edge (COE). Each mobile user in a small cell is considered capable of adapting its uplink transmit power according to a location-based slow power control mechanism. The COE configuration is observed to increase the uplink area spectral efficiency (ASE) and energy efficiency while reducing the cochannel interference power. A moment-generating-function (MGF)-based approach has been exploited to derive the analytical bounds on the uplink ASE of the COE configuration. The derived expressions are generalized for any composite fading distribution, and closed-form expressions are presented for the generalized- K fading channels. Simulation results are included to support the analysis and to show the efficacy of the COE configuration. A comparative performance analysis is also provided to demonstrate the improvements in the performance of cell-edge users of the COE configuration compared with that of macro-only networks (MoNets) and other unplanned deployment strategies. © 2013 IEEE.

  2. Altered effective connectivity among core neurocognitive networks in idiopathic generalized epilepsy: An fMRI evidence

    Directory of Open Access Journals (Sweden)

    Huilin Wei

    2016-09-01

    Full Text Available Idiopathic generalized epilepsy (IGE patients with generalized tonic-clonic seizures (GTCS suffer long-term cognitive impairments, and present a higher incidence of psychosocial and psychiatric disturbances than healthy people. It is possible that the cognitive dysfunctions and higher psychopathological risk in IGE-GTCS derive from disturbed causal relationship among core neurocognitive brain networks. To test this hypothesis, we examined the effective connectivity across the salience network (SN, default mode network (DMN, and central executive network (CEN using resting-state functional magnetic resonance imaging (fMRI data collected from 27 IGE-GTCS patients and 29 healthy controls. In the study, a combination framework of time domain and frequency domain multivariate Granger causality analysis was firstly proposed, and proved to be valid and accurate by simulation experiments. Using this method, we then observed significant differences in the effective connectivity graphs between the patient and control groups. Specifically, between-group statistical analysis revealed that relative to the healthy controls, the patients established significantly enhanced Granger causal influence from the dorsolateral prefrontal cortex to the dorsal anterior cingulate cortex, which is coherent both in the time and frequency domains analyses. Meanwhile, time domain analysis also revealed decreased Granger causal influence from the right fronto-insular cortex to the posterior cingulate cortex in the patients. These findings may provide new evidence for functional brain organization disruption underlying cognitive dysfunctions and psychopathological risk in IGE-GTCS.

  3. Social support network, mental health and quality of life: a cross-sectional study in primary care.

    Science.gov (United States)

    Portugal, Flávia Batista; Campos, Mônica Rodrigues; Correia, Celina Ragoni; Gonçalves, Daniel Almeida; Ballester, Dinarte; Tófoli, Luis Fernando; Mari, Jair de Jesus; Gask, Linda; Dowrick, Christopher; Bower, Peter; Fortes, Sandra

    2016-12-22

    The objective of this study was to identify the association between emotional distress and social support networks with quality of life in primary care patients. This was a cross-sectional study involving 1,466 patients in the cities of São Paulo and Rio de Janeiro, Brazil, in 2009/2010. The General Health Questionnaire, the Hospital Anxiety and Depression Scale and the brief version of the World Health Organization Quality of Life Instrument were used. The Social Support Network Index classified patients with the highest and lowest index as socially integrated or isolated. A bivariate analysis and four multiple linear regressions were conducted for each quality of life outcome. The means scores for the physical, psychological, social relations, and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. In the multivariate analysis, the psychological domain was negatively associated with isolation, whereas the social relations and environment domains were positively associated with integration. Integration and isolation proved to be important factors for those in emotional distress as they minimize or maximize negative effects on quality of life.

  4. Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

    Science.gov (United States)

    Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

    2016-08-01

    Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

  5. Social support network, mental health and quality of life: a cross-sectional study in primary care

    Directory of Open Access Journals (Sweden)

    Flávia Batista Portugal

    Full Text Available The objective of this study was to identify the association between emotional distress and social support networks with quality of life in primary care patients. This was a cross-sectional study involving 1,466 patients in the cities of São Paulo and Rio de Janeiro, Brazil, in 2009/2010. The General Health Questionnaire, the Hospital Anxiety and Depression Scale and the brief version of the World Health Organization Quality of Life Instrument were used. The Social Support Network Index classified patients with the highest and lowest index as socially integrated or isolated. A bivariate analysis and four multiple linear regressions were conducted for each quality of life outcome. The means scores for the physical, psychological, social relations, and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. In the multivariate analysis, the psychological domain was negatively associated with isolation, whereas the social relations and environment domains were positively associated with integration. Integration and isolation proved to be important factors for those in emotional distress as they minimize or maximize negative effects on quality of life.

  6. A General Combinatorial Ant System-based Distributed Routing Algorithm for Communication Networks

    Directory of Open Access Journals (Sweden)

    Jose Aguilar

    2007-08-01

    Full Text Available In this paper, a general Combinatorial Ant System-based distributed routing algorithm modeled like a dynamic combinatorial optimization problem is presented. In the proposed algorithm, the solution space of the dynamic combinatorial optimization problem is mapped into the space where the ants will walk, and the transition probability and the pheromone update formula of the Ant System is defined according to the objective function of the communication problem. The general nature of the approach allows for the optimization of the routing function to be applied in different types of networks just changing the performance criteria to be optimized. In fact, we test and compare the performance of our routing algorithm against well-known routing schemes for wired and wireless networks, and show its superior performance in terms throughput, delay and energy efficiency.

  7. A general framework for global asymptotic stability analysis of delayed neural networks based on LMI approach

    International Nuclear Information System (INIS)

    Cao Jinde; Ho, Daniel W.C.

    2005-01-01

    In this paper, global asymptotic stability is discussed for neural networks with time-varying delay. Several new criteria in matrix inequality form are given to ascertain the uniqueness and global asymptotic stability of equilibrium point for neural networks with time-varying delay based on Lyapunov method and Linear Matrix Inequality (LMI) technique. The proposed LMI approach has the advantage of considering the difference of neuronal excitatory and inhibitory efforts, which is also computationally efficient as it can be solved numerically using recently developed interior-point algorithm. In addition, the proposed results generalize and improve previous works. The obtained criteria also combine two existing conditions into one generalized condition in matrix form. An illustrative example is also given to demonstrate the effectiveness of the proposed results

  8. Limits to high-speed simulations of spiking neural networks using general-purpose computers

    Directory of Open Access Journals (Sweden)

    Friedemann eZenke

    2014-09-01

    Full Text Available To understand how the central nervous system performs computations using recurrent neuronal circuitry, simulations have become an indispensable tool for theoretical neuroscience. To study neuronal circuits and their ability to self-organize, increasing attention has been directed towards synaptic plasticity. In particular spike-timing-dependent plasticity (STDP creates specific demands for simulations of spiking neural networks. On the one hand a high temporal resolution is required to capture the millisecond timescale of typical STDP windows. On the other hand network simulations have to evolve over hours up to days, to capture the timescale of long-term plasticity. To do this efficiently, fast simulation speed is the crucial ingredient rather than large neuron numbers. Using different medium-sized network models consisting of several thousands of neurons and off-the-shelf hardware, we compare the simulation speed of the simulators: Brian, NEST and Neuron as well as our own simulator Auryn. Our results show that real-time simulations of different plastic network models are possible in parallel simulations in which numerical precision is not a primary concern. Even so, the speed-up margin of parallelism is limited and boosting simulation speeds beyond one tenth of real-time is difficult. By profiling simulation code we show that the run times of typical plastic network simulations encounter a hard boundary. This limit is partly due to latencies in the inter-process communications and thus cannot be overcome by increased parallelism. Overall these results show that to study plasticity in medium-sized spiking neural networks, adequate simulation tools are readily available which run efficiently on small clusters. However, to run simulations substantially faster than real-time, special hardware is a prerequisite.

  9. Evaluation of generalized pruritus in patients without primary skin lesions in Razi Hospital

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    Jomhori P

    2001-09-01

    Full Text Available Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting to dermatological clinics of Razi Hospital, from April 97 until December 99 were evaluated. The work up procedure consisted of medical history, physical examination, laboratory findings (CBC, ESR, blood chemistry, thyroid function tests, urinalysis, stool exam, chest X-ray and in selected cases, additional specific tests. Fifty-four patients were female, and 21 male the mean age was 45.7y±16.41, and the mean duration of pruritus, 21.8m±21. In 43 patients (75.4 percent, no abnormal finding was detected. Five patients (6.66 percent had atopy. In the remaining 27 patients (36 percent, the following abnormalities were found: Iron deficiency in 6 patients (8 percent, diabetes mellitus in 6 patients (8 percent, hyperthyroidism in 4 patients (5.33 percent, hypothyroidism in 2 patients (2.66 percent, lymphoma in 3 patients (4 percent, chronic hepatitis, hypocalcaemia, cholelithiasis, psychosis and chronic renal failure each in one patient (1.3 percent. Evaluation of patients with pruritus may be a valuable tool for early detection of underlying systemic diseases.

  10. General practitioners with a special interest in respiratory medicine: national survey of UK primary care organisations

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    Price David

    2005-05-01

    Full Text Available Abstract Background To meet the universally recognised challenge of caring for people with long-term diseases many healthcare cultures are encouraging family physicians to develop specialist skills. We aimed to determine the major factors influencing the appointment of respiratory General Practitioners with a Special Interest (GPwSI in the UK, and to determine the priority attached to the potential roles, perceived barriers to implementation, and monitoring planned. Methods We sent a piloted semi-structured questionnaire to a random sample of 50% of English and Welsh primary care organisations (PCOs (n = 161 during winter 2003. In addition to descriptive statistics, we used hierarchical cluster analysis to classify service priorities. Free-text responses to open-ended questions were analysed qualitatively by a multidisciplinary group to identify emerging themes. Results Of the 111 (69% PCOs who responded, 7 (6% already have, and a further 35 (32% are planning, a respiratory GPwSI service. This proportion is considerably lower than in specialities linked to National Health Service clinical priorities. Local needs and pressure on hospital beds were the main described motives for developing a service. Stated service priorities were to relieve pressure on secondary care and to improve quality of care, including the strategic planning of respiratory services within PCOs. Conclusion The relatively few respiratory GPwSIs currently in post reflects the lack of government prioritisation of respiratory care. However, respiratory GPwSI services are increasingly being considered as a local strategy for reducing pressure on secondary care respiratory services and raising standards of chronic disease management in primary care.

  11. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

    Science.gov (United States)

    2013-01-01

    Background A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Methods Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. Results The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. Conclusions The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself. PMID:23945286

  12. Hypothalamus-Related Resting Brain Network Underlying Short-Term Acupuncture Treatment in Primary Hypertension

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    Hongyan Chen

    2013-01-01

    Full Text Available The present study attempted to explore modulated hypothalamus-seeded resting brain network underlying the cardiovascular system in primary hypertensive patients after short-term acupuncture treatment. Thirty right-handed patients (14 male were divided randomly into acupuncture and control groups. The acupuncture group received a continuous five-day acupuncture treatment and undertook three resting-state fMRI scans and 24-hour ambulatory blood pressure monitoring (ABPM as well as SF-36 questionnaires before, after, and one month after acupuncture treatment. The control group undertook fMRI scans and 24-hour ABPM. For verum acupuncture, average blood pressure (BP and heart rate (HR decreased after treatment but showed no statistical differences. There were no significant differences in BP and HR between the acupuncture and control groups. Notably, SF-36 indicated that bodily pain (P = 0.005 decreased and vitality (P = 0.036 increased after acupuncture compared to the baseline. The hypothalamus-related brain network showed increased functional connectivity with the medulla, brainstem, cerebellum, limbic system, thalamus, and frontal lobes. In conclusion, short-term acupuncture did not decrease BP significantly but appeared to improve body pain and vitality. Acupuncture may regulate the cardiovascular system through a complicated brain network from the cortical level, the hypothalamus, and the brainstem.

  13. Stimulus-specific adaptation in a recurrent network model of primary auditory cortex.

    Directory of Open Access Journals (Sweden)

    Tohar S Yarden

    2017-03-01

    Full Text Available Stimulus-specific adaptation (SSA occurs when neurons decrease their responses to frequently-presented (standard stimuli but not, or not as much, to other, rare (deviant stimuli. SSA is present in all mammalian species in which it has been tested as well as in birds. SSA confers short-term memory to neuronal responses, and may lie upstream of the generation of mismatch negativity (MMN, an important human event-related potential. Previously published models of SSA mostly rely on synaptic depression of the feedforward, thalamocortical input. Here we study SSA in a recurrent neural network model of primary auditory cortex. When the recurrent, intracortical synapses display synaptic depression, the network generates population spikes (PSs. SSA occurs in this network when deviants elicit a PS but standards do not, and we demarcate the regions in parameter space that allow SSA. While SSA based on PSs does not require feedforward depression, we identify feedforward depression as a mechanism for expanding the range of parameters that support SSA. We provide predictions for experiments that could help differentiate between SSA due to synaptic depression of feedforward connections and SSA due to synaptic depression of recurrent connections. Similar to experimental data, the magnitude of SSA in the model depends on the frequency difference between deviant and standard, probability of the deviant, inter-stimulus interval and input amplitude. In contrast to models based on feedforward depression, our model shows true deviance sensitivity as found in experiments.

  14. Stability and generalization in seed dispersal networks: a case study of frugivorous fish in Neotropical wetlands.

    Science.gov (United States)

    Correa, Sandra Bibiana; Arujo, Joisiane K; Penha, Jerry; Nunes da Cunha, Catia; Bobier, Karen E; Anderson, Jill T

    2016-08-31

    When species within guilds perform similar ecological roles, functional redundancy can buffer ecosystems against species loss. Using data on the frequency of interactions between fish and fruit, we assessed whether co-occurring frugivores provide redundant seed dispersal services in three species-rich Neotropical wetlands. Our study revealed that frugivorous fishes have generalized diets; however, large-bodied fishes had greater seed dispersal breadth than small species, in some cases, providing seed dispersal services not achieved by smaller fish species. As overfishing disproportionately affects big fishes, the extirpation of these species could cause larger secondary extinctions of plant species than the loss of small specialist frugivores. To evaluate the consequences of frugivore specialization for network stability, we extracted data from 39 published seed dispersal networks of frugivorous birds, mammals and fish (our networks) across ecosystems. Our analysis of interaction frequencies revealed low frugivore specialization and lower nestedness than analyses based on binary data (presence-absence of interactions). In that case, ecosystems may be resilient to loss of any given frugivore. However, robustness to frugivore extinction declines with specialization, such that networks composed primarily of specialist frugivores are highly susceptible to the loss of generalists. In contrast with analyses of binary data, recently developed algorithms capable of modelling interaction strengths provide opportunities to enhance our understanding of complex ecological networks by accounting for heterogeneity of frugivore-fruit interactions. © 2016 The Author(s).

  15. A neutron spectrum unfolding code based on generalized regression artificial neural networks

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz R, J. M.; Martinez B, M. R.; Castaneda M, R.; Solis S, L. O. [Universidad Autonoma de Zacatecas, Unidad Academica de Ingenieria Electrica, Av. Ramon Lopez Velarde 801, Col. Centro, 98000 Zacatecas, Zac. (Mexico); Vega C, H. R., E-mail: morvymm@yahoo.com.mx [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas, Zac. (Mexico)

    2015-10-15

    The most delicate part of neutron spectrometry, is the unfolding process. Then derivation of the spectral information is not simple because the unknown is not given directly as result of the measurements. Novel methods based on Artificial Neural Networks have been widely investigated. In prior works, back propagation neural networks (BPNN) have been used to solve the neutron spectrometry problem, however, some drawbacks still exist using this kind of neural nets, as the optimum selection of the network topology and the long training time. Compared to BPNN, is usually much faster to train a generalized regression neural network (GRNN). That is mainly because spread constant is the only parameter used in GRNN. Another feature is that the network will converge to a global minimum. In addition, often are more accurate than BPNN in prediction. These characteristics make GRNN be of great interest in the neutron spectrometry domain. In this work is presented a computational tool based on GRNN, capable to solve the neutron spectrometry problem. This computational code, automates the pre-processing, training and testing stages, the statistical analysis and the post-processing of the information, using 7 Bonner spheres rate counts as only entrance data. The code was designed for a Bonner Spheres System based on a {sup 6}LiI(Eu) neutron detector and a response matrix expressed in 60 energy bins taken from an International Atomic Energy Agency compilation. (Author)

  16. A neutron spectrum unfolding code based on generalized regression artificial neural networks

    International Nuclear Information System (INIS)

    Ortiz R, J. M.; Martinez B, M. R.; Castaneda M, R.; Solis S, L. O.; Vega C, H. R.

    2015-10-01

    The most delicate part of neutron spectrometry, is the unfolding process. Then derivation of the spectral information is not simple because the unknown is not given directly as result of the measurements. Novel methods based on Artificial Neural Networks have been widely investigated. In prior works, back propagation neural networks (BPNN) have been used to solve the neutron spectrometry problem, however, some drawbacks still exist using this kind of neural nets, as the optimum selection of the network topology and the long training time. Compared to BPNN, is usually much faster to train a generalized regression neural network (GRNN). That is mainly because spread constant is the only parameter used in GRNN. Another feature is that the network will converge to a global minimum. In addition, often are more accurate than BPNN in prediction. These characteristics make GRNN be of great interest in the neutron spectrometry domain. In this work is presented a computational tool based on GRNN, capable to solve the neutron spectrometry problem. This computational code, automates the pre-processing, training and testing stages, the statistical analysis and the post-processing of the information, using 7 Bonner spheres rate counts as only entrance data. The code was designed for a Bonner Spheres System based on a 6 LiI(Eu) neutron detector and a response matrix expressed in 60 energy bins taken from an International Atomic Energy Agency compilation. (Author)

  17. General analytical solutions for DC/AC circuit-network analysis

    Science.gov (United States)

    Rubido, Nicolás; Grebogi, Celso; Baptista, Murilo S.

    2017-06-01

    In this work, we present novel general analytical solutions for the currents that are developed in the edges of network-like circuits when some nodes of the network act as sources/sinks of DC or AC current. We assume that Ohm's law is valid at every edge and that charge at every node is conserved (with the exception of the source/sink nodes). The resistive, capacitive, and/or inductive properties of the lines in the circuit define a complex network structure with given impedances for each edge. Our solution for the currents at each edge is derived in terms of the eigenvalues and eigenvectors of the Laplacian matrix of the network defined from the impedances. This derivation also allows us to compute the equivalent impedance between any two nodes of the circuit and relate it to currents in a closed circuit which has a single voltage generator instead of many input/output source/sink nodes. This simplifies the treatment that could be done via Thévenin's theorem. Contrary to solving Kirchhoff's equations, our derivation allows to easily calculate the redistribution of currents that occurs when the location of sources and sinks changes within the network. Finally, we show that our solutions are identical to the ones found from Circuit Theory nodal analysis.

  18. Near-optimal Downlink precoding of a MISO system for a secondary network under the SINR constraints of a primary network

    KAUST Repository

    Park, Kihong

    2013-04-01

    In this paper, we study a multiple-input single-output cognitive radio (CR) system where only the primary base station (BS) has multiple antennas. We consider a rate maximization problem of the secondary network under signal-to-interference-plus-noise-ratio constraints on the primary network in order to guarantee the quality-of-service for the latter network. While the interference due to the secondary transmission in the conventional underlay CR approach may severely degrade the performance of the primary network, we propose a primary BS-aided approach in which the primary BS helps relay the secondary users\\' signals instead of allowing them to communicate with each other via a direct path between them. In addition, an algorithm to find a near-optimal beamforming solution at the primary BS is proposed. Finally, based on some selected numerical results, we show that the proposed scheme outperforms the conventional underlay CR configuration over a wide transmit power range. © 2013 IEEE.

  19. Usage of Probabilistic and General Regression Neural Network for Early Detection and Prevention of Oral Cancer

    OpenAIRE

    Sharma, Neha; Om, Hari

    2015-01-01

    In India, the oral cancers are usually presented in advanced stage of malignancy. It is critical to ascertain the diagnosis in order to initiate most advantageous treatment of the suspicious lesions. The main hurdle in appropriate treatment and control of oral cancer is identification and risk assessment of early disease in the community in a cost-effective fashion. The objective of this research is to design a data mining model using probabilistic neural network and general regression neural...

  20. Envisioning a learning health care system: the electronic primary care research network, a case study.

    Science.gov (United States)

    Delaney, Brendan C; Peterson, Kevin A; Speedie, Stuart; Taweel, Adel; Arvanitis, Theodoros N; Hobbs, F D Richard

    2012-01-01

    The learning health care system refers to the cycle of turning health care data into knowledge, translating that knowledge into practice, and creating new data by means of advanced information technology. The electronic Primary Care Research Network (ePCRN) was a project, funded by the U.S. National Institutes of Health, with the aim to facilitate clinical research using primary care electronic health records (EHRs). We identified the requirements necessary to deliver clinical studies via a distributed electronic network linked to EHRs. After we explored a variety of informatics solutions, we constructed a functional prototype of the software. We then explored the barriers to adoption of the prototype software within U.S. practice-based research networks. We developed a system to assist in the identification of eligible cohorts from EHR data. To preserve privacy, counts and flagging were performed remotely, and no data were transferred out of the EHR. A lack of batch export facilities from EHR systems and ambiguities in the coding of clinical data, such as blood pressure, have so far prevented a full-scale deployment. We created an international consortium and a model for sharing further ePCRN development across a variety of ongoing projects in the United States and Europe. A means of accessing health care data for research is not sufficient in itself to deliver a learning health care system. EHR systems need to use sophisticated tools to capture and preserve rich clinical context in coded data, and business models need to be developed that incentivize all stakeholders from clinicians to vendors to participate in the system.

  1. Speech Intelligibility Potential of General and Specialized Deep Neural Network Based Speech Enhancement Systems

    DEFF Research Database (Denmark)

    Kolbæk, Morten; Tan, Zheng-Hua; Jensen, Jesper

    2017-01-01

    In this paper, we study aspects of single microphone speech enhancement (SE) based on deep neural networks (DNNs). Specifically, we explore the generalizability capabilities of state-of-the-art DNN-based SE systems with respect to the background noise type, the gender of the target speaker...... general. Finally, we compare how a DNN-based SE system trained to be noise type general, speaker general, and SNR general performs relative to a state-of-the-art short-time spectral amplitude minimum mean square error (STSA-MMSE) based SE algorithm. We show that DNN-based SE systems, when trained...... specifically to handle certain speakers, noise types and SNRs, are capable of achieving large improvements in estimated speech quality (SQ) and speech intelligibility (SI), when tested in matched conditions. Furthermore, we show that improvements in estimated SQ and SI can be achieved by a DNN-based SE system...

  2. Use of generalized linear mixed models for network meta-analysis.

    Science.gov (United States)

    Tu, Yu-Kang

    2014-10-01

    In the past decade, a new statistical method-network meta-analysis-has been developed to address limitations in traditional pairwise meta-analysis. Network meta-analysis incorporates all available evidence into a general statistical framework for comparisons of multiple treatments. Bayesian network meta-analysis, as proposed by Lu and Ades, also known as "mixed treatments comparisons," provides a flexible modeling framework to take into account complexity in the data structure. This article shows how to implement the Lu and Ades model in the frequentist generalized linear mixed model. Two examples are provided to demonstrate how centering the covariates for random effects estimation within each trial can yield correct estimation of random effects. Moreover, under the correct specification for random effects estimation, the dummy coding and contrast basic parameter coding schemes will yield the same results. It is straightforward to incorporate covariates, such as moderators and confounders, into the generalized linear mixed model to conduct meta-regression for multiple treatment comparisons. Moreover, this approach may be extended easily to other types of outcome variables, such as continuous, counts, and multinomial. © The Author(s) 2014.

  3. General practitioners: Between integration and co-location. The case of primary care centers in Tuscany, Italy.

    Science.gov (United States)

    Barsanti, Sara; Bonciani, Manila

    2018-01-01

    Healthcare systems have followed several strategies aimed at integrating primary care services and professionals. Medical homes in the USA and Canada, and primary care centres across Europe have collocated general practitioners and other health and social professionals in the same building in order to boost coordination among services and the continuity of care for patients. However, in the literature, the impact of co-location on primary care has led to controversial results. This article analyses the possible benefits of the co-location of services in primary care focusing on the Italian model of primary care centres (Case della Salute) in terms of general practitioners' perception. We used the results of a web survey of general practitioners in Tuscany to compare the experiences and satisfaction of those general practitioners involved and not involved in a primary care centre, performed a MONAVA and ANOVA analysis. Our case study highlights the positive impact of co-location on the integration of professionals, especially with nurses and social workers, and on organizational integration, in terms of frequency of meeting to discuss about quality of care. Conversely, no significant differences were found in terms of either clinical or system integration. Furthermore, the collaboration with specialists is still weak. Considering the general practitioners' perspective in terms of experience and satisfaction towards primary care, co-location strategies is a necessary step in order to facilitate the collaboration among professionals and to prevent unintended consequences in terms of an even possible isolation of primary care as an involuntary 'disintegration of the integration'.

  4. A neutron spectrum unfolding code based on generalized regression artificial neural networks

    International Nuclear Information System (INIS)

    Rosario Martinez-Blanco, Ma. del

    2016-01-01

    The most delicate part of neutron spectrometry, is the unfolding process. The derivation of the spectral information is not simple because the unknown is not given directly as a result of the measurements. Novel methods based on Artificial Neural Networks have been widely investigated. In prior works, back propagation neural networks (BPNN) have been used to solve the neutron spectrometry problem, however, some drawbacks still exist using this kind of neural nets, i.e. the optimum selection of the network topology and the long training time. Compared to BPNN, it's usually much faster to train a generalized regression neural network (GRNN). That's mainly because spread constant is the only parameter used in GRNN. Another feature is that the network will converge to a global minimum, provided that the optimal values of spread has been determined and that the dataset adequately represents the problem space. In addition, GRNN are often more accurate than BPNN in the prediction. These characteristics make GRNNs to be of great interest in the neutron spectrometry domain. This work presents a computational tool based on GRNN capable to solve the neutron spectrometry problem. This computational code, automates the pre-processing, training and testing stages using a k-fold cross validation of 3 folds, the statistical analysis and the post-processing of the information, using 7 Bonner spheres rate counts as only entrance data. The code was designed for a Bonner Spheres System based on a 6 LiI(Eu) neutron detector and a response matrix expressed in 60 energy bins taken from an International Atomic Energy Agency compilation. - Highlights: • Main drawback of neutron spectrometry with BPNN is network topology optimization. • Compared to BPNN, it’s usually much faster to train a (GRNN). • GRNN are often more accurate than BPNN in the prediction. These characteristics make GRNNs to be of great interest. • This computational code, automates the pre

  5. General Voltage Feedback Circuit Model in the Two-Dimensional Networked Resistive Sensor Array

    Directory of Open Access Journals (Sweden)

    JianFeng Wu

    2015-01-01

    Full Text Available To analyze the feature of the two-dimensional networked resistive sensor array, we firstly proposed a general model of voltage feedback circuits (VFCs such as the voltage feedback non-scanned-electrode circuit, the voltage feedback non-scanned-sampling-electrode circuit, and the voltage feedback non-scanned-sampling-electrode circuit. By analyzing the general model, we then gave a general mathematical expression of the effective equivalent resistor of the element being tested in VFCs. Finally, we evaluated the features of VFCs with simulation and test experiment. The results show that the expression is applicable to analyze the VFCs’ performance of parameters such as the multiplexers’ switch resistors, the nonscanned elements, and array size.

  6. Working memory training mostly engages general-purpose large-scale networks for learning.

    Science.gov (United States)

    Salmi, Juha; Nyberg, Lars; Laine, Matti

    2018-03-21

    The present meta-analytic study examined brain activation changes following working memory (WM) training, a form of cognitive training that has attracted considerable interest. Comparisons with perceptual-motor (PM) learning revealed that WM training engages domain-general large-scale networks for learning encompassing the dorsal attention and salience networks, sensory areas, and striatum. Also the dynamics of the training-induced brain activation changes within these networks showed a high overlap between WM and PM training. The distinguishing feature for WM training was the consistent modulation of the dorso- and ventrolateral prefrontal cortex (DLPFC/VLPFC) activity. The strongest candidate for mediating transfer to similar untrained WM tasks was the frontostriatal system, showing higher striatal and VLPFC activations, and lower DLPFC activations after training. Modulation of transfer-related areas occurred mostly with longer training periods. Overall, our findings place WM training effects into a general perception-action cycle, where some modulations may depend on the specific cognitive demands of a training task. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Primary User Localization Algorithm Based on Compressive Sensing in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Fang Ye

    2016-04-01

    Full Text Available In order to locate source signal more accurately in authorized frequency bands, a novel primary user localization algorithm based on compressive sensing (PU-CSL in cognitive radio networks (CRNs is proposed in this paper. In comparison to existing centroid locating algorithms, PU-CSL shows higher locating accuracy for integrally exploring correlation between source signal and secondary users (SUs. Energy detection is first adopted for collecting the energy fingerprint of source signal at each SU, then degree of correlation between source signal and SUs is reconstructed based on compressive sensing (CS, which determines weights of centroid coordinates. A weighted centroid scheme is finally utilized to estimate source position. Simulation results show that PU-CSL has smaller maximum error of positioning and root-mean-square error. Moreover, the proposed PU-CSL algorithm possess excellent location accuracy and strong anti-noise performance.

  8. Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams.

    Science.gov (United States)

    Grant, Suzanne; Ring, Adele; Gabbay, Mark; Guthrie, Bruce; McLean, Gary; Mair, Frances S; Watt, Graham; Heaney, David; O'Donnell, Catherine

    2015-01-01

    In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. This article examines the impact of nGMS on the governance of UK general practice by PCO managers through a qualitative analysis of data from an empirical study in four UK PCOs and eight general practices, drawing on Hood's four-part governance framework. Two hybrids emerged: (i) PCO managers emphasised a hybrid of oversight, competition (comptrol) and peer-based mutuality by granting increased support, guidance and autonomy to compliant practices; and (ii) practices emphasised a broad acceptance of increased PCO oversight of clinical work that incorporated a restratified elite of general practice clinical peers at both PCO and practice levels. Given the increased international focus on the quality, safety and efficiency in primary care, a key issue for PCOs and practices will be to achieve an effective, contextually appropriate balance between the counterposing governance mechanisms of peer-led mutuality and externally led comptrol. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  9. An exploration of food intolerance in the primary care setting: the general practitioner's experience.

    Science.gov (United States)

    Nelson, Mia; Ogden, Jane

    2008-09-01

    Food intolerance is one of medicine's modern enigmas. Its etiology and mechanism are unclear and the subject of constant debate, while estimates of its prevalence vary widely from 2% to over 20% of the population. Using interpretive phenomenonological analysis, this study explored the phenomenon of food intolerance in primary care from the general practitioner's (GP) perspective. Semi-structured interviews were carried out with 17 GPs from around the UK. Food intolerance was primarily conceptualised as a spectrum of clinical importance with medical conditions arranged in three hierarchies; the certainty that the GP would have in making a diagnosis, the authenticity of the patients' experience, and the threat posed to physical health. Since some conditions within the spectrum had a medical name that was used in preference to the term 'food intolerance', food intolerance essentially became a 'dustbin diagnosis', focused at just one end of the spectrum and viewed with scepticism. The scepticism about food intolerance as a specific condition influenced the GPs' perceptions of patients and of the patients' underlying problems. This was, however, tempered by an element of awareness of the limitations of modern medicine. Rather than risk damaging the doctor-patient relationship, the GPs chose, despite their scepticism, to negotiate mutually acceptable ground with patients and with patients' beliefs. As a result, whether due to a placebo effect, secondary benefit, or as a biophysical result of excluding a food from the diet, the GPs acknowledged both personal and therapeutic benefit in working with the patients' belief in food intolerance and with behaviours associated with the beliefs.

  10. Implementation of Finite Volume based Navier Stokes Algorithm Within General Purpose Flow Network Code

    Science.gov (United States)

    Schallhorn, Paul; Majumdar, Alok

    2012-01-01

    This paper describes a finite volume based numerical algorithm that allows multi-dimensional computation of fluid flow within a system level network flow analysis. There are several thermo-fluid engineering problems where higher fidelity solutions are needed that are not within the capacity of system level codes. The proposed algorithm will allow NASA's Generalized Fluid System Simulation Program (GFSSP) to perform multi-dimensional flow calculation within the framework of GFSSP s typical system level flow network consisting of fluid nodes and branches. The paper presents several classical two-dimensional fluid dynamics problems that have been solved by GFSSP's multi-dimensional flow solver. The numerical solutions are compared with the analytical and benchmark solution of Poiseulle, Couette and flow in a driven cavity.

  11. Traffic Load on Interconnection Lines of Generalized Double Ring Network Structures

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Riaz, Muhammad Tahir; Madsen, Ole Brun

    2004-01-01

    consists of two planar rings, which are easily embedded by fiber or other wired solutions. It is shown that for large N2R structures, the interconnection lines carry notably lower loads than the other lines if shortest-path routing is used, and the effects of two other routing schemes are explored, leading......Generalized Double Ring (N2R) network structures possess a number of good properties, but being not planar they are hard to physically embed in communication networks. However, if some of the lines, the interconnection lines, are implemented by wireless technologies, the remaining structure...... to lower load on interconnection lines at the price of larger efficient average distance and diameter....

  12. Generalized in vitro-in vivo relationship (IVIVR model based on artificial neural networks

    Directory of Open Access Journals (Sweden)

    Mendyk A

    2013-03-01

    Full Text Available Aleksander Mendyk,1 Pawel Tuszynski,1 Sebastian Polak,2 Renata Jachowicz1 1Department of Pharmaceutical Technology and Biopharmaceutics, 2Department of Social Pharmacy, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland Background: The aim of this study was to develop a generalized in vitro-in vivo relationship (IVIVR model based on in vitro dissolution profiles together with quantitative and qualitative composition of dosage formulations as covariates. Such a model would be of substantial aid in the early stages of development of a pharmaceutical formulation, when no in vivo results are yet available and it is impossible to create a classical in vitro-in vivo correlation (IVIVC/IVIVR. Methods: Chemoinformatics software was used to compute the molecular descriptors of drug substances (ie, active pharmaceutical ingredients and excipients. The data were collected from the literature. Artificial neural networks were used as the modeling tool. The training process was carried out using the 10-fold cross-validation technique. Results: The database contained 93 formulations with 307 inputs initially, and was later limited to 28 in a course of sensitivity analysis. The four best models were introduced into the artificial neural network ensemble. Complete in vivo profiles were predicted accurately for 37.6% of the formulations. Conclusion: It has been shown that artificial neural networks can be an effective predictive tool for constructing IVIVR in an integrated generalized model for various formulations. Because IVIVC/IVIVR is classically conducted for 2–4 formulations and with a single active pharmaceutical ingredient, the approach described here is unique in that it incorporates various active pharmaceutical ingredients and dosage forms into a single model. Thus, preliminary IVIVC/IVIVR can be available without in vivo data, which is impossible using current IVIVC/IVIVR procedures. Keywords: artificial neural networks

  13. Role of vision loss, functional limitations and the supporting network in depression in a general population.

    Science.gov (United States)

    van Nispen, Ruth M A; Vreeken, Hilde L; Comijs, Hannie C; Deeg, Dorly J H; van Rens, Ger H M B

    2016-02-01

    Although the prevalence of depression in visually impaired older persons is high, the association between vision loss and depression seems to be influenced by factors other than visual impairment. In this study, the role of vision loss, functional limitations and social network characteristics in relation to depressive symptoms was investigated. Cross-sectional data (N = 1237) from the Longitudinal Aging Study Amsterdam were used to investigate the prevalence of depression (Center of Epidemiological Studies-Depression scale) within subgroups with increasing vision loss. In linear regression models, functional limitations and social network characteristics were examined as possible mediators in the association between vision loss and depression. Having a partner was considered to be a potential moderator. Although a significant linear trend was found in the presence of depressive symptoms with 14% in normally sighted, 23% in mild and 37% in severe vision loss (χ(2)(1) = 14.9; p depression. Mediators were functional limitations (p social network size (p = 0.009). No interaction with partner status was found. In the presence of depression, a trend was found with increasing severity of vision loss, indicating the need for more attention in (mental) health care and low-vision rehabilitation. In the general older population, vision loss was not an independent determinant of depression but was mediated by functional limitations and social network size. Rather than receiving actual social support, the idea of having a social network to rely on when needed seemed to be associated with lower levels of depression. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  14. Defining dimensions of research readiness: a conceptual model for primary care research networks.

    Science.gov (United States)

    Carr, Helen; de Lusignan, Simon; Liyanage, Harshana; Liaw, Siaw-Teng; Terry, Amanda; Rafi, Imran

    2014-11-26

    Recruitment to research studies in primary care is challenging despite widespread implementation of electronic patient record (EPR) systems which potentially make it easier to identify eligible cases. Literature review and applying the learning from a European research readiness assessment tool, the TRANSFoRm International Research Readiness instrument (TIRRE), to the context of the English NHS in order to develop a model to assess a practice's research readiness. Seven dimensions of research readiness were identified: (1) Data readiness: Is there good data quality in EPR systems; (2) Record readiness: Are EPR data able to identify eligible cases and other study data; (3) Organisational readiness: Are the health system and socio-cultural environment supportive; (4) Governance readiness: Does the study meet legal and local health system regulatory compliance; (5) Study-specific readiness; (6) Business process readiness: Are business processes tilted in favour of participation: including capacity and capability to take on extra work, financial incentives as well as intangibles such as social and intellectual capital; (7) Patient readiness: Are systems in place to recruit patients and obtain informed consent? The model might enable the development of interventions to increase participation in primary care-based research and become a tool to measure the progress of practice networks towards the most advanced state of readiness.

  15. [Multimorbidity and primary care: Emergence of new forms of network organization].

    Science.gov (United States)

    Lamothe, Lise; Sylvain, Chantal; Sit, Vanessa

    2015-01-01

    This study was designed to analyse the adaptive strategies used by primary care professionals to provide more adapted and continuous services to patients with more than one chronic disease. A qualitative case study was conducted in a primary care structure (GMF in Québec). Data were derived from two sources: semi-structured interviews and documents. Based on our thematic analysis of data, we illustrate the adaptive processes at play. Our analysis identified the challenges raised by the increased prevalence of patients with more than one chronic disease and how they influence adaptive strategic initiatives from professionals at the following levels: (1) the patients themselves, (2) the professional-patient relationship, (3) the relationships between professionals of the GMF (4) the relationships between the GMF and other healthcare organizations. The description of these phenomena illustrates the dynamic emergence ofa network form of organization. This phenomenon leads to transformation of the core of the healthcare production system. A deeper understanding of its emergence, impacts and management is necessary.

  16. An optimal general type-2 fuzzy controller for Urban Traffic Network

    DEFF Research Database (Denmark)

    Khooban, Mohammad Hassan; Vafamand, Navid; Liaghat, Alireza

    2017-01-01

    Urban traffic network model is illustrated by state-charts and object-diagram. However, they have limitations to show the behavioral perspective of the Traffic Information flow. Consequently, a state space model is used to calculate the half-value waiting time of vehicles. In this study......, a combination of the general type-2 fuzzy logic sets and the Modified Backtracking Search Algorithm (MBSA) techniques are used in order to control the traffic signal scheduling and phase succession so as to guarantee a smooth flow of traffic with the least wait times and average queue length. The parameters...

  17. General purpose graphics-processing-unit implementation of cosmological domain wall network evolution.

    Science.gov (United States)

    Correia, J R C C C; Martins, C J A P

    2017-10-01

    Topological defects unavoidably form at symmetry breaking phase transitions in the early universe. To probe the parameter space of theoretical models and set tighter experimental constraints (exploiting the recent advances in astrophysical observations), one requires more and more demanding simulations, and therefore more hardware resources and computation time. Improving the speed and efficiency of existing codes is essential. Here we present a general purpose graphics-processing-unit implementation of the canonical Press-Ryden-Spergel algorithm for the evolution of cosmological domain wall networks. This is ported to the Open Computing Language standard, and as a consequence significant speedups are achieved both in two-dimensional (2D) and 3D simulations.

  18. General purpose graphics-processing-unit implementation of cosmological domain wall network evolution

    Science.gov (United States)

    Correia, J. R. C. C. C.; Martins, C. J. A. P.

    2017-10-01

    Topological defects unavoidably form at symmetry breaking phase transitions in the early universe. To probe the parameter space of theoretical models and set tighter experimental constraints (exploiting the recent advances in astrophysical observations), one requires more and more demanding simulations, and therefore more hardware resources and computation time. Improving the speed and efficiency of existing codes is essential. Here we present a general purpose graphics-processing-unit implementation of the canonical Press-Ryden-Spergel algorithm for the evolution of cosmological domain wall networks. This is ported to the Open Computing Language standard, and as a consequence significant speedups are achieved both in two-dimensional (2D) and 3D simulations.

  19. The role of a bus network in access to primary health care in Metropolitan Auckland, New Zealand.

    Science.gov (United States)

    Rocha, C M; McGuire, S; Whyman, R; Kruger, E; Tennant, M

    2015-09-01

    Background: This study examined the spatial accessibility of the population of metropolitan Auckland, New Zealand to the bus network, to connect them to primary health providers, in this case doctors (GP) and dentists. Analysis of accessibility by ethnic identity and socio-economic status were also carried out, because of existing health inequalities along these dimensions. The underlying hypothesis was that most people would live within easy reach of primary health providers, or easy bus transport to such providers. An integrated geographic model of bus transport routes and stops, with population and primary health providers (medical. and dental practices) was developed and analysed. Although the network of buses in metropolitan Auckland is substantial and robust it was evident that many people live more than 150 metres from a stop. Improving the access to bus stops, particularly in areas of high primary health care need (doctors and dentists), would certainly be an opportunity to enhance spatial access in a growing metropolitan area.

  20. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    LENUS (Irish Health Repository)

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  1. Calculation for Primary Combustion Characteristics of Boron-Based Fuel-Rich Propellant Based on BP Neural Network

    OpenAIRE

    Wan'e, Wu; Zuoming, Zhu

    2012-01-01

    A practical scheme for selecting characterization parameters of boron-based fuel-rich propellant formulation was put forward; a calculation model for primary combustion characteristics of boron-based fuel-rich propellant based on backpropagation neural network was established, validated, and then was used to predict primary combustion characteristics of boron-based fuel-rich propellant. The results show that the calculation error of burning rate is less than ± 7 . 3 %; in the formulation rang...

  2. Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners

    NARCIS (Netherlands)

    Keizer, E.; Maassen, I.; Smits, M.; Wensing, M.; Giesen, P.

    2016-01-01

    BACKGROUND: Out-of-hours primary care services have a high general practitioner (GP) workload with increasing costs, while half of all contacts are non-urgent. OBJECTIVES: To identify views of GPs to influence the use of the out-of-hours GP cooperatives. METHODS: Cross-sectional survey study among a

  3. Interfacing a General Purpose Fluid Network Flow Program with the SINDA/G Thermal Analysis Program

    Science.gov (United States)

    Schallhorn, Paul; Popok, Daniel

    1999-01-01

    A general purpose, one dimensional fluid flow code is currently being interfaced with the thermal analysis program Systems Improved Numerical Differencing Analyzer/Gaski (SINDA/G). The flow code, Generalized Fluid System Simulation Program (GFSSP), is capable of analyzing steady state and transient flow in a complex network. The flow code is capable of modeling several physical phenomena including compressibility effects, phase changes, body forces (such as gravity and centrifugal) and mixture thermodynamics for multiple species. The addition of GFSSP to SINDA/G provides a significant improvement in convective heat transfer modeling for SINDA/G. The interface development is conducted in multiple phases. This paper describes the first phase of the interface which allows for steady and quasi-steady (unsteady solid, steady fluid) conjugate heat transfer modeling.

  4. Global stability of a network-based SIS epidemic model with a general nonlinear incidence rate.

    Science.gov (United States)

    Huang, Shouying; Jiang, Jifa

    2016-08-01

    In this paper, we develop and analyze an SIS epidemic model with a general nonlinear incidence rate, as well as degree-dependent birth and natural death, on heterogeneous networks. We analytically derive the epidemic threshold R0 which completely governs the disease dynamics: when R0 1, the disease is permanent. It is interesting that the threshold value R0 bears no relation to the functional form of the nonlinear incidence rate and degree-dependent birth. Furthermore, by applying an iteration scheme and the theory of cooperative system respectively, we obtain sufficient conditions under which the endemic equilibrium is globally asymptotically stable. Our results improve and generalize some known results. To illustrate the theoretical results, the corresponding numerical simulations are also given.

  5. Campaigning on Twitter: Microblogging and online social networking as campaign tools in the 2010 general elections in the Netherlands

    NARCIS (Netherlands)

    Vergeer, M.R.M.; Hermans, E.A.H.M.

    2013-01-01

    The present study focuses on how candidates in the Dutch general elections of 2010 use Twitter, a popular microblogging and social networking service. Specifically the study focuses on explaining why some candidates are more likely to adopt Twitter, have larger networks, and show more reciprocation

  6. Avalanches and generalized memory associativity in a network model for conscious and unconscious mental functioning

    Science.gov (United States)

    Siddiqui, Maheen; Wedemann, Roseli S.; Jensen, Henrik Jeldtoft

    2018-01-01

    We explore statistical characteristics of avalanches associated with the dynamics of a complex-network model, where two modules corresponding to sensorial and symbolic memories interact, representing unconscious and conscious mental processes. The model illustrates Freud's ideas regarding the neuroses and that consciousness is related with symbolic and linguistic memory activity in the brain. It incorporates the Stariolo-Tsallis generalization of the Boltzmann Machine in order to model memory retrieval and associativity. In the present work, we define and measure avalanche size distributions during memory retrieval, in order to gain insight regarding basic aspects of the functioning of these complex networks. The avalanche sizes defined for our model should be related to the time consumed and also to the size of the neuronal region which is activated, during memory retrieval. This allows the qualitative comparison of the behaviour of the distribution of cluster sizes, obtained during fMRI measurements of the propagation of signals in the brain, with the distribution of avalanche sizes obtained in our simulation experiments. This comparison corroborates the indication that the Nonextensive Statistical Mechanics formalism may indeed be more well suited to model the complex networks which constitute brain and mental structure.

  7. Breast tumor classification in ultrasound images using neural networks with improved generalization methods.

    Science.gov (United States)

    de S Silva, S D; Costa, M G F; de A Pereira, W C; Costa Filho, C F F

    2015-01-01

    Mammography, scintimammography and ultrasound images have been used to increase the specificity of breast cancer image diagnosis. Concerning breast cancer image diagnosis with ultrasound, some results found in the literature show better performance of morphological features in breast cancer lesion differentiation and that a reduced set of features shows a better performance than a large set of features. In this study we evaluated the performance of neural network classifiers, with different training stop criteria: mean square error, early stop and regularization. The last two criteria were developed to improve neural network generalization. Different sets of morphological features were used as neural network inputs. Training sets comprised of 22, 8, 7, 6, 5 and 4 features were employed. To select reduced sets of features, a scalar selection technique with correlation was used. The best results obtained for accuracy and area under the ROC curve were 96.98% and 0.98, respectively. The performance obtained with all 22 features is slightly better than the one obtained with a reduced set of features.

  8. Cellular computational generalized neuron network for frequency situational intelligence in a multi-machine power system.

    Science.gov (United States)

    Wei, Yawei; Venayagamoorthy, Ganesh Kumar

    2017-09-01

    To prevent large interconnected power system from a cascading failure, brownout or even blackout, grid operators require access to faster than real-time information to make appropriate just-in-time control decisions. However, the communication and computational system limitations of currently used supervisory control and data acquisition (SCADA) system can only deliver delayed information. However, the deployment of synchrophasor measurement devices makes it possible to capture and visualize, in near-real-time, grid operational data with extra granularity. In this paper, a cellular computational network (CCN) approach for frequency situational intelligence (FSI) in a power system is presented. The distributed and scalable computing unit of the CCN framework makes it particularly flexible for customization for a particular set of prediction requirements. Two soft-computing algorithms have been implemented in the CCN framework: a cellular generalized neuron network (CCGNN) and a cellular multi-layer perceptron network (CCMLPN), for purposes of providing multi-timescale frequency predictions, ranging from 16.67 ms to 2 s. These two developed CCGNN and CCMLPN systems were then implemented on two different scales of power systems, one of which installed a large photovoltaic plant. A real-time power system simulator at weather station within the Real-Time Power and Intelligent Systems (RTPIS) laboratory at Clemson, SC, was then used to derive typical FSI results. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Outage analysis of selective cooperation in underlay cognitive networks with fixed gain relays and primary interference modeling

    KAUST Repository

    Hussain, Syed Imtiaz

    2012-09-01

    Selective cooperation is a well investigated technique in non-cognitive networks for efficient spectrum utilization and performance improvement. However, it is still a nascent topic for underlay cognitive networks. Recently, it was investigated for underlay networks where the secondary nodes were able to adapt their transmit power to always satisfy the interference threshold to the primary users. This is a valid assumption for cellular networks but many non-cellular devices have fixed transmit powers. In this situation, selective cooperation poses a more challenging problem and performs entirely differently. In this paper, we extend our previous work of selective cooperation based on either hop\\'s signal to noise ratio (SNR) with fixed gain and fixed transmit power relays in an underlay cognitive network. This work lacked in considering the primary interference over the cognitive network and presented a rather idealistic analysis. This paper deals with a more realistic system model and includes the effects of primary interference on the secondary transmission. We first derive end-to-end signal to interference and noise ratio (SINR) expression and the related statistics for a dual-hop relay link using asymptotic and approximate approaches. We then derive the statistics of the selected relay link based on maximum end-to-end SINR among the relays satisfying the interference threshold to the primary user. Using this statistics, we derive closed form asymptotic and approximate expressions for the outage probability of the system. Analytical results are verified through simulations. It is concluded that selective cooperation in underlay cognitive networks performs better only in low to medium SNR regions. © 2012 IEEE.

  10. Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis.

    Science.gov (United States)

    Linde, Klaus; Rücker, Gerta; Sigterman, Kirsten; Jamil, Susanne; Meissner, Karin; Schneider, Antonius; Kriston, Levente

    2015-08-19

    A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mode for depressed patients in this setting. Randomized trials comparing a psychological treatment with usual care, placebo, another psychological treatment, pharmacotherapy, or a combination treatment in adult depressed primary care patients were identified by database searches up to December 2013. We performed both conventional pairwise meta-analysis and network meta-analysis combining direct and indirect evidence. Outcome measures were response to treatment (primary outcome), remission of symptoms, post-treatment depression scores and study discontinuation. A total of 37 studies with 7,024 patients met the inclusion criteria. Among the psychological treatments investigated in at least 150 patients face-to-face cognitive behavioral therapy (CBT; OR 1.80; 95 % credible interval 1.35-2.39), face-to-face counselling and psychoeducation (1.65; 1.27-2.13), remote therapist lead CBT (1.87; 1.38-2.53), guided self-help CBT (1.68; 1.22-2.30) and no/minimal contact CBT (1.53; 1.07-2.17) were superior to usual care or placebo, but not face-to-face problem-solving therapy and face-to-face interpersonal therapy. There were no statistical differences between psychological treatments apart from face-to-face interpersonal psychotherapy being inferior to remote therapist-lead CBT (0.60; 0.37-0.95). Remote therapist-led (0.86; 0.21-3.67), guided self-help (0.93; 0.62-1.41) and no/minimal contact CBT (0.85; 0.54-1.36) had similar effects as face-to-face CBT. The limited available evidence precludes a sufficiently reliable assessment of the comparative effectiveness of psychological treatments in depressed primary care patients. Findings suggest that psychological interventions

  11. Delay reduction in lossy intermittent feedback for generalized instantly decodable network coding

    KAUST Repository

    Douik, Ahmed S.

    2013-10-01

    In this paper, we study the effect of lossy intermittent feedback loss events on the multicast decoding delay performance of generalized instantly decodable network coding. These feedback loss events create uncertainty at the sender about the reception statues of different receivers and thus uncertainty to accurately determine subsequent instantly decodable coded packets. To solve this problem, we first identify the different possibilities of uncertain packets at the sender and their probabilities. We then derive the expression of the mean decoding delay. We formulate the Generalized Instantly Decodable Network Coding (G-IDNC) minimum decoding delay problem as a maximum weight clique problem. Since finding the optimal solution is NP-hard, we design a variant of the algorithm employed in [1]. Our algorithm is compared to the two blind graph update proposed in [2] through extensive simulations. Results show that our algorithm outperforms the blind approaches in all the situations and achieves a tolerable degradation, against the perfect feedback, for large feedback loss period. © 2013 IEEE.

  12. Influence of population and general practice characteristics on prescribing of minor tranquilisers in primary care

    Directory of Open Access Journals (Sweden)

    Wagner AC

    2010-09-01

    Full Text Available Prevalence of generalised anxiety disorders is widespread in Great Britain. Previous small-scale research has shown variations in minor tranquiliser prescribing, identifying several potential predictors of prescribing volume. Objective: This study aimed to investigate the relationship between general practice minor tranquiliser prescribing rates and practice population and general practice characteristics for all general practices in England.Methods: Multiple regression analysis of minor tranquiliser prescribing volumes during 2004/2005 for 8,291 English general practices with general practice and population variables obtained from the General Medical Services (GMS statistics, Quality and Outcomes Framework (QOF, 2001 Census and 2004 Index of Multiple Deprivation (IMD. Results: The highest rates of minor tranquiliser prescribing were in areas with the greatest local deprivation while general practices situated in areas with larger proportions of residents of black ethnic origin had lower rates of prescribing. Other predictors of increased prescribing were general practices with older general practitioners and general practices with older registered practice populations.Conclusion: Our findings show that there is wide variation of minor tranquilisers prescribing across England which has implications regarding access to treatment and inequity of service provision. Future research should determine the barriers to equitable prescribing amongst general practices serving larger populations of black ethnic origin.

  13. The relationship between learning mathematics and general cognitive ability in primary school.

    Science.gov (United States)

    Cowan, Richard; Hurry, Jane; Midouhas, Emily

    2017-08-12

    Three relationships between learning mathematics and general cognitive ability have been hypothesized: The educational hypothesis that learning mathematics develops general cognitive skills, the psychometric hypothesis that differences in general cognitive ability cause differences in mathematical attainment, and the reciprocal influence hypothesis that developments in mathematical ability and general cognitive ability influence each other. These hypotheses are assessed with a sample of 948 children from the Twins Early Development Study who were assessed at 7, 9, and 10 years on mathematics, English, and general cognitive ability. A cross-lagged path analysis with mathematics and general cognitive ability measures supports the reciprocal influence hypothesis between 7 and 9 and between 9 and 10. A second analysis including English assessments only provides evidence of a reciprocal relationship between 7 and 9. Statement of Contribution What is already known on this subject? The correlations between mathematical attainment, literacy, and measures of general cognitive skills are well established. The role of literacy in developing general cognitive skills is emerging. What the present study adds? Mathematics contributes to the development of general cognitive skills. General cognitive ability contributes to mathematical development between 7 and 10. These findings support the hypothesis of reciprocal influence between mathematics and general cognitive ability, at least between 7 and 9. © 2017 The British Psychological Society.

  14. Gene-Expression Profiles in Generalized Aggressive Periodontitis: A Gene Network-Based Microarray Analysis.

    Science.gov (United States)

    Guzeldemir-Akcakanat, Esra; Sunnetci-Akkoyunlu, Deniz; Orucguney, Begum; Cine, Naci; Kan, Bahadır; Yılmaz, Elif Büsra; Gümüşlü, Esen; Savli, Hakan

    2016-01-01

    In this study, molecular biomarkers that play a role in the development of generalized aggressive periodontitis (GAgP) are investigated using gingival tissue samples through omics-based whole-genome transcriptomics while using healthy individuals as background controls. Gingival tissue biopsies from 23 patients with GAgP and 25 healthy individuals were analyzed using gene-expression microarrays with network and pathway analyses to identify gene-expression patterns. To substantiate the results of the microarray studies, real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was performed to assess the messenger RNA (mRNA) expression of MZB1 and DSC1. The microarrays and qRT-PCR resulted in similar gene-expression changes, confirming the reliability of the microarray results at the mRNA level. As a result of the gene-expression microarray studies, four significant gene networks were identified. The most upregulated genes were found as MZB1, TNFRSF17, PNOC, FCRL5, LAX1, BMS1P20, IGLL5, MMP7, SPAG4, and MEI1; the most downregulated genes were found as LOR, LAMB4, AADACL2, MAPT, ARG1, NPR3, AADAC, DSC1, LRRC4, and CHP2. Functions of the identified genes that were involved in gene networks were cellular development, cell growth and proliferation, cellular movement, cell-cell signaling and interaction, humoral immune response, protein synthesis, cell death and survival, cell population and organization, organismal injury and abnormalities, molecular transport, and small-molecule biochemistry. The data suggest new networks that have important functions as humoral immune response and organismal injury/abnormalities. Future analyses may facilitate proteomic profiling analyses to identify gene-expression patterns related to clinical outcome.

  15. Brief cognitive behavioral therapy compared to general practitioners care for depression in primary care: a randomized trial

    Science.gov (United States)

    2010-01-01

    Background Depressive disorders are highly prevalent in primary care (PC) and are associated with considerable functional impairment and increased health care use. Research has shown that many patients prefer psychological treatments to pharmacotherapy, however, it remains unclear which treatment is most optimal for depressive patients in primary care. Methods/Design A randomized, multi-centre trial involving two intervention groups: one receiving brief cognitive behavioral therapy and the other receiving general practitioner care. General practitioners from 109 General Practices in Nijmegen and Amsterdam (The Netherlands) will be asked to include patients aged between 18-70 years presenting with depressive symptomatology, who do not receive an active treatment for their depressive complaints. Patients will be telephonically assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to ascertain study eligibility. Eligible patients will be randomized to one of two treatment conditions: either 8 sessions of cognitive behavioral therapy by a first line psychologist or general practitioner's care according to The Dutch College of General Practitioners Practice Guideline (NHG- standaard). Baseline and follow-up assessments are scheduled at 0, 6, 12 and 52 weeks following the start of the intervention. Primary outcome will be measured with the Hamilton Depression Rating Scale-17 (HDRS-17) and the Patient Health Questionnaire-9 (PHQ-9). Outcomes will be analyzed on an intention to treat basis. Trial Registration ISRCTN65811640 PMID:20939917

  16. Generalized in vitro-in vivo relationship (IVIVR) model based on artificial neural networks.

    Science.gov (United States)

    Mendyk, Aleksander; Tuszyński, Paweł K; Polak, Sebastian; Jachowicz, Renata

    2013-01-01

    The aim of this study was to develop a generalized in vitro-in vivo relationship (IVIVR) model based on in vitro dissolution profiles together with quantitative and qualitative composition of dosage formulations as covariates. Such a model would be of substantial aid in the early stages of development of a pharmaceutical formulation, when no in vivo results are yet available and it is impossible to create a classical in vitro-in vivo correlation (IVIVC)/IVIVR. Chemoinformatics software was used to compute the molecular descriptors of drug substances (ie, active pharmaceutical ingredients) and excipients. The data were collected from the literature. Artificial neural networks were used as the modeling tool. The training process was carried out using the 10-fold cross-validation technique. The database contained 93 formulations with 307 inputs initially, and was later limited to 28 in a course of sensitivity analysis. The four best models were introduced into the artificial neural network ensemble. Complete in vivo profiles were predicted accurately for 37.6% of the formulations. It has been shown that artificial neural networks can be an effective predictive tool for constructing IVIVR in an integrated generalized model for various formulations. Because IVIVC/IVIVR is classically conducted for 2-4 formulations and with a single active pharmaceutical ingredient, the approach described here is unique in that it incorporates various active pharmaceutical ingredients and dosage forms into a single model. Thus, preliminary IVIVC/IVIVR can be available without in vivo data, which is impossible using current IVIVC/IVIVR procedures.

  17. The network structure of major depressive disorder, generalized anxiety disorder and somatic symptomatology.

    Science.gov (United States)

    Bekhuis, E; Schoevers, R A; van Borkulo, C D; Rosmalen, J G M; Boschloo, L

    2016-10-01

    Major depressive disorder (MDD) and generalized anxiety disorder (GAD) often co-occur with somatic symptomatology. Little is known about the contributions of individual symptoms to this association and more insight into their relationships could help to identify symptoms that are central in the processes behind the co-occurrence. This study explores associations between individual MDD/GAD symptoms and somatic symptoms by using the network approach. MDD/GAD symptoms were assessed in 2704 participants (mean age 41.7 years, 66.1% female) from the Netherlands Study of Depression and Anxiety using the Inventory of Depressive Symptomatology. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire. The technique eLasso was used to estimate the network of MDD/GAD and somatic symptoms. The network structure showed numerous associations between MDD/GAD and somatic symptoms. In general, neurovegetative and cognitive/affective MDD/GAD symptoms showed a similar strength of connections to the somatic domain. However, associations varied substantially across individual symptoms. MDD/GAD symptoms with many and strong associations to the somatic domain included anxiety and fatigue, whereas hypersomnia and insomnia showed no connections to somatic symptoms. Among somatic symptoms, excessive perspiration and pressure/tight feeling in chest were associated with the MDD/GAD domain, while muscle pain and tingling in fingers showed only a few weak associations. Individual symptoms show differential associations in the co-occurrence of MDD/GAD with somatic symptomatology. Strongly interconnected symptoms are important in furthering our understanding of the interaction between the symptom domains, and may be valuable targets for future research and treatment.

  18. Using Generalized Linear Mixed Models to Evaluate Inconsistency within a Network Meta-Analysis.

    Science.gov (United States)

    Tu, Yu-Kang

    2015-12-01

    Network meta-analysis compares multiple treatments by incorporating direct and indirect evidence into a general statistical framework. One issue with the validity of network meta-analysis is inconsistency between direct and indirect evidence within a loop formed by three treatments. Recently, the inconsistency issue has been explored further and a complex design-by-treatment interaction model proposed. The aim of this article was to show how to evaluate the design-by-treatment interaction model using the generalized linear mixed model. We proposed an arm-based approach to evaluating the design-by-treatment inconsistency, which is flexible in modeling different types of outcome variables. We used the smoking cessation data to compare results from our arm-based approach with those from the standard contrast-based approach. Because the contrast-based approach requires transformation of data, our example showed that such a transformation may yield biases in the treatment effect and inconsistency evaluation, when event rates were low in some treatments. We also compared contrast-based and arm-based models in the evaluation of design inconsistency when different heterogeneity variances were estimated, and the arm-based model yielded more accurate results. Because some statistical software commands can detect the collinearity among variables and automatically remove the redundant ones, we can use this advantage to help with placing the inconsistency parameters. This could be very useful for a network meta-analysis involving many designs and treatments. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Prenatal care in the primary health care network in FortalezaCE: an assessment of the structure, process and results

    Directory of Open Access Journals (Sweden)

    Rebeca Silveira Rocha

    2012-09-01

    Full Text Available Objective: To evaluate the prenatal care assistance in the primary health care network in Fortaleza-CE, considering the structure, process and results. Methods: A cross sectional descriptive study, of quantitative approach, performed between October 2009 and February 2011, in 30 Health Units randomly selected, keeping the ratio for each Regional Executive Secretary. For analysis of the structure, the information obtained was scored and classified as: excellent, satisfactory, precarious or insufficient. The form used was submitted to four experts for validation. In evaluating the process and results, data was available by the Municipal Health Secretary of Fortaleza for obtainance of the indicators recommended by the Ministry of Health. Results: There was, in general, a satisfactory structure. As for the process and result, we obtained: pregnant women who had, at least, six prenatal visits (7.6%; pregnant women who received tetanus immunization (22.8%; newborns with congenital syphilis (1.4%; newborns with neonatal tetanus (0%; maternal mortality rate (78.5% in 2008 and 51% in 2009 and total neonatal mortality rate (10.1% in 2008 and 11.2% in 2009. Conclusions: Despite good results with regard to the structure, the reflections on the process and outcome indicators were not positive, with low rates compared to those expected by the World Health Organization or the Ministry of Health, or in comparison with other regions.

  20. Integer programming models and branch-and-cut approaches to generalized {0,1,2}-survivable network design problems.

    Science.gov (United States)

    Leitner, Markus

    In this article, we introduce the Generalized [Formula: see text]-Survivable Network Design Problem ([Formula: see text]-GSNDP) which has applications in the design of backbone networks. Different mixed integer linear programming formulations are derived by combining previous results obtained for the related [Formula: see text]-GSNDP and Generalized Network Design Problems. An extensive computational study comparing the correspondingly developed branch-and-cut approaches shows clear advantages for two particular variants. Additional insights into individual advantages and disadvantages of the developed algorithms for different instance characteristics are given.

  1. Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

    Directory of Open Access Journals (Sweden)

    Yong Sun Choi

    2013-09-01

    Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293. Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital.

  2. A Primary Role for Nucleus Accumbens and Related Limbic Network in Vocal Tics.

    Science.gov (United States)

    McCairn, Kevin W; Nagai, Yuji; Hori, Yukiko; Ninomiya, Taihei; Kikuchi, Erika; Lee, Ju-Young; Suhara, Tetsuya; Iriki, Atsushi; Minamimoto, Takafumi; Takada, Masahiko; Isoda, Masaki; Matsumoto, Masayuki

    2016-01-20

    Inappropriate vocal expressions, e.g., vocal tics in Tourette syndrome, severely impact quality of life. Neural mechanisms underlying vocal tics remain unexplored because no established animal model representing the condition exists. We report that unilateral disinhibition of the nucleus accumbens (NAc) generates vocal tics in monkeys. Whole-brain PET imaging identified prominent, bilateral limbic cortico-subcortical activation. Local field potentials (LFPs) developed abnormal spikes in the NAc and the anterior cingulate cortex (ACC). Vocalization could occur without obvious LFP spikes, however, when phase-phase coupling of alpha oscillations were accentuated between the NAc, ACC, and the primary motor cortex. These findings contrasted with myoclonic motor tics induced by disinhibition of the dorsolateral putamen, where PET activity was confined to the ipsilateral sensorimotor system and LFP spikes always preceded motor tics. We propose that vocal tics emerge as a consequence of dysrhythmic alpha coupling between critical nodes in the limbic and motor networks. VIDEO ABSTRACT. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Primary and Secondary Education in Morocco: From Access to School into Generalization to Dropout

    Science.gov (United States)

    Mansouri, Zoulal; Moumine, Mohamed El Amine

    2017-01-01

    This article provides an overview of school wastage, namely repetition and dropout in primary and secondary schools in Morocco. It describes how this phenomenon has progressed since school was implemented in the 1960s. It shows that the fundamental principles of the education system established in the aftermath of Morocco?s independence in 1956…

  4. Prescribing pattern of general practitioners for osteoarthritis in primary care settings in Bolu, Turkey

    International Nuclear Information System (INIS)

    Kartal, M.; Maral, I.; Coskun, O.

    2007-01-01

    Objective was to assess the drug preferences of primary care physicians for osteoarthritis (OA) in comparison with the current guidelines and their reflections in the cost of prescriptions. Data were collected from all primary health care centers in Bolu, Turkey during from November 2002 from patient polyclinic logbooks. Drugs prescribed were classified according to the Anatomical Therapeutical Chemical Classification system for comparison purposes. Gender, age and health insurance of patients were analyzed for drug preferences and costs. Forty-eight primary care physicians prescribed 1047 drugs for 507 OA patients with total cost of $10,254. Anti-inflammatory and antirheumatic products were the leading group accounting for 59.6% of the prescribed drugs, and 84.1% of the total expenditure. Paracetamol, the most commonly recommended in the guidelines, constituted 6.9% of all prescribed drugs and 0.9% of the total cost. Drug preferences showed a statistical difference among the health insurance types while drugs cost showed statistical significance among the gender and health insurance types. Cyclooygenase-2-specific inhibitors were the most commonly prescribed subgroup, constituting 23.2% of prescribed drugs and 62.6% of the total expenditure. Paracetamol in practice was not the first-line drug preferred by primary care physicians. Drug prescription data showed that the preference of drugs was affected by health insurance types and the gender of patients in favor of expensive new drugs. There is a need for improvement of drug prescriptions to reflect current recommendations and guidelines. (author)

  5. Node-Splitting Generalized Linear Mixed Models for Evaluation of Inconsistency in Network Meta-Analysis.

    Science.gov (United States)

    Yu-Kang, Tu

    2016-12-01

    Network meta-analysis for multiple treatment comparisons has been a major development in evidence synthesis methodology. The validity of a network meta-analysis, however, can be threatened by inconsistency in evidence within the network. One particular issue of inconsistency is how to directly evaluate the inconsistency between direct and indirect evidence with regard to the effects difference between two treatments. A Bayesian node-splitting model was first proposed and a similar frequentist side-splitting model has been put forward recently. Yet, assigning the inconsistency parameter to one or the other of the two treatments or splitting the parameter symmetrically between the two treatments can yield different results when multi-arm trials are involved in the evaluation. We aimed to show that a side-splitting model can be viewed as a special case of design-by-treatment interaction model, and different parameterizations correspond to different design-by-treatment interactions. We demonstrated how to evaluate the side-splitting model using the arm-based generalized linear mixed model, and an example data set was used to compare results from the arm-based models with those from the contrast-based models. The three parameterizations of side-splitting make slightly different assumptions: the symmetrical method assumes that both treatments in a treatment contrast contribute to inconsistency between direct and indirect evidence, whereas the other two parameterizations assume that only one of the two treatments contributes to this inconsistency. With this understanding in mind, meta-analysts can then make a choice about how to implement the side-splitting method for their analysis. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. Efficient reconstruction of biological networks via transitive reduction on general purpose graphics processors.

    Science.gov (United States)

    Bošnački, Dragan; Odenbrett, Maximilian R; Wijs, Anton; Ligtenberg, Willem; Hilbers, Peter

    2012-10-30

    Techniques for reconstruction of biological networks which are based on perturbation experiments often predict direct interactions between nodes that do not exist. Transitive reduction removes such relations if they can be explained by an indirect path of influences. The existing algorithms for transitive reduction are sequential and might suffer from too long run times for large networks. They also exhibit the anomaly that some existing direct interactions are also removed. We develop efficient scalable parallel algorithms for transitive reduction on general purpose graphics processing units for both standard (unweighted) and weighted graphs. Edge weights are regarded as uncertainties of interactions. A direct interaction is removed only if there exists an indirect interaction path between the same nodes which is strictly more certain than the direct one. This is a refinement of the removal condition for the unweighted graphs and avoids to a great extent the erroneous elimination of direct edges. Parallel implementations of these algorithms can achieve speed-ups of two orders of magnitude compared to their sequential counterparts. Our experiments show that: i) taking into account the edge weights improves the reconstruction quality compared to the unweighted case; ii) it is advantageous not to distinguish between positive and negative interactions since this lowers the complexity of the algorithms from NP-complete to polynomial without loss of quality.

  7. Usage of Probabilistic and General Regression Neural Network for Early Detection and Prevention of Oral Cancer

    Directory of Open Access Journals (Sweden)

    Neha Sharma

    2015-01-01

    Full Text Available In India, the oral cancers are usually presented in advanced stage of malignancy. It is critical to ascertain the diagnosis in order to initiate most advantageous treatment of the suspicious lesions. The main hurdle in appropriate treatment and control of oral cancer is identification and risk assessment of early disease in the community in a cost-effective fashion. The objective of this research is to design a data mining model using probabilistic neural network and general regression neural network (PNN/GRNN for early detection and prevention of oral malignancy. The model is built using the oral cancer database which has 35 attributes and 1025 records. All the attributes pertaining to clinical symptoms and history are considered to classify malignant and non-malignant cases. Subsequently, the model attempts to predict particular type of cancer, its stage and extent with the help of attributes pertaining to symptoms, gross examination and investigations. Also, the model envisages anticipating the survivability of a patient on the basis of treatment and follow-up details. Finally, the performance of the PNN/GRNN model is compared with that of other classification models. The classification accuracy of PNN/GRNN model is 80% and hence is better for early detection and prevention of the oral cancer.

  8. Usage of Probabilistic and General Regression Neural Network for Early Detection and Prevention of Oral Cancer.

    Science.gov (United States)

    Sharma, Neha; Om, Hari

    2015-01-01

    In India, the oral cancers are usually presented in advanced stage of malignancy. It is critical to ascertain the diagnosis in order to initiate most advantageous treatment of the suspicious lesions. The main hurdle in appropriate treatment and control of oral cancer is identification and risk assessment of early disease in the community in a cost-effective fashion. The objective of this research is to design a data mining model using probabilistic neural network and general regression neural network (PNN/GRNN) for early detection and prevention of oral malignancy. The model is built using the oral cancer database which has 35 attributes and 1025 records. All the attributes pertaining to clinical symptoms and history are considered to classify malignant and non-malignant cases. Subsequently, the model attempts to predict particular type of cancer, its stage and extent with the help of attributes pertaining to symptoms, gross examination and investigations. Also, the model envisages anticipating the survivability of a patient on the basis of treatment and follow-up details. Finally, the performance of the PNN/GRNN model is compared with that of other classification models. The classification accuracy of PNN/GRNN model is 80% and hence is better for early detection and prevention of the oral cancer.

  9. The General-Use Nodal Network Solver (GUNNS) Modeling Package for Space Vehicle Flow System Simulation

    Science.gov (United States)

    Harvey, Jason; Moore, Michael

    2013-01-01

    The General-Use Nodal Network Solver (GUNNS) is a modeling software package that combines nodal analysis and the hydraulic-electric analogy to simulate fluid, electrical, and thermal flow systems. GUNNS is developed by L-3 Communications under the TS21 (Training Systems for the 21st Century) project for NASA Johnson Space Center (JSC), primarily for use in space vehicle training simulators at JSC. It has sufficient compactness and fidelity to model the fluid, electrical, and thermal aspects of space vehicles in real-time simulations running on commodity workstations, for vehicle crew and flight controller training. It has a reusable and flexible component and system design, and a Graphical User Interface (GUI), providing capability for rapid GUI-based simulator development, ease of maintenance, and associated cost savings. GUNNS is optimized for NASA's Trick simulation environment, but can be run independently of Trick.

  10. Depression and unemployment incidence rate evolution in Portugal, 1995-2013: General Practitioner Sentinel Network data.

    Science.gov (United States)

    Rodrigues, Ana Paula; Sousa-Uva, Mafalda; Fonseca, Rita; Marques, Sara; Pina, Nuno; Matias-Dias, Carlos

    2017-11-17

    Quantify, for both genders, the correlation between the depression incidence rate and the unemployment rate in Portugal between 1995 and 2013. An ecological study was developed to correlate the evolution of the depression incidence rates estimated by the General Practitioner Sentinel Network and the annual unemployment rates provided by the National Statistical Institute in official publications. There was a positive correlation between the depression incidence rate and the unemployment rate in Portugal, which was significant only for males (R2 = 0.83, p = 0.04). For this gender, an increase of 37 new cases of depression per 100,000 inhabitants was estimated for each 1% increase in the unemployment rate between 1995 and 2013. Although the study design does not allow the establishment of a causal association between unemployment and depression, the results suggest that the evolution of unemployment in Portugal may have had a significant impact on the level of mental health of the Portuguese, especially among men.

  11. Combined D-optimal design and generalized regression neural network for modeling of plasma etching rate

    Directory of Open Access Journals (Sweden)

    You Hailong

    2014-01-01

    Full Text Available Plasma etching process plays a critical role in semiconductor manufacturing. Because physical and chemical mechanisms involved in plasma etching are extremely complicated, models supporting process control are difficult to construct. This paper uses a 35-run D-optimal design to efficiently collect data under well planned conditions for important controllable variables such as power, pressure, electrode gap and gas flows of Cl2 and He and the response, etching rate, for building an empirical underlying model. Since the relationship between the control and response variables could be highly nonlinear, a generalized regression neural network is used to select important model variables and their combination effects and to fit the model. Compared with the response surface methodology, the proposed method has better prediction performance in training and testing samples. A success application of the model to control the plasma etching process demonstrates the effectiveness of the methods.

  12. Patient Complaint Cases in Primary Health Care: What Are the Characteristics of General Practitioners Involved?

    Directory of Open Access Journals (Sweden)

    Søren Birkeland

    2013-01-01

    Full Text Available Background. Limited knowledge exists about factors increasing the risk of general practitioners becoming involved in a complaint case or getting disciplined in connection with a complaint case. Aim. The present study aimed to identify the general practitioner and practice characteristics associated with complaint cases and discipline. Methods. Information on general practitioners involved in complaint case decisions during one year (2007 was linked to Danish National register data on all general practitioners (. Logistic regression was used for statistical analysis. Results. With regard to complaints concerning daytime services (, the professional seniority of the general practitioner was positively associated with the odds of receiving a complaint decision (OR = 1.44 per 20 years of seniority; CI 95%, 1.04–1.98. Likewise, having more consultations per day was associated with increased odds (OR = 1.29 per 10 extra consultations per day; CI 95%, 1.07–1.54. No statistically significant association could be demonstrated between being disciplined and general practitioner or practice characteristics. Conclusion. The possible relationship between professional seniority, rate of consultations, and complaint cases merits further studies to clarify the impact of professional seniority and workload on professional performance and to furthermore consider the role of factors such as job content and communication styles.

  13. RELATIONS BETWEEN GENERAL MOTOR SKILLS AND HANDBALL SPECIFIC TEST "BALL SLALOM" IN STUDENTS OF THE IV GRADE OF PRIMARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Dragan Branković

    2012-09-01

    Full Text Available Teaching physical education and physical training of children, should be appropriate to their age abilities and needs. Acquire the diversified movement experience is a priority of physical education in junior school age. Students fourth grade of primary school - age 10-11 years, in the sensitive period for developing coordination and speed capabilities. Sports game handball and mode of the game "mini-handball", which is adapted to students age abilities and spatial characteristics of the majority of primary schools, abundant with various tasks, specifically dominated by natural forms of movement - running, jumping, throwing. Therefore, handball has a significant role in solving the tasks of physical education. The specific motor tests and relations with the general motor skills are particularly important for continuous monitoring of motor development of children. The survey was conducted on 79 boys fourth grade of primary school who participated in the electoral sport of handball in the regular physical education classes. The results of the handball test "ball slalom" and its relation with general motor skills of students fourth grade of primary school, should contribute to the perception of the value of handball as the content of physical education, but also to contribute to the selection and forecast performance of children in handball.

  14. Mutual connectivity analysis (MCA) using generalized radial basis function neural networks for nonlinear functional connectivity network recovery in resting-state functional MRI

    Science.gov (United States)

    D'Souza, Adora M.; Abidin, Anas Zainul; Nagarajan, Mahesh B.; Wismüller, Axel

    2016-03-01

    We investigate the applicability of a computational framework, called mutual connectivity analysis (MCA), for directed functional connectivity analysis in both synthetic and resting-state functional MRI data. This framework comprises of first evaluating non-linear cross-predictability between every pair of time series prior to recovering the underlying network structure using community detection algorithms. We obtain the non-linear cross-prediction score between time series using Generalized Radial Basis Functions (GRBF) neural networks. These cross-prediction scores characterize the underlying functionally connected networks within the resting brain, which can be extracted using non-metric clustering approaches, such as the Louvain method. We first test our approach on synthetic models with known directional influence and network structure. Our method is able to capture the directional relationships between time series (with an area under the ROC curve = 0.92 +/- 0.037) as well as the underlying network structure (Rand index = 0.87 +/- 0.063) with high accuracy. Furthermore, we test this method for network recovery on resting-state fMRI data, where results are compared to the motor cortex network recovered from a motor stimulation sequence, resulting in a strong agreement between the two (Dice coefficient = 0.45). We conclude that our MCA approach is effective in analyzing non-linear directed functional connectivity and in revealing underlying functional network structure in complex systems.

  15. General practitioners versus other physicians in the quality of primary care: a cross-sectional study in Guangdong Province, China.

    Science.gov (United States)

    Zou, Yaming; Zhang, Xiao; Hao, Yuantao; Shi, Leiyu; Hu, Ruwei

    2015-10-09

    The primary care in China can be provided by general practitioners (GPs) and other physicians (non-GPs). However, China's general practice system has never been really established. Chinese patients tend to consider the quality of primary care provided by GPs much lower than that of non-GPs. Besides, many GPs presently prefer leaving their own positions and seeking better development in big hospitals, which has made the already weak GP system weaker. Yet, few studies have specially compared the quality of primary care provided by Chinese GPs and other physicians and no studies have explored the independent predictors of Chinese GPs' intentions to stay on their current job. In this study, we aimed to compare the quality of primary care offered by GPs with non-GPs and to explore the independent predictors of GPs' future work intentions. This cross-sectional study applied multi-stage random cluster sampling methodology. The data were collected from November 2013 to September 2014 in Guangdong Province. In total, 401 effective questionnaires were selected from the physicians. Quality of primary care was assessed using the Primary Care Assessment Tool (PCAT) Provider Part, representing six primary care domains: ongoing care, coordination (i.e., referrals and information systems), comprehensiveness (i.e., service available and service provided), family-centeredness, community orientation and cultural competence. Of 401 participating physicians, 163 (40.6 %) were GPs. The total PCAT score was 26.32 ± 2.24 which was the sum score of the six domains and represent the quality of primary care. GPs achieved significantly different total scores and scores on three individual scales: comprehensiveness: service available, comprehensiveness: service provided and community orientation. Multiple linear regressions revealed GPs had a higher total score and scores for comprehensiveness: service provided and community orientation after adjusting for sociodemographic characteristics

  16. Functional connectivity of paired default mode network subregions in primary insomnia

    Directory of Open Access Journals (Sweden)

    Nie X

    2015-12-01

    Full Text Available Xiao Nie,1,* Yi Shao,2,* Si-yu Liu,3 Hai-jun Li,1 Ai-lan Wan,4 Si Nie,1 De-chang Peng,1 Xi-jian Dai1,5 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Ophthalmology,The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 3Medical College of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 4Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 5Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, People’s Republic of China *These authors contributed equally to this work Objective: The aim of this study is to explore the resting-state functional connectivity (FC differences between the paired default mode network (DMN subregions in patients with primary insomnia (PIs.Methods: Forty-two PIs and forty-two age- and sex-matched good sleepers (GSs were recruited. All subjects underwent the resting-state functional magnetic resonance imaging scans. The seed-based region-to-region FC method was used to evaluate the abnormal connectivity within the DMN subregions between the PIs and the GSs. Pearson correlation analysis was used to investigate the relationships between the abnormal FC strength within the paired DMN subregions and the clinical features in PIs.Results: Compared with the GSs, the PIs showed higher Pittsburgh Sleep Quality Index score, Hamilton Anxiety Rating Scale score, Hamilton Depression Rating Scale score, Self-Rating Depression Scale score, Self Rating Anxiety Scale score, Self-Rating Scale of Sleep score, and Profile of Mood States score (P<0.001. Compared with the GSs, the PIs showed significant decreased region-to-region FC between the medial prefrontal cortex and the right medial temporal lobe (t=-2.275, P

  17. Re: Pregabalin prescriptions in the United Kingdom – a drug utilisation study of The Health Improvement Network (THIN) primary care database by Asomaning et al

    DEFF Research Database (Denmark)

    Pottegård, Anton; Tjäderborn, M.; Schjerning, Ole

    2016-01-01

    Aim In Europe, pregabalin is approved for treatment of neuropathic pain, general anxiety disorder (GAD) and as adjunctive therapy for epilepsy. The purpose of this study was to assess utilisation of pregabalin in the UK, including patients with a recorded history of substance abuse, from a large...... general practice database. Methods This observational drug utilisation study (DUS) analysed pregabalin prescription data from the UK Health Improvement Network primary care database between September 2004 and July 2009. Patient demographics, diagnoses (by READ codes) and pregabalin dosing data were...... approved dose of 600 mg/day. Of these, 18.4% (25/136) of patients had a history of substance abuse compared with 14.0% (1884/13,480) in the full population. Conclusion Data from this DUS indicated that the majority of pregabalin prescribing in the UK was consistent with product labelling. The proportion...

  18. Primary Progressive Aphasia in the Network of French Alzheimer Plan Memory Centers.

    Science.gov (United States)

    Magnin, Eloi; Démonet, Jean-François; Wallon, David; Dumurgier, Julien; Troussière, Anne-Cécile; Jager, Alain; Duron, Emmanuelle; Gabelle, Audrey; de la Sayette, Vincent; Volpe-Gillot, Lisette; Tio, Gregory; Evain, Sarah; Boutoleau-Bretonnière, Claire; Enderle, Adeline; Mouton-Liger, François; Robert, Philippe; Hannequin, Didier; Pasquier, Florence; Hugon, Jacques; Paquet, Claire

    2016-10-18

    Few demographical data about primary progressive aphasia (PPA) are available, and most knowledge regarding PPA is based on tertiary centers' results. Our aims were to describe demographical characteristics of the PPA population in a large sample of PPA patients from the network of French Alzheimer plan memory centers (Sample 1), and to describe the stratification of cerebrospinal fluid (CSF) biomarkers in two different samples of PPA patients (Samples 2 and 3). All registered PPA patients in the French Alzheimer's disease (AD) databank (Sample 1: n = 2,035) and a subsample (Sample 2: n = 65) derived from a multicentric prospective cohort with CSF biomarker analysis were analyzed. A multicentric retrospective cohort from language expert tertiary centers (Sample 3: n = 97) with CSF biomarker analysis was added. Sample 3 was added to replicate the CSF results of the Sample 2 and to evaluate repartition of AD pathology in the three variant of PPA according to the latest classification. Non-Fluent/Agrammatic, Logopenic, and Unclassifiable PPA patients (NF/A-Logo-Unclass PPA) were older and more frequent than Semantic PPA patients (2.2 versus 0.8/100,000 inhabitants; p < 0.00001). Male predominance occurred after the age of 80 (p < 0.00001). A higher level of education was observed in the PPA population compared to a typical amnesic AD group. No demographical significant difference between PPA due to AD and not due to AD was observed. The Logopenic variant was most frequent with 85% of AD CSF biomarker profiles (35% in NF/A PPA; 20% in Semantic PPA). PPA occurs also in an elderly population, especially in male patients over 80. CSF biomarkers are useful to stratify PPA. The epidemiology of PPA should be further investigated to confirm gender and cognitive reserve role in PPA to better understand the factors and mechanisms leading to this language-predominant deficit during neurodegenerative diseases.

  19. How do general practice residents use social networking sites in asynchronous distance learning?

    Science.gov (United States)

    Maisonneuve, Hubert; Chambe, Juliette; Lorenzo, Mathieu; Pelaccia, Thierry

    2015-09-21

    Blended learning environments - involving both face-to-face and remote interactions - make it easier to adapt learning programs to constraints such as residents' location and low teacher-student ratio. Social networking sites (SNS) such as Facebook®, while not originally intended to be used as learning environments, may be adapted for the distance-learning part of training programs. The purpose of our study was to explore the use of SNS for asynchronous distance learning in a blended learning environment as well as its influence on learners' face-to-face interactions. We conducted a qualitative study and carried out semi-structured interviews. We performed purposeful sampling for maximal variation to include eight general practice residents in 2(nd) and 3(rd) year training. A thematic analysis was performed. The social integration of SNS facilitates the engagement of users in their learning tasks. This may also stimulate students' interactions and group cohesion when members meet up in person. Most of the general practice residents who work in the blended learning environment we studied had a positive appraisal on their use of SNS. In particular, we report a positive impact on their engagement in learning and their participation in discussions during face-to-face instruction. Further studies are needed in order to evaluate the effectiveness of SNS in blended learning environments and the appropriation of SNS by teachers.

  20. Primary health care service delivery networks for the prevention and management of type 2 diabetes: using social network methods to describe interorganisational collaboration in a rural setting.

    Science.gov (United States)

    McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort

    2011-01-01

    Adults with type 2 diabetes or with behavioural risk factors require comprehensive and well coordinated responses from a range of health care providers who often work in different organisational settings. This study examines three types of collaborative links between organisations involved in a rural setting. Social network methods were employed using survey data on three types of links, and data was collected from a purposive sample of 17 organisations representing the major provider types. The analysis included a mix of unconfirmed and confirmed links, and network measures. General practices were the most influential provider group in initiating referrals, and they referred to the broadest range of organisations in the network. Team care arrangements formed a small part of the general practice referral network. They were used more for access to private sector allied health care providers and less for sharing care with public sector health services. Involvement in joint programs/activities was limited to public and non-government sector services, with no participation from the private sector. The patterns of interactions suggest that informal referral networks provide access to services and coordination of care for individual patients with diabetes. Two population subgroups would benefit from more proactive approaches to ensure equitable access to services and coordination of care across organisational boundaries: people with more complex health care needs and people at risk of developing diabetes.

  1. Skin tumour surgery in primary care: do general practitioners need to improve their surgical skills?

    NARCIS (Netherlands)

    Rijsingen, M.C.J. van; Vossen, R.; Huystee, B.E.W.L. van; Gorgels, W.J.; Gerritsen, M.J.P.

    2015-01-01

    BACKGROUND: Due to a rapid increase in the incidence of skin cancer, it seems inevitable that general practitioners (GPs) will play a larger role in skin cancer care. OBJECTIVES: To assess surgical procedures used by GPs in skin tumour management. METHODS: We performed a retrospective study of 1,898

  2. Screening in primary care: health for all? A study in Dutch general practice.

    NARCIS (Netherlands)

    Velden, K. van der; Fleming, D.M.; Abrahamse, H.

    1999-01-01

    Background: in recent years there has been an increasing emphasis on the delivery of preventive care in general practice. At the same time, available evidence suggests people from lower social classes receive less preventive care compared with people from higher social class. The objective of this

  3. Primary School Science: Implementation of Domain-General Strategies into Teaching Didactics

    Science.gov (United States)

    Dejonckheere, Peter J. N.; Van de Keere, Kristof; Tallir, Isabel; Vervaet, Stephanie

    2013-01-01

    In the present study we present a didactic method to help children aged 11 and 12 learn science in such a way as to enable a dynamic interaction between domain general strategies and the development of conceptual knowledge, whilst each type of scientific process has been considered (forming of hypotheses, experimenting and evaluating). We have…

  4. General

    Indian Academy of Sciences (India)

    Page S20: NMR compound 4i. Page S22: NMR compound 4j. General: Chemicals were purchased from Fluka, Merck and Aldrich Chemical Companies. All the products were characterized by comparison of their IR, 1H NMR and 13C NMR spectroscopic data and their melting points with reported values. General procedure ...

  5. A grey neural network and input-output combined forecasting model. Primary energy consumption forecasts in Spanish economic sectors

    International Nuclear Information System (INIS)

    Liu, Xiuli; Moreno, Blanca; García, Ana Salomé

    2016-01-01

    A combined forecast of Grey forecasting method and neural network back propagation model, which is called Grey Neural Network and Input-Output Combined Forecasting Model (GNF-IO model), is proposed. A real case of energy consumption forecast is used to validate the effectiveness of the proposed model. The GNF-IO model predicts coal, crude oil, natural gas, renewable and nuclear primary energy consumption volumes by Spain's 36 sub-sectors from 2010 to 2015 according to three different GDP growth scenarios (optimistic, baseline and pessimistic). Model test shows that the proposed model has higher simulation and forecasting accuracy on energy consumption than Grey models separately and other combination methods. The forecasts indicate that the primary energies as coal, crude oil and natural gas will represent on average the 83.6% percent of the total of primary energy consumption, raising concerns about security of supply and energy cost and adding risk for some industrial production processes. Thus, Spanish industry must speed up its transition to an energy-efficiency economy, achieving a cost reduction and increase in the level of self-supply. - Highlights: • Forecasting System Using Grey Models combined with Input-Output Models is proposed. • Primary energy consumption in Spain is used to validate the model. • The grey-based combined model has good forecasting performance. • Natural gas will represent the majority of the total of primary energy consumption. • Concerns about security of supply, energy cost and industry competitiveness are raised.

  6. Can clinical governance deliver quality improvement in Australian general practice and primary care? A systematic review of the evidence.

    Science.gov (United States)

    Phillips, Christine B; Pearce, Christopher M; Hall, Sally; Travaglia, Joanne; de Lusignan, Simon; Love, Tom; Kljakovic, Marjan

    2010-11-15

    To review the literature on different models of clinical governance and to explore their relevance to Australian primary health care, and their potential contributions on quality and safety. 25 electronic databases, scanning reference lists of articles and consultation with experts in the field. We searched publications in English after 1999, but a search of the German language literature for a specific model type was also undertaken. The grey literature was explored through a hand search of the medical trade press and websites of relevant national and international clearing houses and professional or industry bodies. 11 software packages commonly used in Australian general practice were reviewed for any potential contribution to clinical governance. 19 high-quality studies that assessed outcomes were included. All abstracts were screened by one researcher, and 10% were screened by a second researcher to crosscheck screening quality. Studies were reviewed and coded by four reviewers, with all studies being rated using standard critical appraisal tools such as the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Two researchers reviewed the Australian general practice software. Interviews were conducted with 16 informants representing service, regional primary health care, national and international perspectives. Most evidence supports governance models which use targeted, peer-led feedback on the clinician's own practice. Strategies most used in clinical governance models were audit, performance against indicators, and peer-led reflection on evidence or performance. The evidence base for clinical governance is fragmented, and focuses mainly on process rather than outcomes. Few publications address models that enhance safety, efficiency, sustainability and the economics of primary health care. Locally relevant clinical indicators, the use of computerised medical record systems, regional primary health care organisations that have the

  7. Optimising value and quality in general practice within the primary health care sector through relationship marketing: a conceptual framework.

    Science.gov (United States)

    Bansal, Manjit K

    2004-01-01

    Discusses the rationale of applying relationship marketing and service quality concepts within the primary health care sector. The use of relational strategies in general practice, by modelling the relationships between practitioners and patients from a marketing perspective, could potentially lead to sustained high quality service being provided, and to more efficient use of resources. This essentially conceptually focused paper addresses an area that has not yet been researched in detail, and furthers understanding of the relationships that facilitate exchange within general practice and service delivery in non-profit, resource-constrained conditions. Deeper understanding of the needs and expectations of patients and the way these can be delivered by general practice can only lead to improvements for all parties involved. The relationship marketing paradigm presents itself as a potentially exciting way of addressing issues associated with ensuring that the highest level of quality is delivered in this area of the UK National Health Service.

  8. Graph theoretical analysis reveals the reorganization of the brain network pattern in primary open angle glaucoma patients

    International Nuclear Information System (INIS)

    Wang, Jieqiong; Li, Ting; Xian, Junfang; Wang, Ningli; He, Huiguang

    2016-01-01

    Most previous glaucoma studies with resting-state fMRI have focused on the neuronal activity in the individual structure of the brain, yet ignored the functional communication of anatomically separated structures. The purpose of this study is to investigate the efficiency of the functional communication change or not in glaucoma patients. We applied the resting-state fMRI data to construct the connectivity network of 25 normal controls and 25 age-gender-matched primary open angle glaucoma patients. Graph theoretical analysis was performed to assess brain network pattern differences between the two groups. No significant differences of the global network measures were found between the two groups. However, the local measures were radically reorganized in glaucoma patients. Comparing with the hub regions in normal controls' network, we found that six hub regions disappeared and nine hub regions appeared in the network of patients. In addition, the betweenness centralities of two altered hub regions, right fusiform gyrus and right lingual gyrus, were significantly correlated with the visual field mean deviation. Although the efficiency of functional communication is preserved in the brain network of the glaucoma at the global level, the efficiency of functional communication is altered in some specialized regions of the glaucoma. (orig.)

  9. Graph theoretical analysis reveals the reorganization of the brain network pattern in primary open angle glaucoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jieqiong [Chinese Academy of Sciences, State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Beijing (China); Li, Ting; Xian, Junfang [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); Wang, Ningli [Capital Medical University, Department of Ophthalmology, Beijing Tongren Hospital, Beijing (China); He, Huiguang [Chinese Academy of Sciences, State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Beijing (China); Chinese Academy of Sciences, Research Center for Brain-Inspired Intelligence, Institute of Automation, Beijing (China)

    2016-11-15

    Most previous glaucoma studies with resting-state fMRI have focused on the neuronal activity in the individual structure of the brain, yet ignored the functional communication of anatomically separated structures. The purpose of this study is to investigate the efficiency of the functional communication change or not in glaucoma patients. We applied the resting-state fMRI data to construct the connectivity network of 25 normal controls and 25 age-gender-matched primary open angle glaucoma patients. Graph theoretical analysis was performed to assess brain network pattern differences between the two groups. No significant differences of the global network measures were found between the two groups. However, the local measures were radically reorganized in glaucoma patients. Comparing with the hub regions in normal controls' network, we found that six hub regions disappeared and nine hub regions appeared in the network of patients. In addition, the betweenness centralities of two altered hub regions, right fusiform gyrus and right lingual gyrus, were significantly correlated with the visual field mean deviation. Although the efficiency of functional communication is preserved in the brain network of the glaucoma at the global level, the efficiency of functional communication is altered in some specialized regions of the glaucoma. (orig.)

  10. Optimal Allocation of Generalized Power Sources in Distribution Network Based on Multi-Objective Particle Swarm Optimization Algorithm

    Directory of Open Access Journals (Sweden)

    Li Ran

    2017-01-01

    Full Text Available Optimal allocation of generalized power sources in distribution network is researched. A simple index of voltage stability is put forward. Considering the investment and operation benefit, the stability of voltage and the pollution emissions of generalized power sources in distribution network, a multi-objective optimization planning model is established. A multi-objective particle swarm optimization algorithm is proposed to solve the optimal model. In order to improve the global search ability, the strategies of fast non-dominated sorting, elitism and crowding distance are adopted in this algorithm. Finally, tested the model and algorithm by IEEE-33 node system to find the best configuration of GP, the computed result shows that with the generalized power reasonable access to the active distribution network, the investment benefit and the voltage stability of the system is improved, and the proposed algorithm has better global search capability.

  11. Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran

    OpenAIRE

    Golkari, Ali; Sabokseir, Aira; Sheiham, Aubrey; Watt, Richard G.

    2016-01-01

    Background: Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and ge...

  12. Common mental health problems in immigrants and refugees: general approach in primary care.

    Science.gov (United States)

    Kirmayer, Laurence J; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

    2011-09-06

    Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and

  13. Common mental health problems in immigrants and refugees: general approach in primary care

    Science.gov (United States)

    Kirmayer, Laurence J.; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G.; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

    2011-01-01

    Background: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. Methods: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. Results: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. Interpretation: Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally

  14. The primary case is not enough: Variation among individuals, groups and social networks modify bacterial transmission dynamics.

    Science.gov (United States)

    Keiser, Carl N; Pinter-Wollman, Noa; Ziemba, Michael J; Kothamasu, Krishna S; Pruitt, Jonathan N

    2018-03-01

    The traits of the primary case of an infectious disease outbreak, and the circumstances for their aetiology, potentially influence the trajectory of transmission dynamics. However, these dynamics likely also depend on the traits of the individuals with whom the primary case interacts. We used the social spider Stegodyphus dumicola to test how the traits of the primary case, group phenotypic composition and group size interact to facilitate the transmission of a GFP-labelled cuticular bacterium. We also compared bacterial transmission across experimentally generated "daisy-chain" vs. "star" networks of social interactions. Finally, we compared social network structure across groups of different sizes. Groups of 10 spiders experienced more bacterial transmission events compared to groups of 30 spiders, regardless of groups' behavioural composition. Groups containing only one bold spider experienced the lowest levels of bacterial transmission regardless of group size. We found no evidence for the traits of the primary case influencing any transmission dynamics. In a second experiment, bacteria were transmitted to more individuals in experimentally induced star networks than in daisy-chains, on which transmission never exceeded three steps. In both experimental network types, transmission success depended jointly on the behavioural traits of the interacting individuals; however, the behavioural traits of the primary case were only important for transmission on star networks. Larger social groups exhibited lower interaction density (i.e. had a low ratio of observed to possible connections) and were more modular, i.e. they had more connections between nodes within a subgroup and fewer connections across subgroups. Thus, larger groups may restrict transmission by forming fewer interactions and by isolating subgroups that interacted with the primary case. These findings suggest that accounting for the traits of single exposed hosts has less power in predicting transmission

  15. THE GENERAL METHODOLOGICAL PRINCIPLES OF COMBINED OPTIONAL ONLINE ENGLISH LANGUAGE TRAINING OF PRIMARY SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    E. I. Zadorozhnaya

    2016-01-01

    Full Text Available The aim of the publication is to demonstrate the implementation of general methodological principles of optional elementary school online foreign languages learning on an example of a virtual course for students of the second and third grades.Methods. The methods involve pedagogical modeling and projecting; the experience of foreign and Russian methodists, teachers and researchers is analysed, generalized and adjusted to the modern realias.Results and scientific novelty. On the basis of the requirements of the state educational standard and interest of pupils in computer games, the author’s technique of the combined facultative educational activities integrated to training in English at elementary school is developed. Online training in the form of games (additional to the major classroom activities gives a possibility of the choice of tasks interesting to children, studying the material at optimum comfortable and individual speed; it is possible to perform the tasks at home excluding the stressful situations that are specific to school examination, and allows pupils to master most effectively personal, metasubject and object competences. In general context of quality improvement of the general education, the modernization of educational process assumes not only justification of its new maintenance, but also restructuring of scientific and methodical support which has to meet essential needs of teachers and pupils, to facilitate access to necessary specific information. The lack of methodical base of creation of electronic distance resources for foreign-language education of younger school students has motivated the author to create own methodical concept of online training taking into account age of pupils. The complex of the general methodical principles is thoroughly considered; based on the general methodical principles, the proposed modular technique of the organization of an online class is created and implemented. Interactive blocks are

  16. General asymmetric neutral networks and structure design by genetic algorithms: A learning rule for temporal patterns

    Energy Technology Data Exchange (ETDEWEB)

    Bornholdt, S. [Heidelberg Univ., (Germany). Inst., fuer Theoretische Physik; Graudenz, D. [Lawrence Berkeley Lab., CA (United States)

    1993-07-01

    A learning algorithm based on genetic algorithms for asymmetric neural networks with an arbitrary structure is presented. It is suited for the learning of temporal patterns and leads to stable neural networks with feedback.

  17. General asymmetric neutral networks and structure design by genetic algorithms: A learning rule for temporal patterns

    International Nuclear Information System (INIS)

    Bornholdt, S.

    1993-07-01

    A learning algorithm based on genetic algorithms for asymmetric neural networks with an arbitrary structure is presented. It is suited for the learning of temporal patterns and leads to stable neural networks with feedback

  18. Effectiveness of intensive practice nurse counselling versus brief general practitioner advice, both combined with varenicline, for smoking cessation: a randomized pragmatic trial in primary care.

    Science.gov (United States)

    van Rossem, Carolien; Spigt, Mark; Viechtbauer, Wolfgang; Lucas, Annelies E M; van Schayck, Onno C P; Kotz, Daniel

    2017-12-01

    To study the effectiveness of intensive counselling by a practice nurse (PN) versus brief advice by a general practitioner (GP), each combined with pharmacotherapy, for 6 months' tobacco abstinence (primary outcome). Secondary outcomes included 12-month abstinence, medication adherence and incremental costs per life-year gained. A multi-site (n = 10), two-group, parallel, pragmatic randomized controlled trial. A network of primary health-care centres in the Netherlands. A total of 295 adult daily smokers (mean age = 48 years; mean cigarettes/day = 19). Patients were randomized to receive individual counselling by a practice nurse (PN) (n = 149) or brief advice by a general practitioner (GP) (146). All patients received 12 weeks of open-label varenicline. The primary outcome was prolonged biochemically validated abstinence from weeks 9 to 26 after treatment initiation. Secondary outcomes included abstinence from weeks 9 to 52, good dosing adherence (> 80% days taken) and incremental costs per life-year gained. Abstinence rates in the PN versus GP groups were 32.2% (n = 48) versus 39.0% [n = 57; odds ratio (OR) = 0.71; 95% confidence interval (CI) = 0.44-1.16] from weeks 9 to 26 and 25.5% (n = 38) versus 28.8% (n = 42; OR = 0.84, 95% CI = 0.50-1.43) from weeks 9 to 52, respectively. Values of the Bayes factor indicated that the PN and GP were equally effective. Good dosing adherence was significantly lower in the PN (45.5%, n = 56/123) than in the GP group (62.0%, n = 75/121; OR = 0.45, 95% CI = 0.26-0.77), and the incremental costs per life-year gained were -€416.10. Among people seeking help to stop smoking from their general practice, one-off brief advice from a general practitioner appears to be as effective as several sessions of behavioural support from a practice nurse when smoking cessation medication is provided. © 2017 Society for the Study of Addiction.

  19. Personal networks of prisoners prior to incarceration : A comparison with the general Dutch population

    NARCIS (Netherlands)

    De Cuyper, R.H.; Dirkzwager, A.J.E.; Völker, B.; van der Laan, P.H.; Nieuwbeerta, P.

    2013-01-01

    This study examines inmates' core discussion network prior to their incarceration. The core discussion network consists of the immediate social circle of relatively strong ties. The aims of the study are twofold: (1) to describe inmates' core discussion network prior to their incarceration in terms

  20. Nutritional counselling in primary health care: a randomized comparison of an intervention by general practitioner or dietician

    DEFF Research Database (Denmark)

    Willaing, Ingrid; Ladelund, Steen; Jørgensen, Torben

    2004-01-01

    AIMS: To compare health effects and risk reduction in two different strategies of nutritional counselling in primary health care for patients at high risk of ischaemic heart disease. METHODS: In a cluster-randomized trial 60 general practitioners (GPs) in the Copenhagen County were randomized....... Risk of cardiovascular disease was calculated by The Copenhagen Risk Score. Data on use of medicine and primary health care was obtained from central registers. RESULTS: Altogether 339 (67%) patients completed the intervention. Weight loss was larger in the dietician group (mean 4.5 kg vs. 2.4 kg...... to give nutritional counselling or to refer patients to a dietician. Patients were included after opportunistically screening (n=503 patients), and received nutritional counselling by GP or dietician over 12 months. Health effects were measured by changes in weight, waist circumference and blood lipids...

  1. Network performance, hub connectivity potential, and competitive position of primary airports in Asia/Pacific region

    NARCIS (Netherlands)

    Matsumoto, H.; Veldhuis, J.; de Wit, J.; Burghouwt, G.

    2008-01-01

    Recently, hub-and-spoke network configurations are more and more developed in the Asia/Pacific region. In this paper, it is argued that the measurement of network performance in hub-and-spoke systems should take into account the quantity and quality of both direct and indirect connections. The

  2. Intrinsic and extrinsic motivations in primary care: an explanatory study among French general practitioners.

    Science.gov (United States)

    Sicsic, Jonathan; Le Vaillant, Marc; Franc, Carine

    2012-12-01

    Like many other OECD nations, France has implemented a pay-for-performance (P4P) model in primary care. However, the benefits have been debated, particularly regarding the possibly undesirable effects of extrinsic motivation (EM) on intrinsic motivation (IM). To examine the relationship between French GPs' IM and EM based on an intrinsic motivation composite score (IMCS) developed for this purpose. If a negative relationship is found, P4P schemes could have side effects on GPs' IM that is a key determinant of quality of care. From data on 423 GPs practicing in a region of France, IM indicators are selected using a multiple correspondence analysis and aggregated from a multilevel model. Several doctors' characteristics have significant impacts on IMCS variability, especially group practice and salaried practice. Qualitative EM variables are negatively correlated with the IMCS: GPs who report not being satisfied with their income or feeling "often" constrained by patients' requests in terms of consultations length and office appointments obtain a lower mean IMCS than other GPs. Our results provide a cautionary message to regulators who should take into account the potential side effects of increasing EM through policies such as P4P. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Geographical accessibility and spatial coverage modeling of the primary health care network in the Western Province of Rwanda

    Directory of Open Access Journals (Sweden)

    Huerta Munoz Ulises

    2012-09-01

    Full Text Available Abstract Background Primary health care is essential in improving and maintaining the health of populations. It has the potential to accelerate achievement of the Millennium Development Goals and fulfill the “Health for All” doctrine of the Alma-Ata Declaration. Understanding the performance of the health system from a geographic perspective is important for improved health planning and evidence-based policy development. The aims of this study were to measure geographical accessibility, model spatial coverage of the existing primary health facility network, estimate the number of primary health facilities working under capacity and the population underserved in the Western Province of Rwanda. Methods This study uses health facility, population and ancillary data for the Western Province of Rwanda. Three different travel scenarios utilized by the population to attend the nearest primary health facility were defined with a maximum travelling time of 60 minutes: Scenario 1 – walking; Scenario 2 – walking and cycling; and Scenario 3 – walking and public transportation. Considering these scenarios, a raster surface of travel time between primary health facilities and population was developed. To model spatial coverage and estimate the number of primary health facilities working under capacity, the catchment area of each facility was calculated by taking into account population coverage capacity, the population distribution, the terrain topography and the travelling modes through the different land categories. Results Scenario 2 (walking and cycling has the highest degree of geographical accessibility followed by Scenario 3 (walking and public transportation. The lowest level of accessibility can be observed in Scenario 1 (walking. The total population covered differs depending on the type of travel scenario. The existing primary health facility network covers only 26.6% of the population in Scenario 1. In Scenario 2, the use of a bicycle

  4. Geographical accessibility and spatial coverage modeling of the primary health care network in the Western Province of Rwanda.

    Science.gov (United States)

    Huerta Munoz, Ulises; Källestål, Carina

    2012-09-17

    Primary health care is essential in improving and maintaining the health of populations. It has the potential to accelerate achievement of the Millennium Development Goals and fulfill the "Health for All" doctrine of the Alma-Ata Declaration. Understanding the performance of the health system from a geographic perspective is important for improved health planning and evidence-based policy development. The aims of this study were to measure geographical accessibility, model spatial coverage of the existing primary health facility network, estimate the number of primary health facilities working under capacity and the population underserved in the Western Province of Rwanda. This study uses health facility, population and ancillary data for the Western Province of Rwanda. Three different travel scenarios utilized by the population to attend the nearest primary health facility were defined with a maximum travelling time of 60 minutes: Scenario 1--walking; Scenario 2--walking and cycling; and Scenario 3--walking and public transportation. Considering these scenarios, a raster surface of travel time between primary health facilities and population was developed. To model spatial coverage and estimate the number of primary health facilities working under capacity, the catchment area of each facility was calculated by taking into account population coverage capacity, the population distribution, the terrain topography and the travelling modes through the different land categories. Scenario 2 (walking and cycling) has the highest degree of geographical accessibility followed by Scenario 3 (walking and public transportation). The lowest level of accessibility can be observed in Scenario 1 (walking). The total population covered differs depending on the type of travel scenario. The existing primary health facility network covers only 26.6% of the population in Scenario 1. In Scenario 2, the use of a bicycle greatly increases the population being served to 58% of inhabitants

  5. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners.

    Directory of Open Access Journals (Sweden)

    Philipp J Bless

    Full Text Available Acute gastroenteritis (AG is frequently caused by infectious intestinal diseases (IID including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID. Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics ("test" and antibiotic therapy ("treat" are interrelated and follow four strategies: "Wait & See", "Treat & See", "Treat & Test", and "Test & See". AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely leads to

  6. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners.

    Science.gov (United States)

    Bless, Philipp J; Muela Ribera, Joan; Schmutz, Claudia; Zeller, Andreas; Mäusezahl, Daniel

    2016-01-01

    Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID). Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics ("test") and antibiotic therapy ("treat") are interrelated and follow four strategies: "Wait & See", "Treat & See", "Treat & Test", and "Test & See". AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely leads to improved case

  7. Conference report: Undergraduate family medicine and primary care training in Sub-Saharan Africa: Reflections of the PRIMAFAMED network

    Directory of Open Access Journals (Sweden)

    Innocent Besigye

    2017-01-01

    Full Text Available Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference.

  8. A General Fuzzy Cerebellar Model Neural Network Multidimensional Classifier Using Intuitionistic Fuzzy Sets for Medical Identification

    Directory of Open Access Journals (Sweden)

    Jing Zhao

    2016-01-01

    Full Text Available The diversity of medical factors makes the analysis and judgment of uncertainty one of the challenges of medical diagnosis. A well-designed classification and judgment system for medical uncertainty can increase the rate of correct medical diagnosis. In this paper, a new multidimensional classifier is proposed by using an intelligent algorithm, which is the general fuzzy cerebellar model neural network (GFCMNN. To obtain more information about uncertainty, an intuitionistic fuzzy linguistic term is employed to describe medical features. The solution of classification is obtained by a similarity measurement. The advantages of the novel classifier proposed here are drawn out by comparing the same medical example under the methods of intuitionistic fuzzy sets (IFSs and intuitionistic fuzzy cross-entropy (IFCE with different score functions. Cross verification experiments are also taken to further test the classification ability of the GFCMNN multidimensional classifier. All of these experimental results show the effectiveness of the proposed GFCMNN multidimensional classifier and point out that it can assist in supporting for correct medical diagnoses associated with multiple categories.

  9. Delay reduction in persistent erasure channels for generalized instantly decodable network coding

    KAUST Repository

    Sorour, Sameh

    2013-06-01

    In this paper, we consider the problem of minimizing the decoding delay of generalized instantly decodable network coding (G-IDNC) in persistent erasure channels (PECs). By persistent erasure channels, we mean erasure channels with memory, which are modeled as a Gilbert-Elliott two-state Markov model with good and bad channel states. In this scenario, the channel erasure dependence, represented by the transition probabilities of this channel model, is an important factor that could be exploited to reduce the decoding delay. We first formulate the G-IDNC minimum decoding delay problem in PECs as a maximum weight clique problem over the G-IDNC graph. Since finding the optimal solution of this formulation is NP-hard, we propose two heuristic algorithms to solve it and compare them using extensive simulations. Simulation results show that each of these heuristics outperforms the other in certain ranges of channel memory levels. They also show that the proposed heuristics significantly outperform both the optimal strict IDNC in the literature and the channel-unaware G-IDNC algorithms. © 2013 IEEE.

  10. Two-dimensional shape classification using generalized Fourier representation and neural networks

    Science.gov (United States)

    Chodorowski, Artur; Gustavsson, Tomas; Mattsson, Ulf

    2000-04-01

    A shape-based classification method is developed based upon the Generalized Fourier Representation (GFR). GFR can be regarded as an extension of traditional polar Fourier descriptors, suitable for description of closed objects, both convex and concave, with or without holes. Explicit relations of GFR coefficients to regular moments, moment invariants and affine moment invariants are given in the paper. The dual linear relation between GFR coefficients and regular moments was used to compare shape features derive from GFR descriptors and Hu's moment invariants. the GFR was then applied to a clinical problem within oral medicine and used to represent the contours of the lesions in the oral cavity. The lesions studied were leukoplakia and different forms of lichenoid reactions. Shape features were extracted from GFR coefficients in order to classify potentially cancerous oral lesions. Alternative classifiers were investigated based on a multilayer perceptron with different architectures and extensions. The overall classification accuracy for recognition of potentially cancerous oral lesions when using neural network classifier was 85%, while the classification between leukoplakia and reticular lichenoid reactions gave 96% (5-fold cross-validated) recognition rate.

  11. Reduced Default Mode Network Connectivity in Treatment-Resistant Idiopathic Generalized Epilepsy

    Science.gov (United States)

    Kay, Benjamin P; DiFrancesco, Mark W; Privitera, Michael D; Gotman, Jean; Holland, Scott K; Szaflarski, Jerzy P

    2012-01-01

    Summary Purpose Idiopathic generalized epilepsy (IGE) resistant to treatment is common, but its neuronal correlates are not entirely understood. Thus, the aim of this study was to examine resting-state default mode network (DMN) functional connectivity in patients with treatment-resistant IGE. Methods Treatment-resistance was defined as continuing seizures despite an adequate dose of valproic acid (valproate, VPA). Data from 60 epilepsy patients and 38 healthy controls who underwent simultaneous EEG and resting-state fMRI were included (EEG/fMRI). Independent component analysis (ICA) and dual regression were used to quantify DMN connectivity. Confirmatory analysis using seed-based voxel correlation was performed. Key Findings There was a significant reduction of DMN connectivity in patients with treatment-resistant epilepsy when compared to patients who were treatment-responsive and healthy controls. Connectivity was negatively correlated with duration of epilepsy. Significance Our findings in this large sample of patients with IGE indicate the presence of reduced DMN connectivity in IGE and show that connectivity is further reduced in treatment-resistant epilepsy. DMN connectivity may be useful as a biomarker for treatment-resistance. PMID:23293853

  12. A lossy graph model for delay reduction in generalized instantly decodable network coding

    KAUST Repository

    Douik, Ahmed S.

    2014-06-01

    The problem of minimizing the decoding delay in Generalized instantly decodable network coding (G-IDNC) for both perfect and lossy feedback scenarios is formulated as a maximum weight clique problem over the G-IDNC graph in. In this letter, we introduce a new lossy G-IDNC graph (LG-IDNC) model to further minimize the decoding delay in lossy feedback scenarios. Whereas the G-IDNC graph represents only doubtless combinable packets, the LG-IDNC graph represents also uncertain packet combinations, arising from lossy feedback events, when the expected decoding delay of XORing them among themselves or with other certain packets is lower than that expected when sending these packets separately. We compare the decoding delay performance of LG-IDNC and G-IDNC graphs through extensive simulations. Numerical results show that our new LG-IDNC graph formulation outperforms the G-IDNC graph formulation in all lossy feedback situations and achieves significant improvement in the decoding delay especially when the feedback erasure probability is higher than the packet erasure probability. © 2012 IEEE.

  13. Prevalence of smoking in general practitioners and teachers at primary schools in České Budějovice.

    OpenAIRE

    STRNADOVÁ, Monika

    2009-01-01

    The objective of my thesis was to determine the prevalence of smoking in a selected group of general practitioners and primary school teachers in České Budějovice. I also wanted to emphasize the important role of physicians and teachers in smoking prevention. Therefore I focused on finding out what preventive activities are used in their professions to reduce smoking. To achieve the goal the interview technique for quantitative research was used. The results of the research show that prevalen...

  14. Improving incidence estimation in practice-based sentinel surveillance networks using spatial variation in general practitioner density

    Directory of Open Access Journals (Sweden)

    Cécile Souty

    2016-11-01

    Full Text Available Abstract Background In surveillance networks based on voluntary participation of health-care professionals, there is little choice regarding the selection of participants’ characteristics. External information about participants, for example local physician density, can help reduce bias in incidence estimates reported by the surveillance network. Methods There is an inverse association between the number of reported influenza-like illness (ILI cases and local general practitioners (GP density. We formulated and compared estimates of ILI incidence using this relationship. To compare estimates, we simulated epidemics using a spatially explicit disease model and their observation by surveillance networks with different characteristics: random, maximum coverage, largest cities, etc. Results In the French practice-based surveillance network – the “Sentinelles” network – GPs reported 3.6% (95% CI [3;4] less ILI cases as local GP density increased by 1 GP per 10,000 inhabitants. Incidence estimates varied markedly depending on scenarios for participant selection in surveillance. Yet accounting for change in GP density for participants allowed reducing bias. Applied on data from the Sentinelles network, changes in overall incidence ranged between 1.6 and 9.9%. Conclusions Local GP density is a simple measure that provides a way to reduce bias in estimating disease incidence in general practice. It can contribute to improving disease monitoring when it is not possible to choose the characteristics of participants.

  15. General expressions for downlink signal to interference and noise ratio in homogeneous and heterogeneous LTE-Advanced networks

    Directory of Open Access Journals (Sweden)

    Nora A. Ali

    2016-11-01

    Full Text Available The interference is the most important problem in LTE or LTE-Advanced networks. In this paper, the interference was investigated in terms of the downlink signal to interference and noise ratio (SINR. In order to compare the different frequency reuse methods that were developed to enhance the SINR, it would be helpful to have a generalized expression to study the performance of the different methods. Therefore, this paper introduces general expressions for the SINR in homogeneous and in heterogeneous networks. In homogeneous networks, the expression was applied for the most common types of frequency reuse techniques: soft frequency reuse (SFR and fractional frequency reuse (FFR. The expression was examined by comparing it with previously developed ones in the literature and the comparison showed that the expression is valid for any type of frequency reuse scheme and any network topology. Furthermore, the expression was extended to include the heterogeneous network; the expression includes the problem of co-tier and cross-tier interference in heterogeneous networks (HetNet and it was examined by the same method of the homogeneous one.

  16. General expressions for downlink signal to interference and noise ratio in homogeneous and heterogeneous LTE-Advanced networks.

    Science.gov (United States)

    Ali, Nora A; Mourad, Hebat-Allah M; ElSayed, Hany M; El-Soudani, Magdy; Amer, Hassanein H; Daoud, Ramez M

    2016-11-01

    The interference is the most important problem in LTE or LTE-Advanced networks. In this paper, the interference was investigated in terms of the downlink signal to interference and noise ratio (SINR). In order to compare the different frequency reuse methods that were developed to enhance the SINR, it would be helpful to have a generalized expression to study the performance of the different methods. Therefore, this paper introduces general expressions for the SINR in homogeneous and in heterogeneous networks. In homogeneous networks, the expression was applied for the most common types of frequency reuse techniques: soft frequency reuse (SFR) and fractional frequency reuse (FFR). The expression was examined by comparing it with previously developed ones in the literature and the comparison showed that the expression is valid for any type of frequency reuse scheme and any network topology. Furthermore, the expression was extended to include the heterogeneous network; the expression includes the problem of co-tier and cross-tier interference in heterogeneous networks (HetNet) and it was examined by the same method of the homogeneous one.

  17. Nonlinear recurrent neural networks for finite-time solution of general time-varying linear matrix equations.

    Science.gov (United States)

    Xiao, Lin; Liao, Bolin; Li, Shuai; Chen, Ke

    2018-02-01

    In order to solve general time-varying linear matrix equations (LMEs) more efficiently, this paper proposes two nonlinear recurrent neural networks based on two nonlinear activation functions. According to Lyapunov theory, such two nonlinear recurrent neural networks are proved to be convergent within finite-time. Besides, by solving differential equation, the upper bounds of the finite convergence time are determined analytically. Compared with existing recurrent neural networks, the proposed two nonlinear recurrent neural networks have a better convergence property (i.e., the upper bound is lower), and thus the accurate solutions of general time-varying LMEs can be obtained with less time. At last, various different situations have been considered by setting different coefficient matrices of general time-varying LMEs and a great variety of computer simulations (including the application to robot manipulators) have been conducted to validate the better finite-time convergence of the proposed two nonlinear recurrent neural networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Approximate analysis of non-stationary loss queues and networks of loss queues with general service time distributions

    OpenAIRE

    Izady, N; Worthington, D J

    2011-01-01

    A Fixed Point Approximation (FPA) method has recently been suggested for non-stationary analysis of loss queues and networks of loss queues with Exponential service times. Deriving exact equations relating time-dependent mean numbers of busy servers to blocking probabilities, we generalize the FPA method to loss systems with general service time distributions. These equations are combined with associated formulae for stationary analysis of loss systems in steady state through a carried load t...

  19. Cognitive multiple-antenna network in outage-restricted primary system

    DEFF Research Database (Denmark)

    Maham, Behrouz; Popovski, Petar

    2013-01-01

    interference from the downlink MISO cognitive radio, also called secondary system. We derive exact expressions for outage probability of the primary user under Rayleigh fading, when the primary system is exposed to interference from a secondary base station. Moreover, in high-SNR scenario, a closed......In the commons model for the spectrum sharing, cognitive users can access the spectrum as long as the target performance in the legitimate primary system is not violated. In this paper, we consider a downlink primary multiple-input-single-output (MISO) system which operates under a controlled...

  20. Using Social Network Analysis to Examine the Effect of Care Management Structure on Chronic Disease Management Communication Within Primary Care.

    Science.gov (United States)

    Holtrop, Jodi Summers; Ruland, Sandra; Diaz, Stephanie; Morrato, Elaine H; Jones, Eric

    2018-01-08

    Care management and care managers are becoming increasingly prevalent in primary care medical practice as a means of improving population health and reducing unnecessary care. Care managers are often involved in chronic disease management and associated transitional care. In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Individual written surveys were given to all practice members in the participating practices. Survey questions assessed demographics as well as practice culture, quality improvement, care management activities, and communication regarding chronic disease care. Using social network analysis and other statistical methods, we analyzed the communication dynamics related to chronic disease care for each practice. The structure of chronic disease communication varies greatly from practice to practice. Care managers who were embedded in the practice or co-located were more likely to be in the core of the communication network than were off-site care managers. These care managers also had higher in-degree centrality, indicating that they acted as a hub for communication with team members in many other roles. Social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. Structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.

  1. General solution of the chemical master equation and modality of marginal distributions for hierarchic first-order reaction networks.

    Science.gov (United States)

    Reis, Matthias; Kromer, Justus A; Klipp, Edda

    2018-01-20

    Multimodality is a phenomenon which complicates the analysis of statistical data based exclusively on mean and variance. Here, we present criteria for multimodality in hierarchic first-order reaction networks, consisting of catalytic and splitting reactions. Those networks are characterized by independent and dependent subnetworks. First, we prove the general solvability of the Chemical Master Equation (CME) for this type of reaction network and thereby extend the class of solvable CME's. Our general solution is analytical in the sense that it allows for a detailed analysis of its statistical properties. Given Poisson/deterministic initial conditions, we then prove the independent species to be Poisson/binomially distributed, while the dependent species exhibit generalized Poisson/Khatri Type B distributions. Generalized Poisson/Khatri Type B distributions are multimodal for an appropriate choice of parameters. We illustrate our criteria for multimodality by several basic models, as well as the well-known two-stage transcription-translation network and Bateman's model from nuclear physics. For both examples, multimodality was previously not reported.

  2. Time trends in the prescription of statins for the primary prevention of cardiovascular disease in the United Kingdom: a cohort study using The Health Improvement Network primary care data

    Directory of Open Access Journals (Sweden)

    O’Keeffe AG

    2016-05-01

    Full Text Available Aidan G O’Keeffe,1 Irwin Nazareth,2 Irene Petersen2 1Department of Statistical Science, 2Department of Primary Care and Population Health, University College London, London, UK Background: Statins are widely prescribed for the primary prevention of cardiovascular disease. Guidelines exist for statin prescriptions, but there is little recent analysis concerning prescription trends over time and how these vary with respect to demographic variables.Methods and results: Using The Health Improvement Network primary care database, statin therapy initiation and statin prescription prevalence rates were calculated using data from 7,027,711 individuals across the UK for the years 1995 to 2013, overall and stratified by sex, age group, and socioeconomic deprivation level (Townsend score. Statin therapy initiation rates rose sharply from 1995 (0.51 per 1,000 person-years up to 2006 (19.83 per 1,000 person-years and thereafter declined (10.76 per 1,000 person-years in 2013. Males had higher initiation rates than females and individuals aged 60–85 years had higher initiation rates than younger or more elderly age groups. Initiation rates were slightly higher as social deprivation level increased, after accounting for age and sex. Prescription prevalence increased sharply from 1995 (2.36 per 1,000 person-years to 2013 (128.03 per 1,000 person-years with males generally having a higher prevalence rate, over time, than females. Prevalence rates over time were generally higher for older age groups but were similar with respect to social deprivation level.Conclusion: The uptake of statins within UK primary care has increased greatly over time with statins being more commonly prescribed to older patients in general and, in recent years, males appear to have been prescribed statins at higher rates than females. After accounting for age and sex, the statin therapy initiation rate increases with the level of social deprivation. Keywords: cardiovascular disease

  3. Resilience and smoking: the implications for general practitioners and other primary healthcare practitioners.

    Science.gov (United States)

    Lin, Annie; Ward, Paul R

    2012-01-01

    Smoking cessation counselling is a key component of medical treatment and health promotion activities performed by general practitioners (GPs); however, GPs are often left wondering why their patients continue to smoke in spite of being given information about the damaging health effects and medical treatments. The concept of resilience to smoking is an emerging idea that offers an innovative perspective to smoking cessation. To understand why some people continue to smoke in spite of well-known adverse health effects, what and how resilience factors impact on people's smoking, and the role and limitations of the GP in fostering resilience to smoking. A qualitative study of 22 oral-history interviews was conducted in Adelaide, South Australia. Interviews were audio-recorded, transcribed and analysed for emergent themes. The main themes of most relevance to GPs are the resilience to health messages, resilience factors associated with smoking abstinence and the common pathways that lead to successful smoking cessation. Understanding smoking and resilience can assist the GP to provide more effective and supportive smoking cessation assistance. The GP may assist in the process by fostering the adoption of resilience factors, much of which is already part of routine GP work but may not yet be considered part of a holistic smoking cessation strategy. Through this holistic approach, smoking cessation is likely to be just one of many physical and social benefits, and avoids victim blaming. Broad system change to increase the levels of resilience within individuals and communities may then mean that smokers can stop more easily with brief interventions. Such changes are beyond the limits of a single GP, but provide opportunities to lobby government for future public health programmes aimed at promoting both the internal traits and external resources that are required for resilience building.

  4. Understanding the work of general practitioners: a social science perspective on the context of medical decision making in primary care.

    Science.gov (United States)

    Geneau, Robert; Lehoux, Pascale; Pineault, Raynald; Lamarche, Paul

    2008-02-19

    The work of general practitioners (GPs) is increasingly being looked at from the perspective of the strategies and factors shaping it. This reflects the importance given to primary care services in health care system reform. However, the literature provides little insight into the medical decision-making processes in general practice. Our main objective was to better understand how organizational and environmental factors influence the work of GPs. We interviewed 28 GPs working in contrasting organizational settings and environments. The data analysis involved using structuration theory to enrich the interpretation of empirical material. We identified four main factors that influence the practice of GPs: mode of remuneration, peer-to-peer interactions, patients' demands and the availability of other medical resources in the environment. These four conditions of action - what we call primary effects - can directly influence the performance of medical acts and time management, as well as the degree of specialization of GPs. Decisions related to each of those aspects can have a variety of both intentional and non-intentional consequences - what we call secondary effects - that are then likely to become conditions for subsequent action. This qualitative study helps shed light on the complex causal loops of interrelated factors that shape the work of GPs.

  5. Exponential stability of Cohen-Grossberg neural networks with a general class of activation functions

    International Nuclear Information System (INIS)

    Wan Anhua; Wang Miansen; Peng Jigen; Qiao Hong

    2006-01-01

    In this Letter, the dynamics of Cohen-Grossberg neural networks model are investigated. The activation functions are only assumed to be Lipschitz continuous, which provide a much wider application domain for neural networks than the previous results. By means of the extended nonlinear measure approach, new and relaxed sufficient conditions for the existence, uniqueness and global exponential stability of equilibrium of the neural networks are obtained. Moreover, an estimate for the exponential convergence rate of the neural networks is precisely characterized. Our results improve those existing ones

  6. Science collaboration networks in sociology and their general characteristics in Serbia

    Directory of Open Access Journals (Sweden)

    Lazar Zsolt

    2012-01-01

    Full Text Available Science collaboration networks occupy an important place in the analysis of social networks. There are several directions of concern in this kind of research: one attempts to explain the structure of science collaboration networks, the second one analyses the invisible scientific communities and the third one is dealing with the problems of different citation forms which function as a base from which many of the conclusions concerning these networks are being derived. However, the results of recent research in science collaboration networks indicate that there are a number of idiosyncratic characteristics of collaboration networks in sociology. In the first part of the paper the author analyzes the results of previous research of sociological social networks, published in scientific papers available in the following databases: JSTOR, ScienceDirect and SpringerLink. The authors then proceeds with the analysis of social networks of sociologists in Serbia and gives guidelines of the first research project dedicated to the analysis of social networks in Serbia.

  7. PHYSICAL AND CHEMICAL CHARACTERIZATION OF NEUROLOGICAL INJURY IN AN AVIAN MODEL OF PRIMARY GENERALIZED EPILEPSY

    Directory of Open Access Journals (Sweden)

    Edward Kendall

    2011-05-01

    Full Text Available Purpose This study was undertaken to determine if the epileptic chicken phenotype exhibited unique physical and chemical neurological changes. Methods Quantitative 1H-MRI/MRS measurements were performed on adult control (Rr and epileptic (rr chickens. The metrics included nuclear relaxation rate, diffusion rate and concentration of metabolites associated with neuronal cells. Comparisons were performed using Students t or Mann-Whitney tests according to the data distribution. Results Proton density measurements detected no significant difference in density among the cerebral hemispheres and optic lobes within the control and epi birds, nor between bird phenotypes. Thus, within experimental error it appears that brain tissue density is similar in adult control and epi birds. Volume calculation from images spanning the entire brain confirmed that a consistent feature of the epi genotype was megalencephaly. Nuclear relaxation (T2 values obtained for the control bird were within the normal variant range for neuronal tissue. However, T2's of the epi birds were significantly higher than that of the controls ((158 ms versus 123 ms. Similarly, in the diffusion data there was no apparent hemispheric bias. The optic lobes of the control animals exhibited an apparent diffusion coefficient significantly lower than that found for the cerebrum (Table 2. Interestingly, this differential was not apparent in the epi birds. The control birds across all regions of interest exhibited an ADC significantly less than that of the epi birds. Quantitative 1Hspectroscopy using tissue extracts collected immediately after sacrifice revealed phenotypic differences in lactate, glutamate, creatine and NAA but not GABA. A reduction in NAA was detected in the cerebrum of epi birds. This is in agreement with the generally held view that seizure activity causes loss of neurones, thus the loss of N-acetyl aspartate. HPLC data corroborated the spectroscopic NAA findings but also

  8. Special issue on primary care practice-based research networks: insights on innovative strategies for harnessing health information technology to help individuals, teams.

    Science.gov (United States)

    Roper, Rebecca

    2014-01-01

    This issue of the Journal highlights the problem-solving perspectives of primary care practices, including practice-based research networks. Informed, dedicated primary care teams are seeking incremental insight on how to use health information technology to support holistic enhancements in primary care, including how health information technology can support individual patients and how it can support care teams. Practice-based research networks comprise groups of primary care clinicians, their diversified practice teams, and skilled researchers, all of whom work together to answer community-based health care questions, seek practical solutions, and translate research findings into practice.

  9. NET-Works: Linking families, communities and primary care to prevent obesity in preschool-age children.

    Science.gov (United States)

    Sherwood, Nancy E; French, Simone A; Veblen-Mortenson, Sara; Crain, A Lauren; Berge, Jerica; Kunin-Batson, Alicia; Mitchell, Nathan; Senso, Meghan

    2013-11-01

    Obesity prevention in children offers a unique window of opportunity to establish healthful eating and physical activity behaviors to maintain a healthful body weight and avoid the adverse proximal and distal long-term health consequences of obesity. Given that obesity is the result of a complex interaction between biological, behavioral, family-based, and community environmental factors, intervention at multiple levels and across multiple settings is critical for both short- and long-term effectiveness. The Minnesota NET-Works (Now Everybody Together for Amazing and Healthful Kids) study is one of four obesity prevention and/or treatment trials that are part of the Childhood Obesity Prevention and Treatment (COPTR) Consortium. The goal of the NET-Works study is to evaluate an intervention that integrates home, community, primary care and neighborhood strategies to promote healthful eating, activity patterns, and body weight among low income, racially/ethnically diverse preschool-age children. Critical to the success of this intervention is the creation of linkages among the settings to support parents in making home environment and parenting behavior changes to foster healthful child growth. Five hundred racially/ethnically diverse, two-four year old children and their parent or primary caregiver will be randomized to the multi-component intervention or to a usual care comparison group for a three-year period. This paper describes the study design, measurement and intervention protocols, and statistical analysis plan for the NET-Works trial. © 2013 Elsevier Inc. All rights reserved.

  10. Constructing a generalized network design model to study air distribution in ventilation networks in subway with a single-track tunnel

    Science.gov (United States)

    Lugin, IV

    2018-03-01

    In focus are the features of construction of the generalized design model for the network method to study air distribution in ventilation system in subway with the single-track tunnel. The generalizations, assumptions and simplifications included in the model are specified. The air distribution is calculated with regard to the influence of topology and air resistances of the ventilation network sections. The author studies two variants of the subway line: half-open and closed with dead end on the both sides. It is found that the total air exchange at a subway station depends on the station location within the line. The operating mode of fans remains unaltered in this case. The article shows that elimination of air leakage in the station ventilation room allows an increase in the air flow rate by 7–8% at the same energy consumption by fans. The influence of the stop of a train in the tunnel on the air distribution is illustrated.

  11. Periodicity and global exponential stability of generalized Cohen-Grossberg neural networks with discontinuous activations and mixed delays.

    Science.gov (United States)

    Wang, Dongshu; Huang, Lihong

    2014-03-01

    In this paper, we investigate the periodic dynamical behaviors for a class of general Cohen-Grossberg neural networks with discontinuous right-hand sides, time-varying and distributed delays. By means of retarded differential inclusions theory and the fixed point theorem of multi-valued maps, the existence of periodic solutions for the neural networks is obtained. After that, we derive some sufficient conditions for the global exponential stability and convergence of the neural networks, in terms of nonsmooth analysis theory with generalized Lyapunov approach. Without assuming the boundedness (or the growth condition) and monotonicity of the discontinuous neuron activation functions, our results will also be valid. Moreover, our results extend previous works not only on discrete time-varying and distributed delayed neural networks with continuous or even Lipschitz continuous activations, but also on discrete time-varying and distributed delayed neural networks with discontinuous activations. We give some numerical examples to show the applicability and effectiveness of our main results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Why General Outlier Detection Techniques Do Not Suffice For Wireless Sensor Networks?

    NARCIS (Netherlands)

    Zhang, Y.; Meratnia, Nirvana; Havinga, Paul J.M.

    2009-01-01

    Raw data collected in wireless sensor networks are often unreliable and inaccurate due to noise, faulty sensors and harsh environmental effects. Sensor data that significantly deviate from normal pattern of sensed data are often called outliers. Outlier detection in wireless sensor networks aims at

  13. Pseudomonas fluorescens induces strain-dependent and strain-independent host plant responses in defense networks, primary metabolism and photosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Pelletier, Dale A [ORNL; Morrell-Falvey, Jennifer L [ORNL; Karve, Abhijit A [ORNL; Lu, Tse-Yuan S [ORNL; Tschaplinski, Timothy J [ORNL; Tuskan, Gerald A [ORNL; Chen, Jay [ORNL; Martin, Madhavi Z [ORNL; Jawdy, Sara [ORNL; Weston, David [ORNL; Doktycz, Mitchel John [ORNL; Schadt, Christopher Warren [ORNL

    2012-01-01

    Colonization of plants by nonpathogenic Pseudomonas fluorescens strains can confer enhanced defense capacity against a broad spectrum of pathogens. Few studies, however, have linked defense pathway regulation to primary metabolism and physiology. In this study, physiological data, metabolites, and transcript profiles are integrated to elucidate how molecular networks initiated at the root-microbe interface influence shoot metabolism and whole-plant performance. Experiments with Arabidopsis thaliana were performed using the newly identified P. fluorescens GM30 or P. fluorescens Pf-5 strains. Co-expression networks indicated that Pf-5 and GM30 induced a subnetwork specific to roots enriched for genes participating in RNA regulation, protein degradation, and hormonal metabolism. In contrast, only GM30 induced a subnetwork enriched for calcium signaling, sugar and nutrient signaling, and auxin metabolism, suggesting strain dependence in network architecture. In addition, one subnetwork present in shoots was enriched for genes in secondary metabolism, photosynthetic light reactions, and hormone metabolism. Metabolite analysis indicated that this network initiated changes in carbohydrate and amino acid metabolism. Consistent with this, we observed strain-specific responses in tryptophan and phenylalanine abundance. Both strains reduced host plant carbon gain and fitness, yet provided a clear fitness benefit when plants were challenged with the pathogen P. syringae DC3000.

  14. Iterative design of peptide-based hydrogels and the effect of network electrostatics on primary chondrocyte behavior.

    Science.gov (United States)

    Sinthuvanich, Chomdao; Haines-Butterick, Lisa A; Nagy, Katelyn J; Schneider, Joel P

    2012-10-01

    Iterative peptide design was used to generate two peptide-based hydrogels to study the effect of network electrostatics on primary chondrocyte behavior. MAX8 and HLT2 peptides have formal charge states of +7 and +5 per monomer, respectively. These peptides undergo triggered folding and self-assembly to afford hydrogel networks having similar rheological behavior and local network morphologies, yet different electrostatic character. Each gel can be used to directly encapsulate and syringe-deliver cells. The influence of network electrostatics on cell viability after encapsulation and delivery, extracellular matrix deposition, gene expression, and the bulk mechanical properties of the gel-cell constructs as a function of culture time was assessed. The less electropositive HLT2 gel provides a microenvironment more conducive to chondrocyte encapsulation, delivery, and phenotype maintenance. Cell viability was higher for this gel and although a moderate number of cells dedifferentiated to a fibroblast-like phenotype, many retained their chondrocytic behavior. As a result, gel-cell constructs prepared with HLT2, cultured under static in vitro conditions, contained more GAG and type II collagen resulting in mechanically superior constructs. Chondrocytes delivered in the more electropositive MAX8 gel experienced a greater degree of cell death during encapsulation and delivery and the remaining viable cells were less prone to maintain their phenotype. As a result, MAX8 gel-cell constructs had fewer cells, of which a limited number were capable of laying down cartilage-specific ECM. Published by Elsevier Ltd.

  15. Organization of brain networks governed by long-range connections index autistic traits in the general population.

    Science.gov (United States)

    Barttfeld, Pablo; Amoruso, Lucía; Ais, Joaquín; Cukier, Sebastián; Bavassi, Luz; Tomio, Ailin; Manes, Facundo; Ibanez, Agustín; Sigman, Mariano

    2013-06-27

    The dimensional approach to autism spectrum disorder (ASD) considers ASD as the extreme of a dimension traversing through the entire population. We explored the potential utility of electroencephalography (EEG) functional connectivity as a biomarker. We hypothesized that individual differences in autistic traits of typical subjects would involve a long-range connectivity diminution within the delta band. Resting-state EEG functional connectivity was measured for 74 neurotypical subjects. All participants also provided a questionnaire (Social Responsiveness Scale, SRS) that was completed by an informant who knows the participant in social settings. We conducted multivariate regression between the SRS score and functional connectivity in all EEG frequency bands. We explored modulations of network graph metrics characterizing the optimality of a network using the SRS score. Our results show a decay in functional connectivity mainly within the delta and theta bands (the lower part of the EEG spectrum) associated with an increasing number of autistic traits. When inspecting the impact of autistic traits on the global organization of the functional network, we found that the optimal properties of the network are inversely related to the number of autistic traits, suggesting that the autistic dimension, throughout the entire population, modulates the efficiency of functional brain networks. EEG functional connectivity at low frequencies and its associated network properties may be associated with some autistic traits in the general population.

  16. Stability of Almost Periodic Solution for a General Class of Discontinuous Neural Networks with Mixed Time-Varying Delays

    Directory of Open Access Journals (Sweden)

    Yingwei Li

    2013-01-01

    Full Text Available The global exponential stability issues are considered for almost periodic solution of the neural networks with mixed time-varying delays and discontinuous neuron activations. Some sufficient conditions for the existence, uniqueness, and global exponential stability of almost periodic solution are achieved in terms of certain linear matrix inequalities (LMIs, by applying differential inclusions theory, matrix inequality analysis technique, and generalized Lyapunov functional approach. In addition, the existence and asymptotically almost periodic behavior of the solution of the neural networks are also investigated under the framework of the solution in the sense of Filippov. Two simulation examples are given to illustrate the validity of the theoretical results.

  17. Management of first depression or generalized anxiety disorder episode in adults in primary care: A systematic metareview.

    Science.gov (United States)

    Driot, Damien; Bismuth, Michel; Maurel, Adrien; Soulie-Albouy, Julie; Birebent, Jordan; Oustric, Stéphane; Dupouy, Julie

    2017-12-01

    General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described. The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care. PubMed, Cochrane, and ISI Web of Science were explored using mainly the following keywords: depressive disorder, anxiety disorders, antidepressive agents or antidepressant. PubMed was explored using Medical Subject Headings (MeSH). Grey literature was also considered through the analysis of articles references, congress publications, guidelines and clinical practice recommendations. A systematic meta-review (overview of reviews) including systematic reviews, meta-analyses, guidelines and clinical practice recommendations, published from January 2002 to December 2015, was performed. The methodological and report qualities were assessed by the AGREE II, PRISMA checklist and R-AMSTAR grid. Each step was performed independently by two researchers following a process derived from the PRISMA statement. A narrative synthesis on main clinical data to collect before prescription in primary care, key information for patients, and recommended follow-up was realized. Thirty articles were included: 11 meta-analyses, 19 guidelines. For moderate to severe MDD, selective serotonin reuptake inhibitors (SSRI) should be associated with psychotherapy (cognitive behavioral therapy). For GAD, SSRI or CBT should be proposed if functional impairment is marked. Two algorithms to guide GPs for the management of MDD and or the management of GAD were created based on the data synthesis of this review. A GPs expert group discussed and adapted the algorithms to match with GPs expectancies. Few articles dealt specifically with primary care practice, and only one meta-analysis of clinical trial on

  18. Children's Health in Brazil: orienting basic network to Primary Health Care.

    Science.gov (United States)

    Damasceno, Simone Soares; Nóbrega, Vanessa Medeiros da; Coutinho, Simone Elizabeth Duarte; Reichert, Altamira Pereira da Silva; Toso, Beatriz Rosana Gonçalves de Oliveira; Collet, Neusa

    2016-09-01

    This is an integrative literature review that analyzed the scientific knowledge produced on the orientation of Brazilian basic care services to primary health care focusing on child health. Searches were carried out in SciELO, Lilacs and Medline databases using descriptors "primary health care", "family health program", "child health" and "evaluation of health services". Studies published in Portuguese, English and Spanish between 2000 and 2013 were selected. A total of 32 studies were chosen and characterized in relation to the features of primary health care, region of the country, type of study and authors' practice area. A thematic review of studies was conducted and resulted in two categories: child care in the context of Brazilian primary health care and primary health care features: limitations to child care. It can be understood that Brazilian primary health care services are heterogeneous regarding the presence and scope of essential child care characteristics. There is a lack of structural and process changes in the services to substantially plan child care actions in basic care.

  19. Molecular analysis reveals high compartmentalization in aphid-primary parasitoid networks and low parasitoid sharing between crop and noncrop habitats.

    Science.gov (United States)

    Derocles, Stephane A P; Le Ralec, Anne; Besson, Mathilde M; Maret, Marion; Walton, Alan; Evans, Darren M; Plantegenest, Manuel

    2014-08-01

    The ecosystem service of insect pest regulation by natural enemies, such as primary parasitoids, may be enhanced by the presence of uncultivated, semi-natural habitats within agro-ecosystems, although quantifying such host-parasitoid interactions is difficult. Here, we use rRNA 16S gene sequencing to assess both the level of parasitism by Aphidiinae primary parasitoids and parasitoid identity on a large sample of aphids collected in cultivated and uncultivated agricultural habitats in Western France. We used these data to construct ecological networks to assess the level of compartmentalization between aphid and parasitoid food webs of cultivated and uncultivated habitats. We evaluated the extent to which uncultivated margins provided a resource for parasitoids shared between pest and nonpest aphids. We compared the observed quantitative ecological network described by our molecular approach to an empirical qualitative network based on aphid-parasitoid interactions from traditional rearing data found in the literature. We found that the molecular network was highly compartmentalized and that parasitoid sharing is relatively rare between aphids, especially between crop and noncrop compartments. Moreover, the few cases of putative shared generalist parasitoids were questionable and could be due to the lack of discrimination of cryptic species or from intraspecific host specialization. Our results suggest that apparent competition mediated by Aphidiinae parasitoids is probably rare in agricultural areas and that the contribution of field margins as a source of these biocontrol agents is much more limited than expected. Further large-scale (spatial and temporal) studies on other crops and noncrop habitats are needed to confirm this. © 2014 John Wiley & Sons Ltd.

  20. Backpropagation-Based Cooperative Localization of Primary User for Avoiding Hidden-Node Problem in Cognitive Networks

    Directory of Open Access Journals (Sweden)

    Lin Liu

    2010-01-01

    Full Text Available Cognitive radio (CR is a technology to implement opportunistic spectrum sharing to improve the spectrum utilization. However, there exists a hidden-node problem, which can be a big challenge to solve especially when the primary receiver is passive listening. We aim to provide a solution to the hidden-node problem for passive-listening receiver based on cooperation of multiple CRs. Specifically, we consider a cooperative GPS-enabled cognitive network. Once the existence of PU is detected, a localization algorithm will be employed to first estimate the path loss model for the environment based on backpropagation method and then to locate the position of PU. Finally, a disable region is identified taking into account the communication range of both the PU and the CR. The CRs within the disabled region are prohibited to transmit in order to avoid interfering with the primary receiver. Both analysis and simulation results are provided.

  1. Calculation for Primary Combustion Characteristics of Boron-Based Fuel-Rich Propellant Based on BP Neural Network

    Directory of Open Access Journals (Sweden)

    Wu Wan'e

    2012-01-01

    Full Text Available A practical scheme for selecting characterization parameters of boron-based fuel-rich propellant formulation was put forward; a calculation model for primary combustion characteristics of boron-based fuel-rich propellant based on backpropagation neural network was established, validated, and then was used to predict primary combustion characteristics of boron-based fuel-rich propellant. The results show that the calculation error of burning rate is less than ±7.3%; in the formulation range (hydroxyl-terminated polybutadiene 28%–32%, ammonium perchlorate 30%–35%, magnalium alloy 4%–8%, catocene 0%–5%, and boron 30%, the variation of the calculation data is consistent with the experimental results.

  2. Principles of Neuroempiricism and generalization of network topology for health service delivery

    CSIR Research Space (South Africa)

    Niehaus, E

    2009-01-01

    Full Text Available these layers of complexity are operating on different scales on one side and on the other side they have in common that they depend on a huge number of parameters. These layers are linked in a complex network and their characteristics are changing over space...- networks leads to a useful visual representation of the data (technically called a chart of the input space) by mapping the earth surface to the representing areas of the ANN. The Kohonen-network is self-organising based on the importance of the input...

  3. Business opportunities and dynamic competition through distributed generation in primary electricity distribution networks

    International Nuclear Information System (INIS)

    Raineri, R.; Rios, S.; Vasquez, R.

    2005-01-01

    In this paper, for a real electricity distribution network, an assessment of business opportunities to invest in distributed generation (DG) is performed through a simulation based on a full representation of three medium voltage (12 kV) feeders. The three feeders representation includes 1062 sections of conductors with 13 different sizes. The economic assessment focuses on both, the incentives of the incumbent distribution company and those of a new entrant. The technical and economic impact on losses, reliability and voltage regulation in the network area are verified. The DG solution analyzed determines a business opportunity for new investors where end users are also benefited. This work calls in the debate on the need to reformulate the current regulation model on electricity distribution, by defining clear rules to incorporate DG to the existing network, and to enable any agent to develop the proposed business. DG success depends on the location of adequate sites to strategically establish few DG units being a substitute to network expansion

  4. Screening for generalized anxiety disorder symptoms in the wake of terrorist attacks: a study in primary care.

    Science.gov (United States)

    Ghafoori, Bita; Neria, Yuval; Gameroff, Marc J; Olfson, Mark; Lantigua, Rafael; Shea, Steven; Weissman, Myrna M

    2009-06-01

    Little is known about the mental health impact of terrorism beyond posttraumatic stress disorder (PTSD) and depression. The associations between exposure to the September 11, 2001 (9/11) attacks in New York City and generalized anxiety disorder (GAD) symptoms were examined in a sample of 929 primary care patients. After controlling for PTSD, depression, panic and substance use disorders, and pre-9/11 trauma, patients who screened positive (vs. negative) for GAD symptoms were roughly twice as likely to report having a loved one at the 9/11 disaster site, twice as likely to know someone who was killed by the attacks, and twice as likely to know someone who was involved with the rescue/recovery efforts after the disaster. Implications for treatment and future research are discussed.

  5. Nutritional counselling in primary health care: a randomized comparison of an intervention by general practitioner or dietician

    DEFF Research Database (Denmark)

    Willaing, Ingrid; Ladelund, Steen; Jørgensen, Torben

    2004-01-01

    of cardiovascular disease and addressed these when counselling. The guidance from a GP was of significant importance for risk reduction in relation to IHD. However, a long-term lifestyle intervention by GP was difficult to implement. In the case of obesity it was effective to refer to long-term nutritional......AIMS: To compare health effects and risk reduction in two different strategies of nutritional counselling in primary health care for patients at high risk of ischaemic heart disease. METHODS: In a cluster-randomized trial 60 general practitioners (GPs) in the Copenhagen County were randomized...... to give nutritional counselling or to refer patients to a dietician. Patients were included after opportunistically screening (n=503 patients), and received nutritional counselling by GP or dietician over 12 months. Health effects were measured by changes in weight, waist circumference and blood lipids...

  6. Control of primary production in the Arctic by nutrients and light: insights from a high resolution ocean general circulation model

    Directory of Open Access Journals (Sweden)

    E. E. Popova

    2010-11-01

    Full Text Available Until recently, the Arctic Basin was generally considered to be a low productivity area and was afforded little attention in global- or even basin-scale ecosystem modelling studies. Due to anthropogenic climate change however, the sea ice cover of the Arctic Ocean is undergoing an unexpectedly fast retreat, exposing increasingly large areas of the basin to sunlight. As indicated by existing Arctic phenomena such as ice-edge blooms, this decline in sea-ice is liable to encourage pronounced growth of phytoplankton in summer and poses pressing questions concerning the future of Arctic ecosystems. It thus provides a strong impetus to modelling of this region.

    The Arctic Ocean is an area where plankton productivity is heavily influenced by physical factors. As these factors are strongly responding to climate change, we analyse here the results from simulations of the 1/4° resolution global ocean NEMO (Nucleus for European Modelling of the Ocean model coupled with the MEDUSA (Model for Ecosystem Dynamics, carbon Utilisation, Sequestration and Acidification biogeochemical model, with a particular focus on the Arctic basin. Simulated productivity is consistent with the limited observations for the Arctic, with significant production occurring both under the sea-ice and at the thermocline, locations that are difficult to sample in the field.

    Results also indicate that a substantial fraction of the variability in Arctic primary production can be explained by two key physical factors: (i the maximum penetration of winter mixing, which determines the amount of nutrients available for summer primary production, and (ii short-wave radiation at the ocean surface, which controls the magnitude of phytoplankton blooms. A strong empirical correlation was found in the model output between primary production and these two factors, highlighting the importance of physical processes in the Arctic Ocean.

  7. The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries.

    Science.gov (United States)

    Bonciani, M; Schäfer, W; Barsanti, S; Heinemann, S; Groenewegen, P P

    2018-02-21

    There is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location with other GPs and/or other professionals and the GP outcomes and patients' experiences. We wanted to test whether GP co-location is related to a broader range of services provided, the use of clinical governance tools and inter-professional collaboration, and whether the patients of co-located GPs perceive a better quality of care in terms of accessibility, comprehensiveness and continuity of care with their GPs. The source of data was the QUALICOPC study (Quality and Costs of Primary Care in Europe), which involved surveys of GPs and their patients in 34 countries, mostly in Europe. In order to study the relationships between GP co-location and both GPs' outcomes and patients' experience, multilevel linear regression analysis was carried out. The GP questionnaire was filled in by 7183 GPs and the patient experience questionnaire by 61,931 patients. Being co-located with at least one other professional is the most common situation of the GPs involved in the study. Compared with single-handed GP practices, GP co-location are positively associated with the GP outcomes. Considering the patients' perspective, comprehensiveness of care has the strongest negative relationship of GP co-location of all the dimensions of patient experiences analysed. The paper highlights that GP mono- and multi-disciplinary co-location is related to positive outcomes at a GP level, such as a broader provision of technical procedures, increased collaboration among different providers and wider coordination with secondary care. However, GP co-location, particularly in a multidisciplinary setting, is related to less positive patient experiences, especially in countries with health systems

  8. Power Flow Calculation for Weakly Meshed Distribution Networks with Multiple DGs Based on Generalized Chain-table Storage Structure

    DEFF Research Database (Denmark)

    Chen, Shuheng; Hu, Weihao; Chen, Zhe

    2014-01-01

    Based on generalized chain-table storage structure (GCTSS), a novel power flow method is proposed, which can be used to solve the power flow of weakly meshed distribution networks with multiple distributed generators (DGs). GCTSS is designed based on chain-table technology and its target...... done on the modified version of the IEEE 69-bus distribution system. The results verify that the proposed method can keep a good efficiency level. Hence, it is promising to calculate the power flow of weakly meshed distribution networks with multiple DGs....... is to describe the topology of radial distribution networks with a clear logic and a small memory size. The strategies of compensating the equivalent currents of break-point branches and the reactive power outputs of PV-type DGs are presented on the basis of superposition theorem. Their formulations...

  9. KEY ISSUES OF CONCEPTS' FORMATION OF THE NETWORK OF RESOURCE CENTER OF DISTANCE EDUCATION OF GENERAL EDUCATION INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Yuriy M. Bogachkov

    2013-06-01

    Full Text Available In the article the problem of constructing a network of resource centers for Distance Education to meet the needs of general secondary schools is presented. Modern educational trends in the use of Internet services in education are viewed.  Main contradictions, solution of which helps to create a network of resource centers, are identified. The definition of key terms related to the range of issues are given. The basic categories of participants, who  implementation of e-learning and networking are oriented on. There are considered the basic tasks of  distance education resource centers' functioning and types of supporting: personnel, regulatory, informative, systematic and  technical etc. The review of possible models of implementation of  students' distance education is reviewed . Three options for business models of resource centers, depending on funding  sources are offered.

  10. Radiation monitoring network (Telerad) for the areas surrounding nuclear sites and the belgian territory in general

    International Nuclear Information System (INIS)

    Samain, J.P.

    1989-01-01

    It is proposed to structure a network around each nuclear site (Doel, Tihange, Mol, Fleurus) to collect data which would then be consolidated at a National Centre in Brussels. This network would measure: - emission and operational parameters from data provided by the operator equipment; - meteorological parameters with which to assess the local situation, possibly using dispersion models; - environmental dose rates (environmental quality); - Meuse and Scheldt water quality parameters. The proposal also includes mobile radioactivity measurement apparatus for additional monitoring [fr

  11. Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study

    Science.gov (United States)

    Mundt, Marlon P.; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I.; Kamnetz, Sandra A.; Gilchrist, Valerie J.

    2016-01-01

    Background Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. Objective To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. Methods A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. Participants 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Results Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (Rate Ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds Ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Conclusions Primary care teams which relied on frequent daily face-to-face communication among more

  12. Assessment of general public exposure to lte signals compared to other cellular networks present in Thessaloniki, Greece

    International Nuclear Information System (INIS)

    Gkonis, Fotios; Boursianis, Achilles; Samaras, Theodoros

    2017-01-01

    To assess general public exposure to electromagnetic fields from Long Term Evolution (LTE) base stations, measurements at 10 sites in Thessaloniki, Greece were performed. Results are compared with other mobile cellular networks currently in use. All exposure values satisfy the guidelines for general public exposure of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), as well as the reference levels by the Greek legislation at all sites. LTE electric field measurements were recorded up to 0.645 V/m. By applying the ICNIRP guidelines, the exposure ratio for all LTE signals is between 2.9 x 10 -5 and 2.8 x 10 -2 . From the measurements results it is concluded that the average and maximum power density contribution of LTE down-link signals to the overall cellular networks signals are 7.8% and 36.7%, respectively. (authors)

  13. Predicting dihedral angle probability distributions for protein coil residues from primary sequence using neural networks

    DEFF Research Database (Denmark)

    Helles, Glennie; Fonseca, Rasmus

    2009-01-01

    done previously, none have, to our knowledge, presented comparable results for the probability distribution of dihedral angles. Results: In this paper we develop an artificial neural network that uses an input-window of amino acids to predict a dihedral angle probability distribution for the middle...... residue in the input-window. The trained neural network shows a significant improvement (4-68%) in predicting the most probable bin (covering a 30°×30° area of the dihedral angle space) for all amino acids in the data set compared to first order statistics. An accuracy comparable to that of secondary......Predicting the three-dimensional structure of a protein from its amino acid sequence is currently one of the most challenging problems in bioinformatics. The internal structure of helices and sheets is highly recurrent and help reduce the search space significantly. However, random coil segments...

  14. Neural Networks In Mining Sciences - General Overview And Some Representative Examples

    Science.gov (United States)

    Tadeusiewicz, Ryszard

    2015-12-01

    The many difficult problems that must now be addressed in mining sciences make us search for ever newer and more efficient computer tools that can be used to solve those problems. Among the numerous tools of this type, there are neural networks presented in this article - which, although not yet widely used in mining sciences, are certainly worth consideration. Neural networks are a technique which belongs to so called artificial intelligence, and originates from the attempts to model the structure and functioning of biological nervous systems. Initially constructed and tested exclusively out of scientific curiosity, as computer models of parts of the human brain, neural networks have become a surprisingly effective calculation tool in many areas: in technology, medicine, economics, and even social sciences. Unfortunately, they are relatively rarely used in mining sciences and mining technology. The article is intended to convince the readers that neural networks can be very useful also in mining sciences. It contains information how modern neural networks are built, how they operate and how one can use them. The preliminary discussion presented in this paper can help the reader gain an opinion whether this is a tool with handy properties, useful for him, and what it might come in useful for. Of course, the brief introduction to neural networks contained in this paper will not be enough for the readers who get convinced by the arguments contained here, and want to use neural networks. They will still need a considerable portion of detailed knowledge so that they can begin to independently create and build such networks, and use them in practice. However, an interested reader who decides to try out the capabilities of neural networks will also find here links to references that will allow him to start exploration of neural networks fast, and then work with this handy tool efficiently. This will be easy, because there are currently quite a few ready-made computer

  15. Synchronization of generalized reaction-diffusion neural networks with time-varying delays based on general integral inequalities and sampled-data control approach.

    Science.gov (United States)

    Dharani, S; Rakkiyappan, R; Cao, Jinde; Alsaedi, Ahmed

    2017-08-01

    This paper explores the problem of synchronization of a class of generalized reaction-diffusion neural networks with mixed time-varying delays. The mixed time-varying delays under consideration comprise of both discrete and distributed delays. Due to the development and merits of digital controllers, sampled-data control is a natural choice to establish synchronization in continuous-time systems. Using a newly introduced integral inequality, less conservative synchronization criteria that assure the global asymptotic synchronization of the considered generalized reaction-diffusion neural network and mixed delays are established in terms of linear matrix inequalities (LMIs). The obtained easy-to-test LMI-based synchronization criteria depends on the delay bounds in addition to the reaction-diffusion terms, which is more practicable. Upon solving these LMIs by using Matlab LMI control toolbox, a desired sampled-data controller gain can be acuqired without any difficulty. Finally, numerical examples are exploited to express the validity of the derived LMI-based synchronization criteria.

  16. The perceived meaning of a (wholistic view among general practitioners and district nurses in Swedish primary care: a qualitative study

    Directory of Open Access Journals (Sweden)

    Borgquist Lars

    2007-03-01

    Full Text Available Abstract Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs and district nurses (DNs. Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both

  17. Structuring energy supply and demand networks in a general equilibrium model to simulate global warming control strategies

    International Nuclear Information System (INIS)

    Hamilton, S.; Veselka, T.D.; Cirillo, R.R.

    1991-01-01

    Global warming control strategies which mandate stringent caps on emissions of greenhouse forcing gases can substantially alter a country's demand, production, and imports of energy products. Although there is a large degree of uncertainty when attempting to estimate the potential impact of these strategies, insights into the problem can be acquired through computer model simulations. This paper presents one method of structuring a general equilibrium model, the ENergy and Power Evaluation Program/Global Climate Change (ENPEP/GCC), to simulate changes in a country's energy supply and demand balance in response to global warming control strategies. The equilibrium model presented in this study is based on the principle of decomposition, whereby a large complex problem is divided into a number of smaller submodules. Submodules simulate energy activities and conversion processes such as electricity production. These submodules are linked together to form an energy supply and demand network. Linkages identify energy and fuel flows among various activities. Since global warming control strategies can have wide reaching effects, a complex network was constructed. The network represents all energy production, conversion, transportation, distribution, and utilization activities. The structure of the network depicts interdependencies within and across economic sectors and was constructed such that energy prices and demand responses can be simulated. Global warming control alternatives represented in the network include: (1) conservation measures through increased efficiency; and (2) substitution of fuels that have high greenhouse gas emission rates with fuels that have lower emission rates. 6 refs., 4 figs., 4 tabs

  18. General-purpose computer networks and resource sharing in ERDA. Volume 3. Remote resource-sharing experience and findings

    Energy Technology Data Exchange (ETDEWEB)

    1977-07-15

    The investigation focused on heterogeneous networks in which a variety of dissimilar computers and operating systems were interconnected nationwide. Homogeneous networks, such as MFE net and SACNET, were not considered since they could not be used for general purpose resource sharing. Issues of privacy and security are of concern in any network activity. However, consideration of privacy and security of sensitive data arise to a much lesser degree in unclassified scientific research than in areas involving personal or proprietary information. Therefore, the existing mechanisms at individual sites for protecting sensitive data were relied on, and no new protection mechanisms to prevent infringement of privacy and security were attempted. Further development of ERDA networking will need to incorporate additional mechanisms to prevent infringement of privacy. The investigation itself furnishes an excellent example of computational resource sharing through a heterogeneous network. More than twenty persons, representing seven ERDA computing sites, made extensive use of both ERDA and non-ERDA computers in coordinating, compiling, and formatting the data which constitute the bulk of this report. Volume 3 analyzes the benefits and barriers encountered in actual resource sharing experience, and provides case histories of typical applications.

  19. Primary Phenomenon in the Network Formation of Endothelial Cells: Effect of Charge.

    Science.gov (United States)

    Arai, Shunto

    2015-12-07

    Blood vessels are essential organs that are involved in the supply of nutrients and oxygen and play an important role in regulating the body's internal environment, including pH, body temperature, and water homeostasis. Many studies have examined the formation of networks of endothelial cells. The results of these studies have revealed that vascular endothelial growth factor (VEGF) affects the interactions of these cells and modulates the network structure. Though almost all previous simulation studies have assumed that the chemoattractant VEGF is present before network formation, vascular endothelial cells secrete VEGF only after the cells bind to the substrate. This suggests VEGF is not essential for vasculogenesis especially at the early stage. Using a simple experiment, we find chain-like structures which last quite longer than it is expected, unless the energetically stable cluster should be compact. Using a purely physical model and simulation, we find that the hydrodynamic interaction retard the compaction of clusters and that the chains are stabilized through the effects of charge. The charge at the surface of the cells affect the interparticle potential, and the resulting repulsive forces prevent the chains from folding. The ions surrounding the cells may also be involved in this process.

  20. The significance and modalities of internet abuse as the primary global communication computer networks in cyberspace

    Directory of Open Access Journals (Sweden)

    Matijašević-Obradović Jelena

    2014-01-01

    Full Text Available Along with the rapid development of computers, computer networks have also been developed. Computer crimes are carried out in a specific environment - cyberspace, whose important characteristic is transnational scope, which goes beyond the control of the territorial nation-states. There is no doubt that computer networks can be subject of various abuses. They appear in a triple role: as a target or object of the attack, as a means or a tool, or as a framework of the offense. This kind of crime rapidly changes forms and forms of manifestation, the border between the states and the other injured. The biggest problem in this area is the misuse of the Internet, as the main global computer network communication, which has fundamentally revolutionized many areas of human life and work. The subject of this paperwork is analyzing the most important modalities of Internet abuse, as well as the scope and importance of using the Internet in a modern society. A separate section is dedicated to case studies of judicial authorities in Republic of Serbia.

  1. A Study Regarding the Generalization Capacity of ‎Image Classification by Using Neuroal Networks In ‎Matlab

    Directory of Open Access Journals (Sweden)

    Evan Madhi Al Rubaie

    2018-02-01

    Full Text Available The paper performs an algorithmic and experimental study regarding the generalization capacity of the scheme based on neuronal networks for the recognition of new images of the face. This enables both a rendering of graphic representations and the classification of image classes in Matlab. The purpose is to describe the recognition algorithm, to project and implement an application which proposes both the graphic representation of the images used by the neuronal training algorithm but also the implementation of the perceptron neuronal algorithm and the determination of the generalization capacity of the separating hyper plane of the considered image classes

  2. Social network analysis. Review of general concepts and use in preventive veterinary medicine.

    Science.gov (United States)

    Martínez-López, B; Perez, A M; Sánchez-Vizcaíno, J M

    2009-05-01

    Social network analysis (SNA) and graph theory have been used widely in sociology, psychology, anthropology, biology and medicine. Social network analysis and graph theory provide a conceptual framework to study contact patterns and to identify units of analysis that are frequently or intensely connected within the network. Social network analysis has been used in human epidemiology as a tool to explore the potential transmission of infectious agents such as HIV, tuberculosis, hepatitis B and syphilis. In preventive veterinary medicine, SNA is an approach that offers benefits for exploring the nature and extent of the contacts between animals or farms, which ultimately leads to a better understanding of the potential risk for disease spread in a susceptible population. Social network analysis, however, has been applied only recently in preventive veterinary medicine, therefore the characteristics of the technique and the potential benefits of its use remain unknown for an important section of the international veterinary medicine community. The objectives of this paper were to review the concepts and theoretical aspects underlying the use of SNA and graph theory, with particular emphasis on their application to the study of infectious diseases of animals. The paper includes a review of recent applications of SNA in preventive veterinary medicine and a discussion of the potential uses and limitations of this methodology for the study of animal diseases.

  3. Documentation of body mass index and control of associated risk factors in a large primary care network

    Directory of Open Access Journals (Sweden)

    Grant Richard W

    2009-12-01

    Full Text Available Abstract Background Body mass index (BMI will be a reportable health measure in the United States (US through implementation of Healthcare Effectiveness Data and Information Set (HEDIS guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network. Methods We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m2, overweight (OW, 25-29.9, and obese (OB, ≥ 30. We measured documentation (yes/no and control (above/below of the following three risk factors: blood pressure (BP ≤130/≤85 mmHg, low-density lipoprotein (LDL ≤130 mg/dL (3.367 mmol/L, and fasting glucose Results BMI was documented in 48,376 patients (61%, range 34-94%, distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend Conclusions In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.

  4. A mechanistic model for predicting flow-assisted and general corrosion of carbon steel in reactor primary coolants

    International Nuclear Information System (INIS)

    Lister, D.

    2002-01-01

    Flow-assisted corrosion (FAC) of carbon steel in high-temperature lithiated water can be described with a model that invokes dissolution of the protective oxide film and erosion of oxide particles that are loosened as a result. General corrosion under coolant conditions where oxide is not dissolved is described as well. In the model, the electrochemistry of magnetite dissolution and precipitation and the effect of particle size on solubility move the dependence on film thickness of the diffusion processes (and therefore the corrosion rate) away from reciprocal. Particle erosion under dissolving conditions is treated stochastically and depends upon the fluid shear stress at the surface. The corrosion rate dependence on coolant flow under FAC conditions then becomes somewhat less than that arising purely from fluid shear (proportional to the velocity squared). Under non-dissolving conditions, particle erosion occurs infrequently and general corrosion is almost unaffected by flow For application to a CANDU primary circuit and its feeders, the model was bench-marked against the outlet feeder S08 removed from the Point Lepreau reactor, which furnished one value of film thickness and one of corrosion rate for a computed average coolant velocity. Several constants and parameters in the model had to be assumed or were optimised, since values for them were not available. These uncertainties are no doubt responsible for the rather high values of potential that evolved as steps in the computation. The model predicts film thickness development and corrosion rate for the whole range of coolant velocities in outlet feeders very well. In particular, the detailed modelling of FAC in the complex geometry of one outlet feeder (F11) is in good agreement with measurements. When the particle erosion computations are inserted in the balance equations for the circuit, realistic values of crud level are obtained. The model also predicts low corrosion rates and thick oxide films for inlet

  5. Accurate and fast path computation on large urban road networks: A general approach.

    Science.gov (United States)

    Song, Qing; Li, Meng; Li, Xiaolei

    2018-01-01

    Accurate and fast path computation is essential for applications such as onboard navigation systems and traffic network routing. While a number of heuristic algorithms have been developed in the past few years for faster path queries, the accuracy of them are always far below satisfying. In this paper, we first develop an agglomerative graph partitioning method for generating high balanced traverse distance partitions, and we constitute a three-level graph model based on the graph partition scheme for structuring the urban road network. Then, we propose a new hierarchical path computation algorithm, which benefits from the hierarchical graph model and utilizes a region pruning strategy to significantly reduce the search space without compromising the accuracy. Finally, we present a detailed experimental evaluation on the real urban road network of New York City, and the experimental results demonstrate the effectiveness of the proposed approach to generate optimal fast paths and to facilitate real-time routing applications.

  6. Structural factors for public dental health services in Regional Health Care Network 13: an analysis of the Brazilian National Program for Improving Access and Quality of Primary Care

    Directory of Open Access Journals (Sweden)

    Lucila Brandão HIROOKA

    2018-02-01

    Full Text Available Abstract Introduction The Brazilian National Program for Improving Access and Quality of Primary Care aims to induce the institution of processes that expand the capacity of federal, state and municipal administrations and Primary Care teams to offer services that ensure greater access and quality. Objective To identify the characteristics of infrastructure for the dental health care of the health units from the Regional Health Care Network 13, from the perspective of a health evaluation. Material and method This is a descriptive and cross-sectional study in which is used the Module V database of the External Evaluation instrument of 156 health units of this region that participated of the 2nd cycle of the referred program, which discuss the modality of the health teams, structure and environment of the dental office, the hours of operation, equipment, instruments and dental supplies. Result In general, the oral health units of this study have dental offices with good structural conditions and sufficient equipment and supplies to carry out clinical activities, except those for dental prostheses, possibly due to the permanence of this service in secondary care. However, they point out that advances in access and coverage by oral health services are still necessary. Conclusion Although the theme includes other studies and reflections, the present work may contribute to discussions about the present condition, and it is recommended the active participation of all the actors involved in the care, in the search for the qualification of oral health services in this region.

  7. Competition and regulation in the European network industries. From general case to the case of electricity

    International Nuclear Information System (INIS)

    Jonquieres, F.

    1995-01-01

    The paper focuses on the institutional arrangements present situation in the European Electricity Supply Industry, which is characterized by its diversity. There is unquestionably, a trend to put pressure on the national electricity systems by the European Union organisms to accept the unbundling, Third Party Access to the network, deregulation etc. An opposing reaction appears, trying to underline the potential important drawbacks of such a trend. The conclusion of the author can be summarised as follows: Competition at the generation level? Yes[ Access to the network ? No[ (author)

  8. The Wisdom of Networks: A General Adaptation and Learning Mechanism of Complex Systems: The Network Core Triggers Fast Responses to Known Stimuli; Innovations Require the Slow Network Periphery and Are Encoded by Core-Remodeling.

    Science.gov (United States)

    Csermely, Peter

    2018-01-01

    I hypothesize that re-occurring prior experience of complex systems mobilizes a fast response, whose attractor is encoded by their strongly connected network core. In contrast, responses to novel stimuli are often slow and require the weakly connected network periphery. Upon repeated stimulus, peripheral network nodes remodel the network core that encodes the attractor of the new response. This "core-periphery learning" theory reviews and generalizes the heretofore fragmented knowledge on attractor formation by neural networks, periphery-driven innovation, and a number of recent reports on the adaptation of protein, neuronal, and social networks. The core-periphery learning theory may increase our understanding of signaling, memory formation, information encoding and decision-making processes. Moreover, the power of network periphery-related "wisdom of crowds" inventing creative, novel responses indicates that deliberative democracy is a slow yet efficient learning strategy developed as the success of a billion-year evolution. Also see the video abstract here: https://youtu.be/IIjP7zWGjVE. © 2017 WILEY Periodicals, Inc.

  9. Can music improve sleep quality in adults with primary insomnia? A systematic review and network meta-analysis.

    Science.gov (United States)

    Feng, Fan; Zhang, Yingshi; Hou, Jun; Cai, Jiayi; Jiang, Qiyu; Li, Xiaojuan; Zhao, Qingchun; Li, Bo-An

    2018-01-01

    Primary insomnia is one of the most common issues for adults. However, whether to use music intervention as a non-pharmacological method of treatment, as well as which treatment should be preferred, is still a matter of controversy. Therefore, we aimed to compare and rank music interventions and no-music controls for primary insomnia patients. A network meta-analysis was used to identify evidence from relevant clinical trials. We searched PubMed, Embase, the Cochrane Library, and the China National Knowledge Infrastructure Library for publications up to May 2017, pertaining to music intervention for primary insomnia patients. The prespecified primary outcome was sleep quality (scored by the PSQI and overall), and the secondary outcomes were sleep onset latency and sleep efficiency. We did pairwise meta-analyses using the random-effects model, later completing the random-effects network meta-analyses. The study was registered with PROSPERO, number CRD42017064750. We deemed 20 trials to be eligible, involving 1339 patients and 12 intervention arms. For PSQI scores, all intervention arms were statistically more effective than the usual care, with patients ranking listening to music as the best means of intervention (SMD: -0.61, 95%CrI: -1.01 to -0.20). For overall sleep quality, only music-associated relaxation was statistically more effective than the patients' usual care (-0.28, -0.48 to -0.08). In terms of sleep onset latency, music-associated relaxation and listening to music had significant advantages (-0.26, -0.64 to -0.09, and -0.28, -0.53 to -0.02); listening to music and music with exercise displayed a tendency to improve sleep efficiency. When considering the efficacy, music intervention seemed to offer clear advantages for adults with primary insomnia. Listening to music and music-associated relaxation are probably the best options to consider in the application of music intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol.

    Science.gov (United States)

    Bracco, Mario Maia; Mafra, Ana Carolina Cintra Nunes; Abdo, Alexandre Hannud; Colugnati, Fernando Antonio Basile; Dalla, Marcello Dala Bernardina; Demarzo, Marcelo Marcos Piva; Abrahamsohn, Ises; Rodrigues, Aline Pacífico; Delgado, Ana Violeta Ferreira de Almeida; Dos Prazeres, Glauber Alves; Teixeira, José Carlos; Possa, Silvio

    2016-08-12

    Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes. A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients' medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients' 30-day hospital readmission rates. A sample size of 560

  11. [Prevalence of oral anticoagulation and quality of its management in primary healthcare: A study by the Health Sentinel Network of the Region of Valencia (Spain)].

    Science.gov (United States)

    Boned-Ombuena, Ana; Pérez-Panadés, Jordi; López-Maside, Aurora; Miralles-Espí, Maite; Guardiola Vilarroig, Sandra; Adam Ruiz, Desamparados; Zurriaga, Oscar

    2017-11-01

    To estimate the prevalence of patients with oral anticoagulant therapy (OAT) in the Region of Valencia and to evaluate the quality of management of OAT with vitaminK antagonists (VKA) carried out in primary healthcare. Observational cross-sectional study conducted through the Health Sentinel Network of the Region of Valencia, which includes a survey and the retrospective analysis of OAT monitoring. Primary healthcare, Region of Valencia, Spain. All patients aged 18years or older on OAT who consulted during the year 2014. The population covered by the 59 doctors of the Health Sentinel Network constitutes 2.2% of the adult population of the Region of Valencia, and it is representative of it. Demographic, socioeconomic and health data as well as information concerning OAT. Quality of OAT management with VKA was assessed by means of the percentage of time in therapeutic range (TTR), computed using the Rosendaal method. A total of 1,144 patients were recorded (mean age 74.5±11 years; 49.7% women). Prevalence of OAT in the Region of Valencia is 1.3 cases per 100 population. The characteristic profile of these patients is an old person, with several comorbidities and a low level of education, who lives accompanied. Atrial fibrillation is the most common indication. 82.8% of patients on OAT with VKA were monitored in primary healthcare. The average TTR was 65.0%, and 53.9% of patients had a TTR ≥65%. Among inadequately controlled patients, 74.4% were perceived as well-controlled by their primary care doctor. Prevalence of OAT is high, and it is expected to increase. The degree of control achieved meets the generally accepted quality standard (mean TTR ≥65%), and it is comparable to that observed in other national and international studies. However, there is wide scope for improvement. It is crucial to optimize the management of this therapy in the most effective and cost-effective way. Among other measures, access of physicians to their patients' clinical information

  12. Integrating a suicide prevention program into the primary health care network: a field trial study in Iran.

    Science.gov (United States)

    Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

    2015-01-01

    To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ (2) = 14.8, P suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

  13. Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

    Directory of Open Access Journals (Sweden)

    Seyed Kazem Malakouti

    2015-01-01

    Full Text Available Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ2=14.8, P<0.001. We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

  14. Reveal, A General Reverse Engineering Algorithm for Inference of Genetic Network Architectures

    Science.gov (United States)

    Liang, Shoudan; Fuhrman, Stefanie; Somogyi, Roland

    1998-01-01

    Given the immanent gene expression mapping covering whole genomes during development, health and disease, we seek computational methods to maximize functional inference from such large data sets. Is it possible, in principle, to completely infer a complex regulatory network architecture from input/output patterns of its variables? We investigated this possibility using binary models of genetic networks. Trajectories, or state transition tables of Boolean nets, resemble time series of gene expression. By systematically analyzing the mutual information between input states and output states, one is able to infer the sets of input elements controlling each element or gene in the network. This process is unequivocal and exact for complete state transition tables. We implemented this REVerse Engineering ALgorithm (REVEAL) in a C program, and found the problem to be tractable within the conditions tested so far. For n = 50 (elements) and k = 3 (inputs per element), the analysis of incomplete state transition tables (100 state transition pairs out of a possible 10(exp 15)) reliably produced the original rule and wiring sets. While this study is limited to synchronous Boolean networks, the algorithm is generalizable to include multi-state models, essentially allowing direct application to realistic biological data sets. The ability to adequately solve the inverse problem may enable in-depth analysis of complex dynamic systems in biology and other fields.

  15. NeuroFlow: A General Purpose Spiking Neural Network Simulation Platform using Customizable Processors.

    Science.gov (United States)

    Cheung, Kit; Schultz, Simon R; Luk, Wayne

    2015-01-01

    NeuroFlow is a scalable spiking neural network simulation platform for off-the-shelf high performance computing systems using customizable hardware processors such as Field-Programmable Gate Arrays (FPGAs). Unlike multi-core processors and application-specific integrated circuits, the processor architecture of NeuroFlow can be redesigned and reconfigured to suit a particular simulation to deliver optimized performance, such as the degree of parallelism to employ. The compilation process supports using PyNN, a simulator-independent neural network description language, to configure the processor. NeuroFlow supports a number of commonly used current or conductance based neuronal models such as integrate-and-fire and Izhikevich models, and the spike-timing-dependent plasticity (STDP) rule for learning. A 6-FPGA system can simulate a network of up to ~600,000 neurons and can achieve a real-time performance of 400,000 neurons. Using one FPGA, NeuroFlow delivers a speedup of up to 33.6 times the speed of an 8-core processor, or 2.83 times the speed of GPU-based platforms. With high flexibility and throughput, NeuroFlow provides a viable environment for large-scale neural network simulation.

  16. Including 10-Gigabit-capable Passive Optical Network under End-to-End Generalized Multi-Protocol Label Switching Provisioned Quality of Service

    Science.gov (United States)

    Brewka, Lukasz; Gavler, Anders; Wessing, Henrik; Dittmann, Lars

    2012-04-01

    End-to-end quality of service provisioning is still a challenging task despite many years of research and development in this area. Considering a generalized multi-protocol label switching based core/metro network and resource reservation protocol capable home gateways, it is the access part of the network where quality of service signaling is bridged. This article proposes strategies for generalized multi-protocol label switching control over next emerging passive optical network standard, i.e., the 10-gigabit-capable passive optical network. Node management and resource allocation approaches are discussed, and possible issues are raised. The analysis shows that consideration of a 10-gigabit-capable passive optical network as a generalized multi-protocol label switching controlled domain is valid and may advance end-to-end quality of service provisioning for passive optical network based customers.

  17. Including 10-Gigabit-capable Passive Optical Network under End-to-End Generalized Multi-Protocol Label Switching Provisioned Quality of Service

    DEFF Research Database (Denmark)

    Brewka, Lukasz Jerzy; Gavler, Anders; Wessing, Henrik

    2012-01-01

    of the network where quality of service signaling is bridged. This article proposes strategies for generalized multi-protocol label switching control over next emerging passive optical network standard, i.e., the 10-gigabit-capable passive optical network. Node management and resource allocation approaches...... are discussed, and possible issues are raised. The analysis shows that consideration of a 10-gigabit-capable passive optical network as a generalized multi-protocol label switching controlled domain is valid and may advance end-to-end quality of service provisioning for passive optical network based customers.......End-to-end quality of service provisioning is still a challenging task despite many years of research and development in this area. Considering a generalized multi-protocol label switching based core/metro network and resource reservation protocol capable home gateways, it is the access part...

  18. Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations.

    Directory of Open Access Journals (Sweden)

    Kevin V Lemley

    Full Text Available Most predictive models of kidney disease progression have not incorporated structural data. If structural variables have been used in models, they have generally been only semi-quantitative.We examined the predictive utility of quantitative structural parameters measured on the digital images of baseline kidney biopsies from the NEPTUNE study of primary proteinuric glomerulopathies. These variables were included in longitudinal statistical models predicting the change in estimated glomerular filtration rate (eGFR over up to 55 months of follow-up.The participants were fifty-six pediatric and adult subjects from the NEPTUNE longitudinal cohort study who had measurements made on their digital biopsy images; 25% were African-American, 70% were male and 39% were children; 25 had focal segmental glomerular sclerosis, 19 had minimal change disease, and 12 had membranous nephropathy. We considered four different sets of candidate predictors, each including four quantitative structural variables (for example, mean glomerular tuft area, cortical density of patent glomeruli and two of the principal components from the correlation matrix of six fractional cortical areas-interstitium, atrophic tubule, intact tubule, blood vessel, sclerotic glomerulus, and patent glomerulus along with 13 potentially confounding demographic and clinical variables (such as race, age, diagnosis, and baseline eGFR, quantitative proteinuria and BMI. We used longitudinal linear models based on these 17 variables to predict the change in eGFR over up to 55 months. All 4 models had a leave-one-out cross-validated R2 of about 62%.Several combinations of quantitative structural variables were significantly and strongly associated with changes in eGFR. The structural variables were generally stronger than any of the confounding variables, other than baseline eGFR. Our findings suggest that quantitative assessment of diagnostic renal biopsies may play a role in estimating the baseline

  19. General Data Acquisition Platform for Wireless Sensor Network Based on CC2538

    Directory of Open Access Journals (Sweden)

    Yang Zhi-Jun

    2017-01-01

    Full Text Available Wireless sensor networks are the hotspots of current research and have very wide application prospects. Its front end is a sensor that can sense and check the external world. This paper takes temperature and humidity as the research object, and builds a wireless sensor network data acquisition platform by combining the Internet of things and the WeChat public platform. The platform uses DHT11 temperature and humidity sensors and CC2538 sensor nodes to obtain the relevant data, through the server and database for data access. The combination with WeChat public platform not only allows us to view the temperature and humidity in the WeChat public, but also allows us to understand the environmental changes of the relevant detection area more conveniently and quickly. The effectiveness of the platform is also demonstrated by the collection of temperature and humidity data.

  20. Serial 1H-MRS of thalamus during deep brain stimulation of bilateral globus pallidus internus for primary generalized dystonia

    International Nuclear Information System (INIS)

    Chernov, Mikhail F.; Iseki, Hiroshi; Takakura, Kintomo; Ochiai, Taku; Taira, Takaomi; Hori, Tomokatsu; Ono, Yuko; Nakamura, Ryoichi; Muragaki, Yoshihiro

    2008-01-01

    The physiological mechanisms of deep brain stimulation (DBS) are not completely clear. Our understanding of them may be facilitated with the use of proton magnetic resonance spectroscopy ( 1 H-MRS). Serial 1 H-MRS of both thalami was performed during the course of DBS of bilateral globus pallidus internus in a patient with primary generalized dystonia. Two days after microelectrode implantation, a pulse frequency of 185 Hz was applied for stimulation. It resulted in relief of symptoms and a decrease of Burke-Fahn-Marsden dystonia rating scale (BFMDRS) scores, and was accompanied by a prominent increase of N-acetylaspartate (NAA)/choline-containing compounds (Cho) ratio, a mild increase of NAA/creatine (Cr) ratio, and a moderate decrease of Cho/Cr ratio. Two weeks later, for a search of the optimal stimulation mode, the pulse frequency was switched to 60 Hz, which resulted in clinical deterioration and significant increase of BFMDRS scores. At that time, all investigated 1 H-MRS-detected metabolic parameters had nearly returned to the pretreatment levels. Use of serial 1 H-MRS investigations of various brain structures during DBS in cases of movement disorders permits detailed evaluation of the treatment response, has a potential for its possible prediction, and may facilitate understanding of the physiological mechanisms of stimulation. (orig.)

  1. Using Generalized Annotated Programs to Solve Social Network Diffusion Optimization Problems

    Science.gov (United States)

    2013-01-01

    Flickr, YouTube , etc.), cell phone net- work data [N. Eagle and Lazer 2008] collected by virtually all cell phone vendors, email Author’s addresses: P... kids might be more susceptible than adults, those previously inoculated against the disease are safe, etc.), they want to find a set of k people who...framework for modeling com- petitive diffusion in social networks. Social Computing / IEEE International Conference on Privacy , Security, Risk and

  2. Resource Allocation in a Generalized Framework for Virtualized Heterogeneous Wireless Network

    Directory of Open Access Journals (Sweden)

    Bo Fan

    2016-01-01

    Full Text Available As a prevailing concept in 5G, virtualization provides efficient coordination among multiple radio access technologies (RATs and enables multiple service providers (SPs to share different RATs’ infrastructure. This paper proposes a generic framework for virtualizing heterogeneous wireless network with different RATs. A novel “VMAC” (virtualized medium access control concept is introduced to converge different RAT protocols and perform inter-RAT resource allocation. To suit the proposed framework, a virtualization based resource allocation scheme is devised. We formulate the problem as a mixed combinatorial optimization, which jointly considers network access and rate allocation. First, to solve the network access problem, “adaptability ratio” is developed to model the fact that different RATs possess different adaptability to different services. And a Grey Relational Analysis (GRA method is adopted to calculate the adaptability ratio. Second, services are modeled as players, bargaining for RAT resources in a Nash bargaining game. And a closed-form Nash bargaining solution (NBS is derived. Combining adaptability ratio with NBS, a novel resource allocation algorithm is devised. Through simulation, the superiority and feasibility of the proposed algorithm are validated.

  3. First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database.

    Directory of Open Access Journals (Sweden)

    Robert L Grant

    2013-08-01

    Full Text Available Dementia is one of the most disabling and burdensome diseases. Incontinence in people with dementia is distressing, adds to carer burden, and influences decisions to relocate people to care homes. Successful and safe management of incontinence in people with dementia presents additional challenges. The aim of this study was to investigate the rates of first diagnosis in primary care of urinary and faecal incontinence among people aged 60-89 with dementia, and the use of medication or indwelling catheters for urinary incontinence.We extracted data on 54,816 people aged 60-89 with dementia and an age-gender stratified sample of 205,795 people without dementia from 2001 to 2010 from The Health Improvement Network (THIN, a United Kingdom primary care database. THIN includes data on patients and primary care consultations but does not identify care home residents. Rate ratios were adjusted for age, sex, and co-morbidity using multilevel Poisson regression. The rates of first diagnosis per 1,000 person-years at risk (95% confidence interval for urinary incontinence in the dementia cohort, among men and women, respectively, were 42.3 (40.9-43.8 and 33.5 (32.6-34.5. In the non-dementia cohort, the rates were 19.8 (19.4-20.3 and 18.6 (18.2-18.9. The rates of first diagnosis for faecal incontinence in the dementia cohort were 11.1 (10.4-11.9 and 10.1 (9.6-10.6. In the non-dementia cohort, the rates were 3.1 (2.9-3.3 and 3.6 (3.5-3.8. The adjusted rate ratio for first diagnosis of urinary incontinence was 3.2 (2.7-3.7 in men and 2.7 (2.3-3.2 in women, and for faecal incontinence was 6.0 (5.1-7.0 in men and 4.5 (3.8-5.2 in women. The adjusted rate ratio for pharmacological treatment of urinary incontinence was 2.2 (1.4-3.7 for both genders, and for indwelling urinary catheters was 1.6 (1.3-1.9 in men and 2.3 (1.9-2.8 in women.Compared with those without a dementia diagnosis, those with a dementia diagnosis have approximately three times the rate of

  4. Current status and issues of nuclear human resource development/General activities of Japan nuclear human resource development network

    International Nuclear Information System (INIS)

    Murakami, Hiroyuki; Hino, Sadami; Tsuru, Hisanori

    2013-01-01

    The Japan Nuclear Human Resource Development Network (JN-HRD Net) was established in November 2010 with the aim of developing a framework for mutual cooperation and information sharing among nuclear-related organizations. Although the tasks and goals of developing human resources in the nuclear field have been shifted since the accident at the Tokyo Electric Power Company (TEPCO) Fukushima Daiichi Nuclear Power Plant, the necessity of fostering capable personnel in this field stays unchanged and the importance of our network activities has further emphasized. The meeting of JN-HRD Net was held on the 5th of February 2013, where its activities by each field were reported and views and opinions were actively exchanged between more than 90 participants. This paper briefly describes current status and issues of JN-HRD Net and its general activities conducted by the JN-HRD Net secretariat. (J.P.N.)

  5. Comprehensive preference optimization of an irreversible thermal engine using pareto based mutable smart bee algorithm and generalized regression neural network

    DEFF Research Database (Denmark)

    Mozaffari, Ahmad; Gorji-Bandpy, Mofid; Samadian, Pendar

    2013-01-01

    Optimizing and controlling of complex engineering systems is a phenomenon that has attracted an incremental interest of numerous scientists. Until now, a variety of intelligent optimizing and controlling techniques such as neural networks, fuzzy logic, game theory, support vector machines...... performance of the proposed method. In order to find the maximum exploration potentials, these techniques are equipped with an external archive. These archives aid the methods to record all of the non-dominated solutions. Eventually, the proposed method and generalized regression neural network (GRNN......) are simultaneously used to optimize the major parameters of an irreversible thermal engine. In order to direct the PBMSB to explore deliberate spaces within the solution domain, a reference point obtained from finite time thermodynamic (FTT) approach, is utilized in the optimization. The outcome results show...

  6. Development, implementation, and pilot study of a sentinel network ("The Watchtowers" for monitoring emergency primary health care activity in Norway

    Directory of Open Access Journals (Sweden)

    Hunskaar Steinar

    2008-03-01

    Full Text Available Abstract Background In Norway there is a shortage of valid health activity statistics from the primary care out-of-hours services and the pre-hospital emergency health care system. There is little systematic information available because data registration is lacking or is only recorded periodically, and definitions of variables are not consistent. Method A representative sample of Norwegian municipalities and out-of-hours districts was contracted to establish a sentinel network, "The Watchtowers", and procedures were developed for collecting continuous data from out-of-hours services. All contacts, either per telephone or direct attendance, are recorded during day and night. The variables are registered in a computer program developed by the National Centre for Emergency Primary Health Care, and sent by email in Excel-file format to the Centre on a monthly basis. Results The selection process yielded a group of 18 municipalities, with a fair degree of representativeness for Norwegian municipalities as a whole. The sample has 212,921 inhabitants, which constitutes 4.6% of the total Norwegian population. During a pilot period lasting three months the Watchtowers recorded all individual contacts. The procedures for registration, submitting and checking data worked satisfactorily. There was little data missing, and during the last three months of 2006 a total of 23,346 contacts were registered. Conclusion We have been able to establish a sentinel network with a fair degree of representativeness for Norwegian out-of-hours districts and municipalities. The data collected reflect national activities from casualty clinics in Norway. Such data are useful for both research and system improvements.

  7. Induction of motor associative plasticity in the posterior parietal cortex-primary motor network

    DEFF Research Database (Denmark)

    Chao, Chi-Chao; Karabanov, Anke Ninija; Paine, Rainer

    2015-01-01

    There is anatomical and functional connectivity between the primary motor cortex (M1) and posterior parietal cortex (PPC) that plays a role in sensorimotor integration. In this study, we applied corticocortical paired-associative stimuli to ipsilateral PPC and M1 (parietal ccPAS) in healthy right...... the excitability of conditioned left M1 assessed by motor evoked potentials (MEPs) and the input–output curve. Motor behavior assessed by the Purdue pegboard task was unchanged compared with controls. At baseline, conditioning stimuli over the left PPC potentiated MEPs from left M1 when ISI was 8 ms...... excitability and PPC–M1 connectivity and is a new approach to modify motor excitability and sensorimotor interaction....

  8. White matter microstructural changes of thalamocortical networks in photosensitivity and idiopathic generalized epilepsy

    DEFF Research Database (Denmark)

    Groppa, Sergiu; Moeller, Friederike; Siebner, Hartwig

    2012-01-01

    Photosensitivity or photoparoxysmal response (PPR) is an electroencephalography trait that is highly associated with idiopathic generalized epilepsies (IGEs) and characterized by changes in cortical excitability in response to photic stimulation. Studying functional and structural changes of PPR ...

  9. Cluster imaging of multi-brain networks (CIMBN: a general framework for hyperscanning and modeling a group of interacting brains

    Directory of Open Access Journals (Sweden)

    Lian eDuan

    2015-07-01

    Full Text Available Studying the neural basis of human social interactions is a key topic in the field of social neuroscience. Brain imaging studies in this field usually focus on the neural correlates of the social interactions between two participants. However, as the participant number further increases, even by a small amount, great difficulties raise. One challenge is how to concurrently scan all the interacting brains with high ecological validity, especially for a large number of participants. The other challenge is how to effectively model the complex group interaction behaviors emerging from the intricate neural information exchange among a group of socially organized people. Confronting these challenges, we propose a new approach called Cluster Imaging of Multi-brain Networks (CIMBN. CIMBN consists of two parts. The first part is a cluster imaging technique with high ecological validity based on multiple functional near-infrared spectroscopy (fNIRS systems. Using this technique, we can easily extend the simultaneous imaging capacity of social neuroscience studies up to dozens of participants. The second part of CIMBN is a multi-brain network (MBN modeling method based on graph theory. By taking each brain as a network node and the relationship between any two brains as a network edge, one can construct a network model for a group of interacting brains. The emergent group social behaviors can then be studied using the network’s properties, such as its topological structure and information exchange efficiency. Although there is still much work to do, as a general framework for hyperscanning and modeling a group of interacting brains, CIMBN can provide new insights into the neural correlates of group social interactions, and advance social neuroscience and social psychology.

  10. Nationwide continuous monitoring of end-of-life care via representative networks of general practitioners in Europe.

    Science.gov (United States)

    Van den Block, Lieve; Onwuteaka-Philipsen, Bregje; Meeussen, Koen; Donker, Gé; Giusti, Francesco; Miccinesi, Guido; Van Casteren, Viviane; Alonso, Tomas Vega; Zurriaga, Oscar; Deliens, Luc

    2013-06-03

    Although end-of-life care has become an issue of great clinical and public health concern in Europe and beyond, we lack population-based nationwide data that monitor and compare the circumstances of dying and care received in the final months of life in different countries. The European Sentinel GP Networks Monitoring End of Life Care (EURO SENTIMELC) study was designed to describe and compare the last months of life of patients dying in different European countries. We aim to describe how representative GP networks in the EURO SENTIMELC study operate to monitor end of life care in a country, to describe used methodology, research procedures, representativity and characteristics of the population reached using this methodology. Nationwide representative Networks of General Practitioners (GPs)--ie epidemiological surveillance systems representative of all GPs in a country or large region of a country--in Belgium, The Netherlands, Italy and Spain continuously registered every deceased patient (>18 year) in their practice, using weekly standardized registration forms, during two consecutive years (2009-2010). A total of 6858 deaths were registered of which two thirds died non-suddenly (from 62% in The Netherlands to 69% in Spain), representative for the GP populations in the participating countries. Of all non-sudden deaths, between 32% and 44% of deaths were aged 85 or older; between 46% and 54% were female, and between 23% and 49% died at home. Cancer was cause of death in 37% to 53% of non-sudden death cases in the four participating countries. Via the EURO SENTI-MELC methodology, we can build a descriptive epidemiological database on end-of-life care provision in several EU countries, measuring across setting and diseases. The data can serve as baseline measurement to compare and monitor end-of-life care over time. The use of representative GP networks for end-of-life care monitoring has huge potential in Europe where several of these networks are operational.

  11. Summary of : piloting a local dental network across Hampshire and Isle of Wight Primary Care Trusts.

    Science.gov (United States)

    McGrady, Dr Michael

    2014-09-01

    To pilot a local dental network (LDN) within the Hampshire and Isle of Wight region. An LDN Coordinating Group was set up, which was chaired by the local consultant in dental public health and included representatives from dental commissioning and performance management teams, dental practice advisory team, finance, Oxford and Wessex Dental Deanery and the Hampshire and Isle of Wight Local Dental Committee. The LDN successfully led the organisation of a leadership training course for local dentists, and produced recommendations for local oral surgery and orthodontics care pathways. Key to the success was the collaboration achieved between the commissioners, local postgraduate dental deanery and local dental committee. There were challenges associated with involving non-salaried dental practitioners without a source of funding, and with communicating with the wider dental community. The new Wessex LDN needs to be adequately resourced and integrated into the local commissioning structure, as well as the wider health system, to function effectively. Most importantly, the LDN needs local dental professionals to embrace the opportunities for leadership and use their skills to inform and influence local dental commissioning for the benefit of the local population.

  12. Piloting a local dental network across Hampshire and Isle of Wight Primary Care Trusts.

    Science.gov (United States)

    John, J H; Easterby-Smith, V; Percival, K R

    2014-09-01

    To pilot a local dental network (LDN) within the Hampshire and Isle of Wight region. An LDN Coordinating Group was set up, which was chaired by the local consultant in dental public health and included representatives from dental commissioning and performance management teams, dental practice advisory team, finance, Oxford and Wessex Dental Deanery and the Hampshire and Isle of Wight Local Dental Committee. The LDN successfully led the organisation of a leadership training course for local dentists, and produced recommendations for local oral surgery and orthodontics care pathways. Key to the success was the collaboration achieved between the commissioners, local postgraduate dental deanery and local dental committee. There were challenges associated with involving non-salaried dental practitioners without a source of funding, and with communicating with the wider dental community. The new Wessex LDN needs to be adequately resourced and integrated into the local commissioning structure, as well as the wider health system, to function effectively. Most importantly, the LDN needs local dental professionals to embrace the opportunities for leadership and use their skills to inform and influence local dental commissioning for the benefit of the local population.

  13. A problem of finding an acceptable variant in generalized project networks

    Directory of Open Access Journals (Sweden)

    David Blokh

    2005-01-01

    Full Text Available A project network often has some activities or groups of activities which can be performed at different stages of the project. Then, the problem of finding an optimal/acceptable time or/and optimal/acceptable order of such an activity or a group of activities arises. Such a problem emerges, in particular, in house-building management when the beginnings of some activities may vary in time or/and order. We consider a mathematical formulation of the problem, show its computational complexity, and describe an algorithm for solving the problem.

  14. Pinning synchronization of two general complex networks with periodically intermittent control

    Directory of Open Access Journals (Sweden)

    Meng Fanyu

    2015-12-01

    Full Text Available In this paper, the method of periodically pinning intermittent control is introduced to solve the problem of outer synchronization between two complex networks. Based on the Lyapunov stability theory, differential inequality method and adaptive technique, some simple synchronous criteria have been derived analytically. At last, both the theoretical and numerical analysis illustrate the effectiveness of the proposed control methodology. This method not only reduces the conservatism of control gain but also saves the cost of production.These advantages make this method having a large application scope in the real production process.

  15. Towards A General Integrated Broadband Optical Fiber Telecommunications Network In The Subscriber Area

    Science.gov (United States)

    Lange, Manfred J. W.

    1984-03-01

    After a short description of previous optical fiber tests within the city area of Berlin (West) the reasoning that led Deutsche Bundespost to the concept of the BIGFON systems test is explained. The requirements for and the basic architecture of a local broadband network are dealt with in some detail. The scope of solutions offered by the six BIGFON contractors is demonstrated by means of block diagrams of two rather different designs. Some information on the present status of the BIGFON project is given; in closing, questions of cost, introduction procedure and need for further research are discussed as well as the problem of broadband long distance connections.

  16. A unified approach to the stability of generalized static neural networks with linear fractional uncertainties and delays.

    Science.gov (United States)

    Li, Xianwei; Gao, Huijun; Yu, Xinghuo

    2011-10-01

    In this paper, the robust global asymptotic stability (RGAS) of generalized static neural networks (SNNs) with linear fractional uncertainties and a constant or time-varying delay is concerned within a novel input-output framework. The activation functions in the model are assumed to satisfy a more general condition than the usually used Lipschitz-type ones. First, by four steps of technical transformations, the original generalized SNN model is equivalently converted into the interconnection of two subsystems, where the forward one is a linear time-invariant system with a constant delay while the feedback one bears the norm-bounded property. Then, based on the scaled small gain theorem, delay-dependent sufficient conditions for the RGAS of generalized SNNs are derived via combining a complete Lyapunov functional and the celebrated discretization scheme. All the results are given in terms of linear matrix inequalities so that the RGAS problem of generalized SNNs is projected into the feasibility of convex optimization problems that can be readily solved by effective numerical algorithms. The effectiveness and superiority of our results over the existing ones are demonstrated by two numerical examples.

  17. General, crystallized and fluid intelligence are not associated with functional global network efficiency: A replication study with the human connectome project 1200 data set.

    Science.gov (United States)

    Kruschwitz, J D; Waller, L; Daedelow, L S; Walter, H; Veer, I M

    2018-05-01

    One hallmark example of a link between global topological network properties of complex functional brain connectivity and cognitive performance is the finding that general intelligence may depend on the efficiency of the brain's intrinsic functional network architecture. However, although this association has been featured prominently over the course of the last decade, the empirical basis for this broad association of general intelligence and global functional network efficiency is quite limited. In the current study, we set out to replicate the previously reported association between general intelligence and global functional network efficiency using the large sample size and high quality data of the Human Connectome Project, and extended the original study by testing for separate association of crystallized and fluid intelligence with global efficiency, characteristic path length, and global clustering coefficient. We were unable to provide evidence for the proposed association between general intelligence and functional brain network efficiency, as was demonstrated by van den Heuvel et al. (2009), or for any other association with the global network measures employed. More specifically, across multiple network definition schemes, ranging from voxel-level networks to networks of only 100 nodes, no robust associations and only very weak non-significant effects with a maximal R 2 of 0.01 could be observed. Notably, the strongest (non-significant) effects were observed in voxel-level networks. We discuss the possibility that the low power of previous studies and publication bias may have led to false positive results fostering the widely accepted notion of general intelligence being associated to functional global network efficiency. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. The Management of Patients With Diverticulosis and Diverticular Disease in Primary Care: An Online Survey Among Italian General Pratictioners.

    Science.gov (United States)

    De Bastiani, Rudi; Sanna, Guido; Fracasso, Pierluigi; D'Urso, Maurizio; Benedetto, Edoardo; Tursi, Antonio

    2016-10-01

    To investigate the current opinion of Italian general practitioners (GPs) on the management of patients with diverticular disease (DD) of the colon. The management of DD remains a point of debate, and guidelines are not uniform in their advice. A web-based survey was conducted among Italian GPs. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. In total, 245 surveys were filled out. A high-fiber diet was prescribed widely in diverticulosis (44%), together with advice to allow seeds (30%). Rifaximin (26%) and probiotics (25%) were the most frequently prescribed drugs in this population. Colonoscopy was the most prescribed instrumental tool in the diagnosis (77%) and follow-up (21%) of symptomatic uncomplicated diverticular disease patients. Rifaximin, probiotics, and mesalazine were the most frequently prescribed drugs in symptomatic uncomplicated diverticular disease patients (82.8, 59.5%, and 36.3%, respectively). Finally, 77% of the Italian GPs prescribed laboratory exams in the follow-up of these patients. The vast majority of the Italian GPs (83%) managed suspected acute diverticulitis at home, and did not consider two episodes of acute diverticulitis as a strict surgical indication (86%). Rifaximin, probiotics, and mesalazine were the most frequently prescribed drugs to prevent recurrence of the disease (42.5%, 28.2%, and 12.4%, respectively). Finally, 87% of the Italian GPs prescribed laboratory examinations in the follow-up of these patients. This survey shows that the current management of DD in primary care by Italian GPs is not fully in line with current guidelines and more recent literature data.

  19. Improving allergy management in the primary care network--a holistic approach.

    Science.gov (United States)

    Jutel, M; Angier, L; Palkonen, S; Ryan, D; Sheikh, A; Smith, H; Valovirta, E; Yusuf, O; van Wijk, R G; Agache, I

    2013-11-01

    The incidence, prevalence and costs of allergy have increased substantially in recent decades in many parts of Europe. The dominant model of allergy care within Europe is at the moment specialist-based. This model will become unsustainable and undeliverable with increasing disease prevalence. One solution to increase provision of allergy services is to diversify the providers. A new model for the provision of allergy care in the community with the general practitioner at the forefront is proposed. Pre- and postgraduate allergy education and training, implementation of pathways of care, allergy specialization and political will to generate resources and support are essential to achieve this new model. In parallel the holistic view of allergic diseases should be maintained, including assessment of severity and risk, psychological factors and health-care related costs in the context of the patient-centered decision making process. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Access to cancer screening in people with learning disabilities in the UK: cohort study in the health improvement network, a primary care research database.

    Directory of Open Access Journals (Sweden)

    David P J Osborn

    Full Text Available To assess whether people with learning disability in the UK have poorer access to cancer screening.Four cohort studies comparing people with and without learning disability, within the recommended age ranges for cancer screening in the UK. We used Poisson regression to determine relative incidence rates of cancer screening.The Health Improvement Network, a UK primary care database with over 450 General practices.Individuals with a recorded diagnosis of learning disability including general diagnostic terms, specific syndromes, chromosomal abnormalities and autism in their General Practitioner computerised notes. For each type of cancer screening, a comparison cohort of up to six people without learning disability was selected for each person with a learning disability, using stratified sampling on age within GP practice.Incidence rate ratios for receiving 1 a cervical smear test, 2 a mammogram, 3 a faecal occult blood test and 4 a prostate specific antigen test.Relative rates of screening for all four cancers were significantly lower for people with learning disability. The adjusted incidence rate ratios (95% confidence intervals were Cervical smears: Number eligible with learning disability = 6,254; IRR = 0.54 (0.52-0.56. Mammograms: Number eligible with learning disability = 2,956; IRR = 0.76 (0.72-0.81; Prostate Specific Antigen: Number eligible = 3,520; IRR = 0.87 (0.80-0.96 and Faecal Occult Blood Number eligible = 6,566; 0.86 (0.78-0.94. Differences in screening rates were less pronounced in more socially deprived areas. Disparities in cervical screening rates narrowed over time, but were 45% lower in 2008/9, those for breast cancer screening appeared to widen and were 35% lower in 2009.Despite recent incentives, people with learning disability in the UK are significantly less likely to receive screening tests for cancer that those without learning disability. Other methods for reducing inequalities in access to cancer screening should be

  1. The Network Nation: The Relevance of This for Possible Educational and General Public Administrative Structures and Strategies in the 1980's and 90's.

    Science.gov (United States)

    Freeman, Andrew R.

    In this thesis, consideration is given to the interrelationships between a number of key concepts (devolution, decentralization, participation, consultation, coordination, and networking) and reports in educational and general public administration which have been produced over the last decade. Networking is the interconnecting concept. In the…

  2. Intrinsic Functional Connectivity of Amygdala-Based Networks in Adolescent Generalized Anxiety Disorder

    Science.gov (United States)

    Roy, Amy K.; Fudge, Julie L.; Kelly, Clare; Perry, Justin S. A.; Daniele, Teresa; Carlisi, Christina; Benson, Brenda; Castellanos, F. Xavier; Milham, Michael P.; Pine, Daniel S.; Ernst, Monique

    2013-01-01

    Objective: Generalized anxiety disorder (GAD) typically begins during adolescence and can persist into adulthood. The pathophysiological mechanisms underlying this disorder remain unclear. Recent evidence from resting state functional magnetic resonance imaging (R-fMRI) studies in adults suggests disruptions in amygdala-based circuitry; the…

  3. End-of-life communication: a retrospective survey of representative General Practitioner networks in four countries.

    NARCIS (Netherlands)

    Evans, N.; Costantini, M.; Pasman, H.R.; Block, L. van den; Donker, G.A.; Miccinesi, G.; Bertolissi, S.; Gil, M.; Boffin, N.; Zurriaga, O.; Deliens, L.; Onwuteaka-Philipsen, B.

    2014-01-01

    Context: Effective communication is central to high-quality end-of-life care. Objectives: This study examined the prevalence of general practitioner (GP)-patient discussion of end-of-life topics (according to the GP) in Italy, Spain, Belgium, and The Netherlands and associated patient and care

  4. The network structure of major depressive disorder, generalized anxiety disorder and somatic symptomatology

    NARCIS (Netherlands)

    Bekhuis, E.; Schoevers, R.A.; van Borkulo, C.D.; Rosmalen, J.G.M.; Boschloo, L.

    2016-01-01

    Major depressive disorder (MDD) and generalized anxiety disorder (GAD) often co-occur with somatic symptomatology. Little is known about the contributions of individual symptoms to this association and more insight into their relationships could help to identify symptoms that are central in the

  5. The network structure of major depressive disorder, generalized anxiety disorder and somatic symptomatology

    NARCIS (Netherlands)

    Bekhuis, E.; Schoevers, R. A.; van Borkulo, C. D.; Rosmalen, J. G. M.; Boschloo, L.

    2016-01-01

    Background Major depressive disorder (MDD) and generalized anxiety disorder (GAD) often co-occur with somatic symptomatology. Little is known about the contributions of individual symptoms to this association and more insight into their relationships could help to identify symptoms that are central

  6. Metabolic control and morbidity of Type 2 diabetic patients in a general practice network.

    NARCIS (Netherlands)

    Bouma, M.; Dekker, J.H.; Eijk, J.T.M. van; Schellevis, F.G.; Kriegsman, D.M.W.; Heine, R.J.

    1999-01-01

    Methods: glycaemic control and the prevalence of modifiable cardiovascular risk factors, and micro- and macrovascular morbidity was examined in 637 Type 2 diabetic patients in general practice, of whom 405 consented to undergo a more extensive examination. Results: in these 405 patients, HbA1c was

  7. Assessment of General Public Exposure to LTE signals compared to other Cellular Networks Present in Thessaloniki, Greece.

    Science.gov (United States)

    Gkonis, Fotios; Boursianis, Achilles; Samaras, Theodoros

    2017-07-01

    To assess general public exposure to electromagnetic fields from Long Term Evolution (LTE) base stations, measurements at 10 sites in Thessaloniki, Greece were performed. Results are compared with other mobile cellular networks currently in use. All exposure values satisfy the guidelines for general public exposure of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), as well as the reference levels by the Greek legislation at all sites. LTE electric field measurements were recorded up to 0.645 V/m. By applying the ICNIRP guidelines, the exposure ratio for all LTE signals is between 2.9 × 10-5 and 2.8 × 10-2. From the measurements results it is concluded that the average and maximum power density contribution of LTE downlink signals to the overall cellular networks signals are 7.8% and 36.7%, respectively. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Transferring Pre-Trained Deep CNNs for Remote Scene Classification with General Features Learned from Linear PCA Network

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2017-03-01

    Full Text Available Deep convolutional neural networks (CNNs have been widely used to obtain high-level representation in various computer vision tasks. However, in the field of remote sensing, there are not sufficient images to train a useful deep CNN. Instead, we tend to transfer successful pre-trained deep CNNs to remote sensing tasks. In the transferring process, generalization power of features in pre-trained deep CNNs plays the key role. In this paper, we propose two promising architectures to extract general features from pre-trained deep CNNs for remote scene classification. These two architectures suggest two directions for improvement. First, before the pre-trained deep CNNs, we design a linear PCA network (LPCANet to synthesize spatial information of remote sensing images in each spectral channel. This design shortens the spatial “distance” of target and source datasets for pre-trained deep CNNs. Second, we introduce quaternion algebra to LPCANet, which further shortens the spectral “distance” between remote sensing images and images used to pre-train deep CNNs. With five well-known pre-trained deep CNNs, experimental results on three independent remote sensing datasets demonstrate that our proposed framework obtains state-of-the-art results without fine-tuning and feature fusing. This paper also provides baseline for transferring fresh pretrained deep CNNs to other remote sensing tasks.

  9. Synthesis of general linear networks using causal and J-isometric dilations

    International Nuclear Information System (INIS)

    D'Attellis, C.E.

    1977-06-01

    The problem of the synthesis of linear systems characterized by their scattering operator is studied. This problem is considered solved once an adequate dilation for the operator is obtained, from which the synthesis is performed following the method of Saeks (35) and Levan (19). Known results appear sistematized and generalized in this paper, obtaining an unique method of synthesis for different caterories of operators. (Author) [es

  10. Finite-time generalized function matrix projective lag synchronization of coupled dynamical networks with different dimensions via the double power function nonlinear feedback control method

    International Nuclear Information System (INIS)

    Dai, Hao; Si, Gangquan; Jia, Lixin; Zhang, Yanbin

    2014-01-01

    This paper investigates the problem of finite-time generalized function matrix projective lag synchronization between two different coupled dynamical networks with different dimensions of network nodes. The double power function nonlinear feedback control method is proposed in this paper to guarantee that the state trajectories of the response network converge to the state trajectories of the drive network according to a function matrix in a given finite time. Furthermore, in comparison with the traditional nonlinear feedback control method, the new method improves the synchronization efficiency, and shortens the finite synchronization time. Numerical simulation results are presented to illustrate the effectiveness of this method. (papers)

  11. General practitioner views on the determinants of test ordering: a theory-based qualitative approach to the development of an intervention to improve immunoglobulin requests in primary care.

    LENUS (Irish Health Repository)

    Cadogan, S L

    2016-07-19

    Research suggests that variation in laboratory requesting patterns may indicate unnecessary test use. Requesting patterns for serum immunoglobulins vary significantly between general practitioners (GPs). This study aims to explore GP\\'s views on testing to identify the determinants of behaviour and recommend feasible intervention strategies for improving immunoglobulin test use in primary care.

  12. Generalizing a nonlinear geophysical flood theory to medium-sized river networks

    Science.gov (United States)

    Gupta, Vijay K.; Mantilla, Ricardo; Troutman, Brent M.; Dawdy, David; Krajewski, Witold F.

    2010-01-01

    The central hypothesis of a nonlinear geophysical flood theory postulates that, given space-time rainfall intensity for a rainfall-runoff event, solutions of coupled mass and momentum conservation differential equations governing runoff generation and transport in a self-similar river network produce spatial scaling, or a power law, relation between peak discharge and drainage area in the limit of large area. The excellent fit of a power law for the destructive flood event of June 2008 in the 32,400-km2 Iowa River basin over four orders of magnitude variation in drainage areas supports the central hypothesis. The challenge of predicting observed scaling exponent and intercept from physical processes is explained. We show scaling in mean annual peak discharges, and briefly discuss that it is physically connected with scaling in multiple rainfall-runoff events. Scaling in peak discharges would hold in a non-stationary climate due to global warming but its slope and intercept would change.

  13. Modeling of energy consumption and related GHG (greenhouse gas) intensity and emissions in Europe using general regression neural networks

    International Nuclear Information System (INIS)

    Antanasijević, Davor; Pocajt, Viktor; Ristić, Mirjana; Perić-Grujić, Aleksandra

    2015-01-01

    This paper presents a new approach for the estimation of energy-related GHG (greenhouse gas) emissions at the national level that combines the simplicity of the concept of GHG intensity and the generalization capabilities of ANNs (artificial neural networks). The main objectives of this work includes the determination of the accuracy of a GRNN (general regression neural network) model applied for the prediction of EC (energy consumption) and GHG intensity of energy consumption, utilizing general country statistics as inputs, as well as analysis of the accuracy of energy-related GHG emissions obtained by multiplying the two aforementioned outputs. The models were developed using historical data from the period 2004–2012, for a set of 26 European countries (EU Members). The obtained results demonstrate that the GRNN GHG intensity model provides a more accurate prediction, with the MAPE (mean absolute percentage error) of 4.5%, than tested MLR (multiple linear regression) and second-order and third-order non-linear MPR (multiple polynomial regression) models. Also, the GRNN EC model has high accuracy (MAPE = 3.6%), and therefore both GRNN models and the proposed approach can be considered as suitable for the calculation of GHG emissions. The energy-related predicted GHG emissions were very similar to the actual GHG emissions of EU Members (MAPE = 6.4%). - Highlights: • ANN modeling of GHG intensity of energy consumption is presented. • ANN modeling of energy consumption at the national level is presented. • GHG intensity concept was used for the estimation of energy-related GHG emissions. • The ANN models provide better results in comparison with conventional models. • Forecast of GHG emissions for 26 countries was made successfully with MAPE of 6.4%

  14. Application of a generalized Sherman–Morrison formula to the computation of network Green's functions and the construction of spanning trees

    International Nuclear Information System (INIS)

    Pozrikidis, C

    2015-01-01

    A recursive algorithm based on a generalization of the Sherman–Morrison formula is proposed for computing the generalized Green's function of an arbitrary network, regarded as the Moore–Penrose pseudoinverse of the graph Laplacian. The Green's function describes the nodal field established when a point source is applied at one node, while complementary point sinks of equal strength are applied at all other nodes to counterbalance the input. Starting with a network whose Green's function is known, such as the complete network described by a complete graph or the ring network described by a cycle graph, links are clipped or added to generate a desired configuration. The method is applied to study the dilapidation of a complete network into spanning trees by Monte Carlo simulation, and thereby confirm an exact formula for the node degree distribution. (paper)

  15. An analysis of noise in recurrent neural networks: convergence and generalization.

    Science.gov (United States)

    Jim, K C; Giles, C L; Horne, B G

    1996-01-01

    Concerns the effect of noise on the performance of feedforward neural nets. We introduce and analyze various methods of injecting synaptic noise into dynamically driven recurrent nets during training. Theoretical results show that applying a controlled amount of noise during training may improve convergence and generalization performance. We analyze the effects of various noise parameters and predict that best overall performance can be achieved by injecting additive noise at each time step. Noise contributes a second-order gradient term to the error function which can be viewed as an anticipatory agent to aid convergence. This term appears to find promising regions of weight space in the beginning stages of training when the training error is large and should improve convergence on error surfaces with local minima. The first-order term is a regularization term that can improve generalization. Specifically, it can encourage internal representations where the state nodes operate in the saturated regions of the sigmoid discriminant function. While this effect can improve performance on automata inference problems with binary inputs and target outputs, it is unclear what effect it will have on other types of problems. To substantiate these predictions, we present simulations on learning the dual parity grammar from temporal strings for all noise models, and present simulations on learning a randomly generated six-state grammar using the predicted best noise model.

  16. Knowledge and attitude of pediatric dentists, general dentists, postgraduates of pediatric dentistry, and dentists of other specialties toward the endodontic treatment of primary teeth

    Directory of Open Access Journals (Sweden)

    P Devendra Patil

    2016-01-01

    Full Text Available Background: Pediatric dentists (PDs play an important role in treating primary teeth and oral health care needs for children. Pulp therapy is widely used in the treatment of primary teeth. The choice of endodontic treatment modality changes among general dentist (GD and PD. Aim and Objectives: The aim of this study is to determine the attitudes of PDs, GDs, postgraduates (PGs of pediatric dentistry and dentists of other specialties toward endodontic treatment of primary teeth. Materials and Methods: A structured 20-item questionnaire was formulated in English and distributed to PD, GD's, PGs of pediatric dentistry, and dentist of other specialties. The filled questionnaire survey was statistically analyzed using simple descriptive analysis and inferential analysis was performed using Chi-square t- test. Results: Out of the 237 survey respondents, 27.43% were BDS (GD's, 16.88% were MDS (PD, 12.66% were PG's (pediatric dentistry, and 43.04% were MDS (other than PD. About 91.6% of the total respondents preferred endodontic procedures in primary teeth. Conclusion: The study concluded that the GD's, PD's, and dentist of other specialty differ in their treatment recommendations for primary teeth. The GDs and dentist of other specialty were regularly performing pulp therapy in primary teeth and should frequently update their knowledge about endodontic procedures in primary teeth.

  17. The Melbourne East Monash General Practice Database (MAGNET: Using data from computerised medical records to create a platform for primary care and health services research

    Directory of Open Access Journals (Sweden)

    Danielle Mazza

    2016-07-01

    Full Text Available The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia

  18. The longitudinal impact of patient navigation on equity in colorectal cancer screening in a large primary care network.

    Science.gov (United States)

    Percac-Lima, Sanja; López, Lenny; Ashburner, Jeffrey M; Green, Alexander R; Atlas, Steven J

    2014-07-01

    The long-term effects of interventions to improve colorectal (CRC) screening in vulnerable populations are uncertain. The authors evaluated the impact of patient navigation (PN) on the equity of CRC prevention over a 5-year period. A culturally tailored CRC screening PN program was implemented in 1 community health center (CHC) in 2007. In a primary care network, CRC screening rates from 2006 to 2010 among eligible patients from the CHC with PN were compared with the rates from other practices without PN. Multivariable logistic regression models for repeated measures were used to assess differences over time. Differences in CRC screening rates diminished among patients at the CHC with PN and at other practices between 2006 (49.2% vs 62.5%, respectively; P practices (5% vs 3.4% per year; P practices, lower CRC screening rates in 2006 (47.5% vs 52.1%, respectively; P = .02) were higher by 2010 (73.5% vs 67.3%, respectively; P practices in 2006 (44.3% vs 44.7%, respectively; P = .79) were higher at the CHC by 2010 (70.6% vs 58.6%, respectively; P practices (both P < .001). A PN program increased CRC screening rates in a CHC and improved equity in vulnerable patients. Long-term funding of PN programs has the potential to reduce cancer screening disparities. © 2014 American Cancer Society.

  19. Primary care clinicians' perspectives on management of skin and soft tissue infections: an Iowa Research Network study.

    Science.gov (United States)

    Daly, Jeanette M; Ely, John W; Levy, Barcey T; Smith, Tara C; Merchant, Mary L; Bergus, George R; Jogerst, Gerald J

    2011-01-01

    An estimated 95,000 people developed methicillin-resistant Staphylococcus aureus (MRSA) infections during 2005 of which 14% were community-associated and 85% were hospital or other health setting associated, and 19,000 Americans died from these infections that year. To explore health care providers' perspectives on management of skin and soft tissue infections to gain a better understanding of the problems faced by busy providers in primary care settings. Focus group meetings were held at 9 family physician offices in the Iowa Research Network. Seventy-eight clinicians including physicians, nurses, nurse practitioners, and house officers attended. Meeting audiotapes were transcribed and coded by 3 investigators, and a MRSA-management taxonomy was developed. The main themes that emerged from the focus groups included epidemiology, diagnosis, treatment, management, prevention, special populations, and public relations. The incidence of MRSA infections was perceived to have increased over the past decade. However, diagnosis and treatment protocols for physicians in the outpatient setting have lagged behind, and no well-accepted diagnostic or treatment algorithms were used by physicians attending the focus groups. The clinicians in this study noted considerable confusion and inconsistency in the management of skin and soft tissue infections, particularly those due to MRSA. © 2010 National Rural Health Association.

  20. 47 CFR 11.14 - Primary Entry Point (PEP) System.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Primary Entry Point (PEP) System. 11.14 Section 11.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.14 Primary Entry Point (PEP) System. The PEP system is a nationwide network of broadcast...

  1. Declarative Networking

    CERN Document Server

    Loo, Boon Thau

    2012-01-01

    Declarative Networking is a programming methodology that enables developers to concisely specify network protocols and services, which are directly compiled to a dataflow framework that executes the specifications. Declarative networking proposes the use of a declarative query language for specifying and implementing network protocols, and employs a dataflow framework at runtime for communication and maintenance of network state. The primary goal of declarative networking is to greatly simplify the process of specifying, implementing, deploying and evolving a network design. In addition, decla

  2. New Smith Internal Model Control of Two-Motor Drive System Based on Neural Network Generalized Inverse

    Directory of Open Access Journals (Sweden)

    Guohai Liu

    2016-01-01

    Full Text Available Multimotor drive system is widely applied in industrial control system. Considering the characteristics of multi-input multioutput, nonlinear, strong-coupling, and time-varying delay in two-motor drive systems, this paper proposes a new Smith internal model (SIM control method, which is based on neural network generalized inverse (NNGI. This control strategy adopts the NNGI system to settle the decoupling issue and utilizes the SIM control structure to solve the delay problem. The NNGI method can decouple the original system into several composite pseudolinear subsystems and also complete the pole-zero allocation of subsystems. Furthermore, based on the precise model of pseudolinear system, the proposed SIM control structure is used to compensate the network delay and enhance the interference resisting the ability of the whole system. Both simulation and experimental results are given, verifying that the proposed control strategy can effectively solve the decoupling problem and exhibits the strong robustness to load impact disturbance at various operations.

  3. Perbandingan Kinerja Jaringan Saraf Tiruan Model Backpropagation dan General Regression Neural Network Untuk Mengidentifikasi Jenis Daging Sapi

    Directory of Open Access Journals (Sweden)

    Nugroho Nugroho

    2012-01-01

    Full Text Available The research on image identification has been conducted to identify the type of beef. The research is aimed to compare the performance of  artificial  neural  network  of  backpropagation  and  general  regression  neural  network  model  in  identifying  the  type  of  meat.  Image management is processed by counting R, G and B value in every meat image, and normalization process is then carried out by obtaining R, G, and B index value which is then converted from RGB model to HSI model to obtain the value of hue, saturation and intensity. The resulting value of image processing will be used as input parameter of training and validation programs. The performance of  G RNN model is more accurate than the backpropagation with accuracy ratio by 51%.Keyword: Identification; Backpropagation; GRNN

  4. Simplified Information Maximization for Improving Generalization Performance in Multilayered Neural Networks

    Directory of Open Access Journals (Sweden)

    Ryotaro Kamimura

    2016-01-01

    Full Text Available A new type of information-theoretic method is proposed to improve prediction performance in supervised learning. The method has two main technical features. First, the complicated procedures used to increase information content are replaced by the direct use of hidden neuron outputs. Information is controlled by directly changing the outputs of the hidden neurons. In addition, to simultaneously increase information content and decrease errors between targets and outputs, the information acquisition and use phases are separated. In the information acquisition phase, the autoencoder tries to acquire as much information content on input patterns as possible. In the information use phase, information obtained in the acquisition phase is used to train supervised learning. The method is a simplified version of actual information maximization and directly deals with the outputs from neurons. The method was applied to the three data sets, namely, Iris, bankruptcy, and rebel participation data sets. Experimental results showed that the proposed simplified information acquisition method was effective in increasing the real information content. In addition, by using the information content, generalization performance was greatly improved.

  5. [Evaluation of the quality of performance of general practitioners. What is the problem with primary care quality indicators in Hungary?].

    Science.gov (United States)

    Kolozsvári, László Róbert; Rurik, Imre

    2016-02-28

    The Hungarian primary care quality indicator system has been introduced in 2009, and has been continuously developed since then. The system offers extra financing for family physicians who are achieving the expected levels of indicators. There are currently 16 indicators for adult and mixed practices and 8 indicators are used in paediatric care. Authors analysed the influencing factors of the indicators other than those related to the performance of family physicians. Expectations and compliance of patients, quality of outpatient (ambulatory) care services, insufficient flow of information, inadequate primary care softwares which need to be updated could be considered as the most important factors. The level of financial motivations should also be significantly increased besides changes in the reporting system. It is recommended, that decision makers in health policy and financing have to declare clearly their expectations, and professional bodies should find the proper solution. These indicators could contribute properly to the improvement of the quality of primary care services in Hungary.

  6. Do characteristics of practices and general practitioners influence the yield of diabetes screening in primary care? The ADDITION Netherlands study

    NARCIS (Netherlands)

    Janssen, Paul G. H.; Gorter, Kees J.; Stolk, Ronald P.; Rutten, Guy E. H. M.

    2008-01-01

    Objective. To investigate whether the yield of population-based diabetes screening is influenced by characteristics of the general practitioner ( GP) and the practice. Design. Cross-sectional study. Setting. Seventy-nine general practices in the south-western region of the Netherlands. Subjects.

  7. Networking

    OpenAIRE

    Rauno Lindholm, Daniel; Boisen Devantier, Lykke; Nyborg, Karoline Lykke; Høgsbro, Andreas; Fries, de; Skovlund, Louise

    2016-01-01

    The purpose of this project was to examine what influencing factor that has had an impact on the presumed increasement of the use of networking among academics on the labour market and how it is expressed. On the basis of the influence from globalization on the labour market it can be concluded that the globalization has transformed the labour market into a market based on the organization of networks. In this new organization there is a greater emphasis on employees having social qualificati...

  8. Evaluation of a generalized regression artificial neural network for extending cadmium's working calibration range in graphite furnace atomic absorption spectrometry.

    Science.gov (United States)

    Hernández-Caraballo, Edwin A; Rivas, Francklin; de Hernández, Rita M Avila

    2005-02-01

    A generalized regression artificial neural network (GRANN) was developed and evaluated for modeling cadmium's nonlinear calibration curve in order to extend its upper concentration limit from 4.0 microg L-1 up to 22.0 microg L-1. This type of neural network presents important advantages over the more popular backpropagation counterpart which are worth exploiting in analytical applications, namely, (1) a smaller number of variables have to be optimized, with the subsequent reduction in "development hassle"; and, (2) shorter development times, thanks to the fact that the adjustment of the weights (the artificial synapses) is a non-iterative, one-pass process. A backpropagation artificial neural network (BPANN), a second-order polynomial, and some less frequently employed polynomial and exponential functions (e.g., Gaussian, Lorentzian, and Boltzmann), were also evaluated for comparison purposes. The quality of the fit of the various models, assessed by calculating the root mean square of the percentage deviations, was as follows: GRANN>Boltzmann>second-order polynomial>BPANN>Gauss>Lorentz. The accuracy and precision of the models were further estimated through the determination of cadmium in the certified reference material "Trace Metals in Drinking Water" (High Purity Standards, Lot No. 490915), which has a cadmium certified concentration (12.00+/-0.06 microg L-1) that lies in the nonlinear regime of the calibration curve. Only the models generated by the GRANN and BPANN accurately predicted the concentrations of a series of solutions, prepared by serial dilution of the CRM, with cadmium concentrations below and above the maximum linear calibration limit (4.0 microg L-1). Extension of the working range by using the proposed methodology represents an attractive alternative from the analytical point of view, since it results in less specimen manipulation and consequently reduced contamination risks without compromising either the accuracy or the precision of the

  9. Eating Disorders in the General Practice: A Case-Control Study on the Utilization of Primary Care

    NARCIS (Netherlands)

    Van Son, G.E.; Hoek, H.W.; van Hoeken, D.; Schellevis, F.G.; van Furth, E.F.

    2012-01-01

    Objective: To investigate primary care utilization between patients with an eating disorder (ED) and other patient groups, and between the ED subgroups anorexia nervosa (AN) and bulimia nervosa (BN). Method: The present study was an observational case-control study. In total, 167 patients with ED

  10. Eating disorders in the general practice: a case–control study on the utilization of primary care.

    NARCIS (Netherlands)

    Son, G.E. van; Hoek, H.W.; Hoeken, D. van; Schellevis, F.G.; Furth, E.F. van

    2012-01-01

    Objective: To investigate primary care utilization between patients with an eating disorder (ED) and other patient groups, and between the ED subgroups anorexia nervosa (AN) and bulimia nervosa (BN). Method: The present study was an observational case–control study. In total, 167 patients with ED

  11. Eating Disorders in the General Practice : A Case-Control Study on the Utilization of Primary Care

    NARCIS (Netherlands)

    Van Son, Gabrielle E.; Hoek, Hans W.; Van Hoeken, Daphne; Schellevis, Francois G.; Van Furth, Eric F.

    Objective To investigate primary care utilization between patients with an eating disorder (ED) and other patient groups, and between the ED subgroups anorexia nervosa (AN) and bulimia nervosa (BN). Method The present study was an observational casecontrol study. In total, 167 patients with ED were

  12. [Psychometric properties and reliability of the general health questionnaire(GHQ-12) for adult patients in primary care centers in Cordoba, Argentina].

    Science.gov (United States)

    Burrone, María Soledad; Abeldaño, Ariel; Lucchese, Marcela; Susser, Leah; Enders, Julio E; Alvarado, Ruben; Valencia, Eliecer; Fernández, A Ruth

    2015-01-01

    The General Health Questionnaire (GHQ-12) is a commonly used instrument to screen for psychiatric distress. However, the psychometric properties and reliability of the GHQ-12 in Argentina and, more specifically, in the city of Cordoba, have not previously been studied. To assess the psychometric properties and reliability of GHQ-12 in adult consultants of primary care in Cordoba, Argentina. Using probabilistic sampling in primary care centers in the city of Cordoba, a cross-sectional study was conducted. The Spanish version of the GHQ-12 was administered. The psychometric properties, including internal consistency and factor structure, for the Spanish version of the GHQ-12 were measured. 854 primary care consultants were included in the study. The questionnaire had high internal consistency, with a Cronbach's alpha of 0.80. An exploratory factor analysis suggested a two-factor model, similar to what has been reported for the original questionnaire. The GHQ-12 showed good psychometric properties and reliability in the studied population.

  13. Intrinsic Neural Linkage between Primary Visual Area and Default Mode Network in Human Brain: Evidence from Visual Mental Imagery.

    Science.gov (United States)

    Zhang, Zheng; Zhang, Delong; Wang, Zengjian; Li, Junchao; Lin, Yuting; Chang, Song; Huang, Ruiwang; Liu, Ming

    2018-03-08

    Previous studies have reported the essence of the sensory-based properties of human brain function, in which mental imagery is of great importance. In this study, we explored the association between the activities of two special regions, i.e., the primary visual area (PVA), which is the classically dominant sensory region, and the default mode network (DMN), which is the classical supra-sensory region, with a focus on their linkage in visual mental imagery. For this purpose, we collected fMRI data from 30 healthy participants (15 males; 22.37 ± 2.52 years) during the resting state and a mental rotation task state. By using a critical time point analysis (CTPA), we investigated the association between the activities of the PVA and the DMN. As the results showed, there existed a PVA-related (i.e., prefrontal cortex, DMN, sensorimotor areas and medial temporal lobe (MTL)) and a DMN-related neural association pattern (i.e., PVA, prefrontal cortex and the MTL) in the human brain. Furthermore, the results showed the steady and tight intrinsic association between the activities of the PVA and the DMN, with the prefrontal cortex and the MTL regions being found to be consistently involved in the resting-state brain. It also was suggested that the observed association between the PVA and the DMN was highly reproducible for the mental rotation task. Together, these observations, from the perspective of visual mental imagery, provided experimental evidence for the robustness and stability of the detailed map of the associations between the activities of the PVA and the DMN. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  14. Communication technology access, use, and preferences among primary care patients: from the Residency Research Network of Texas (RRNeT).

    Science.gov (United States)

    Hill, Jason H; Burge, Sandra; Haring, Anna; Young, Richard A

    2012-01-01

    The digital revolution is changing the manner in which patients communicate with their health care providers, yet many patients still lack access to communication technology. We conducted this study to evaluate access to, use of, and preferences for using communication technology among a predominantly low-income patient population. We determined whether access, use, and preferences were associated with type of health insurance, sex, age, and ethnicity. In 2011, medical student researchers administered questionnaires to patients of randomly selected physicians within 9 primary care clinics in the Residency Research Network of Texas. Surveys addressed access to and use of cell phones and home computers and preferences for communicating with health care providers. In this sample of 533 patients (77% response rate), 448 (84%) owned a cell phone and 325 (62%) owned computers. Only 48% reported conducting Internet searches, sending and receiving E-mails, and looking up health information on the Internet. Older individuals, those in government sponsored insurance programs, and individuals from racial/ethnic minority groups had the lowest levels of technology adoption. In addition, more than 60% of patients preferred not to send and receive health information over the Internet, by instant messaging, or by text messaging. Many patients in this sample did not seek health information electronically nor did they want to communicate electronically with their physicians. This finding raises concerns about the vision of the patient-centered medical home to enhance the doctor-patient relationship through communication technology. Our patients represent some of the more vulnerable populations in the United States and, as such, deserve attention from health care policymakers who are promoting widespread use of communication technology.

  15. Integrated information for integrated care in the general practice setting in Italy: using social network analysis to go beyond the diagnosis of frailty in the elderly.

    Science.gov (United States)

    Franchini, Michela; Pieroni, Stefania; Fortunato, Loredana; Knezevic, Tamara; Liebman, Michael; Molinaro, Sabrina

    2016-12-01

    Frailty has been defined in different ways and several diagnostic tools exist, but most of them are not applicable in routine primary care. Nonetheless, general practitioners (GPs) have a natural advantage in identifying frailty, due to their continued access to patients, patient-centered approach and training. GPs have also an advantage in conducting population-based evaluation as consequence of their role of gatekeepers of the health care system. This paper aims to identify those socio-demographic and clinical profiles and the relative information sources that, from the GPs' perspective, act as frailty markers, not solely as a diagnosis of state but as the ability to identify a patient's trajectory, over time, through the aging process. This study was performed as a survey within a population aged 75 and over, attending 148 GPs in Italy. A total of 23,996 patients were classified by GPs in distinct frailty status, without the use of a specific evaluation tool, but only referring to general indications. Co-morbidity was objectively assessed by a record-linkage with previous hospitalizations, in order to assess the occurrence of previous illnesses that could be associated with the likelihood of being identified as frails or at risk. The methodological approach is based on social network analysis (SNA), suited to explore relational aspects of complex phenomena. Our findings reveal that GPs are able to perform low cost population-based evaluation, by exploiting the advantages of their approach to patients, combined with the information derived from their daily practice and from other sources currently available. We believe that informative integration among different sources of available data can provide a comprehensive picture of the health state of patients in a shorter time and at lower cost. The identification of limited patient trajectories based on these observations can enable the development of critical biomarkers/diagnostics and prognostic indicators that

  16. Drug use and problem drinking associated with primary care and emergency room utilization in the US general population: data from the 2005 national alcohol survey.

    Science.gov (United States)

    Cherpitel, Cheryl J; Ye, Yu

    2008-10-01

    Substance use problems are overrepresented in probability samples of patients in primary care settings including the emergency room (ER) compared to the general population. While large proportions of those with alcohol or drug use disorders are most likely to obtain services for these problems outside the mental health or substance abuse treatment system, accounting, in part, for this overrepresentation, little is known about the association of alcohol misuse or drug use with health services utilization in the general population. The prevalence and predictive value of alcohol misuse and drug use on ER and primary care use was analyzed on 6919 respondents from the 2005 National Alcohol Survey (NAS). Among those reporting an ER visit during the last year, 24% were positive for risky drinking (14+ drinks weekly for men and 7+ for females and/or 5+/4+ in a day in the last 12 months), 8% for problem drinking, 3% for alcohol dependence, and 7% for illicit drug use greater than monthly. Figures for primary care users were, respectively: 24%, 5%, 3%, and 3%. ER users were more likely to be positive for problem drinking and greater than monthly illicit drug use compared to non-ER users, while no significant differences were found in substance use for users and non-users of primary care. In logistic regression controlling for gender, age, and health insurance, problem drinkers were twice as likely as non-problem drinkers (Odds ratio, OR=1.99) (pproblems and for initiating a brief intervention.

  17. Tracking sickness through social networks - the practical use of social network mapping in supporting the management of an E. coli O157 outbreak in a primary school in London.

    Science.gov (United States)

    Devakumar, D; Kitching, A; Zenner, D; Tostmann, A; Meltzer, M

    2013-10-01

    This paper describes the practical use of social network diagrams in the management of an outbreak of Escherichia coli O157 (VTEC) in a primary school in London. The diagrams were created during the outbreak to establish the extent and nature of person-to-person transmission in the cases and their contacts. The diagrams supported a tailored public health action, and hence aided in the control of the outbreak. We conclude that for selected infectious diseases, social network diagrams can provide a valuable tool in the management of an outbreak.

  18. Distractibility during Retrieval of Long-Term Memory: Domain-General Interference, Neural Networks and Increased Susceptibility in Normal Aging

    Directory of Open Access Journals (Sweden)

    Peter Edward Wais

    2014-04-01

    Full Text Available The mere presence of irrelevant external stimuli results in interference with the fidelity of details retrieved from long-term memory (LTM. Recent studies suggest that distractibility during LTM retrieval occurs when the focus of resource-limited, top-down mechanisms that guide the selection of relevant mnemonic details is disrupted by representations of external distractors. We review findings from four studies that reveal distractibility during episodic retrieval. The approach cued participants to recall previously studied visual details when their eyes were closed, or were open and irrelevant visual information was present. The results showed a negative impact of the distractors on the fidelity of details retrieved from LTM. An fMRI experiment using the same paradigm replicated the behavioral results and found that diminished episodic memory was associated with the disruption of functional connectivity in whole-brain networks. Specifically, network connectivity supported recollection of details based on visual imagery when eyes were closed, but connectivity declined in the presence of visual distractors. Another experiment using auditory distractors found equivalent effects for auditory and visual distraction during cued recall, suggesting that the negative impact of distractibility is a domain-general phenomenon in LTM. Comparisons between older and younger adults revealed an aging-related increase in the negative impact of distractibility on retrieval of LTM. Finally, a new study that compared categorization abilities between younger and older adults suggests a cause underlying age-related decline of visual details in LTM. The sum of our findings suggests that cognitive control resources, although limited, have the capability to resolve interference from distractors during tasks of moderate effort, but these resources are overwhelmed when additional processes associated with episodic retrieval, or categorization of complex prototypes, are

  19. Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries.

    Science.gov (United States)

    Nuttall, Jacqueline; Hood, Kerenza; Verheij, Theo Jm; Little, Paul; Brugman, Curt; Veen, Robert Er; Goossens, Herman; Butler, Christopher C

    2011-07-27

    Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs). GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs) within 13 European Countries. General Practitioners (GPs) recruited consecutive patients with an acute cough. GPs completed a case report form (CRF) and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study. The main challenges fell within three domains as follows:i) selecting, setting up and maintaining PCNs;ii) designing local context-appropriate data collection tools and efficient data management systems; andiii) gaining commitment and trust from all involved and maintaining enthusiasm.The main solutions for each domain were:i) appointing key individuals (National Network Facilitator and Coordinator) with clearly defined tasks, involving PCNs early in the development of study materials and procedures.ii) rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress;iii) providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos, celebrating achievements, incorporating social events and

  20. Hartmann's Procedure or Primary Anastomosis for Generalized Peritonitis due to Perforated Diverticulitis: A Prospective Multicenter Randomized Trial (DIVERTI).

    Science.gov (United States)

    Bridoux, Valerie; Regimbeau, Jean Marc; Ouaissi, Mehdi; Mathonnet, Muriel; Mauvais, Francois; Houivet, Estelle; Schwarz, Lilian; Mege, Diane; Sielezneff, Igor; Sabbagh, Charles; Tuech, Jean-Jacques

    2017-12-01

    About 25% of patients with acute diverticulitis require emergency intervention. Currently, most patients with diverticular peritonitis undergo a Hartmann's procedure. Our objective was to assess whether primary anastomosis (PA) with a diverting stoma results in lower mortality rates than Hartmann's procedure (HP) in patients with diverticular peritonitis. We conducted a multicenter randomized controlled trial conducted between June 2008 and May 2012: the DIVERTI (Primary vs Secondary Anastomosis for Hinchey Stage III-IV Diverticulitis) trial. Follow-up duration was up to 18 months. A random sample of 102 eligible participants with purulent or fecal diverticular peritonitis from tertiary care referral centers and associated centers in France were equally randomized to either a PA arm or to an HP arm. Data were analyzed on an intention-to-treat basis. The primary end point was mortality rate at 18 months. Secondary outcomes were postoperative complications, operative time, length of hospital stay, rate of definitive stoma, and morbidity. All 102 patients enrolled were comparable for age (p = 0.4453), sex (p = 0.2347), Hinchey stage III vs IV (p = 0.2347), and Mannheim Peritonitis Index (p = 0.0606). Overall mortality did not differ significantly between HP (7.7%) and PA (4%) (p = 0.4233). Morbidity for both resection and stoma reversal operations were comparable (39% in the HP arm vs 44% in the PA arm; p = 0.4233). At 18 months, 96% of PA patients and 65% of HP patients had a stoma reversal (p = 0.0001). Although mortality was similar in both arms, the rate of stoma reversal was significantly higher in the PA arm. This trial provides additional evidence in favor of PA with diverting ileostomy over HP in patients with diverticular peritonitis. ClinicalTrials.gov Identifier: NCT 00692393. Copyright © 2017. Published by Elsevier Inc.

  1. Surgery under general anaesthesia in severe hidradenitis suppurativa : a study of 363 primary operations in 113 patients

    NARCIS (Netherlands)

    Blok, J. L.; Boersma, M.; Terra, J. B.; Spoo, J. R.; Leeman, F. W. J.; van den Heuvel, E. R.; Huizinga, J.; Jonkman, M. F.; Horvath, B.

    BackgroundTreatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure. ObjectivesTo investigate

  2. General practitioners believe that hypnotherapy could be a useful treatment for irritable bowel syndrome in primary care

    Directory of Open Access Journals (Sweden)

    de Lusignan Simon

    2004-10-01

    Full Text Available Abstract Background Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint. Methods A questionnaire was sent to the 406 GPs listed on the West Sussex Health Authority Medical List to investigate their views of this condition and whether they felt hypnotherapy had a place in its management Results 38% of general practitioners responded. The achieved sample shared the characteristics of target sample. Nearly half thought that irritable bowel syndrome (IBS was a "nervous complaint" and used a combination of "the placebo effect of personal care," therapeutic, and dietary advice. There is considerable divergence in the perceived effectiveness of current approaches. Over 70% thought that hypnotherapy may have a role in the management of patients with IBS; though the majority (68% felt that this should not be offered by general practitioners. 84% felt that this should be offered by qualified hypnotherapist, with 40% feeling that this should be offered outside the health service. Conclusions General practitioners vary in their perceptions of what constitutes effective therapy in IBS. They are willing to consider referral to a qualified hypnotherapist.

  3. Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan.

    Science.gov (United States)

    Lin, Blossom Yen-Ju

    2007-06-19

    Taiwan's primary community care network (PCCN) demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals) within individual PCCNs. The thorough questionnaire items, covering the network working infrastructures--governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003-2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at the early stage of network forming in this study, the detailed surveyed

  4. [Explore the influence factors on primary lung cancer in Fujian province Han population under the use of generalized linear model].

    Science.gov (United States)

    He, Fei; Xiao, Rendong; Yu, Tingting; Zhang, Xin; Liu, Zhiqiang; Cai, Lin

    2015-08-01

    The purpose of this study was to use the data on lung cancer in Han Chinese in Fujian province to explore the value of a generalized, linear model and to investigate the impact related to environment factors on lung cancer as well as the independent and interaction effects on the development of lung cancer. SAS 9.2 was used to build a generalized linear model to evaluate the influence factors and interaction of lung cancer on both smokers and non-smokers. Results showed that the relationship of the factors was multiplied. Under the logistic regression analysis, seven risk factors and nine risk factors were noticed in smokers or in non-smokers, respectively. Heavy smokers and lung diseases appeared a positive multiplying effect on smokers while passive smoking and fresh fruits showed positive multiplying effects on non-smokers. The generalized linear models could filter suitable models thus facilitating further research on the interaction between the two. It seemed easy to carry on the comprehensive and rational analysis on related epidemiological data.

  5. Combining intensive practice nurse counselling or brief general practitioner advice with varenicline for smoking cessation in primary care: study protocol of a pragmatic randomized controlled trial.

    Science.gov (United States)

    van Rossem, C; Spigt, M; Smit, E S; Viechtbauer, W; Mijnheer, K K; van Schayck, C P; Kotz, D

    2015-03-01

    Combining behavioural support and pharmacotherapy is most effective for smoking cessation and recommended in clinical guidelines. Despite that smoking cessation assistance from the general practitioner can be effective, dissemination of clinical practice guidelines and efforts on upskilling has not lead to the routine provision of smoking cessation advice among general practitioners. Intensive counselling from the practice nurse could contribute to better smoking cessation rates in primary care. However, the effectiveness of intensive counselling from a practice nurse versus usual care from a general practitioner in combination with varenicline is still unknown. A pragmatic randomized controlled trial was conducted comparing: (a) intensive individual counselling delivered by a practice nurse and (b) brief advice delivered by a general practitioner; both groups received 12-weeks of open-label varenicline. A minimum of 272 adult daily smoking participants were recruited and treated in their routine primary care setting. The primary outcome was defined as prolonged abstinence from weeks 9 to 26, biochemically validated by exhaled carbon monoxide. Data was analysed blinded according to the intention-to-treat principle and participants with missing data on their smoking status at follow-up were counted as smokers. Secondary outcomes included: one-year prolonged abstinence, short-term incremental cost-effectiveness, medication adherence, and baseline predictors of successful smoking cessation. This trial is the first to provide scientific evidence on the effectiveness, cost-effectiveness, and potential mechanisms of action of intensive practice nurse counselling combined with varenicline under real-life conditions. This paper explains the methodology of the trial and discusses the pragmatic and/or explanatory design aspects. Dutch Trial Register NTR3067. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. A General Bayesian Network Approach to Analyzing Online Game Item Values and Its Influence on Consumer Satisfaction and Purchase Intention

    Science.gov (United States)

    Lee, Kun Chang; Park, Bong-Won

    Many online game users purchase game items with which to play free-to-play games. Because of a lack of research into which there is no specified framework for categorizing the values of game items, this study proposes four types of online game item values based on an analysis of literature regarding online game characteristics. It then proposes to investigate how online game users perceive satisfaction and purchase intention from the proposed four types of online game item values. Though regression analysis has been used frequently to answer this kind of research question, we propose a new approach, a General Bayesian Network (GBN), which can be performed in an understandable way without sacrificing predictive accuracy. Conventional techniques, such as regression analysis, do not provide significant explanation for this kind of problem because they are fixed to a linear structure and are limited in explaining why customers are likely to purchase game items and if they are satisfied with their purchases. In contrast, the proposed GBN provides a flexible underlying structure based on questionnaire survey data and offers robust decision support on this kind of research question by identifying its causal relationships. To illustrate the validity of GBN in solving the research question in this study, 327 valid questionnaires were analyzed using GBN with what-if and goal-seeking approaches. The experimental results were promising and meaningful in comparison with regression analysis results.

  7. Generalized hidden-mapping ridge regression, knowledge-leveraged inductive transfer learning for neural networks, fuzzy systems and kernel methods.

    Science.gov (United States)

    Deng, Zhaohong; Choi, Kup-Sze; Jiang, Yizhang; Wang, Shitong

    2014-12-01

    Inductive transfer learning has attracted increasing attention for the training of effective model in the target domain by leveraging the information in the source domain. However, most transfer learning methods are developed for a specific model, such as the commonly used support vector machine, which makes the methods applicable only to the adopted models. In this regard, the generalized hidden-mapping ridge regression (GHRR) method is introduced in order to train various types of classical intelligence models, including neural networks, fuzzy logical systems and kernel methods. Furthermore, the knowledge-leverage based transfer learning mechanism is integrated with GHRR to realize the inductive transfer learning method called transfer GHRR (TGHRR). Since the information from the induced knowledge is much clearer and more concise than that from the data in the source domain, it is more convenient to control and balance the similarity and difference of data distributions between the source and target domains. The proposed GHRR and TGHRR algorithms have been evaluated experimentally by performing regression and classification on synthetic and real world datasets. The results demonstrate that the performance of TGHRR is competitive with or even superior to existing state-of-the-art inductive transfer learning algorithms.

  8. Design and feasibility of an international study assessing the prevalence of contact allergy to fragrances in the general population: the European Dermato-Epidemiology Network Fragrance Study

    OpenAIRE

    Rossi, M; Coenraads, PJ; Diepgen, T; Svensson, A; Elsner, P; Gonçalo, Margarida; Bruze, M; Naldi, L

    2010-01-01

    Background/Aims: Data on contact allergy to fragrances in the general population are limited. Data from allergological services suggest that the frequency of contact allergy to fragrances is increasing. The European Dermato-Epidemiology Network (EDEN) Fragrance Study aims to obtain reliable data on the prevalence of contact allergy to fragrances and other sensitizers of the European baseline series, in the general population of different geographical areas of Europe. We report the methodology...

  9. Detecting mood disorder in resource-limited primary care settings: comparison of a self-administered screening tool to general practitioner assessment.

    Science.gov (United States)

    Vöhringer, Paul A; Jimenez, Mirtha I; Igor, Mirko A; Fores, Gonzalo A; Correa, Matias O; Sullivan, Matthew C; Holtzman, Niki S; Whitham, Elizabeth A; Barroilhet, Sergio A; Alvear, Katherine; Logvinenko, Tanya; Kent, David M; Ghaemi, Nassir S

    2013-01-01

    Although efficacious treatments for mood disorders are available in primary care, under-diagnosis is associated with under-treatment and poorer outcomes. This study compares the accuracy of self-administered screening tests with routine general practitioner (GP) assessment for detection of current mood disorder. 197 consecutive patients attending primary care centres in Santiago, Chile enrolled in this cross-sectional study, filling out the Patients Health Questionnaire-9 (PHQ-9) for depression and the Mood Disorder Questionnaire (MDQ) for bipolar disorder, after routine GP assessment. Diagnostic accuracy of these self-administered tools was compared with GP assessment, with gold standard diagnosis established by a structured diagnostic interview with trained clinicians (SCID-I). The sample was 75% female, with a mean age of 48.5 (SD 16.8); 37% had a current mood disorder (positive SCID-I result for depression or bipolar disorder). Sensitivity of the screening instruments (SI) was substantially higher than GP assessment (SI: 0.8, [95% CI 0.71, 0.81], versus GP: 0.2, [95% CI 0.12, 0.25]: p-value primary care. Such screening tests may improve detection of current mood disorder if implemented in primary care settings.

  10. A Critical Review of Surveys Emphasizing on Routing in Wireless Sensor Networks-An Anatomization under General Survey Design Framework.

    Science.gov (United States)

    Rehan, Waqas; Fischer, Stefan; Rehan, Maaz

    2017-07-26

    A large number of routing-related surveys are published so far for Wireless Sensor Networks (WSNs) that exhibit either complete or partial emphasis on routing in WSNs. These surveys classify and discuss the relevant routing protocols published mainly in the fields of classical, energy efficient, secure, hierarchical, geographic, intelligent, Quality of Service (QoS)-based and multipath WSNs. However, to the best of our knowledge, no study is presented so far which may clearly categorize the routing-related survey literature for WSNs.To fill this gap, an effort is made in this paper for presenting an in-depth review of already published routing-related survey literature in WSNs. Our review initially proposes a generalized survey design model and afterwards analyzes the routing-related survey literature in the light of the devised General Survey Design Framework (GSDF) . Such an analysis describes the design soundness of the published routing-related surveys. Therefore, our review puts forth an original classification based on the frequency-of-survey-publication and taxonomizes the corresponding routing-related fields into high, medium and low focused areas of survey publication in WSNs. Furthermore, the surveys belonging to each main category are sub-categorized into various sub-classes and briefly discussed according to their design characteristics. On the one hand, this review is useful for beginners who may easily explore the already published routing-related survey literature in WSNs in a single document and investigate it by spending less effort. On the other hand, it is useful for expert researchers who may explore the trends and frequency of writing surveys in different areas of routing in WSNs. The experts may explore those areas of routing which are either neglected or least focused or lack in design soundness as per general survey design framework. In the end, insights and future research directions are outlined and a reasonable conclusion is put forth

  11. Design and Feasibility of an International Study Assessing the Prevalence of Contact Allergy to Fragrances in the General Population : The European Dermato-Epidemiology Network Fragrance Study

    NARCIS (Netherlands)

    Rossi, Marta; Coenraads, Pieter-Jan; Diepgen, Thomas; Svensson, Ake; Elsner, Peter; Goncalo, Margarida; Bruze, Magnus; Naldi, Luigi

    2010-01-01

    Background/Aims: Data on contact allergy to fragrances in the general population are limited. Data from allergological services suggest that the frequency of contact allergy to fragrances is increasing. The European Dermato-Epidemiology Network (EDEN) Fragrance Study aims to obtain reliable data on

  12. A UN Initiative on Youth Employment: Presentation of the Secretary-General's Youth Employment Network Meeting of the International Vocational and Educational Training Association (IVETA).

    Science.gov (United States)

    Miller, Steven K.

    The United Nations (UN) General Assembly has mandated the Youth Employment Network, an initiative to address youth unemployment. Policy recommendations have been finalized, including an ambitious political process now being put into place. It invites heads of state and government to develop national action plans with targets for job creation and…

  13. Core pathology of eating disorders as measured by the Eating Disorder Examination Questionnaire (EDE-Q): the predictive role of a nested general (g) and primary factors.

    Science.gov (United States)

    Friborg, Oddgeir; Reas, Deborah L; Rosenvinge, Jan H; Rø, Øyvind

    2013-09-01

    The present study examined several factor models of the Eating Disorder Examination Questionnaire (EDE-Q), and in particular, whether a nested general factor ('g') was present, hence supporting a common pathology factor. A total of 1094 women were randomly selected by Statistics Norway and mailed a questionnaire packet. The sample was randomly split, using the first half for exploratory analyses and the second for confirmatory validation purposes. A four-factor solution received the best support, but the structure deviated from the original model of Fairburn. The internal consistency was high for the first three factors (.93, .82 and .86) and satisfactory for the fourth (.78). The additional specification of a general (g) factor improved model fit significantly, implying that the EDE-Q scores are indicators of both a general core and four primary symptom patterns. Furthermore, the g was more strongly related to predictors like age and body mass index (BMI) than the four primary factors in a full structural equation model. The validity of interpreting the global EDE-Q score as indicative of g was supported. A brief Shape and Weight Concern subscale of 11 items was strongly related to the g-factor, and may provide an abbreviated measure of overall eating disorder pathology. Copyright © 2013 John Wiley & Sons, Ltd.

  14. [Survey of general practioners in the management of diabetes in primary health facilities of Casablanca city, Morocco: opportunities and constraints].

    Science.gov (United States)

    Nani, S; Hassoune, S; Chinab, N; Boumdi, Z; Maaroufi, A

    2013-06-01

    Diabetes is a global health problem in full expansion, because of its increasing frequency, it frightening complications and the costs of its medical covering. In this study, we tried to make the current situation of the diabetes management in first-line public structures of the city of Casablanca. The survey of transverse observation to descriptive aiming was conducted using a pre questionnaire tested and selfadministered. It shows that 46.7 % of the questioned general practitioner judged that the quantity and the quality of average therapeutic existing in the center were insufficient to meet the needs for their diabetic patients. The weak socio-economic statute of the patients (78.8% of the cases), the lack of personnel (76.6%), the low educational level of patients (75.2%) and the problem of access to hospital (73.3%) constituted major problems of the correct diabetic medical covering. However, the majority of the doctors (98.1%) estimated to need training on diabetes management. The most required topics requested are: The control of the insulin treatment (97%), the diabetic education (91%) and the follow-up of diabetic (89%). The training of general practitioners particularly motivated and interested in diabetes could be the solution to improve the management of diabetes especially because of the lack of specialists in our country.

  15. Impact of primary care funding on secondary care utilisation and patient outcomes: a retrospective cross-sectional study of English general practice.

    Science.gov (United States)

    L'Esperance, Veline; Sutton, Matt; Schofield, Peter; Round, Thomas; Malik, Umer; White, Patrick; Ashworth, Mark

    2017-11-01

    In international studies, greater investment in primary health care is associated with improved population health outcomes. To determine whether investment in general practice is associated with secondary care utilisation, patient satisfaction, and clinical outcomes. Retrospective cross-sectional study of general practices in England, 2014-2015. Practice-level data were stratified into three groups according to GP contract type: national General Medical Services (GMS) contracts, with or without the capitation supplement (mean practice income guarantee), or local Personal Medical Services (PMS) contracts. Regression models were used to explore associations between practice funding (capitation payments and capitation supplements) and secondary care usage, patient satisfaction (general practice patient survey scores), and clinical outcomes (Quality and Outcomes Framework [QOF] scores). The authors conducted financial modelling to predict secondary care cost savings associated with notional changes in primary care funding. Mean capitation payments per patient were £69.82 in GMS practices in receipt of capitation supplements ( n = 2784), £78.79 in GMS practices without capitation supplements ( n = 1672), and £84.43 in PMS practices ( n = 3022). The mean capitation supplement was £5.72 per patient. Financial modelling demonstrated little or no relationship between capitation payments and secondary care costs. In contrast, notional investment in capitation supplements was associated with modelled savings in secondary care costs. The relationship between funding and patient satisfaction was inconsistent. QOF performance was not associated with funding in any practice type. Capitation payments appear to be broadly aligned to patient need in terms of secondary care usage. Supplements to the current capitation formula are associated with reduced secondary care costs. © British Journal of General Practice 2017.

  16. Once a Navegante, Always a Navegante: Latino Men Sustain Their Roles as Lay Health Advisors to Promote General and Sexual Health to Their Social Network.

    Science.gov (United States)

    Sun, Christina J; Mann, Lilli; Eng, Eugenia; Downs, Mario; Rhodes, Scott D

    2015-10-01

    Little is known about the sustainability of male- and men's health-focused lay health advisors. HoMBReS Por un Cambio was a community-level social network intervention designed to improve sexual health among Latino men who were members of soccer teams. During the year after the intervention implementation, lay health advisors (Navegantes) continued to promote sexual health; over 84% (16 of the 19) Navegantes conducted 9 of 10 primary health promotion activities. Describing where to get condoms was the activity that the most Navegantes reported having conducted. Navegantes had broad reach with their social networks, although the number of Navegantes that conducted each activity differed across the categories of social network members (soccer teammates, nonteammates, and women). Results suggest that HIV-related health disparities may be addressed through lay health advisor interventions because they are sustained after the intervention ends and reach large numbers of community members.

  17. Cyberspace Assurance Metrics: Utilizing Models of Networks, Complex Systems Theory, Multidimensional Wavelet Analysis, and Generalized Entrophy Measures

    National Research Council Canada - National Science Library

    Johnson, Joseph E; Gudkov, Vladimir

    2005-01-01

    ... as continuous group theory and Markov processes. Based upon this research he has proposed that entropy metrics, and the associated cluster analysis of the network so measured by these metrics, can be useful indicators of aberrant processes and behavior. Other team members have obtained important connections using higher order Renyi entropy metrics, and complexity theory to both monitor real networks and to study networks by simulation.

  18. Effects of an Environmentally-relevant Mixture of Pyrethroid Insecticides on Spontaneous Activity in Primary Cortical Networks on Microelectrode Arrays

    Data.gov (United States)

    U.S. Environmental Protection Agency — This manuscript tests the hypothesis of dose additivity of an environmental mixture of pyrethriod insecticides at the level of network function, in vitro. The...

  19. Daytime use of general practice and use of the Out-of-Hours Primary Care Service for patients with chronic disease

    DEFF Research Database (Denmark)

    Flarup, Lone; Moth, Grete; Christensen, Morten Bondo

    2014-01-01

    BACKGROUND: The importance of proactive chronic care has become increasingly evident. Yet, it is unknown whether the use of general practice (GP) during daytime may affect the use of Out-of-Hours (OOH) Primary Care Service for people with chronic disease. We aimed to analyse the association between...... use of daytime general practice (GP) and use of OOH services for heart disease, lung disease, diabetes, psychiatric disease, or cancer. In particular, we intended to study the association between OOH contacts due to chronic disease exacerbation and recent use of daytime GP. METHODS: Data comprised...... a random sample of contacts to the OOH services ('LV-KOS2011'). Included patients were categorised into the following chronic diseases: heart disease, lung disease, diabetes, psychiatric disease, or cancer. Information on face-to-face contacts to daytime GP was obtained from the Danish National Health...

  20. Envelope periodic solutions for a discrete network with the Jacobi elliptic functions and the alternative (G'/G)-expansion method including the generalized Riccati equation

    Science.gov (United States)

    Tala-Tebue, E.; Tsobgni-Fozap, D. C.; Kenfack-Jiotsa, A.; Kofane, T. C.

    2014-06-01

    Using the Jacobi elliptic functions and the alternative ( G'/ G-expansion method including the generalized Riccati equation, we derive exact soliton solutions for a discrete nonlinear electrical transmission line in (2+1) dimension. More precisely, these methods are general as they lead us to diverse solutions that have not been previously obtained for the nonlinear electrical transmission lines. This study seeks to show that it is not often necessary to transform the equation of the network into a well-known differential equation before finding its solutions. The solutions obtained by the current methods are generalized periodic solutions of nonlinear equations. The shape of solutions can be well controlled by adjusting the parameters of the network. These exact solutions may have significant applications in telecommunication systems where solitons are used to codify or for the transmission of data.

  1. Home visit delegation in primary care: acceptability to general practitioners in the state of Mecklenburg-Western Pomerania, Germany.

    Science.gov (United States)

    Dini, Lorena; Sarganas, Giselle; Heintze, Christoph; Braun, Vittoria

    2012-11-01

    Shortages and maldistribution of primary care physicians (PCPs) are affecting many countries today, including in Germany. As has been suggested, the ensuing problems might be alleviated by delegating some medical tasks to physicians' assistants (PAs). This was tried in three regions of the German state of Mecklenburg-Western Pomerania under a pilot project entitled AGnES (Arztentlastende gemeindenahe E-Health-gestützte Systemische Intervention, i.e., a community-based, e-health-assisted, systemic intervention to reduce physicians' workloads). We conducted a survey of all practicing PCPs in the state to assess their overall attitude toward the delegation of home visit tasks, and to determine what they would prefer as the job description and type of employment contract for a PA who would be hired to assist them. All PCPs practicing in Mecklenburg-Western Pomerania were asked in a quantitative survey about their willingness to delegate home visits, their perceived barriers to and benefits of home visit delegation to a qualified assistant, the skills they would require of a PA who would be hired to carry out home visits, and their preferred type of employment contract for the PA. 47% of the PCPs (515/1096) responded to the survey. 46% of the respondents were already informally delegating home visit tasks to qualified PAs. Female PCPs were more likely to do so (odds ratio [OR] 1.70), as were PCPs practicing in rural areas (OR 1.63) and those working in individual practice (OR 1.94). Most PCPs were in favor of delegating home visits to qualified PAs (77%). Main advantages were seen in reducing physicians' workloads (70%) and in increasing their job satisfaction (48%). 34% of PCPs said they would not cover the cost of training PAs. Acceptance of home visit delegation among PCPs in the state of Mecklenburg-Western Pomerania is high, mainly among the younger physicians. Perceived barriers and benefits of delegation of home visits to qualified PAs should be taken into

  2. Expanding the National Drug Abuse Treatment Clinical Trials Network to address the management of substance use disorders in general medical settings

    Directory of Open Access Journals (Sweden)

    Tai B

    2014-07-01

    Full Text Available Betty Tai, Steven Sparenborg, Udi E Ghitza, David Liu Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA Abstract: The Patient Protection and Affordable Care Act (2010 and the Mental Health Parity and Addiction Equity Act (2008 expand substance use disorder (SUD care services in the USA into general medical settings. Care offered in these settings will engage substance-using patients in an integrated and patient-centered environment that addresses physical and mental health comorbidities and follows a chronic care model. This expansion of SUD services presents a great need for evidence-based practices useful in general medical settings, and reveals several research gaps to be addressed. The National Drug Abuse Treatment Clinical Trials Network of the National Institute on Drug Abuse can serve an important role in this endeavor. High-priority research gaps are highlighted in this commentary. A discussion follows on how the National Drug Abuse Treatment Clinical Trials Network can transform to address changing patterns in SUD care to efficiently generate evidence to guide SUD treatment practice within the context of recent US health care legislation. Keywords: Patient Protection and Affordable Care Act, National Drug Abuse Treatment Clinical Trials Network, substance use disorders, practice-based research network, electronic health records

  3. Managing ESBL-producing Enterobacteriaceae-related urinary tract infection in primary care: a tool kit for general practitioners.

    Science.gov (United States)

    Zucconi, Aurélie; Courjon, Johan; Maruéjouls, Christophe; Saintpère, Fabrice; Degand, Nicolas; Pandiani, Lilli; Pradier, Christian; Mondain, Véronique

    2018-03-28

    In Southern France, approximately 4% of E. coli isolates from community-acquired urinary tract infections are extended spectrum beta-lactamase producers, while carriage rates for enterobacteriaceae (ESBL-E) range from 3 to 6%. General practitioners (GP) are unfamiliar with the management of patients harboring ESBL-E. Providing them with a specific tool kit should assist in their therapeutic approach and optimize antimicrobial prescription an ESBL-E tool kit was developed by a multidisciplinary team: infectious diseases (ID) specialists, microbiologists, pharmacologists, and nursing home staff. This tool kit includes treatment protocols, GP and patient information leaflets, a list of infection control measures, and contact details of ID physicians for specialized advice. A community-based (including nursing homes) prospective study was conducted in 2012 in Southeastern France to test the tool kit in the context of ESBL-E-related urinary tract infections (UTI). ESBL-E-related UTI were identified in 88 patients, 66 GPs were contacted by the microbiology laboratory, 56 stated they were offered the tool kit, 48 said they had received it, and 41 stated they had read its contents. Use of the tool kit was significantly correlated with appropriate antibiotic prescription, which concerned 36/39 tool kit users versus 13/20 non-users (p = 0.0125) and 40 GPs expressed an average satisfaction rate of 4.2 on a scale of 0 to 5. Availability of a specific tool for managing patients harboring ESBL-E, now completed with a website, can assist community-based GPs and improve antimicrobial prescription.

  4. A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital.

    Science.gov (United States)

    Jameson, K; Averley, P A; Shackley, P; Steele, J

    2007-09-22

    To compare the cost-effectiveness of dental sedation techniques used in the treatment of children, focusing on hospital-based dental general anaesthetic (DGA) and advanced conscious sedation in a controlled primary care environment. Data on fees, costs and treatment pathways were obtained from a primary care clinic specialising in advanced sedation techniques. For the hospital-based DGA cohort, data were gathered from hospital trusts in the same area. Comparison was via an average cost per child treated and subsequent sensitivity analysis. Analysing records spanning one year, the average cost per child treated via advanced conscious sedation was pound245.47. As some treatments fail (3.5% of cases attempted), and the technique is not deemed suitable for all patients (4-5%), DGA is still required and has been factored into this cost. DGA has an average cost per case treated of pound359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters. The costs of advanced conscious sedation techniques, applied in a controlled primary care environment, are substantially lower than the equivalent costs of hospital-based DGA, informing the debate about the optimum way of managing this patient group.

  5. The Prevalence and Types of Child Abuse among Teachers and its Relationship with their Demographic Characteristics and General Health in Primary Schools

    Directory of Open Access Journals (Sweden)

    Zahra Boroumandfar

    2015-08-01

    Full Text Available Introduction Teachers are one of the groups that in addition to teaching the students can have a role in control and identification of child abuse and violence in schools. Certainly, before doing any action and choose an approach to reduce misbehavior, we should be aware of situation, how and prevalence of child abuse in schools. The present study aims to investigate the prevalence and types of child abuse among teachers and its relationship with demographic characteristics and general health in teachers whom teaching in primary schools. Materials and Methods This was a cross-sectional study on 350 female and male students and 82 teachers that performed with a multi-stage sampling method. The tools for data gathering included: questionnaire of teachers' personal and job characteristics (12 questions, General Health Questionnaire (GHQ (28 questions, and standard questionnaire of Conflict Tactics Scale. Data were analyzed by the statistical tests of independent t-test, Mann–Whitney, chi-square, one-way analysis of variance (ANOVA, with SPSS version 16. Results Results of statistical analysis revealed that there wasn’t a significant association between general health and physical abuse. But there was a significant association between general health, emotional abuse and neglect. So that their general health score was higher (more score was not associated with better general health, the emotional abuse and neglect were also higher. Conclusions According to the results, it is suggested to design and implement some programs for prevention and reduction of violence in schools of our country and education of violence prevention methods should be part of school curriculum.

  6. Large scale comparative codon-pair context analysis unveils general rules that fine-tune evolution of mRNA primary structure.

    Directory of Open Access Journals (Sweden)

    Gabriela Moura

    Full Text Available BACKGROUND: Codon usage and codon-pair context are important gene primary structure features that influence mRNA decoding fidelity. In order to identify general rules that shape codon-pair context and minimize mRNA decoding error, we have carried out a large scale comparative codon-pair context analysis of 119 fully sequenced genomes. METHODOLOGIES/PRINCIPAL FINDINGS: We have developed mathematical and software tools for large scale comparative codon-pair context analysis. These methodologies unveiled general and species specific codon-pair context rules that govern evolution of mRNAs in the 3 domains of life. We show that evolution of bacterial and archeal mRNA primary structure is mainly dependent on constraints imposed by the translational machinery, while in eukaryotes DNA methylation and tri-nucleotide repeats impose strong biases on codon-pair context. CONCLUSIONS: The data highlight fundamental differences between prokaryotic and eukaryotic mRNA decoding rules, which are partially independent of codon usage.

  7. Primary care utilization among patients with influenza during the 2009 pandemic. Does risk for severe influenza disease or prior contact with the general practitioner have any influence?

    Science.gov (United States)

    Simonsen, Kristian A; Hunskaar, Steinar; Sandvik, Hogne; Rortveit, Guri

    2015-02-01

    Little is known about how patients belonging to risk groups for influenza used the primary care system during the influenza pandemic. To investigate the use of general practice and out-of-hours (OOH) services in patients with influenza-like illness (ILI) according to (i) risk for severe influenza disease and (ii) the number of regular general practitioner (GP) visits before the pandemic. Observational study of all ILI patients during the 2009 pandemic. Data were recorded prospectively and collected after the pandemic. Patients at risk were identified during an 18-month period by diagnoses from GPs' billing claims. Associations between risk factors for severe influenza disease and utilization of primary care were analysed using bivariate and multivariate regression analyses. Similar analyses were used for the association between number of GP visits before the pandemic and the primary care utilization during the pandemic. ILI patients who were pregnant [odds ratio (OR) 1.70; 95% confidence interval (CI) 1.52, 1.89], had diabetes (OR 1.68; 95% CI 1.49, 1.89) or chronic lung disease (OR 1.44; 95 CI 1.34, 1.55) had increased risk of attending OOH services compared with patients with no risk factor. ILI patients with at least one GP visit prior to the pandemic used OOH services less during the pandemic compared with those with no GP visit. An increased use of OOH services was found in ILI patients who were pregnant, with diabetes or with chronic lung disease. Having visited the GP before the pandemic was associated with less use of OOH services among ILI patients. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Raising awareness of carrier testing for hereditary haemoglobinopathies in high-risk ethnic groups in the Netherlands: a pilot study among the general public and primary care providers

    Directory of Open Access Journals (Sweden)

    Cornel Martina C

    2009-09-01

    Full Text Available Abstract Background In the Netherlands no formal recommendations exist concerning preconceptional or antenatal testing for carriership of hereditary haemoglobinopathies. Those at highest risk may be unaware of the possibility of carrier screening. While universal newborn screening has recently been introduced, neither preconceptional nor antenatal carrier testing is routinely offered by health care services to the general public. A municipal health service and a foundation for public information on medical genetics undertook a pilot project with the aim of increasing knowledge and encouraging informed choice. Two groups were targeted: members of the public from ethnic groups at increased risk, and primary health care providers. This study examines the effectiveness of culturally specific 'infotainment' to inform high-risk ethnic groups about their increased risk for haemoglobinopathies. In addition, the study explores attitudes and intentions of primary care providers towards haemoglobinopathy carrier testing of their patients from high-risk ethnic groups. Methods Informational sessions tailored to the public or professionals were organised in Amsterdam, and evaluated for their effect. Psychological parameters were measured using structured questionnaires based on the Theory of Planned Behaviour. Results The pre-test/post-test questionnaire showed that members of the public gained understanding of inheritance and carriership of haemoglobinopathies from the "infotainment" session (p Conclusion The "infotainment" programme may have a positive effect on people from high-risk groups, but informed general practitioners and midwives were reluctant to facilitate their patients' getting tested. Additional initiatives are needed to motivate primary care providers to facilitate haemoglobinopathy carrier testing for their patients from high-risk backgrounds.

  9. Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the diagnosis of dementia within a general practice (primary care) setting.

    Science.gov (United States)

    Harrison, Jennifer K; Fearon, Patricia; Noel-Storr, Anna H; McShane, Rupert; Stott, David J; Quinn, Terry J

    2014-07-03

    The IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) is a commonly used questionnaire based tool that uses collateral information to assess for cognitive decline and dementia. Brief tools that can be used for dementia "screening" or "triage" may have particular utility in primary care / general practice healthcare settings but only if they have suitable test accuracy.A synthesis of the available data regarding IQCODE accuracy in a primary care setting should help inform cognitive assessment strategies for clinical practice; research and policy. We sought to describe the accuracy of IQCODE (the index test) against a clinical diagnosis of dementia (the reference standard). In this review we focus on those studies conducted in a primary care (general practice) setting. A search was performed in the following sources on the 28th of January 2013: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO (Ovid SP), BIOSIS (Ovid SP), ISI Web of Science and Conference Proceedings (ISI Web of Knowledge), CINHAL (EBSCOhost) and LILACs (BIREME). We also searched sources specific to diagnostic test accuracy: MEDION (Universities of Maastricht and Leuven); DARE (York University); HTA Database (Health Technology Assessments Database via The Cochrane Library) and ARIF (Birmingham University). We developed a sensitive search strategy; search terms were designed to cover key concepts using several different approaches run in parallel and included terms relating to cognitive tests, cognitive screening and dementia. We used standardized database subject headings such as MeSH terms (in MEDLINE) and other standardized headings (controlled vocabulary) in other databases, as appropriate. We selected those studies performed in primary care settings, which included (not necessarily exclusively) IQCODE to assess for the presence of dementia and where dementia diagnosis was confirmed with clinical assessment. For the

  10. Network class superposition analyses.

    Directory of Open Access Journals (Sweden)

    Carl A B Pearson

    Full Text Available Networks are often used to understand a whole system by modeling the interactions among its pieces. Examples include biomolecules in a cell interacting to provide some primary function, or species in an environment forming a stable community. However, these interactions are often unknown; instead, the pieces' dynamic states are known, and network structure must be inferred. Because observed function may be explained by many different networks (e.g., ≈ 10(30 for the yeast cell cycle process, considering dynamics beyond this primary function means picking a single network or suitable sample: measuring over all networks exhibiting the primary function is computationally infeasible. We circumvent that obstacle by calculating the network class ensemble. We represent the ensemble by a stochastic matrix T, which is a transition-by-transition superposition of the system dynamics for each member of the class. We present concrete results for T derived from boolean time series dynamics on networks obeying the Strong Inhibition rule, by applying T to several traditional questions about network dynamics. We show that the distribution of the number of point attractors can be accurately estimated with T. We show how to generate Derrida plots based on T. We show that T-based Shannon entropy outperforms other methods at selecting experiments to further narrow the network structure. We also outline an experimental test of predictions based on T. We motivate all of these results in terms of a popular molecular biology boolean network model for the yeast cell cycle, but the methods and analyses we introduce are general. We conclude with open questions for T, for example, application to other models, computational considerations when scaling up to larger systems, and other potential analyses.

  11. Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus

    Directory of Open Access Journals (Sweden)

    Stoffers Henri E

    2008-08-01

    Full Text Available Abstract Background Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. In this correspondence we present the methodological approach of a multifaceted quality improvement intervention aiming to improve quality of care in primary care, properly tailored for a country such as Cyprus where general practice is currently seeking recognition. Methods Our methodological approach was focused on the design of an open label, community-based intervention controlled trial using all patients from two urban and two rural public primary care centers diagnosed with hypertension and type II diabetes mellitus. The design of our intervention was grounded on a strong theoretical framework that included the Unified Theory of Acceptance and Use of Technology, and the Chronic Care Model, which synthesize evidence-based system changes in accordance with the Theory of Planned Behavior and the Theory of Reasoned Action. The primary outcome measure was improvement in the quality of care for two chronic diseases evaluated through specific clinical indicators, as well as the patient satisfaction assessed by the EUROPEP questionnaire and additional personal interviews. Results We designed a multifaceted quality improvement intervention model, supported by a varying degree of scientific evidence, tailored to local needs and specific country characteristics. Overall, the main components of the intervention were the development and adoption of an electronic medical record and the introduction of clinical guidelines for the management of the targeted chronic diseases facilitated by the necessary model of organizational changes. Conclusion Health planners and policy makers need to be aware of the potential use of certain theoretical models and applied methodology as well as inexpensive tools that may be suitably tailored to the local needs, in order to

  12. Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus.

    Science.gov (United States)

    Samoutis, George A; Soteriades, Elpidoforos S; Stoffers, Henri E; Zachariadou, Theodora; Philalithis, Anastasios; Lionis, Christos

    2008-08-27

    Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. I