WorldWideScience

Sample records for general primary network

  1. 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

  2. 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

  3. 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.

  4. Inferring general relations between network characteristics from specific network ensembles.

    Science.gov (United States)

    Cardanobile, Stefano; Pernice, Volker; Deger, Moritz; Rotter, Stefan

    2012-01-01

    Different network models have been suggested for the topology underlying complex interactions in natural systems. These models are aimed at replicating specific statistical features encountered in real-world networks. However, it is rarely considered to which degree the results obtained for one particular network class can be extrapolated to real-world networks. We address this issue by comparing different classical and more recently developed network models with respect to their ability to generate networks with large structural variability. In particular, we consider the statistical constraints which the respective construction scheme imposes on the generated networks. After having identified the most variable networks, we address the issue of which constraints are common to all network classes and are thus suitable candidates for being generic statistical laws of complex networks. In fact, we find that generic, not model-related dependencies between different network characteristics do exist. This makes it possible to infer global features from local ones using regression models trained on networks with high generalization power. Our results confirm and extend previous findings regarding the synchronization properties of neural networks. Our method seems especially relevant for large networks, which are difficult to map completely, like the neural networks in the brain. The structure of such large networks cannot be fully sampled with the present technology. Our approach provides a method to estimate global properties of under-sampled networks in good approximation. Finally, we demonstrate on three different data sets (C. elegans neuronal network, R. prowazekii metabolic network, and a network of synonyms extracted from Roget's Thesaurus) that real-world networks have statistical relations compatible with those obtained using regression models.

  5. Primary intestinal lymphangiectasia with generalized warts.

    Science.gov (United States)

    Lee, Soon Jae; Song, Hyun Joo; Boo, Sun-Jin; Na, Soo-Young; Kim, Heung Up; Hyun, Chang Lim

    2015-07-21

    Primary intestinal lymphangiectasia (PIL) is a rare protein-losing enteropathy with lymphatic leakage into the small intestine. Dilated lymphatics in the small intestinal wall and mesentery are observed in this disease. Laboratory tests of PIL patients revealed hypoalbuminemia, lymphocytopenia, hypogammaglobulinemia and increased stool α-1 antitrypsin clearance. Cell-mediated immunodeficiency is also present in PIL patients because of loss of lymphocytes. As a result, the patients are vulnerable to chronic viral infection and lymphoma. However, cases of PIL with chronic viral infection, such as human papilloma virus-induced warts, are rarely reported. We report a rare case of PIL with generalized warts in a 36-year-old male patient. PIL was diagnosed by capsule endoscopy and colonoscopic biopsy with histological tissue confirmation. Generalized warts were observed on the head, chest, abdomen, back, anus, and upper and lower extremities, including the hands and feet of the patient.

  6. Logarithmic learning for generalized classifier neural network.

    Science.gov (United States)

    Ozyildirim, Buse Melis; Avci, Mutlu

    2014-12-01

    Generalized classifier neural network is introduced as an efficient classifier among the others. Unless the initial smoothing parameter value is close to the optimal one, generalized classifier neural network suffers from convergence problem and requires quite a long time to converge. In this work, to overcome this problem, a logarithmic learning approach is proposed. The proposed method uses logarithmic cost function instead of squared error. Minimization of this cost function reduces the number of iterations used for reaching the minima. The proposed method is tested on 15 different data sets and performance of logarithmic learning generalized classifier neural network is compared with that of standard one. Thanks to operation range of radial basis function included by generalized classifier neural network, proposed logarithmic approach and its derivative has continuous values. This makes it possible to adopt the advantage of logarithmic fast convergence by the proposed learning method. Due to fast convergence ability of logarithmic cost function, training time is maximally decreased to 99.2%. In addition to decrease in training time, classification performance may also be improved till 60%. According to the test results, while the proposed method provides a solution for time requirement problem of generalized classifier neural network, it may also improve the classification accuracy. The proposed method can be considered as an efficient way for reducing the time requirement problem of generalized classifier neural network. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. 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)

  8. 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.

  9. 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.

  10. Quantum Networks: General theory and applications

    International Nuclear Information System (INIS)

    Bisio, A.; D'Ariano, G. M.; Perinotti, P.; Chiribella, G.

    2011-01-01

    In this work we present a general mathematical framework to deal with Quantum Networks, i.e. networks resulting from the interconnection of elementary quantum circuits. The cornerstone of our approach is a generalization of the Choi isomorphism that allows one to efficiently represent any given Quantum Network in terms of a single positive operator. Our formalism allows one to face and solve many quantum information processing problems that would be hardly manageable otherwise, the most relevant of which are reviewed in this work: quantum process tomography, quantum cloning and learning of transformations, inversion of a unitary gate, information-disturbance tradeoff in estimating a unitary transformation, cloning and learning of a measurement device (Authors)

  11. 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.

  12. Robust adaptive synchronization of general dynamical networks ...

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics; Volume 86; Issue 6. Robust ... A robust adaptive synchronization scheme for these general complex networks with multiple delays and uncertainties is established and raised by employing the robust adaptive control principle and the Lyapunov stability theory. We choose ...

  13. Generalized epidemic process on modular networks.

    Science.gov (United States)

    Chung, Kihong; Baek, Yongjoo; Kim, Daniel; Ha, Meesoon; Jeong, Hawoong

    2014-05-01

    Social reinforcement and modular structure are two salient features observed in the spreading of behavior through social contacts. In order to investigate the interplay between these two features, we study the generalized epidemic process on modular networks with equal-sized finite communities and adjustable modularity. Using the analytical approach originally applied to clique-based random networks, we show that the system exhibits a bond-percolation type continuous phase transition for weak social reinforcement, whereas a discontinuous phase transition occurs for sufficiently strong social reinforcement. Our findings are numerically verified using the finite-size scaling analysis and the crossings of the bimodality coefficient.

  14. Gambling addiction in primary care: a survey of general practitioners ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    experiences of, and confidence in, managing these patients in primary care, their perceived role and ... KEY WORDS: Gambling addiction; Primary care; General practitioners; Management ..... Petry NM, Blanco C, Auriacombe M, Borges.

  15. 78 FR 75442 - Designation of the Primary Freight Network

    Science.gov (United States)

    2013-12-11

    ...] Designation of the Primary Freight Network AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice... period for the Designation of the highway Primary Freight Network (PFN) notice, which was published on... the complete National Freight Network (NFN), and to solicit comments on aspects of the NFN. The five...

  16. Robust adaptive synchronization of general dynamical networks ...

    Indian Academy of Sciences (India)

    Robust adaptive synchronization; dynamical network; multiple delays; multiple uncertainties. ... Networks such as neural networks, communication transmission networks, social rela- tionship networks etc. ..... a very good effect. Pramana – J.

  17. Some general rules governing huge power networks

    International Nuclear Information System (INIS)

    Clade, J.

    2010-01-01

    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. 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

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

    DEFF Research Database (Denmark)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

    2013-01-01

    Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known....

  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. 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 ...

  2. Basic general concepts in the network analysis

    Directory of Open Access Journals (Sweden)

    Boja Nicolae

    2004-01-01

    Full Text Available This survey is concerned oneself with the study of those types of material networks which can be met both in civil engineering and also in electrotechnics, in mechanics, or in hydrotechnics, and of which behavior lead to linear problems, solvable by means of Finite Element Method and adequate algorithms. Here, it is presented a unitary theory of networks met in the domains mentioned above and this one is illustrated with examples for the structural networks in civil engineering, electric circuits, and water supply networks, but also planar or spatial mechanisms can be comprised in this theory. The attention is focused to make evident the essential proper- ties and concepts in the network analysis, which differentiate the networks under force from other types of material networks. To such a network a planar, connected, and directed or undirected graph is associated, and with some vector fields on the vertex set this graph is endowed. .

  3. 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

  4. 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...... this controls directional cell migration as a physiological response. The ciliary pocket is a membrane invagination with elevated activity of clathrin-dependent endocytosis (CDE). In paper I, we show that the primary cilium regulates TGF-β signaling and the ciliary pocket is a compartment for CDE...... on formation of the primary cilium and CDE at the pocket region. The ciliary protein Inversin functions as a molecular switch between canonical and non-canonical Wnt signaling. In paper II, we show that Inversin and the primary cilium control Wnt signaling and are required for polarization and cell migration...

  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. 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…

  7. 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.

  8. General Template for the FMEA Applications in Primary Food Processing.

    Science.gov (United States)

    Özilgen, Sibel; Özilgen, Mustafa

    Data on the hazards involved in the primary steps of processing cereals, fruit and vegetables, milk and milk products, meat and meat products, and fats and oils are compiled with a wide-ranging literature survey. After determining the common factors from these data, a general FMEA template is offered, and its use is explained with a case study on pasteurized milk production.

  9. 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.

  10. 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)

  11. Primary care research conducted in networks: getting down to business.

    Science.gov (United States)

    Mold, James W

    2012-01-01

    This seventh annual practice-based research theme issue of the Journal of the American Board of Family Medicine highlights primary care research conducted in practice-based research networks (PBRNs). The issue includes discussion of (1) theoretical and methodological research, (2) health care research (studies addressing primary care processes), (3) clinical research (studies addressing the impact of primary care on patients), and (4) health systems research (studies of health system issues impacting primary care including the quality improvement process). We had a noticeable increase in submissions from PBRN collaborations, that is, studies that involved multiple networks. As PBRNs cooperate to recruit larger and more diverse patient samples, greater generalizability and applicability of findings lead to improved primary care processes.

  12. Generalized Mutual Synchronization between Two Controlled Interdependent Networks

    OpenAIRE

    Xu, Quan; Zhuang, Shengxian; Hu, Dan; Zeng, Yingfeng; Xiao, Jian

    2014-01-01

    This paper mainly focuses on the generalized mutual synchronization between two controlled interdependent networks. First, we propose the general model of controlled interdependent networks $A$ and $B$ with time-varying internetwork delays coupling. Then, by constructing Lyapunov functions and utilizing adaptive control technique, some sufficient conditions are established to ensure that the mutual synchronization errors between the state variables of networks $A$ and $B$ can asymptotically c...

  13. A general framework for performance guaranteed green data center networking

    OpenAIRE

    Wang, Ting; Xia, Yu; Muppala, Jogesh; Hamdi, Mounir; Foufou, Sebti

    2014-01-01

    From the perspective of resource allocation and routing, this paper aims to save as much energy as possible in data center networks. We present a general framework, based on the blocking island paradigm, to try to maximize the network power conservation and minimize sacrifices of network performance and reliability. The bandwidth allocation mechanism together with power-aware routing algorithm achieve a bandwidth guaranteed tighter network. Besides, our fast efficient heuristics for allocatin...

  14. 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.

  15. 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.

  16. 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.

  17. [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.

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

    KAUST Repository

    Elmahdy, Adel M.; Sorour, Sameh; Seddik, Karim G.

    2013-01-01

    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

  19. Nanoscaffold's stiffness affects primary cortical cell network formation

    NARCIS (Netherlands)

    Xie, Sijia; Schurink, Bart; Wolbers, F.; Lüttge, Regina; Hassink, Gerrit Cornelis

    2014-01-01

    Networks of neurons cultured on-chip can provide insights into both normal and disease-state brain function. The ability to guide neuronal growth in specific, artificially designed patterns allows us to study how brain function follows form. Primary cortical cells cultured on nanograting scaffolds,

  20. 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.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    Hybrid-source impedance networks have attracted attention among researchers because of their flexibility in performing buck-boost energy conversion. To date, three distinct types of impedance networks can be summarized for implementing voltage-type inverters, with another three types summarized...... 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...

  2. General practice and primary health care in Denmark

    DEFF Research Database (Denmark)

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

    2012-01-01

    General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized...... 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...... 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...

  3. Global synchronization of general delayed complex networks with stochastic disturbances

    International Nuclear Information System (INIS)

    Tu Li-Lan

    2011-01-01

    In this paper, global synchronization of general delayed complex networks with stochastic disturbances, which is a zero-mean real scalar Wiener process, is investigated. The networks under consideration are continuous-time networks with time-varying delay. Based on the stochastic Lyapunov stability theory, Ito's differential rule and the linear matrix inequality (LMI) optimization technique, several delay-dependent synchronous criteria are established, which guarantee the asymptotical mean-square synchronization of drive networks and response networks with stochastic disturbances. The criteria are expressed in terms of LMI, which can be easily solved using the Matlab LMI Control Toolbox. Finally, two examples show the effectiveness and feasibility of the proposed synchronous conditions. (general)

  4. 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.

  5. A general evolving model for growing bipartite networks

    International Nuclear Information System (INIS)

    Tian, Lixin; He, Yinghuan; Liu, Haijun; Du, Ruijin

    2012-01-01

    In this Letter, we propose and study an inner evolving bipartite network model. Significantly, we prove that the degree distribution of two different kinds of nodes both obey power-law form with adjustable exponents. Furthermore, the joint degree distribution of any two nodes for bipartite networks model is calculated analytically by the mean-field method. The result displays that such bipartite networks are nearly uncorrelated networks, which is different from one-mode networks. Numerical simulations and empirical results are given to verify the theoretical results. -- Highlights: ► We proposed a general evolving bipartite network model which was based on priority connection, reconnection and breaking edges. ► We prove that the degree distribution of two different kinds of nodes both obey power-law form with adjustable exponents. ► The joint degree distribution of any two nodes for bipartite networks model is calculated analytically by the mean-field method. ► The result displays that such bipartite networks are nearly uncorrelated networks, which is different from one-mode networks.

  6. 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.

  7. Detection of generalized synchronization using echo state networks

    OpenAIRE

    Ibáñez-Soria, D.; García Ojalvo, Jordi; Soria Frisch, Aureli; Ruffini, G.

    2018-01-01

    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 i...

  8. Primary Biliary Cirrhosis Is a Generalized Autoimmune Epithelitis

    Directory of Open Access Journals (Sweden)

    Jun Gao

    2015-03-01

    Full Text Available Primary biliary cirrhosis (PBC is a chronic progressive autoimmune cholestatic liver disease characterized by highly specific antimitochondrial antibodies (AMAs and the specific immune-mediated injury of small intrahepatic bile ducts. Unique apoptotic feature of biliary epithelial cells (BECs may contribute to apotope presentation to the immune system, causing unique tissue damage in PBC. Perpetuation of inflammation may result in senescence of BECs, contributing to irreversible loss of bile duct. In addition to the classic liver manifestations, focal inflammation and tissue damage are also seen in salivary glands and urinary tract in a significant proportion of PBC patients. These findings provide potent support to the idea that molecular mimicry may be involved in the breakdown of autoimmune tolerance and mucosal immunity may lead to a systematic epithelitis in PBC patients. Thus, PBC is considered a generalized epithelitis in clinical practice.

  9. 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.

  10. Primary Intestinal Lymphangiectasia and its Association With Generalized Lymphatic Anomaly

    Directory of Open Access Journals (Sweden)

    Victoria María Díaz Marugán

    2016-01-01

    Full Text Available Background: Lymph is a fluid originating in the interstitial spaces of the body that contains cells, proteins, particles, chylomicrons, and sometimes bacteria. Objectives: The aim of the present study is to demonstrate that primary intestinal lymphangiectasia (PIL results from a disruption of lymphatic circulation, thus corresponding to a secondary rather than a primary event in the context of generalized lymphatic anomaly. Materials and Methods: In this case series and record review, an analysis of intestinal lymphatic involvement was performed on patients diagnosed with PIL between 1965 and 2013. Of the 21 patients included in the study, 10 had been diagnosed before 5 years of age (1 prenatal, 8 between 5 and 18 years of age, and 3 while older than 18 years of age. The follow-up period varied between 1 and 34 years. Clinical data, blood and fecal parameters, imaging studies, endoscopy results, biopsy analyses, treatment details, and outcome information were collected from medical records. Endoscopy, histological studies, magnetic resonance imaging, and lymphoscintigraphy were performed on all patients. Dynamic intranodal lymphangiography was performed on 8 patients. Results: Central lymphatic channel obstruction was identified in 12 patients (57%. Associated lymphatic malformation (LM was present in 16, diarrhea in 10, chylothorax in 11, chylous ascites in 10, pericardial effusion in 6, coagulopathy in 3, and osteolysis in 7. Conclusions: We consider intestinal lymphangiectasia not as an entity in itself, but as a consequence of lymphatic flow impairment in the thoracic duct, producing chylous reflux into the intestinal lymphatics.

  11. Generalization of Clustering Coefficients to Signed Correlation Networks

    Science.gov (United States)

    Costantini, Giulio; Perugini, Marco

    2014-01-01

    The recent interest in network analysis applications in personality psychology and psychopathology has put forward new methodological challenges. Personality and psychopathology networks are typically based on correlation matrices and therefore include both positive and negative edge signs. However, some applications of network analysis disregard negative edges, such as computing clustering coefficients. In this contribution, we illustrate the importance of the distinction between positive and negative edges in networks based on correlation matrices. The clustering coefficient is generalized to signed correlation networks: three new indices are introduced that take edge signs into account, each derived from an existing and widely used formula. The performances of the new indices are illustrated and compared with the performances of the unsigned indices, both on a signed simulated network and on a signed network based on actual personality psychology data. The results show that the new indices are more resistant to sample variations in correlation networks and therefore have higher convergence compared with the unsigned indices both in simulated networks and with real data. PMID:24586367

  12. Generalized Mutual Synchronization between Two Controlled Interdependent Networks

    Directory of Open Access Journals (Sweden)

    Quan Xu

    2014-01-01

    Full Text Available This paper mainly focuses on the generalized mutual synchronization between two controlled interdependent networks. First, we propose the general model of controlled interdependent networks A and B with time-varying internetwork delays coupling. Then, by constructing Lyapunov functions and utilizing adaptive control technique, some sufficient conditions are established to ensure that the mutual synchronization errors between the state variables of networks A and B can asymptotically converge to zero. Finally, two numerical examples are given to illustrate the effectiveness of the theoretical results and to explore potential application in future smart grid. The simulation results also show how interdependent topologies and internetwork coupling delays influence the mutual synchronizability, which help to design interdependent networks with optimal mutual synchronizability.

  13. 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

  14. Generalized Tavis-Cummings models and quantum networks

    Science.gov (United States)

    Gorokhov, A. V.

    2018-04-01

    The properties of quantum networks based on generalized Tavis-Cummings models are theoretically investigated. We have calculated the information transfer success rate from one node to another in a simple model of a quantum network realized with two-level atoms placed in the cavities and interacting with an external laser field and cavity photons. The method of dynamical group of the Hamiltonian and technique of corresponding coherent states were used for investigation of the temporal dynamics of the two nodes model.

  15. Toward a generalized theory of epidemic awareness in social networks

    Science.gov (United States)

    Wu, Qingchu; Zhu, Wenfang

    We discuss the dynamics of a susceptible-infected-susceptible (SIS) model with local awareness in networks. Individual awareness to the infectious disease is characterized by a general function of epidemic information in its neighborhood. We build a high-accuracy approximate equation governing the spreading dynamics and derive an approximate epidemic threshold above which the epidemic spreads over the whole network. Our results extend the previous work and show that the epidemic threshold is dependent on the awareness function in terms of one infectious neighbor. Interestingly, when a pow-law awareness function is chosen, the epidemic threshold can emerge in infinite networks.

  16. 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.

  17. Identification of generalized state transfer matrix using neural networks

    International Nuclear Information System (INIS)

    Zhu Changchun

    2001-01-01

    The research is introduced on identification of generalized state transfer matrix of linear time-invariant (LTI) system by use of neural networks based on LM (Levenberg-Marquart) algorithm. Firstly, the generalized state transfer matrix is defined. The relationship between the identification of state transfer matrix of structural dynamics and the identification of the weight matrix of neural networks has been established in theory. A singular layer neural network is adopted to obtain the structural parameters as a powerful tool that has parallel distributed processing ability and the property of adaptation or learning. The constraint condition of weight matrix of the neural network is deduced so that the learning and training of the designed network can be more effective. The identified neural network can be used to simulate the structural response excited by any other signals. In order to cope with its further application in practical problems, some noise (5% and 10%) is expected to be present in the response measurements. Results from computer simulation studies show that this method is valid and feasible

  18. Robustness of pinning a general complex dynamical network

    International Nuclear Information System (INIS)

    Wang Lei; Sun Youxian

    2010-01-01

    This Letter studies the robustness problem of pinning a general complex dynamical network toward an assigned synchronous evolution. Several synchronization criteria are presented to guarantee the convergence of the pinning process locally and globally by construction of Lyapunov functions. In particular, if a pinning strategy has been designed for synchronization of a given complex dynamical network, then no matter what uncertainties occur among the pinned nodes, synchronization can still be guaranteed through the pinning. The analytical results show that pinning control has a certain robustness against perturbations on network architecture: adding, deleting and changing the weights of edges. Numerical simulations illustrated by scale-free complex networks verify the theoretical results above-acquired.

  19. 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.

  20. 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.

  1. Constructing general partial differential equations using polynomial and neural networks.

    Science.gov (United States)

    Zjavka, Ladislav; Pedrycz, Witold

    2016-01-01

    Sum fraction terms can approximate multi-variable functions on the basis of discrete observations, replacing a partial differential equation definition with polynomial elementary data relation descriptions. Artificial neural networks commonly transform the weighted sum of inputs to describe overall similarity relationships of trained and new testing input patterns. Differential polynomial neural networks form a new class of neural networks, which construct and solve an unknown general partial differential equation of a function of interest with selected substitution relative terms using non-linear multi-variable composite polynomials. The layers of the network generate simple and composite relative substitution terms whose convergent series combinations can describe partial dependent derivative changes of the input variables. This regression is based on trained generalized partial derivative data relations, decomposed into a multi-layer polynomial network structure. The sigmoidal function, commonly used as a nonlinear activation of artificial neurons, may transform some polynomial items together with the parameters with the aim to improve the polynomial derivative term series ability to approximate complicated periodic functions, as simple low order polynomials are not able to fully make up for the complete cycles. The similarity analysis facilitates substitutions for differential equations or can form dimensional units from data samples to describe real-world problems. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 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.

  3. Generalized master equations for non-Poisson dynamics on networks.

    Science.gov (United States)

    Hoffmann, Till; Porter, Mason A; Lambiotte, Renaud

    2012-10-01

    The traditional way of studying temporal networks is to aggregate the dynamics of the edges to create a static weighted network. This implicitly assumes that the edges are governed by Poisson processes, which is not typically the case in empirical temporal networks. Accordingly, we examine the effects of non-Poisson inter-event statistics on the dynamics of edges, and we apply the concept of a generalized master equation to the study of continuous-time random walks on networks. We show that this equation reduces to the standard rate equations when the underlying process is Poissonian and that its stationary solution is determined by an effective transition matrix whose leading eigenvector is easy to calculate. We conduct numerical simulations and also derive analytical results for the stationary solution under the assumption that all edges have the same waiting-time distribution. We discuss the implications of our work for dynamical processes on temporal networks and for the construction of network diagnostics that take into account their nontrivial stochastic nature.

  4. 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.

  5. Developments of the general computer network of NIPNE-HH

    International Nuclear Information System (INIS)

    Mirica, M.; Constantinescu, S.; Danet, A.

    1997-01-01

    Since 1991 the general computer network of NIPNE-HH was developed and connected to RNCN (Romanian National Computer Network) for research and development and it offers to the Romanian physics research community an efficient and cost-effective infrastructure to communicate and collaborate with fellow researchers abroad, and to collect and exchange the most up-to-date information in their research area. RNCN is targeted on the following main objectives: Setting up a technical and organizational infrastructure meant to provide national and international electronic services for the Romanian scientific research community; - Providing a rapid and competitive tool for the exchange of information in the framework of Research and Development (R-D) community; - Using the scientific and technical data bases available in the country and offered by the national networks from other countries through international networks; - Providing a support for information, scientific and technical co-operation. RNCN has two international links: to EBONE via ACONET (64kbps) and to EuropaNET via Hungarnet (64 kbps). The guiding principle in designing the project of general computer network of NIPNE-HH, as part of RNCN, was to implement an open system based on OSI standards taking into account the following criteria: - development of a flexible solution, according to OSI specifications; - solutions of reliable gateway with the existing network already in use,allowing the access to the worldwide networks; - using the TCP/IP transport protocol for each Local Area Network (LAN) and for the connection to RNCN; - ensuring the integration of different and heterogeneous software and hardware platforms (DOS, Windows, UNIX, VMS, Linux, etc) through some specific interfaces. The major objectives achieved in direction of developing the general computer network of NIPNE-HH are: - linking all the existing and newly installed computer equipment and providing an adequate connectivity. LANs from departments

  6. 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

  7. Commissioning and equity in primary care in Australia: Views from Primary Health Networks.

    Science.gov (United States)

    Henderson, Julie; Javanparast, Sara; MacKean, Tamara; Freeman, Toby; Baum, Fran; Ziersch, Anna

    2018-01-01

    This paper reports findings from 55 stakeholder interviews undertaken in six Primary Health Networks (PHNs) in Australia as part of a study of the impact of population health planning in regional primary health organisations on service access and equity. Primary healthcare planning is currently undertaken by PHNs which were established in 2015 as commissioning organisations. This was a departure from the role of Medicare Locals, the previous regional primary health organisations which frequently provided services. This paper addresses perceptions of 23 senior staff, 11 board members and 21 members of clinical and community advisory councils or health priority groups from six case study PHNs on the impact of commissioning on equity. Participants view the collection of population health data as facilitating service access through redistributing services on the basis of need and through bringing objectivity to decision-making about services. Conversely, participants question the impact of the political and geographical context and population profile on capacity to improve service access and equity through service commissioning. Service delivery was seen as fragmented, the model is at odds with the manner in which Aboriginal Community Controlled Health Organisations (ACCHOs) operate and rural regions lack services to commission. As a consequence, reliance upon commissioning of services may not be appropriate for the Australian primary healthcare context. © 2017 John Wiley & Sons Ltd.

  8. 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.

  9. Learning in neural networks based on a generalized fluctuation theorem

    Science.gov (United States)

    Hayakawa, Takashi; Aoyagi, Toshio

    2015-11-01

    Information maximization has been investigated as a possible mechanism of learning governing the self-organization that occurs within the neural systems of animals. Within the general context of models of neural systems bidirectionally interacting with environments, however, the role of information maximization remains to be elucidated. For bidirectionally interacting physical systems, universal laws describing the fluctuation they exhibit and the information they possess have recently been discovered. These laws are termed fluctuation theorems. In the present study, we formulate a theory of learning in neural networks bidirectionally interacting with environments based on the principle of information maximization. Our formulation begins with the introduction of a generalized fluctuation theorem, employing an interpretation appropriate for the present application, which differs from the original thermodynamic interpretation. We analytically and numerically demonstrate that the learning mechanism presented in our theory allows neural networks to efficiently explore their environments and optimally encode information about them.

  10. 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.

  11. An Effect of the Co-Operative Network Model for Students' Quality in Thai Primary Schools

    Science.gov (United States)

    Khanthaphum, Udomsin; Tesaputa, Kowat; Weangsamoot, Visoot

    2016-01-01

    This research aimed: 1) to study the current and desirable states of the co-operative network in developing the learners' quality in Thai primary schools, 2) to develop a model of the co-operative network in developing the learners' quality, and 3) to examine the results of implementation of the co-operative network model in the primary school.…

  12. 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.

  13. Teamwork in primary palliative care: general practitioners' and specialised oncology nurses' complementary competencies.

    Science.gov (United States)

    Johansen, May-Lill; Ervik, Bente

    2018-03-07

    Generalists such as general practitioners and district nurses have been the main actors in community palliative care in Norway. Specialised oncology nurses with postgraduate palliative training are increasingly becoming involved. There is little research on their contribution. This study explores how general practitioners (GPs) and oncology nurses (ONs) experience their collaboration in primary palliative care. A qualitative focus group and interview study in rural Northern Norway, involving 52 health professionals. Five uni-professional focus group discussions were followed by five interprofessional discussions and six individual interviews. Transcripts were analysed thematically. The ideal cooperation between GPs and ONs was as a "meeting of experts" with complementary competencies. GPs drew on their generalist backgrounds, including their often long-term relationship with and knowledge of the patient. The ONs contributed longitudinal clinical observations and used their specialised knowledge to make treatment suggestions. While ONs were often experienced and many had developed a form of pattern recognition, they needed GPs' competencies for complex clinical judgements. However, ONs sometimes lacked timely advice from GPs, and could feel left alone with sick patients. To avoid this, some ONs bypassed GPs and contacted palliative specialists directly. While traditional professional hierarchies were not a barrier, we found that organization, funding and remuneration were significant barriers to cooperation. GPs often did not have time to meet with ONs to discuss shared patients. We also found that ONs and GPs had different strategies for learning. While ONs belonged to a networking nursing collective aiming for continuous quality improvement, GPs learned mostly from their individual experience of caring for patients. The complementary competences and autonomous roles of a specialised nurse and a general practitioner represented a good match for primary palliative

  14. 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.

  15. Generalized activity equations for spiking neural network dynamics

    Directory of Open Access Journals (Sweden)

    Michael A Buice

    2013-11-01

    Full Text Available Much progress has been made in uncovering the computational capabilities of spiking neural networks. However, spiking neurons will always be more expensive to simulate compared to rate neurons because of the inherent disparity in time scales - the spike duration time is much shorter than the inter-spike time, which is much shorter than any learning time scale. In numerical analysis, this is a classic stiff problem. Spiking neurons are also much more difficult to study analytically. One possible approach to making spiking networks more tractable is to augment mean field activity models with some information about spiking correlations. For example, such a generalized activity model could carry information about spiking rates and correlations between spikes self-consistently. Here, we will show how this can be accomplished by constructing a complete formal probabilistic description of the network and then expanding around a small parameter such as the inverse of the number of neurons in the network. The mean field theory of the system gives a rate-like description. The first order terms in the perturbation expansion keep track of covariances.

  16. Gambling addiction in primary care: a survey of general practitioners ...

    African Journals Online (AJOL)

    We set out to study GPs' understanding of gambling addiction, their experiences of, and confidence in, managing these patients in primary care, their perceived role and feasibility, their views on funding gambling treatment services, etc. To this end, we carried out a postal questionnaire survey of all GPs (N=136) in Solihull, ...

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

    Science.gov (United States)

    ... black women, but have decreased in both groups. Women who have a family history of ovarian cancer and/or certain inherited gene ... ovarian, fallopian tube, and primary peritoneal cancer: Personal history of breast cancer A woman who has had breast cancer has an increased ...

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

    African Journals Online (AJOL)

    2010-05-10

    May 10, 2010 ... A significant percentage of patients seen at the primary health care level (district ... (GPs) are forced to rely on the knowledge acquired from their limited .... accurate in screening patients for diabetic retinopathy.4. In this study ...

  19. On squaring the primary constraints in a generalized Hamiltonian dynamics

    International Nuclear Information System (INIS)

    Nesterenko, V.V.

    1993-01-01

    Consideration of the model of the relativistic particle with curvature and torsion in the three-dimensional space-time shows that the squaring of the primary constraints entails a wrong result. The complete set of the Hamiltonian constraints arising here corresponds to another model with an action similar but not identical with the initial action. 16 refs

  20. Enhanced Network Efficiency of Functional Brain Networks in Primary Insomnia Patients

    Directory of Open Access Journals (Sweden)

    Xiaofen Ma

    2018-02-01

    Full Text Available Accumulating evidence from neuroimaging studies suggests that primary insomnia (PI affects interregional neural coordination of multiple interacting functional brain networks. However, a complete understanding of the whole-brain network organization from a system-level perspective in PI is still lacking. To this end, we investigated in topological organization changes in brain functional networks in PI. 36 PI patients and 38 age-, sex-, and education-matched healthy controls were recruited. All participants underwent a series of neuropsychological assessments and resting-state functional magnetic resonance imaging scans. Individual whole-brain functional network were constructed and analyzed using graph theory-based network approaches. There were no significant differences with respect to age, sex, or education between groups (P > 0.05. Graph-based analyses revealed that participants with PI had a significantly higher total number of edges (P = 0.022, global efficiency (P = 0.014, and normalized global efficiency (P = 0.002, and a significantly lower normalized local efficiency (P = 0.042 compared with controls. Locally, several prefrontal and parietal regions, the superior temporal gyrus, and the thalamus exhibited higher nodal efficiency in participants with PI (P < 0.05, false discovery rate corrected. In addition, most of these regions showed increased functional connectivity in PI patients (P < 0.05, corrected. Finally, altered network efficiency was correlated with neuropsychological variables of the Epworth Sleepiness Scale and Insomnia Severity Index in patients with PI. PI is associated with abnormal organization of large-scale functional brain networks, which may account for memory and emotional dysfunction in people with PI. These findings provide novel implications for neural substrates associated with PI.

  1. Spreading dynamics on complex networks: a general stochastic approach.

    Science.gov (United States)

    Noël, Pierre-André; Allard, Antoine; Hébert-Dufresne, Laurent; Marceau, Vincent; Dubé, Louis J

    2014-12-01

    Dynamics on networks is considered from the perspective of Markov stochastic processes. We partially describe the state of the system through network motifs and infer any missing data using the available information. This versatile approach is especially well adapted for modelling spreading processes and/or population dynamics. In particular, the generality of our framework and the fact that its assumptions are explicitly stated suggests that it could be used as a common ground for comparing existing epidemics models too complex for direct comparison, such as agent-based computer simulations. We provide many examples for the special cases of susceptible-infectious-susceptible and susceptible-infectious-removed dynamics (e.g., epidemics propagation) and we observe multiple situations where accurate results may be obtained at low computational cost. Our perspective reveals a subtle balance between the complex requirements of a realistic model and its basic assumptions.

  2. Locating Direction Finders in a Generalized Search and Rescue Network

    Science.gov (United States)

    1991-03-01

    David A . Drake and Alfred B. Marsb. Conv-ersation at NationalI Security Agenc, 29 September 1990. 7. Daskin , Mark S. " A M-admum Fpeced Co-:efing...91 7 19 134 .flT/GORjEnSj9I-M LOCATING DIRECTION FIND’RS IN A GENERALIZED SEARCH AND RESCUE NETWORK THESIS Jean M. Steppe Captain, USAF AFIT/GOR/EN S...91-Mk-7 APPROVED FOR PUBLIC RELI ASE: DISTRIBUTION UNLIMITED. 1191-05734 .. 91.. .7 19 134 i i . nMIGOR4M.S/91-MI LOCATING DIRECTION FINDERS IW A

  3. Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

    Science.gov (United States)

    Pawa, Jasmine; Robson, John; Hull, Sally

    2017-11-01

    Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.

  4. Factor Stability of Primary Scales of the General Organization Questionnaire

    Science.gov (United States)

    1980-10-01

    leadership , climate , and processes function optimally. The Leadership and Organizational Effectiveness Work Unit re- searches personal, small-group...the Litwin and Stringer (1968) Organizational Climate Questionnaire found a factor structure that was dif- ferent from the a priori structure...number) General Organization Questionnaire (GOQ) Organizational climate Organizational effectiveness 20. ATRACT (Cnm N eriwem7 d Iderntify by block numbst

  5. 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 ...

  6. 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.

  7. 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

  8. Primary progressive aphasia: A dementia of the language network

    Directory of Open Access Journals (Sweden)

    Marsel Mesulam

    Full Text Available ABSTRACT Primary progressive aphasia (PPA is a clinical syndrome diagnosed when three core criteria are met. First, there should be a language impairment (i.e., aphasia that interferes with the usage or comprehension of words. Second, the neurological work-up should determine that the disease is neurodegenerative, and therefore progressive. Third, the aphasia should arise in relative isolation, without equivalent deficits of comportment or episodic memory. The language impairment can be fluent or non-fluent and may or may not interfere with word comprehension. Memory for recent events is preserved although memory scores obtained in verbally mediated tests may be abnormal. Minor changes in personality and behavior may be present but are not the leading factors that bring the patient to medical attention or that limit daily living activities. This distinctive clinical pattern is most conspicuous in the initial stages of the disease, and reflects a relatively selective atrophy of the language network, usually located in the left hemisphere. There are different clinical variants of PPA, each with a characteristic pattern of atrophy. The underlying neuropathological diseases are heterogeneous and can include Alzheimer's disease as well as frontotemporal lobar degeneration. The clinician's task is to recognize PPA and differentiate it from other neurodegenerative phenotypes, use biomarkers to surmise the nature of the underlying neuropathology, and institute the most fitting multimodal interventions.

  9. Patient safety in primary care: a survey of general practitioners in The Netherlands.

    NARCIS (Netherlands)

    Gaal, S.; Verstappen, W.H.J.M.; Wensing, M.J.P.

    2010-01-01

    BACKGROUND: Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general

  10. 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...

  11. 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

  12. s-core network decomposition: A generalization of k-core analysis to weighted networks

    Science.gov (United States)

    Eidsaa, Marius; Almaas, Eivind

    2013-12-01

    A broad range of systems spanning biology, technology, and social phenomena may be represented and analyzed as complex networks. Recent studies of such networks using k-core decomposition have uncovered groups of nodes that play important roles. Here, we present s-core analysis, a generalization of k-core (or k-shell) analysis to complex networks where the links have different strengths or weights. We demonstrate the s-core decomposition approach on two random networks (ER and configuration model with scale-free degree distribution) where the link weights are (i) random, (ii) correlated, and (iii) anticorrelated with the node degrees. Finally, we apply the s-core decomposition approach to the protein-interaction network of the yeast Saccharomyces cerevisiae in the context of two gene-expression experiments: oxidative stress in response to cumene hydroperoxide (CHP), and fermentation stress response (FSR). We find that the innermost s-cores are (i) different from innermost k-cores, (ii) different for the two stress conditions CHP and FSR, and (iii) enriched with proteins whose biological functions give insight into how yeast manages these specific stresses.

  13. Generalized model for k -core percolation and interdependent networks

    Science.gov (United States)

    Panduranga, Nagendra K.; Gao, Jianxi; Yuan, Xin; Stanley, H. Eugene; Havlin, Shlomo

    2017-09-01

    Cascading failures in complex systems have been studied extensively using two different models: k -core percolation and interdependent networks. We combine the two models into a general model, solve it analytically, and validate our theoretical results through extensive simulations. We also study the complete phase diagram of the percolation transition as we tune the average local k -core threshold and the coupling between networks. We find that the phase diagram of the combined processes is very rich and includes novel features that do not appear in the models studying each of the processes separately. For example, the phase diagram consists of first- and second-order transition regions separated by two tricritical lines that merge and enclose a two-stage transition region. In the two-stage transition, the size of the giant component undergoes a first-order jump at a certain occupation probability followed by a continuous second-order transition at a lower occupation probability. Furthermore, at certain fixed interdependencies, the percolation transition changes from first-order → second-order → two-stage → first-order as the k -core threshold is increased. The analytic equations describing the phase boundaries of the two-stage transition region are set up, and the critical exponents for each type of transition are derived analytically.

  14. 78 FR 69520 - Designation of the Primary Freight Network

    Science.gov (United States)

    2013-11-19

    ... NFN may fit into a multimodal National Freight System; and (5) suggestions for an urban-area route... achieve a contiguous network, and to ensure sufficient connections to Mexico and Canada, requires the... whether the resulting network would meet future public planning and investment needs. Each individual...

  15. 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.

  16. Generalization error analysis: deep convolutional neural network in mammography

    Science.gov (United States)

    Richter, Caleb D.; Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir; Cha, Kenny

    2018-02-01

    We conducted a study to gain understanding of the generalizability of deep convolutional neural networks (DCNNs) given their inherent capability to memorize data. We examined empirically a specific DCNN trained for classification of masses on mammograms. Using a data set of 2,454 lesions from 2,242 mammographic views, a DCNN was trained to classify masses into malignant and benign classes using transfer learning from ImageNet LSVRC-2010. We performed experiments with varying amounts of label corruption and types of pixel randomization to analyze the generalization error for the DCNN. Performance was evaluated using the area under the receiver operating characteristic curve (AUC) with an N-fold cross validation. Comparisons were made between the convergence times, the inference AUCs for both the training set and the test set of the original image patches without corruption, and the root-mean-squared difference (RMSD) in the layer weights of the DCNN trained with different amounts and methods of corruption. Our experiments observed trends which revealed that the DCNN overfitted by memorizing corrupted data. More importantly, this study improved our understanding of DCNN weight updates when learning new patterns or new labels. Although we used a specific classification task with the ImageNet as example, similar methods may be useful for analysis of the DCNN learning processes, especially those that employ transfer learning for medical image analysis where sample size is limited and overfitting risk is high.

  17. 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%

  18. 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.

  19. 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.

  20. Modeling a full-scale primary sedimentation tank using artificial neural networks.

    Science.gov (United States)

    Gamal El-Din, A; Smith, D W

    2002-05-01

    Modeling the performance of full-scale primary sedimentation tanks has been commonly done using regression-based models, which are empirical relationships derived strictly from observed daily average influent and effluent data. Another approach to model a sedimentation tank is using a hydraulic efficiency model that utilizes tracer studies to characterize the performance of model sedimentation tanks based on eddy diffusion. However, the use of hydraulic efficiency models to predict the dynamic behavior of a full-scale sedimentation tank is very difficult as the development of such models has been done using controlled studies of model tanks. In this paper, another type of model, namely artificial neural network modeling approach, is used to predict the dynamic response of a full-scale primary sedimentation tank. The neuralmodel consists of two separate networks, one uses flow and influent total suspended solids data in order to predict the effluent total suspended solids from the tank, and the other makes predictions of the effluent chemical oxygen demand using data of the flow and influent chemical oxygen demand as inputs. An extensive sampling program was conducted in order to collect a data set to be used in training and validating the networks. A systematic approach was used in the building process of the model which allowed the identification of a parsimonious neural model that is able to learn (and not memorize) from past data and generalize very well to unseen data that were used to validate the model. Theresults seem very promising. The potential of using the model as part of a real-time process control system isalso discussed.

  1. 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

  2. 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.

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

    KAUST Repository

    Al-Habob, Ahmed A.; Salhab, Anas M.; Zummo, Salam A.; Alouini, Mohamed-Slim

    2017-01-01

    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

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

    KAUST Repository

    Mahmood, Nurul Huda; Yilmaz, Ferkan; Alouini, Mohamed-Slim

    2011-01-01

    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

  5. [Rethinking the place of primary healthcare in France--role of general practice].

    Science.gov (United States)

    Gay, B

    2013-06-01

    Primary healthcare is poorly structured in France while it is well defined at the international level: it is the point of first medical contact of the population with the healthcare system. General practice is the clinical specialty oriented to primary healthcare. Data in the scientific literature highlight the need of refocusing the health system on primary care known to improve both morbi-mortality and care efficiency. In France, health authorities acknowledge general practitioners as playing a key role in the health care system: its time to move from intention to action. Structural changes are needed to achieve this reinforcement of primary healthcare: to re-orientate medical studies towards primary care; to develop research in primary care; to promote cooperation between care providers; to ease the daily workload of practitioners; to diversify methods of payment; to propose a guide for patient's use of primary care. The transformation of the healthcare system in France requires a real strategy of primary healthcare implementation. Regardless of financial constraints, it is possible to redistribute the resources towards ambulatory care. Strengthening the role of general practice and favoring its societal recognition will be the major stages of this change. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. 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.

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

    KAUST Repository

    Shafie, Ahmed El; Khattab, Tamer; Salem, Ahmed Sultan

    2016-01-01

    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

  8. 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.))

  9. 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.

    2017-01-01

    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 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. Conclusions 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. PMID:28277051

  10. 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.

  11. 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.

  12. 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

  13. PRED-CLASS: cascading neural networks for generalized protein classification and genome-wide applications

    OpenAIRE

    Pasquier, Claude; Promponas, Vasilis; Hamodrakas, Stavros

    2009-01-01

    International audience; A cascading system of hierarchical, artificial neural networks (named PRED-CLASS) is presented for the generalized classification of proteins into four distinct classes-transmembrane, fibrous, globular, and mixed-from information solely encoded in their amino acid sequences. The architecture of the individual component networks is kept very simple, reducing the number of free parameters (network synaptic weights) for faster training, improved generalization, and the av...

  14. 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.

  15. 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

  16. 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

  17. SOCIAL NETWORK OPTIMIZATION A NEW METHAHEURISTIC FOR GENERAL OPTIMIZATION PROBLEMS

    Directory of Open Access Journals (Sweden)

    Hassan Sherafat

    2017-12-01

    Full Text Available In the recent years metaheuristics were studied and developed as powerful technics for hard optimization problems. Some of well-known technics in this field are: Genetic Algorithms, Tabu Search, Simulated Annealing, Ant Colony Optimization, and Swarm Intelligence, which are applied successfully to many complex optimization problems. In this paper, we introduce a new metaheuristic for solving such problems based on social networks concept, named as Social Network Optimization – SNO. We show that a wide range of np-hard optimization problems may be solved by SNO.

  18. 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.

  19. 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…

  20. 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.

  1. 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

  2. On generalizations of network design problems with degree bounds

    NARCIS (Netherlands)

    Bansal, N.; Khandekar, R.; Könemann, J.; Nagarajan, V.; Peis, B.

    2013-01-01

    Iterative rounding and relaxation have arguably become the method of choice in dealing with unconstrained and constrained network design problems. In this paper we extend the scope of the iterative relaxation method in two directions: (1) by handling more complex degree constraints in the minimum

  3. On generalizations of network design problems with degree bounds

    NARCIS (Netherlands)

    N. Bansal (Nikhil); R. Khandekar; J. Könemann (Jochen); V. Nagarajan; B. Peis

    2013-01-01

    htmlabstractIterative rounding and relaxation have arguably become the method of choice in dealing with unconstrained and constrained network design problems. In this paper we extend the scope of the iterative relaxation method in two directions: (1) by handling more complex degree constraints in

  4. Primary School Teachers' Interviews Regarding Pedagogical Content Knowledge (PCK) and General Pedagogical Knowledge (GPK)

    Science.gov (United States)

    Sothayapetch, Pavinee; Lavonen, Jari; Juuti, Kalle

    2013-01-01

    Pedagogical Content Knowledge (PCK) and General Pedagogical Knowledge (GPK) are fundamental types of knowledge for a teacher that he or she must use in order to plan, teach in the classroom, and assess students' learning outcomes. This paper investigates experienced primary school teachers' PCK and GPK while teaching science in Finland and in…

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

    Science.gov (United States)

    Olagundoye, Olawunmi Abimbola; van Boven, Kees; van Weel, Chris

    2016-01-01

    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. 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. 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. 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/cramps general. The top five diagnoses were: Malaria, hypertension

  7. 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.

  8. 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.

  9. 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.

  10. PREDICTION OF DEMAND FOR PRIMARY BOND OFFERINGS USING ARTIFICIAL NEURAL NETWORKS

    Directory of Open Access Journals (Sweden)

    Michal Tkac

    2014-12-01

    Full Text Available Purpose: Primary bond markets represent an interesting investment opportunity not only for banks, insurance companies, and other institutional investors, but also for individuals looking for capital gains. Since offered securities vary in terms of their rating, industrial classification, coupon, or maturity, demand of buyers for particular offerings often overcomes issued volume and price of given bond on secondary market consequently rises. Investors might be regarded as consumers purchasing required service according to their specific preferences at desired price. This paper aims at analysis of demand for bonds on primary market using artificial neural networks.Design/methodology: We design a multilayered feedforward neural network trained by Levenberg-Marquardt algorithm in order to estimate demand for individual bonds based on parameters of particular offerings. Outcomes obtained by artificial neural network are compared with conventional econometric methods.Findings: Our results indicate that artificial neural network significantly outperformed standard econometric techniques and on examined sample of primary bond offerings achieved considerably better performance in terms of prediction accuracy and mean squared error.Originality: We show that proposed neural network is able to successfully predict demand for primary obligation offerings based on their specifications. Moreover, we identify relevant parameters of issues which are able to considerably affect total demand for given security.  Our findings might not only help investors to detect marketable securities, but also enable issuing entities to increase demand for their bonds in order to decrease their offering price. 

  11. 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.

  12. Improving collaboration between primary care research networks using Access Grid technology

    Directory of Open Access Journals (Sweden)

    Zsolt Nagykaldi

    2008-05-01

    Full Text Available Access Grid (AG is an Internet2-driven, high performance audio_visual conferencing technology used worldwide by academic and government organisations to enhance communication, human interaction and group collaboration. AG technology is particularly promising for improving academic multi-centre research collaborations. This manuscript describes how the AG technology was utilised by the electronic Primary Care Research Network (ePCRN that is part of the National Institutes of Health (NIH Roadmap initiative to improve primary care research and collaboration among practice- based research networks (PBRNs in the USA. It discusses the design, installation and use of AG implementations, potential future applications, barriers to adoption, and suggested solutions.

  13. 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.)

  14. 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.)

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

    Science.gov (United States)

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

    2017-10-01

    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.

  16. 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

  17. Query construction, entropy, and generalization in neural-network models

    Science.gov (United States)

    Sollich, Peter

    1994-05-01

    We study query construction algorithms, which aim at improving the generalization ability of systems that learn from examples by choosing optimal, nonredundant training sets. We set up a general probabilistic framework for deriving such algorithms from the requirement of optimizing a suitable objective function; specifically, we consider the objective functions entropy (or information gain) and generalization error. For two learning scenarios, the high-low game and the linear perceptron, we evaluate the generalization performance obtained by applying the corresponding query construction algorithms and compare it to training on random examples. We find qualitative differences between the two scenarios due to the different structure of the underlying rules (nonlinear and ``noninvertible'' versus linear); in particular, for the linear perceptron, random examples lead to the same generalization ability as a sequence of queries in the limit of an infinite number of examples. We also investigate learning algorithms which are ill matched to the learning environment and find that, in this case, minimum entropy queries can in fact yield a lower generalization ability than random examples. Finally, we study the efficiency of single queries and its dependence on the learning history, i.e., on whether the previous training examples were generated randomly or by querying, and the difference between globally and locally optimal query construction.

  18. TRANSPORT OF PATIENTS FOR PRIMARY PTCA FROM GENERAL HOSPITAL NOVO MESTO TO LJUBLJANA IN 2002

    Directory of Open Access Journals (Sweden)

    Renata Okrajšek

    2004-12-01

    Full Text Available Background. The treatment of acute coronary syndrome (ACS with ST-segment elevation with primary percutaneous transluminal coronary angioplasty (PTCA is the best way to treat these patients. Primary PTCA is also practicable with patients who are admitted into institution without catheter laboratory. The transport of patients into the tertiary institution is safe, but it is important to keep the time of ischemia as short as possible and to reach the time interval of door-balloon as recommended by the guidelines. The ACS patients with ST-segment elevation that were directed into General Hospital Novo mesto after examination at the internistic emergency department have been redirected to KC Ljubljana for realization of PTCA since October 2001.Methods. A prospective analysis of patients with ACS with STsegment elevation, who had been transferred from General Hospital Novo mesto to KC Ljubljana in the period from January 1, 2002 to December 31, 2002 to have a primary PTCA, was performed. The analysis comprised the following: the time interval of handling the patients at Internistic department of General Hospital Novo mesto, the time of transport of patients to Ljubljana and total time interval from the arrival of patients to General Hospital Novo mesto to the first inflation of balloon in Ljubljana. We monitored the complications that occurred during the treatment of the patients.Results. In the above mentioned period 29 patients (24 males and 5 females were transported from the General Hospital Novo mesto to the KC Ljubljana to have a primary PTCA performed. The total time interval measured between the patients’ arrival to General Hospital Novo mesto to the first inflation of balloon in Ljubljana in the year 2002 was 145 minutes, which is 17 minutes better than in the previous period. The time interval recommended by the guidelines was achieved with four patients.Conclusions. By recognizing the problems that had encountered with directing the

  19. Connecting primary care clinics and community pharmacies through a nationwide electronic prescribing network: A qualitative study

    Directory of Open Access Journals (Sweden)

    Marie-Pierre Gagnon

    2015-10-01

    Full Text Available Background The use of medication is at the heart of primary care, but is also the cause for major health concerns. It is therefore important to examine the prescription of medication process.Objective This study identifies the barriers and facilitators perceived by community pharmacists and primary care physicians concerning the adoption of a nationwide electronic prescribing (e-prescribing network in the province of Quebec, Canada.Methods We used purposive sampling to identify the most intensive users of the e-prescribing network. We conducted phone and in-person interviews. Interviews were transcribed, and we analysed their content with NVivo, using the clinical adoption framework (CAF for the codification of the data.Results We interviewed 33 pharmacists, 2 pharmacy technicians, 11 physicians and 3 clinic managers. Adoption of the e-prescribing network was fairly low. The respondents underlined adaptation of their work environment, openness to change and perception of benefits as facilitators to the adoption of the network. However, important barriers were perceived, including system quality issues and paper prescriptions being the only legal document in the prescribing process. Even if respondents recognised that the e-prescribing network can offer substantial benefits to the prescribing process, issues still persisted and raised barriers to the full use of such a network, especially in a context where different local information systems are connected within a nationwide e-prescribing network.Conclusion This study, based on the CAF, provides a better understanding of the factors related to the adoption of a nationwide e-prescribing network connecting primary care clinics and community pharmacies. 

  20. Paediatric obesity research in early childhood and the primary care setting: the TARGet Kids! research network.

    Science.gov (United States)

    Morinis, Julia; Maguire, Jonathon; Khovratovich, Marina; McCrindle, Brian W; Parkin, Patricia C; Birken, Catherine S

    2012-04-01

    Primary paediatric health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention and subsequent translation of this evidence into practice are critically needed. This paper explores the role of primary care in obesity prevention and introduces a novel application and development of a primary care research network in Canada--TARGet Kids!--to develop and translate an evidence-base on effective screening and prevention of childhood obesity.

  1. Paediatric Obesity Research in Early Childhood and the Primary Care Setting: The TARGet Kids! Research Network

    Directory of Open Access Journals (Sweden)

    Catherine S. Birken

    2012-04-01

    Full Text Available Primary paediatric health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention and subsequent translation of this evidence into practice are critically needed. This paper explores the role of primary care in obesity prevention and introduces a novel application and development of a primary care research network in Canada—TARGet Kids!—to develop and translate an evidence-base on effective screening and prevention of childhood obesity.

  2. 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

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

    KAUST Repository

    Park, Kihong; Alouini, Mohamed-Slim

    2013-01-01

    -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

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

    OpenAIRE

    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 act...

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

    Energy Technology Data Exchange (ETDEWEB)

    Li, Shumei; Tian, Junzhang; Li, Meng; Wang, Tianyue; Lin, Chulan; Yin, Yi; Jiang, Guihua [Guangdong Second Provincial General Hospital, Department of Medical Imaging, Guangzhou (China); Zeng, Luxian [Guangdong Second Provincial General Hospital, Department of Science and Education, Guangzhou (China); Li, Cheng [Guangdong Second Provincial General Hospital, Department of Renal Transplantation, Guangzhou (China)

    2018-02-15

    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.)

  6. EurOOHnet-the European research network for out-of-hours primary health care.

    Science.gov (United States)

    Huibers, Linda; Philips, Hilde; Giesen, Paul; Remmen, Roy; Christensen, Morten Bondo; Bondevik, Gunnar Tschudi

    2014-09-01

    European countries face similar challenges in the provision of health care. Demographic factors like ageing, population growth, changing patient behaviour, and lack of work force lead to increasing demands, costs, and overcrowding of out-of-hours (OOH) care (i.e. primary care services, emergency departments (EDs), and ambulance services). These developments strain services and imply safety risks. In the last few decades, countries have been re-organizing their OOH primary health care services. AIM AND SCOPE OF THE NETWORK: We established a European research network for out-of-hours primary health care (EurOOHnet), which aims to transfer knowledge, share experiences, and conduct research. Combining research competencies and integrating results can generate a profound information flow to European researchers and decision makers in health policy, contributing towards feasible and high-quality OOH care. It also contributes to a more comparable performance level within European regions. CONDUCTED RESEARCH PROJECTS: The European research network aims to conduct mutual research projects. At present, three projects have been accomplished, among others concerning the diagnostic scope in OOH primary care services and guideline adherence for diagnosis and treatment of cystitis in OOH primary care. Future areas of research will be organizational models for OOH care; appropriate use of the OOH services; quality of telephone triage; quality of medical care; patient safety issues; use of auxiliary personnel; collaboration with EDs and ambulance care; and the role of GPs in OOH care.

  7. 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.)

  8. 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

  9. Generalized Projective Synchronization between Two Complex Networks with Time-Varying Coupling Delay

    International Nuclear Information System (INIS)

    Mei, Sun; Chang-Yan, Zeng; Li-Xin, Tian

    2009-01-01

    Generalized projective synchronization (GPS) between two complex networks with time-varying coupling delay is investigated. Based on the Lyapunov stability theory, a nonlinear controller and adaptive updated laws are designed. Feasibility of the proposed scheme is proven in theory. Moreover, two numerical examples are presented, using the energy resource system and Lü's system [Physica A 382 (2007) 672] as the nodes of the networks. GPS between two energy resource complex networks with time-varying coupling delay is achieved. This study can widen the application range of the generalized synchronization methods and will be instructive for the demand–supply of energy resource in some regions of China

  10. Generalized Projective Synchronization between Two Complex Networks with Time-Varying Coupling Delay

    Science.gov (United States)

    Sun, Mei; Zeng, Chang-Yan; Tian, Li-Xin

    2009-01-01

    Generalized projective synchronization (GPS) between two complex networks with time-varying coupling delay is investigated. Based on the Lyapunov stability theory, a nonlinear controller and adaptive updated laws are designed. Feasibility of the proposed scheme is proven in theory. Moreover, two numerical examples are presented, using the energy resource system and Lü's system [Physica A 382 (2007) 672] as the nodes of the networks. GPS between two energy resource complex networks with time-varying coupling delay is achieved. This study can widen the application range of the generalized synchronization methods and will be instructive for the demand-supply of energy resource in some regions of China.

  11. Vision first? The development of primary visual cortical networks is more rapid than the development of primary motor networks in humans.

    Directory of Open Access Journals (Sweden)

    Patricia Gervan

    Full Text Available The development of cortical functions and the capacity of the mature brain to learn are largely determined by the establishment and maintenance of neocortical networks. Here we address the human development of long-range connectivity in primary visual and motor cortices, using well-established behavioral measures--a Contour Integration test and a Finger-tapping task--that have been shown to be related to these specific primary areas, and the long-range neural connectivity within those. Possible confounding factors, such as different task requirements (complexity, cognitive load are eliminated by using these tasks in a learning paradigm. We find that there is a temporal lag between the developmental timing of primary sensory vs. motor areas with an advantage of visual development; we also confirm that human development is very slow in both cases, and that there is a retained capacity for practice induced plastic changes in adults. This pattern of results seems to point to human-specific development of the "canonical circuits" of primary sensory and motor cortices, probably reflecting the ecological requirements of human life.

  12. Synchronization criteria for generalized reaction-diffusion neural networks via periodically intermittent control.

    Science.gov (United States)

    Gan, Qintao; Lv, Tianshi; Fu, Zhenhua

    2016-04-01

    In this paper, the synchronization problem for a class of generalized neural networks with time-varying delays and reaction-diffusion terms is investigated concerning Neumann boundary conditions in terms of p-norm. The proposed generalized neural networks model includes reaction-diffusion local field neural networks and reaction-diffusion static neural networks as its special cases. By establishing a new inequality, some simple and useful conditions are obtained analytically to guarantee the global exponential synchronization of the addressed neural networks under the periodically intermittent control. According to the theoretical results, the influences of diffusion coefficients, diffusion space, and control rate on synchronization are analyzed. Finally, the feasibility and effectiveness of the proposed methods are shown by simulation examples, and by choosing different diffusion coefficients, diffusion spaces, and control rates, different controlled synchronization states can be obtained.

  13. 40 years of biannual family medicine research meetings--the European General Practice Research Network (EGPRN).

    Science.gov (United States)

    Buono, Nicola; Thulesius, Hans; Petrazzuoli, Ferdinando; Van Merode, Tiny; Koskela, Tuomas; Le Reste, Jean-Yves; Prick, Hanny; Soler, Jean Karl

    2013-12-01

    To document family medicine research in the 25 EGPRN member countries in 2010. Semi-structured survey with open-ended questions. Academic family medicine in 23 European countries, Israel, and Turkey. 25 EGPRN national representatives. Demographics of the general population and family medicine. Assessments, opinions, and suggestions. EGPRN has represented family medicine for almost half a billion people and > 300,000 general practitioners (GPs). Turkey had the largest number of family medicine departments and highest density of GPs, 2.1/1000 people, Belgium had 1.7, Austria 1.6, and France 1.5. Lowest GP density was reported from Israel 0.17, Greece 0.18, and Slovenia 0.4 GPs per 1000 people. Family medicine research networks were reported by 22 of 25 and undergraduate family medicine research education in 20 of the 25 member countries, and in 10 countries students were required to do research projects. Postgraduate family medicine research was reported by 18 of the member countries. Open-ended responses showed that EGPRN meetings promoted stimulating and interesting research questions such as comparative studies of chronic pain management, sleep disorders, elderly care, healthy lifestyle promotion, mental health, clinical competence, and appropriateness of specialist referrals. Many respondents reported a lack of interest in family medicine research related to poor incentives and low family medicine status in general and among medical students in particular. It was suggested that EGPRN exert political lobbying for family medicine research. Since 1974, EGPRN organizes biannual conferences that unite and promote primary care practice, clinical research and academic family medicine in 25 member countries.

  14. 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.

  15. 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.

  16. Inferring topologies via driving-based generalized synchronization of two-layer networks

    Science.gov (United States)

    Wang, Yingfei; Wu, Xiaoqun; Feng, Hui; Lu, Jun-an; Xu, Yuhua

    2016-05-01

    The interaction topology among the constituents of a complex network plays a crucial role in the network’s evolutionary mechanisms and functional behaviors. However, some network topologies are usually unknown or uncertain. Meanwhile, coupling delays are ubiquitous in various man-made and natural networks. Hence, it is necessary to gain knowledge of the whole or partial topology of a complex dynamical network by taking into consideration communication delay. In this paper, topology identification of complex dynamical networks is investigated via generalized synchronization of a two-layer network. Particularly, based on the LaSalle-type invariance principle of stochastic differential delay equations, an adaptive control technique is proposed by constructing an auxiliary layer and designing proper control input and updating laws so that the unknown topology can be recovered upon successful generalized synchronization. Numerical simulations are provided to illustrate the effectiveness of the proposed method. The technique provides a certain theoretical basis for topology inference of complex networks. In particular, when the considered network is composed of systems with high-dimension or complicated dynamics, a simpler response layer can be constructed, which is conducive to circuit design. Moreover, it is practical to take into consideration perturbations caused by control input. Finally, the method is applicable to infer topology of a subnetwork embedded within a complex system and locate hidden sources. We hope the results can provide basic insight into further research endeavors on understanding practical and economical topology inference of networks.

  17. General practice, primary care, and health service psychology: concepts, competencies, and the Combined-Integrated model.

    Science.gov (United States)

    Schulte, Timothy J; Isley, Elayne; Link, Nancy; Shealy, Craig N; Winfrey, LaPearl Logan

    2004-10-01

    The profession of psychology is being impacted profoundly by broader changes within the national system of health care, as mental and behavioral health services are being recognized as essential components of a comprehensive, preventive, and cost-efficient primary care system. To fully define and embrace this role, the discipline of professional psychology must develop a shared disciplinary identity of health service psychology and a generalized competency-based model for doctoral education and training. This very framework has been adopted by Combined-Integrated (C-I) doctoral programs in professional psychology, which train across the practice areas (clinical, counseling, and school psychology) to provide a general and integrative foundation for their students. Because C-I programs produce general practitioners who are competent to function within a variety of health service settings, this innovative training approach has great potential to educate and train psychologists for a changing health care marketplace. Copyright 2004 Wiley Periodicals, Inc.

  18. Generalized Load Sharing for Homogeneous Networks of Distributed Environment

    Directory of Open Access Journals (Sweden)

    A. Satheesh

    2008-01-01

    Full Text Available We propose a method for job migration policies by considering effective usage of global memory in addition to CPU load sharing in distributed systems. When a node is identified for lacking sufficient memory space to serve jobs, one or more jobs of the node will be migrated to remote nodes with low memory allocations. If the memory space is sufficiently large, the jobs will be scheduled by a CPU-based load sharing policy. Following the principle of sharing both CPU and memory resources, we present several load sharing alternatives. Our objective is to reduce the number of page faults caused by unbalanced memory allocations for jobs among distributed nodes, so that overall performance of a distributed system can be significantly improved. We have conducted trace-driven simulations to compare CPU-based load sharing policies with our policies. We show that our load sharing policies not only improve performance of memory bound jobs, but also maintain the same load sharing quality as the CPU-based policies for CPU-bound jobs. Regarding remote execution and preemptive migration strategies, our experiments indicate that a strategy selection in load sharing is dependent on the amount of memory demand of jobs, remote execution is more effective for memory-bound jobs, and preemptive migration is more effective for CPU-bound jobs. Our CPU-memory-based policy using either high performance or high throughput approach and using the remote execution strategy performs the best for both CPU-bound and memory-bound job in homogeneous networks of distributed environment.

  19. 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

  20. Generalized projective synchronization of two coupled complex networks of different sizes

    International Nuclear Information System (INIS)

    Li Ke-Zan; He En; Zeng Zhao-Rong; Chi, K. Tse

    2013-01-01

    We investigate a new generalized projective synchronization between two complex dynamical networks of different sizes. To the best of our knowledge, most of the current studies on projective synchronization have dealt with coupled networks of the same size. By generalized projective synchronization, we mean that the states of the nodes in each network can realize complete synchronization, and the states of a pair of nodes from both networks can achieve projective synchronization. Using the stability theory of the dynamical system, several sufficient conditions for guaranteeing the existence of the generalized projective synchronization under feedback control and adaptive control are obtained. As an example, we use Chua's circuits to demonstrate the effectiveness of our proposed approach

  1. Probabilistic inference in general graphical models through sampling in stochastic networks of spiking neurons.

    Science.gov (United States)

    Pecevski, Dejan; Buesing, Lars; Maass, Wolfgang

    2011-12-01

    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.

  2. 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

  3. Constraint satisfaction adaptive neural network and heuristics combined approaches for generalized job-shop scheduling.

    Science.gov (United States)

    Yang, S; Wang, D

    2000-01-01

    This paper presents a constraint satisfaction adaptive neural network, together with several heuristics, to solve the generalized job-shop scheduling problem, one of NP-complete constraint satisfaction problems. The proposed neural network can be easily constructed and can adaptively adjust its weights of connections and biases of units based on the sequence and resource constraints of the job-shop scheduling problem during its processing. Several heuristics that can be combined with the neural network are also presented. In the combined approaches, the neural network is used to obtain feasible solutions, the heuristic algorithms are used to improve the performance of the neural network and the quality of the obtained solutions. Simulations have shown that the proposed neural network and its combined approaches are efficient with respect to the quality of solutions and the solving speed.

  4. Psychological and social problems in primary care patients - general practitioners' assessment and classification.

    Science.gov (United States)

    Rosendal, Marianne; Vedsted, Peter; Christensen, Kaj Sparle; Moth, Grete

    2013-03-01

    To estimate the frequency of psychological and social classification codes employed by general practitioners (GPs) and to explore the extent to which GPs ascribed health problems to biomedical, psychological, or social factors. A cross-sectional survey based on questionnaire data from GPs. Setting. Danish primary care. 387 GPs and their face-to-face contacts with 5543 patients. GPs registered consecutive patients on registration forms including reason for encounter, diagnostic classification of main problem, and a GP assessment of biomedical, psychological, and social factors' influence on the contact. The GP-stated reasons for encounter largely overlapped with their classification of the managed problem. Using the International Classification of Primary Care (ICPC-2-R), GPs classified 600 (11%) patients with psychological problems and 30 (0.5%) with social problems. Both codes for problems/complaints and specific disorders were used as the GP's diagnostic classification of the main problem. Two problems (depression and acute stress reaction/adjustment disorder) accounted for 51% of all psychological classifications made. GPs generally emphasized biomedical aspects of the contacts. Psychological aspects were given greater importance in follow-up consultations than in first-episode consultations, whereas social factors were rarely seen as essential to the consultation. Psychological problems are frequently seen and managed in primary care and most are classified within a few diagnostic categories. Social matters are rarely considered or classified.

  5. 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

  6. 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

  7. CHAIN-WISE GENERALIZATION OF ROAD NETWORKS USING MODEL SELECTION

    Directory of Open Access Journals (Sweden)

    D. Bulatov

    2017-05-01

    Full Text Available Streets are essential entities of urban terrain and their automatized extraction from airborne sensor data is cumbersome because of a complex interplay of geometric, topological and semantic aspects. Given a binary image, representing the road class, centerlines of road segments are extracted by means of skeletonization. The focus of this paper lies in a well-reasoned representation of these segments by means of geometric primitives, such as straight line segments as well as circle and ellipse arcs. We propose the fusion of raw segments based on similarity criteria; the output of this process are the so-called chains which better match to the intuitive perception of what a street is. Further, we propose a two-step approach for chain-wise generalization. First, the chain is pre-segmented using circlePeucker and finally, model selection is used to decide whether two neighboring segments should be fused to a new geometric entity. Thereby, we consider both variance-covariance analysis of residuals and model complexity. The results on a complex data-set with many traffic roundabouts indicate the benefits of the proposed procedure.

  8. General trust impedes perception of self-reported primary psychopathy in thin slices of social interaction.

    Science.gov (United States)

    Manson, Joseph H; Gervais, Matthew M; Bryant, Gregory A

    2018-01-01

    Little is known about people's ability to detect subclinical psychopathy from others' quotidian social behavior, or about the correlates of variation in this ability. This study sought to address these questions using a thin slice personality judgment paradigm. We presented 108 undergraduate judges (70.4% female) with 1.5 minute video thin slices of zero-acquaintance triadic conversations among other undergraduates (targets: n = 105, 57.1% female). Judges completed self-report measures of general trust, caution, and empathy. Target individuals had completed the Levenson Self-Report Psychopathy (LSRP) scale. Judges viewed the videos in one of three conditions: complete audio, silent, or audio from which semantic content had been removed using low-pass filtering. Using a novel other-rating version of the LSRP, judges' ratings of targets' primary psychopathy levels were significantly positively associated with targets' self-reports, but only in the complete audio condition. Judge general trust and target LSRP interacted, such that judges higher in general trust made less accurate judgments with respect to targets higher in primary and total psychopathy. Results are consistent with a scenario in which psychopathic traits are maintained in human populations by negative frequency dependent selection operating through the costs of detecting psychopathy in others.

  9. General trust impedes perception of self-reported primary psychopathy in thin slices of social interaction.

    Directory of Open Access Journals (Sweden)

    Joseph H Manson

    Full Text Available Little is known about people's ability to detect subclinical psychopathy from others' quotidian social behavior, or about the correlates of variation in this ability. This study sought to address these questions using a thin slice personality judgment paradigm. We presented 108 undergraduate judges (70.4% female with 1.5 minute video thin slices of zero-acquaintance triadic conversations among other undergraduates (targets: n = 105, 57.1% female. Judges completed self-report measures of general trust, caution, and empathy. Target individuals had completed the Levenson Self-Report Psychopathy (LSRP scale. Judges viewed the videos in one of three conditions: complete audio, silent, or audio from which semantic content had been removed using low-pass filtering. Using a novel other-rating version of the LSRP, judges' ratings of targets' primary psychopathy levels were significantly positively associated with targets' self-reports, but only in the complete audio condition. Judge general trust and target LSRP interacted, such that judges higher in general trust made less accurate judgments with respect to targets higher in primary and total psychopathy. Results are consistent with a scenario in which psychopathic traits are maintained in human populations by negative frequency dependent selection operating through the costs of detecting psychopathy in others.

  10. Radionuclide analyses taken during primary coolant decontamination at Three Mile Island indicate general circulation

    International Nuclear Information System (INIS)

    Hofstetter, K.J.; Baston, V.F.; Hitz, C.G.; Malinauskas, A.P.

    1983-01-01

    Radionuclide concentration data taken during decontamination of the primary reactor coolant system at Three Mile Island by a feed-and-bleed process have provided information on future defueling operations. Analysis of the radiocesium concentrations in samples taken at the letdown point indicates general circulation within the primary system, including the reactor vessel and both steam generators. A standard dilution model with parameters consistent with engineering estimates (volume, flow rate, etc.) accurately predicts the radiocesium decontamination rates. Unlike cesium, the behavior of other principal soluble radionuclides ( 90 Sr and 3 H) cannot be readily described by dilution theory. A significant appearance rate is observed for 90 Sr suggesting a chemical solubility mechanism. The use of processed water containing high 3 H for makeup causes uncertainty in the interpretation of the 3 H analysis

  11. Systemic Lupus Erythematosus in Primary Care: An Update and Practical Messages for the General Practitioner

    Science.gov (United States)

    Gergianaki, Irini; Bertsias, George

    2018-01-01

    Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease that manifests a wide range of organ involvement. Traditionally, the diagnosis and management of SLE is provided at secondary and tertiary centers to ensure prompt initiation of treatment, adequate control of flares and prevention of irreversible organ damage. Notwithstanding, the role of primary care in SLE is also emerging as there are still significant unmet needs such as the diagnostic delay at the community level and the high burden of therapy- and disease-related comorbidities. In the present review, we summarize practical messages for primary care physicians and general practitioners (GPs) concerning early diagnosis and proper referral of patients with SLE. In addition, we discuss the main comorbidities complicating the disease course and the recommended preventative measures, and we also provide an update on the role and current educational needs of GPs regarding the disease. PMID:29896474

  12. 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.

  13. 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.

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

    KAUST Repository

    Gaaloul, Fakhreddine; Alouini, Mohamed-Slim; Radaydeh, Redha M.; Yang, Hong-Chuan

    2012-01-01

    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.

  15. Zinc Addition Effects on General Corrosion of Austenitic Stainless Steels in PWR Primary Conditions

    International Nuclear Information System (INIS)

    Qiao Peipeng; Zhang Lefu; Liu Ruiqin; Jiang Suqing; Zhu Fawen

    2010-01-01

    Zinc addition effects on general corrosion of austenitic stainless steel 316 and 304 were investigated in simulated PWR primary coolant without zinc or with 50 ppb zinc addition at 315 degree C for 500 h. The results show that with the addition of zinc, the corrosion rate of austenitic stainless steel is effectively reduced, the surface oxide film is thinner, the morphology and chemical composition of surface oxide scales are evidently different from those without zinc. There are needle-like corrosion products on the surface of stainless steel 304. (authors)

  16. 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.

  17. Patient safety in primary care: a survey of general practitioners in the Netherlands

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2010-01-01

    Full Text Available Abstract Background Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general practitioners (GPs on patient safety were examined. Methods A web-based survey of a sample of GPs was undertaken. The items were derived from aspects of patient safety issues identified in a prior interview study. The questionnaire used 10 clinical cases and 15 potential risk factors to explore GPs' views on patient safety. Results A total of 68 GPs responded (51.5% response rate. None of the clinical cases was uniformly judged as particularly safe or unsafe by the GPs. Cases judged to be unsafe by a majority of the GPs concerned either the maintenance of medical records or prescription and monitoring of medication. Cases which only a few GPs judged as unsafe concerned hygiene, the diagnostic process, prevention and communication. The risk factors most frequently judged to constitute a threat to patient safety were a poor doctor-patient relationship, insufficient continuing education on the part of the GP and a patient age over 75 years. Language barriers and polypharmacy also scored high. Deviation from evidence-based guidelines and patient privacy in the reception/waiting room were not perceived as risk factors by most of the GPs. Conclusion The views of GPs on safety and risk in primary care did not completely match those presented in published papers and policy documents. The GPs in the present study judged a broader range of factors than in previously published research on patient safety in primary care, including a poor doctor-patient relationship, to pose a potential threat to patient safety. Other risk factors such as infection prevention, deviation from guidelines and incident reporting were judged to be less relevant than by policy

  18. Patient safety in primary care: a survey of general practitioners in The Netherlands.

    Science.gov (United States)

    Gaal, Sander; Verstappen, Wim; Wensing, Michel

    2010-01-21

    Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general practitioners (GPs) on patient safety were examined. A web-based survey of a sample of GPs was undertaken. The items were derived from aspects of patient safety issues identified in a prior interview study. The questionnaire used 10 clinical cases and 15 potential risk factors to explore GPs' views on patient safety. A total of 68 GPs responded (51.5% response rate). None of the clinical cases was uniformly judged as particularly safe or unsafe by the GPs. Cases judged to be unsafe by a majority of the GPs concerned either the maintenance of medical records or prescription and monitoring of medication. Cases which only a few GPs judged as unsafe concerned hygiene, the diagnostic process, prevention and communication. The risk factors most frequently judged to constitute a threat to patient safety were a poor doctor-patient relationship, insufficient continuing education on the part of the GP and a patient age over 75 years. Language barriers and polypharmacy also scored high. Deviation from evidence-based guidelines and patient privacy in the reception/waiting room were not perceived as risk factors by most of the GPs. The views of GPs on safety and risk in primary care did not completely match those presented in published papers and policy documents. The GPs in the present study judged a broader range of factors than in previously published research on patient safety in primary care, including a poor doctor-patient relationship, to pose a potential threat to patient safety. Other risk factors such as infection prevention, deviation from guidelines and incident reporting were judged to be less relevant than by policy makers.

  19. 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.

  20. Association Between Sluggish Cognitive Tempo Symptoms and Attentional Network and Working Memory in Primary Schoolchildren.

    Science.gov (United States)

    Camprodon-Rosanas, E; Ribas-Fitó, N; Batlle, S; Persavento, C; Alvarez-Pedrerol, M; Sunyer, J; Forns, J

    2017-04-01

    Few consistent data are available in relation to the cognitive and neuropsychological processes involved in sluggish cognitive tempo (SCT) symptoms. The objective of this study was to determine the association of working memory and attentional networks with SCT symptoms in primary schoolchildren. The participants were schoolchildren aged 7 to 10 years ( n = 183) from primary schools in Catalonia (Spain). All the participants completed a working memory task (n-back) and an attentional network task (ANT). Their parents completed an SCT-Child Behavior Checklist self-report and a questionnaire concerning sociodemographic variables. Teachers of the participants provided information on ADHD symptoms and learning determinants. SCT symptoms were correlated with lower scores in both the n-back and ANT. In multivariate regression analysis, SCT symptoms were associated with slower hit reaction times from the ANT. Our results suggest that SCT symptoms are associated with a neuropsychological profile that is different from the classical ADHD profile and characterized by slower reaction times.

  1. [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.

  2. Experimental and computational tools for analysis of signaling networks in primary cells

    DEFF Research Database (Denmark)

    Schoof, Erwin M; Linding, Rune

    2014-01-01

    Cellular information processing in signaling networks forms the basis of responses to environmental stimuli. At any given time, cells receive multiple simultaneous input cues, which are processed and integrated to determine cellular responses such as migration, proliferation, apoptosis, or differ......Cellular information processing in signaling networks forms the basis of responses to environmental stimuli. At any given time, cells receive multiple simultaneous input cues, which are processed and integrated to determine cellular responses such as migration, proliferation, apoptosis......; this information is critical when trying to elucidate key proteins involved in specific cellular responses. Here, methods to generate high-quality quantitative phosphorylation data from cell lysates originating from primary cells, and how to analyze the generated data to construct quantitative signaling network...

  3. 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 networks * reccurent networks * probabilistic computation * analog computation Subject RIV: BA - General Mathematics Impact factor: 2.747, year: 2003

  4. Questionable assumptions hampered interpretation of a network meta-analysis of primary care depression treatments.

    Science.gov (United States)

    Linde, Klaus; Rücker, Gerta; Schneider, Antonius; Kriston, Levente

    2016-03-01

    We aimed to evaluate the underlying assumptions of a network meta-analysis investigating which depression treatment works best in primary care and to highlight challenges and pitfalls of interpretation under consideration of these assumptions. We reviewed 100 randomized trials investigating pharmacologic and psychological treatments for primary care patients with depression. Network meta-analysis was carried out within a frequentist framework using response to treatment as outcome measure. Transitivity was assessed by epidemiologic judgment based on theoretical and empirical investigation of the distribution of trial characteristics across comparisons. Homogeneity and consistency were investigated by decomposing the Q statistic. There were important clinical and statistically significant differences between "pure" drug trials comparing pharmacologic substances with each other or placebo (63 trials) and trials including a psychological treatment arm (37 trials). Overall network meta-analysis produced results well comparable with separate meta-analyses of drug trials and psychological trials. Although the homogeneity and consistency assumptions were mostly met, we considered the transitivity assumption unjustifiable. An exchange of experience between reviewers and, if possible, some guidance on how reviewers addressing important clinical questions can proceed in situations where important assumptions for valid network meta-analysis are not met would be desirable. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Use of Vagus Nerve Stimulator on Children With Primary Generalized Epilepsy.

    Science.gov (United States)

    Welch, William P; Sitwat, Bilal; Sogawa, Yoshimi

    2018-06-01

    To describe the response to vagus nerve stimulator (VNS) in otherwise neurotypical children with medically intractable primary generalized epilepsy. Retrospective chart review of patients who underwent vagus nerve stimulator surgery between January 2011 and December 2015. Eleven patients were identified. Median follow-up duration was 2.5 years (1.2-8.4 years). Prior to vagus nerve stimulator surgery, all patients had at least 1 seizure per week, and 7/11 (64%) had daily seizures. At 1-year follow-up after vagus nerve stimulator, 7/11 (64%) reported improved seizure frequency and 6/11 (55%) reported fewer than 1 seizure per month. Three patients (27%) reported complications related to vagus nerve stimulator surgery, and no patients required device removal. In children with medically intractable primary generalized epilepsy, vagus nerve stimulator is well tolerated and appears to lead to improvement in seizure frequency. Improvement was not attributable to epilepsy classification, age at vagus nerve stimulator implantation, output current, duty cycle, or follow-up duration.

  6. General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

    Science.gov (United States)

    Appleby, N J; Dunt, D; Southern, D M; Young, D

    1999-08-01

    To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

  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. An Application to the Prediction of LOD Change Based on General Regression Neural Network

    Science.gov (United States)

    Zhang, X. H.; Wang, Q. J.; Zhu, J. J.; Zhang, H.

    2011-07-01

    Traditional prediction of the LOD (length of day) change was based on linear models, such as the least square model and the autoregressive technique, etc. Due to the complex non-linear features of the LOD variation, the performances of the linear model predictors are not fully satisfactory. This paper applies a non-linear neural network - general regression neural network (GRNN) model to forecast the LOD change, and the results are analyzed and compared with those obtained with the back propagation neural network and other models. The comparison shows that the performance of the GRNN model in the prediction of the LOD change is efficient and feasible.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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)

  14. 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)

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Naghmeh Momeni

    Full Text Available 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.

  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. Increasing research capacity and changing the culture of primary care towards reflective inquiring practice: the experience of the West London Research Network (WeLReN).

    Science.gov (United States)

    Thomas, P; While, A

    2001-05-01

    A number of primary care research networks were set up throughout England in 1998 in order to (1) improve the quality of primary care research (2) increase the research capacity of primary care, and (3) change the culture of primary care towards reflective inquiring practice (NHSE, 2000b). It is not clear how best to operate a network to achieve these diverse aims. This paper describes the first 30 months of a network that adopted a whole system approach in the belief that this would offer the best chance of simultaneously achieving the three aims. A cycle of activity was designed to facilitate the formation of multidisciplinary coalitions of interest for research with complementary 'top down' and 'bottom up' programmes of work co-existing. At least 330 people participated in the generation of research questions of whom one third (33%) were general practitioners, 16% community nurses, 6% practice managers and other primary care practitioners. Over two fifths (43%) were 'key allies'--academics, health authority staff, community workers and project workers. One fifth (110) of all practices (500) in the WeLReN area have collaborated in at least one research project. The ratio of doctor:nurse participation in the 24 research project teams was markedly different in the supported coalitions (2:1) compared to projects devised and led by more experienced researchers (6:1). The evidence suggests that it is possible to operate a primary care research network in a way that develops coalitions of interest from different parts of the health care system as well as both 'top down' and 'bottom up' led projects. It is too early to tell if the approach will be able to achieve its aims in the long-term but the activity data are encouraging. There is a need for more research on the theoretical basis of network operation.

  19. 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

  20. 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.

  1. Bilateral primary spontaneous pneumothoraces postcaesarean section – another reason to avoid general anaesthesia in pregnancy

    Science.gov (United States)

    Aye, Christina Yi Ling; McKean, David; Dark, Allan; Akinsola, S Adeyemi

    2012-01-01

    A 36-year-old, healthy, primiparous female underwent a caesarean section under general anaesthetic. She had previously had a severe reaction to dye during a myelogram and therefore, had declined epidural analgesia or regional anaesthesia. Induction and maintenance of anaesthesia was uneventful, but on emergence, and before tracheal extubation, the patient coughed on the endotracheal tube and almost immediately developed right-sided subcutaneous emphysema of the face and neck. At this point her oxygen saturation began to fall and she was noted to be difficult to ventilate. Clinically and radiologically, she had a right-sided pneumothorax which was treated immediately with intercostal drain insertion. She went on to develop a left pneumothorax which also required intercostal drain insertion. She made an uneventful recovery and was discharged 8 days later. A subsequent CT scan of her chest revealed no pre-existing primary pulmonary pathology that would have accounted for the pneumothoraces. PMID:22927264

  2. [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.

  3. Primary molar pulpotomy: a systematic review and network meta-analysis.

    Science.gov (United States)

    Lin, Po-Yen; Chen, Hsueh-Szu; Wang, Yu-Hsiang; Tu, Yu-Kang

    2014-09-01

    Pulpotomy is a common procedure to treat asymptomatic reversible pulpitis in primary molars. The aim of this study is to undertake a systematic review and a network meta-analysis to compare the clinical and radiographic outcomes of different pulpotomy procedures in primary molars. Three authors performed data extraction independently and in duplicate using data collection forms. Disagreements were resolved by discussion. An electronic literature search was performed within MEDLINE (via PubMed), ScienceDirect, Web of Science, Cochrane, and ClinicalKey databases until December 2012. Medications for pulpotomy including formocresol, ferric sulfate, calcium hydroxide, and mineral trioxide aggregate (MTA), and laser pulpotomy are compared using Bayesian network meta-analyses. The outcome is the odds ratio for clinical and radiographic failure including premature tooth loss at 12 and 24 months after treatments amongst different treatment procedures. 37 studies were included in the systematic review, and 22 of them in the final network meta-analyses. After 18-24 months, in terms of treatment failure, the odds ratio for calcium hydroxide vs. formocresol was 1.94 [95% credible interval (CI): 1.11, 3.25]; 3.38 (95% CI: 1.37, 8.61) for lasers vs. formocresol; 2.16 (95% CI: 1.12, 4.31) for calcium hydroxide vs. ferric sulfate; 3.73 (95% CI: 1.27, 11.67) for lasers vs. ferric sulfate; 0.47 (95% CI: 0.26, 0.83) for MTA vs. calcium hydroxide; 3.76 (95% CI: 1.39, 10.08) for lasers vs. After 18-24 months, formocresol, ferric sulfate, and MTA showed significantly better clinical and radiographic outcomes than calcium hydroxide and laser therapies in primary molar pulpotomies. The network meta-analyses showed that MTA is the first choice for primary molar pulpotomies. However, if treatment cost is an issue, especially when the treated primary molars are going to be replaced by permanent teeth, ferric sulfate may be the choice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Interference Calculus A General Framework for Interference Management and Network Utility Optimization

    CERN Document Server

    Schubert, Martin

    2012-01-01

    This book develops a mathematical framework for modeling and optimizing interference-coupled multiuser systems. At the core of this framework is the concept of general interference functions, which provides a simple means of characterizing interdependencies between users. The entire analysis builds on the two core axioms scale-invariance and monotonicity. The proposed network calculus has its roots in power control theory and wireless communications. It adds theoretical tools for analyzing the typical behavior of interference-coupled networks. In this way it complements existing game-theoretic approaches. The framework should also be viewed in conjunction with optimization theory. There is a fruitful interplay between the theory of interference functions and convex optimization theory. By jointly exploiting the properties of interference functions, it is possible to design algorithms that outperform general-purpose techniques that only exploit convexity. The title “network calculus” refers to the fact tha...

  5. Global asymptotic stability to a generalized Cohen-Grossberg BAM neural networks of neutral type delays.

    Science.gov (United States)

    Zhang, Zhengqiu; Liu, Wenbin; Zhou, Dongming

    2012-01-01

    In this paper, we first discuss the existence of a unique equilibrium point of a generalized Cohen-Grossberg BAM neural networks of neutral type delays by means of the Homeomorphism theory and inequality technique. Then, by applying the existence result of an equilibrium point and constructing a Lyapunov functional, we study the global asymptotic stability of the equilibrium solution to the above Cohen-Grossberg BAM neural networks of neutral type. In our results, the hypothesis for boundedness in the existing paper, which discussed Cohen-Grossberg neural networks of neutral type on the activation functions, are removed. Finally, we give an example to demonstrate the validity of our global asymptotic stability result for the above neural networks. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. 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.

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

    Science.gov (United States)

    Martínez-Blanco, Ma Del Rosario; Ornelas-Vargas, Gerardo; Solís-Sánchez, Luis Octavio; Castañeda-Miranada, Rodrigo; Vega-Carrillo, Héctor René; Celaya-Padilla, José M; Garza-Veloz, Idalia; Martínez-Fierro, Margarita; Ortiz-Rodríguez, José Manuel

    2016-11-01

    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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. 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.

  9. Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study.

    Science.gov (United States)

    Gill, James M; Klinkman, Michael S; Chen, Ying Xia

    2010-01-01

    Because comorbid depression can complicate medical conditions (eg, diabetes), physicians may treat depression more aggressively in patients who have these conditions. This study examined whether primary care physicians prescribe antidepressant medications more often and in higher doses for persons with medical comorbidities. This secondary data analysis of electronic health record data was conducted in the Centricity Health Care User Research Network (CHURN), a national network of ambulatory practices that use a common outpatient electronic health record. Participants included 209 family medicine and general internal medicine providers in 40 primary care CHURN offices in 17 US states. Patients included adults with a new episode of depression that had been diagnosed during the period October 2006 through July 2007 (n = 1513). Prescription of antidepressant medication and doses of antidepressant medication were compared for patients with and without 6 comorbid conditions: diabetes, coronary heart disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, and cancer. 20.7% of patients had at least one medical comorbidity whereas 5.8% had multiple comorbidities. Overall, 77% of depressed patients were prescribed antidepressant medication. After controlling for age and sex, patients with multiple comorbidities were less likely to be prescribed medication (adjusted odds ratio, 0.58; 95% CI, 0.35-0.96), but there was no significant difference by individual comorbidities. Patients with cerebrovascular disease were less likely to be prescribed a full dose of medication (adjusted odds ratio, 0.26; 95% CI, 0.08-0.88), but there were no differences for other comorbidities or for multiple comorbidities, and there was no difference for any comorbidities in the prescription of minimally effective doses. Patients with new episodes of depression who present to a primary care practice are not treated more aggressively if they have medical

  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. Diagnosing somatisation disorder (P75) in routine general practice using the International Classification of Primary Care.

    Science.gov (United States)

    Schaefert, Rainer; Laux, Gunter; Kaufmann, Claudia; Schellberg, Dieter; Bölter, Regine; Szecsenyi, Joachim; Sauer, Nina; Herzog, Wolfgang; Kuehlein, Thomas

    2010-09-01

    (i) To analyze general practitioners' diagnosis of somatisation disorder (P75) using the International Classification of Primary Care (ICPC)-2-E in routine general practice. (ii) To validate the distinctiveness of the ICD-10 to ICPC-2 conversion rule which maps ICD-10 dissociative/conversion disorder (F44) as well as half of the somatoform categories (F45.0-2) to P75 and codes the other half of these disorders (F45.3-9), including autonomic organ dysfunctions and pain syndromes, as symptom diagnoses plus a psychosocial code in a multiaxial manner. Cross-sectional analysis of routine data from a German research database comprising the electronic patient records of 32 general practitioners from 22 practices. For each P75 patient, control subjects matched for age, gender, and practice were selected from the 2007 yearly contact group (YCG) without a P75 diagnosis using a propensity-score algorithm that resulted in eight controls per P75 patient. Of the 49,423 patients in the YCG, P75 was diagnosed in 0.6% (302) and F45.3-9 in 1.8% (883) of cases; overall, somatisation syndromes were diagnosed in 2.4% of patients. The P75 coding pattern coincided with typical characteristics of severe, persistent medically unexplained symptoms (MUS). F45.3-9 was found to indicate moderate MUS that otherwise showed little clinical difference from P75. Pain syndromes exhibited an unspecific coding pattern. Mild and moderate MUS were predominantly recorded as symptom diagnoses. Psychosocial codes were rarely documented. ICPC-2 P75 was mainly diagnosed in cases of severe MUS. Multiaxial coding appears to be too complicated for routine primary care. Instead of splitting P75 and F45.3-9 diagnoses, it is proposed that the whole MUS spectrum should be conceptualized as a continuum model comprising categorizations of uncomplicated (mild) and complicated (moderate and severe) courses. Psychosocial factors require more attention. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  12. Outer synchronization between two different fractional-order general complex dynamical networks

    International Nuclear Information System (INIS)

    Xiang-Jun, Wu; Hong-Tao, Lu

    2010-01-01

    Outer synchronization between two different fractional-order general complex dynamical networks is investigated in this paper. Based on the stability theory of the fractional-order system, the sufficient criteria for outer synchronization are derived analytically by applying the nonlinear control and the bidirectional coupling methods. The proposed synchronization method is applicable to almost all kinds of coupled fractional-order general complex dynamical networks. Neither a symmetric nor irreducible coupling configuration matrix is required. In addition, no constraint is imposed on the inner-coupling matrix. Numerical examples are also provided to demonstrate the validity of the presented synchronization scheme. Numeric evidence shows that both the feedback strength k and the fractional order α can be chosen appropriately to adjust the synchronization effect effectively. (general)

  13. Non-Hodgkin's lymphoma - Part II: Management of primary extranodal lymphomas, generalized disease and salvage treatment

    International Nuclear Information System (INIS)

    Gospodarowicz, Mary K.; Sutcliffe, Simon B.

    1996-01-01

    Objective: To review the approach to the diagnosis, classification, assessment, treatment and continuing management of patients with primary extranodal non-Hodgkin's lymphoma, and the management of generalized disease with the emphasis on the current role of salvage treatment with high dose chemotherapy and stem cell/bone marrow support strategies. Non-Hodgkin's lymphoma may involve any part of the body. Many lymphomas, such as MALT, angiocentric T-cell, etc., commonly present in extranodal sites. Lymphomas presenting in the GI tract, and head and neck, are most common with the single most common site being the stomach. Gastric lymphoma is associated with Helicobacter pylorii and is most common in areas endemic for Helicobacter pylorii infection. Recent advances in the understanding of the etiology of gastric MALT, thyroid, and intestinal lymphomas present new opportunities for the application of novel therapeutic approaches e.g. antibiotic therapy for Helicobacter pylori and early stage IPSID. Lymphomas presenting in the orbit, thyroid, breast, bone, extradural and skin are of interest because of the importance of expert RT in securing local control. Primary brain lymphomas present a particular challenge to the radiation oncologist. Although localized, primary brain lymphomas are extremely difficult to control. Rare sites of extranodal lymphoma include testis, female genital tract, and lung. Extranodal lymphomas are often localized and cure with RT or CMT is possible. They represent a assorted group of diseases with diverse presentations, prognosis, sensitivity to RT and expected outcome. They are of particular importance to radiation oncologists as they require special attention to patterns of spread and treatment planning. The principles of management of primary extranodal lymphoma, however, follow those applicable to localized nodal presentations. Although primary extranodal lymphomas are highly curable, a proportion of patients will fail with disseminated

  14. 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.

  15. 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.

  16. Asymmetric generalization in adaptation to target displacement errors in humans and in a neural network model.

    Science.gov (United States)

    Westendorff, Stephanie; Kuang, Shenbing; Taghizadeh, Bahareh; Donchin, Opher; Gail, Alexander

    2015-04-01

    Different error signals can induce sensorimotor adaptation during visually guided reaching, possibly evoking different neural adaptation mechanisms. Here we investigate reach adaptation induced by visual target errors without perturbing the actual or sensed hand position. We analyzed the spatial generalization of adaptation to target error to compare it with other known generalization patterns and simulated our results with a neural network model trained to minimize target error independent of prediction errors. Subjects reached to different peripheral visual targets and had to adapt to a sudden fixed-amplitude displacement ("jump") consistently occurring for only one of the reach targets. Subjects simultaneously had to perform contralateral unperturbed saccades, which rendered the reach target jump unnoticeable. As a result, subjects adapted by gradually decreasing reach errors and showed negative aftereffects for the perturbed reach target. Reach errors generalized to unperturbed targets according to a translational rather than rotational generalization pattern, but locally, not globally. More importantly, reach errors generalized asymmetrically with a skewed generalization function in the direction of the target jump. Our neural network model reproduced the skewed generalization after adaptation to target jump without having been explicitly trained to produce a specific generalization pattern. Our combined psychophysical and simulation results suggest that target jump adaptation in reaching can be explained by gradual updating of spatial motor goal representations in sensorimotor association networks, independent of learning induced by a prediction-error about the hand position. The simulations make testable predictions about the underlying changes in the tuning of sensorimotor neurons during target jump adaptation. Copyright © 2015 the American Physiological Society.

  17. 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.

  18. 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

  19. Capacity planning of a wide-sense nonblocking generalized survivable network

    Science.gov (United States)

    Ho, Kwok Shing; Cheung, Kwok Wai

    2006-06-01

    Generalized survivable networks (GSNs) have two interesting properties that are essential attributes for future backbone networks--full survivability against link failures and support for dynamic traffic demands. GSNs incorporate the nonblocking network concept into the survivable network models. Given a set of nodes and a topology that is at least two-edge connected, a certain minimum capacity is required for each edge to form a GSN. The edge capacity is bounded because each node has an input-output capacity limit that serves as a constraint for any allowable traffic demand matrix. The GSN capacity planning problem is nondeterministic polynomial time (NP) hard. We first give a rigorous mathematical framework; then we offer two different solution approaches. The two-phase approach is fast, but the joint optimization approach yields a better bound. We carried out numerical computations for eight networks with different topologies and found that the cost of a GSN is only a fraction (from 52% to 89%) more than that of a static survivable network.

  20. Probabilistic inference in general graphical models through sampling in stochastic networks of spiking neurons.

    Directory of Open Access Journals (Sweden)

    Dejan Pecevski

    2011-12-01

    Full Text Available 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.

  1. The General Evolving Model for Energy Supply-Demand Network with Local-World

    Science.gov (United States)

    Sun, Mei; Han, Dun; Li, Dandan; Fang, Cuicui

    2013-10-01

    In this paper, two general bipartite network evolving models for energy supply-demand network with local-world are proposed. The node weight distribution, the "shifting coefficient" and the scaling exponent of two different kinds of nodes are presented by the mean-field theory. The numerical results of the node weight distribution and the edge weight distribution are also investigated. The production's shifted power law (SPL) distribution of coal enterprises and the installed capacity's distribution of power plants in the US are obtained from the empirical analysis. Numerical simulations and empirical results are given to verify the theoretical results.

  2. A new evolutionary solution method for dynamic expansion planning of DG-integrated primary distribution networks

    International Nuclear Information System (INIS)

    Ahmadigorji, Masoud; Amjady, Nima

    2014-01-01

    Highlights: • A new dynamic distribution network expansion planning model is presented. • A Binary Enhanced Particle Swarm Optimization (BEPSO) algorithm is proposed. • A Modified Differential Evolution (MDE) algorithm is proposed. • A new bi-level optimization approach composed of BEPSO and MDE is presented. • The effectiveness of the proposed optimization approach is extensively illustrated. - Abstract: Reconstruction in the power system and appearing of new technologies for generation capacity of electrical energy has led to significant innovation in Distribution Network Expansion Planning (DNEP). Distributed Generation (DG) includes the application of small/medium generation units located in power distribution networks and/or near the load centers. Appropriate utilization of DG can affect the various technical and operational indices of the distribution network such as the feeder loading, energy losses and voltage profile. In addition, application of DG in proper size is an essential tool to achieve the DG maximum potential benefits. In this paper, a time-based (dynamic) model for DNEP is proposed to determine the optimal size, location and installation year of DG in distribution system. Also, in this model, the Optimal Power Flow (OPF) is exerted to determine the optimal generation of DGs for every potential solution in order to minimize the investment and operation costs following the load growth in a specified planning period. Besides, the reinforcement requirements of existing distribution feeders are considered, simultaneously. The proposed optimization problem is solved by the combination of evolutionary methods of a new Binary Enhanced Particle Swarm Optimization (BEPSO) and Modified Differential Evolution (MDE) to find the optimal expansion strategy and solve OPF, respectively. The proposed planning approach is applied to two typical primary distribution networks and compared with several other methods. These comparisons illustrate the

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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

  5. Susceptible-infected-susceptible epidemics on networks with general infection and cure times

    Science.gov (United States)

    Cator, E.; van de Bovenkamp, R.; Van Mieghem, P.

    2013-06-01

    The classical, continuous-time susceptible-infected-susceptible (SIS) Markov epidemic model on an arbitrary network is extended to incorporate infection and curing or recovery times each characterized by a general distribution (rather than an exponential distribution as in Markov processes). This extension, called the generalized SIS (GSIS) model, is believed to have a much larger applicability to real-world epidemics (such as information spread in online social networks, real diseases, malware spread in computer networks, etc.) that likely do not feature exponential times. While the exact governing equations for the GSIS model are difficult to deduce due to their non-Markovian nature, accurate mean-field equations are derived that resemble our previous N-intertwined mean-field approximation (NIMFA) and so allow us to transfer the whole analytic machinery of the NIMFA to the GSIS model. In particular, we establish the criterion to compute the epidemic threshold in the GSIS model. Moreover, we show that the average number of infection attempts during a recovery time is the more natural key parameter, instead of the effective infection rate in the classical, continuous-time SIS Markov model. The relative simplicity of our mean-field results enables us to treat more general types of SIS epidemics, while offering an easier key parameter to measure the average activity of those general viral agents.

  6. Prevalence of latent Mycobacterium tuberculosis infection among professionals of the primary healthcare network

    Directory of Open Access Journals (Sweden)

    Tássia Silvana Borges

    2014-06-01

    Full Text Available Objective: To estimate the prevalence of latent M. tuberculosis infection and identify characteristics related to latent infection among workers of the primary healthcare network.Methods: Cross-sectional, observational and descriptive study, conducted in 2011, included 137 basic health workers who performed their activities in a municipality. Interviews were carried out addressing characteristics of exposure at work (BCG vaccination, length of time working in the health system, potential exposure to tuberculosis, HIV infection, use of corticosteroids, diabetes, use of tobacco or alcohol and subsequently performed tuberculin skin test (TST. Data was analyzed with Fischer and Student’s t-test (p < 0.05. Results: Health professionals were mostly women (n=126, 92% with mean age of 35.3 (± 9.1 years. Among the reactors, 25 (55.5% sought medical care, and of these, 7 (28% underwent prophylactic treatment. The prevalence of latent tuberculosis was 32.8%. Of the characteristics evaluated, only smoking (OR 3.03; 95%CI 1.05-8.77 was associated with latent infection. Conclusion: The estimated prevalence of latent M. tuberculosis infection among the evaluated health workers was 32.8%. As for the characteristics studied, it was not possible to relate them to latent infection among workers in primary healthcare network, with the exception of the smoking habit. doi: 10.5020/18061230.2014.p269

  7. [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.

  8. 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.

  9. 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.

  10. 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.

  11. 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)

  12. Application of General Regression Neural Network to the Prediction of LOD Change

    Science.gov (United States)

    Zhang, Xiao-Hong; Wang, Qi-Jie; Zhu, Jian-Jun; Zhang, Hao

    2012-01-01

    Traditional methods for predicting the change in length of day (LOD change) are mainly based on some linear models, such as the least square model and autoregression model, etc. However, the LOD change comprises complicated non-linear factors and the prediction effect of the linear models is always not so ideal. Thus, a kind of non-linear neural networkgeneral regression neural network (GRNN) model is tried to make the prediction of the LOD change and the result is compared with the predicted results obtained by taking advantage of the BP (back propagation) neural network model and other models. The comparison result shows that the application of the GRNN to the prediction of the LOD change is highly effective and feasible.

  13. 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.

  14. The Limitation of Primary Signals Entering DVB-T On-Channel-Repeater Working in SFN Network

    Directory of Open Access Journals (Sweden)

    Marek Dvorsky

    2013-01-01

    Full Text Available This paper considers an issue of signal coverage in uncovered places using a broadcasting device called a Gap Filler. The main focus is placed on the analysis of potential negative effects while signals from two and more primary transmitters simultaneously enter to the Gap Filler. In particular, in the measurements the impact of reception cross delayed signals received by the Gap Filler from two adjacent primary transmitters operating in the Single Frequency Network was analysed. The influence of different receive signal levels from two adjacent primary transmitters was also examined. In the conclusion, based on the experiments, the limiting factors useful for individual transmitters in the Single Frequency Network were determined. The analysis and finding the limit parameters can help bradcasters in further setting and debugging of the Gap Filler network. Finally, the described laboratory experiment was also verified under the real SFN network condition in border region Vsetinsko to verify the laboratory findings.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Effectiveness of school network for childhood obesity prevention (SNOCOP) in primary schools of Saraburi Province, Thailand.

    Science.gov (United States)

    Banchonhattakit, Pannee; Tanasugarn, Chanuantong; Pradipasen, Mandhana; Miner, Kathleen R; Nityasuddhi, Dechavudh

    2009-07-01

    This research was designed to test the effectiveness of a school network for childhood obesity prevention (SNOCOP) in primary schools; a program that aimed to improve student behavior in terms of knowledge, attitude, intention towards obesity prevention, and their food consumption behavior. A quasi-experimental pretest-posttest time series study was conducted. By 2-stage stratified sampling selection 180 students from 6 schools were assigned to the intervention group and 195 students from 6 schools to the control group at Saraburi Province, Thailand in 2006- 2007. In addition, thirty-one participants being school administrators, teachers, parents, and community members from six schools formed the social network initiating the intervention. The schoolchildren in the intervention group improved their eating behavior, knowledge, attitude, intention towards obesity preventive behavior. The six schools of the intervention group changed school policies and school activities aiming to reduce the proportion of obesity among their student. No such activities could be observed in the control group. These findings suggest that the School-Social Network of Childhood Obesity Prevention program is an effective means to prevent childhood obesity.

  17. 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'.

  18. Generalized peritonitis due to perforated diverticulitis: Hartmann's procedure or primary anastomosis?

    Science.gov (United States)

    Trenti, Loris; Biondo, Sebastiano; Golda, Thomas; Monica, Millan; Kreisler, Esther; Fraccalvieri, Domenico; Frago, Ricardo; Jaurrieta, Eduardo

    2011-03-01

    Hartmann's procedure (HP) still remains the most frequently performed procedure for diffuse peritonitis due to perforated diverticulitis. The aims of this study were to assess the feasibility and safety of resection with primary anastomosis (RPA) in patients with purulent or fecal diverticular peritonitis and review morbidity and mortality after single stage procedure and Hartmann in our experience. From January 1995 through December 2008, patients operated for generalized diverticular peritonitis were studied. Patients were classified into two main groups: RPA and HP. A total of 87 patients underwent emergency surgery for diverticulitis complicated with purulent or diffuse fecal peritonitis. Sixty (69%) had undergone HP while RPA was performed in 27 patients (31%). At the multivariate analysis, RPA was associated with less post-operative complications (P clinical anastomotic leakage and needed re-operation. RPA can be safely performed without adding morbidity and mortality in cases of diffuse diverticular peritonitis. HP should be reserved only for hemodynamically unstable or high-risk patients. Specialization in colorectal surgery improves mortality and raises the percentage of one-stage procedures.

  19. Prediction Primary Available Blend Biodiesel of Waste Oil from Aurantiochytrium sp. for General Diesel Engines

    Directory of Open Access Journals (Sweden)

    Shu-Yao Tsai

    2018-01-01

    Full Text Available Chemical and enzyme transesterification were compared by discussing preliminary transesterification of waste oil of Aurantiochytrium sp., which was then used in transesterification for the primary available blend biodiesel for a general diesel engine in this study. We made progress on the winterized characteristics of the waste oil’s biodiesel of Aurantiochytrium sp. and its biodiesel, which included the reactivity parameters and properties. This approach led to the development of a novel idea for the evaluation of kinetic parameters of winterization, along with obtaining the suitable operation and storage conditions of biodiesel. Therefore, the waste oil of Aurantiochytrium sp. could be developed for biodiesel production and successfully made into a suitable blend diesel. Overall, we acquired the best condition of mixtures and the highly mixed rate of petrodiesel: biodiesel = 80 : 20 (activation energy of winterization 21.32 kJ/mol; onset temperature of winterization -4.15 °C; heat of combustion 43.15 MJ/kg; kinematic viscosity 3.51 mm2/s; flash point 67.5 °C, which was an appropriate blend biodiesel from the waste oil’s biodiesel of Aurantiochytrium sp.

  20. 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.

  1. Generalized neurofuzzy network modeling algorithms using Bézier-Bernstein polynomial functions and additive decomposition.

    Science.gov (United States)

    Hong, X; Harris, C J

    2000-01-01

    This paper introduces a new neurofuzzy model construction algorithm for nonlinear dynamic systems based upon basis functions that are Bézier-Bernstein polynomial functions. This paper is generalized in that it copes with n-dimensional inputs by utilising an additive decomposition construction to overcome the curse of dimensionality associated with high n. This new construction algorithm also introduces univariate Bézier-Bernstein polynomial functions for the completeness of the generalized procedure. Like the B-spline expansion based neurofuzzy systems, Bézier-Bernstein polynomial function based neurofuzzy networks hold desirable properties such as nonnegativity of the basis functions, unity of support, and interpretability of basis function as fuzzy membership functions, moreover with the additional advantages of structural parsimony and Delaunay input space partition, essentially overcoming the curse of dimensionality associated with conventional fuzzy and RBF networks. This new modeling network is based on additive decomposition approach together with two separate basis function formation approaches for both univariate and bivariate Bézier-Bernstein polynomial functions used in model construction. The overall network weights are then learnt using conventional least squares methods. Numerical examples are included to demonstrate the effectiveness of this new data based modeling approach.

  2. 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.

  3. 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

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

    Science.gov (United States)

    Zenke, Friedemann; Gerstner, Wulfram

    2014-01-01

    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 toward 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.

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

    KAUST Repository

    Khabazian, Mehdi; Aissa, Sonia; El Kefi, Rania

    2011-01-01

    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.

  6. 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)

  7. 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)

  8. 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).

  9. 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...

  10. 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...... a state-of-the-art STSA-MMSE based SE method, when tested using a range of unseen speakers and noise types. Finally, a listening test using several DNN-based SE systems tested in unseen speaker conditions show that these systems can improve SI for some SNR and noise type configurations but degrade SI...

  11. The algebra of the general Markov model on phylogenetic trees and networks.

    Science.gov (United States)

    Sumner, J G; Holland, B R; Jarvis, P D

    2012-04-01

    It is known that the Kimura 3ST model of sequence evolution on phylogenetic trees can be extended quite naturally to arbitrary split systems. However, this extension relies heavily on mathematical peculiarities of the associated Hadamard transformation, and providing an analogous augmentation of the general Markov model has thus far been elusive. In this paper, we rectify this shortcoming by showing how to extend the general Markov model on trees to include incompatible edges; and even further to more general network models. This is achieved by exploring the algebra of the generators of the continuous-time Markov chain together with the “splitting” operator that generates the branching process on phylogenetic trees. For simplicity, we proceed by discussing the two state case and then show that our results are easily extended to more states with little complication. Intriguingly, upon restriction of the two state general Markov model to the parameter space of the binary symmetric model, our extension is indistinguishable from the Hadamard approach only on trees; as soon as any incompatible splits are introduced the two approaches give rise to differing probability distributions with disparate structure. Through exploration of a simple example, we give an argument that our extension to more general networks has desirable properties that the previous approaches do not share. In particular, our construction allows for convergent evolution of previously divergent lineages; a property that is of significant interest for biological applications.

  12. Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

    Science.gov (United States)

    Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

    2011-05-01

    Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

  13. The effect of provider affiliation with a primary care network on emergency department visits and hospital admissions

    Science.gov (United States)

    Bakal, Jeffrey A.; Green, Lee; Bahler, Brad; Lewanczuk, Richard

    2018-01-01

    BACKGROUND: Primary care networks are designed to facilitate access to inter-professional, team-based care. We compared health outcomes associated with primary care networks versus conventional primary care. METHODS: We obtained data on all adult residents of Alberta who visited a primary care physician during fiscal years 2008 and 2009 and classified them as affiliated with a primary care network or not, based on the physician most involved in their care. The primary outcome was an emergency department visit or nonelective hospital admission for a Patient Medical Home indicator condition (asthma, chronic obstructive pulmonary disease, heart failure, coronary disease, hypertension and diabetes) within 12 months. RESULTS: Adults receiving care within a primary care network (n = 1 502 916) were older and had higher comorbidity burdens than those receiving conventional primary care (n = 1 109 941). Patients in a primary care network were less likely to visit the emergency department for an indicator condition (1.4% v. 1.7%, mean 0.031 v. 0.035 per patient, adjusted risk ratio [RR] 0.98, 95% confidence interval [CI] 0.96–0.99) or for any cause (25.5% v. 30.5%, mean 0.55 v. 0.72 per patient, adjusted RR 0.93, 95% CI 0.93–0.94), but were more likely to be admitted to hospital for an indicator condition (0.6% v. 0.6%, mean 0.018 v. 0.017 per patient, adjusted RR 1.07, 95% CI 1.03–1.11) or all-cause (9.3% v. 9.1%, mean 0.25 v. 0.23 per patient, adjusted RR 1.08, 95% CI 1.07–1.09). Patients in a primary care network had 169 fewer all-cause emergency department visits and 86 fewer days in hospital (owing to shorter lengths of stay) per 1000 patient-years. INTERPRETATION: Care within a primary care network was associated with fewer emergency department visits and fewer hospital days. PMID:29530868

  14. Adaptive generalized matrix projective lag synchronization between two different complex networks with non-identical nodes and different dimensions

    International Nuclear Information System (INIS)

    Dai Hao; Jia Li-Xin; Zhang Yan-Bin

    2012-01-01

    The adaptive generalized matrix projective lag synchronization between two different complex networks with non-identical nodes and different dimensions is investigated in this paper. Based on Lyapunov stability theory and Barbalat's lemma, generalized matrix projective lag synchronization criteria are derived by using the adaptive control method. Furthermore, each network can be undirected or directed, connected or disconnected, and nodes in either network may have identical or different dynamics. The proposed strategy is applicable to almost all kinds of complex networks. In addition, numerical simulation results are presented to illustrate the effectiveness of this method, showing that the synchronization speed is sensitively influenced by the adaptive law strength, the network size, and the network topological structure. (general)

  15. 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 "6LiI(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-processing, training

  16. 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.

  17. A general framework for a collaborative water quality knowledge and information network.

    Science.gov (United States)

    Dalcanale, Fernanda; Fontane, Darrell; Csapo, Jorge

    2011-03-01

    Increasing knowledge about the environment has brought about a better understanding of the complexity of the issues, and more information publicly available has resulted into a steady shift from centralized decision making to increasing levels of participatory processes. The management of that information, in turn, is becoming more complex. One of the ways to deal with the complexity is the development of tools that would allow all players, including managers, researchers, educators, stakeholders and the civil society, to be able to contribute to the information system, in any level they are inclined to do so. In this project, a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative "Water Quality Knowledge and Information Network" was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements.

  18. PRED-CLASS: cascading neural networks for generalized protein classification and genome-wide applications.

    Science.gov (United States)

    Pasquier, C; Promponas, V J; Hamodrakas, S J

    2001-08-15

    A cascading system of hierarchical, artificial neural networks (named PRED-CLASS) is presented for the generalized classification of proteins into four distinct classes-transmembrane, fibrous, globular, and mixed-from information solely encoded in their amino acid sequences. The architecture of the individual component networks is kept very simple, reducing the number of free parameters (network synaptic weights) for faster training, improved generalization, and the avoidance of data overfitting. Capturing information from as few as 50 protein sequences spread among the four target classes (6 transmembrane, 10 fibrous, 13 globular, and 17 mixed), PRED-CLASS was able to obtain 371 correct predictions out of a set of 387 proteins (success rate approximately 96%) unambiguously assigned into one of the target classes. The application of PRED-CLASS to several test sets and complete proteomes of several organisms demonstrates that such a method could serve as a valuable tool in the annotation of genomic open reading frames with no functional assignment or as a preliminary step in fold recognition and ab initio structure prediction methods. Detailed results obtained for various data sets and completed genomes, along with a web sever running the PRED-CLASS algorithm, can be accessed over the World Wide Web at http://o2.biol.uoa.gr/PRED-CLASS.

  19. 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.

  20. Modeling of chemical exergy of agricultural biomass using improved general regression neural network

    International Nuclear Information System (INIS)

    Huang, Y.W.; Chen, M.Q.; Li, Y.; Guo, J.

    2016-01-01

    A comprehensive evaluation for energy potential contained in agricultural biomass was a vital step for energy utilization of agricultural biomass. The chemical exergy of typical agricultural biomass was evaluated based on the second law of thermodynamics. The chemical exergy was significantly influenced by C and O elements rather than H element. The standard entropy of the samples also was examined based on their element compositions. Two predicted models of the chemical exergy were developed, which referred to a general regression neural network model based upon the element composition, and a linear model based upon the high heat value. An auto-refinement algorithm was firstly developed to improve the performance of regression neural network model. The developed general regression neural network model with K-fold cross-validation had a better ability for predicting the chemical exergy than the linear model, which had lower predicted errors (±1.5%). - Highlights: • Chemical exergies of agricultural biomass were evaluated based upon fifty samples. • Values for the standard entropy of agricultural biomass samples were calculated. • A linear relationship between chemical exergy and HHV of samples was detected. • An improved GRNN prediction model for the chemical exergy of biomass was developed.

  1. 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 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.

  2. Primary progressive aphasia and the evolving neurology of the language network.

    Science.gov (United States)

    Mesulam, M-Marsel; Rogalski, Emily J; Wieneke, Christina; Hurley, Robert S; Geula, Changiz; Bigio, Eileen H; Thompson, Cynthia K; Weintraub, Sandra

    2014-10-01

    Primary progressive aphasia (PPA) is caused by selective neurodegeneration of the language-dominant cerebral hemisphere; a language deficit initially arises as the only consequential impairment and remains predominant throughout most of the course of the disease. Agrammatic, logopenic and semantic subtypes, each reflecting a characteristic pattern of language impairment and corresponding anatomical distribution of cortical atrophy, represent the most frequent presentations of PPA. Such associations between clinical features and the sites of atrophy have provided new insights into the neurology of fluency, grammar, word retrieval, and word comprehension, and have necessitated modification of concepts related to the functions of the anterior temporal lobe and Wernicke's area. The underlying neuropathology of PPA is, most commonly, frontotemporal lobar degeneration in the agrammatic and semantic forms, and Alzheimer disease (AD) pathology in the logopenic form; the AD pathology often displays atypical and asymmetrical anatomical features consistent with the aphasic phenotype. The PPA syndrome reflects complex interactions between disease-specific neuropathological features and patient-specific vulnerability. A better understanding of these interactions might help us to elucidate the biology of the language network and the principles of selective vulnerability in neurodegenerative diseases. We review these aspects of PPA, focusing on advances in our understanding of the clinical features and neuropathology of PPA and what they have taught us about the neural substrates of the language network.

  3. Outcomes of endodontic therapy in general practice: a study by the Practitioners Engaged in Applied Research and Learning Network.

    Science.gov (United States)

    Bernstein, Susan D; Horowitz, Allan J; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A; Collie, Damon; Matthews, Abigail G; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

    2012-05-01

    The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical

  4. Application of neural networks and its prospect. 1. General comment on application to nuclear fusion and plasma researches

    International Nuclear Information System (INIS)

    Takeda, Tatsuoki

    2006-01-01

    The back ground of application of neutral networks to R and D of scientific field and increasing of application fields are stated. A definition of neural networks, the kinds of neural networks and functions, error back propagation, and generalization are explained. An application of multi-layer neural networks to nuclear fusion and plasma researches are described by inverse problem, interpolation, time series prediction, and computerized tomography. Some examples of researches such as MHD of plasma from magnetic probe data of fusion reactor systems, parameter prediction of distribution of the impurity spectra and the charge exchange neutral particle energy spectra, disruption prediction, and residual minimization training neural network are commented. (S.Y.)

  5. Growth surveillance in the context of the Primary Public Healthcare Service Network in Brazil: literature review

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza

    2016-03-01

    Full Text Available Abstract Objectives: to identify and analyze the scientific literature on child growth monitoring in the context of the primary public healthcare service network in Brazil, focusing on the main problems detected in studies. Methods: the review was based on searches ofSciELO, Lilacs and PubMed databases to identify articles published between 2006 and 2014. The articles were categorized according to the analytical categories of structure (items needed to carry out primary activities or work processes (set of activities and procedures used in the management of resources. Results: of the 16 articles included in this review, only six dealt with structure and, in these, thetraining of professionals and availability of protocols were the most frequently identified problems. Processes, addressed in 15 articles, highlighted the underutilization of Child Health Handbook to record growth measurements and the adoption of guidelines on the basis of notes taken. Conclusions: the difficulties found demonstrate the everyday circumstances of the public health service which have a detrimental effect on growth surveillance.

  6. 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.

  7. The Spiral Discovery Network as an Automated General-Purpose Optimization Tool

    Directory of Open Access Journals (Sweden)

    Adam B. Csapo

    2018-01-01

    Full Text Available The Spiral Discovery Method (SDM was originally proposed as a cognitive artifact for dealing with black-box models that are dependent on multiple inputs with nonlinear and/or multiplicative interaction effects. Besides directly helping to identify functional patterns in such systems, SDM also simplifies their control through its characteristic spiral structure. In this paper, a neural network-based formulation of SDM is proposed together with a set of automatic update rules that makes it suitable for both semiautomated and automated forms of optimization. The behavior of the generalized SDM model, referred to as the Spiral Discovery Network (SDN, and its applicability to nondifferentiable nonconvex optimization problems are elucidated through simulation. Based on the simulation, the case is made that its applicability would be worth investigating in all areas where the default approach of gradient-based backpropagation is used today.

  8. 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.

  9. 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

    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...... 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...... to lower load on interconnection lines at the price of larger efficient average distance and diameter....

  10. 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

  11. 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.

  12. 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...

  13. 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.

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

    Science.gov (United States)

    Cowan, Richard; Hurry, Jane; Midouhas, Emily

    2018-06-01

    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.

  15. 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...

  16. 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.

  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. 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

  19. 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.

  20. 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.

  1. A Wearable Respiratory Biofeedback System Based on Generalized Body Sensor Network

    Science.gov (United States)

    Liu, Guan-Zheng; Huang, Bang-Yu

    2011-01-01

    Abstract Wearable medical devices have enabled unobtrusive monitoring of vital signs and emerging biofeedback services in a pervasive manner. This article describes a wearable respiratory biofeedback system based on a generalized body sensor network (BSN) platform. The compact BSN platform was tailored for the strong requirements of overall system optimizations. A waist-worn biofeedback device was designed using the BSN. Extensive bench tests have shown that the generalized BSN worked as intended. In-situ experiments with 22 subjects indicated that the biofeedback device was discreet, easy to wear, and capable of offering wearable respiratory trainings. Pilot studies on wearable training patterns and resultant heart rate variability suggested that paced respirations at abdominal level and with identical inhaling/exhaling ratio were more appropriate for decreasing sympathetic arousal and increasing parasympathetic activities. PMID:21545293

  2. Self-organized Criticality in a Modified Evolution Model on Generalized Barabasi-Albert Scale-Free Networks

    International Nuclear Information System (INIS)

    Lin Min; Wang Gang; Chen Tianlun

    2007-01-01

    A modified evolution model of self-organized criticality on generalized Barabasi-Albert (GBA) scale-free networks is investigated. In our model, we find that spatial and temporal correlations exhibit critical behaviors. More importantly, these critical behaviors change with the parameter b, which weights the distance in comparison with the degree in the GBA network evolution.

  3. 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.

  4. 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.

  5. Simulation Study on the Application of the Generalized Entropy Concept in Artificial Neural Networks

    Directory of Open Access Journals (Sweden)

    Krzysztof Gajowniczek

    2018-04-01

    Full Text Available Artificial neural networks are currently one of the most commonly used classifiers and over the recent years they have been successfully used in many practical applications, including banking and finance, health and medicine, engineering and manufacturing. A large number of error functions have been proposed in the literature to achieve a better predictive power. However, only a few works employ Tsallis statistics, although the method itself has been successfully applied in other machine learning techniques. This paper undertakes the effort to examine the q -generalized function based on Tsallis statistics as an alternative error measure in neural networks. In order to validate different performance aspects of the proposed function and to enable identification of its strengths and weaknesses the extensive simulation was prepared based on the artificial benchmarking dataset. The results indicate that Tsallis entropy error function can be successfully introduced in the neural networks yielding satisfactory results and handling with class imbalance, noise in data or use of non-informative predictors.

  6. HealthNavigator: a mobile application for chronic disease screening and linkage to services at an urban Primary Health Network.

    Science.gov (United States)

    Seneviratne, Martin G; Hersch, Fred; Peiris, David P

    2018-03-26

    Mobile applications (apps) are promising tools to support chronic disease screening and linkage to health services. They have the potential to increase healthcare access for vulnerable populations. The HealthNavigator app was developed to provide chronic disease risk assessments, linkage to local general practitioners (GPs) and lifestyle programs, and a personalised health report for discussion with a GP. Assessments were either self-administered or facilitated by community health workers through a Primary Health Network (PHN) initiative targeting ethnically diverse communities. In total, 1492 assessments (80.4% self-administered, 19.6% facilitated) were conducted over a 12-month period in Queensland, Australia. Of these, 26% of people screened came from postcodes representing the lowest quartile of socioeconomic disadvantage. When compared against self-administered assessments, subjects screened by the facilitated program were more likely to be born outside Australia (80.5 v. 33.2%, P<0.001), and to fall within a high risk category based on cardiovascular risk scores (19.8 v. 13.7%, P<0.01) and type 2 diabetes mellitus risk scores (58.0 v. 40.1%, P<0.001). Mobile apps embedded into PHN programs may be a useful adjunct for the implementation of community screening programs. Further research is needed to determine their effect on health service access and health outcomes.

  7. 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.

  8. The Factor Structure of ADHD in a General Population of Primary School Children

    Science.gov (United States)

    Ullebo, Anne Karin; Breivik, Kyrre; Gillberg, Christopher; Lundervold, Astri J.; Posserud, Maj-Britt

    2012-01-01

    Objective: To examine whether a bifactor model with a general ADHD factor and domain specific factors of inattention, hyperactivity and impulsivity was supported in a large general population sample of children. We also explored the utility of forming subscales based on the domain-specific factors. Methods: Child mental health questionnaires were…

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

    KAUST Repository

    Douik, Ahmed S.; Sorour, Sameh; Alouini, Mohamed-Slim; Ai-Naffouri, Tareq Y.

    2013-01-01

    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.

  10. 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.

  11. Use of email in communication between the Finnish primary healthcare system and general practitioners

    Directory of Open Access Journals (Sweden)

    Tuula Karhula

    2011-03-01

    Conclusion Especially during periods of change in the workplace, it is very important that management is conducted personally. Care must be taken so that disinformation does not spoil the informative value of email in the administration of primary health care. The needed technical assistance should be given to everyone in order to get the best advantage from the use of the email system.

  12. 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…

  13. 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)

  14. Development of Communicative Tolerance among Teachers of Primary and Senior Level of the General Education School

    Science.gov (United States)

    Povarenkov, Yury P.; Baranova, Nataly A.; Sidorova, Anna D.; Mitiukov, Nicholas W.

    2018-01-01

    The article is devoted to the study of the influence of the level of development of communicative tolerance on the effectiveness of the teaching and educational activity of primary and senior schoolteachers. In the article the concepts of psychophysiological and communicative tolerance are separated. The psychological content of communicative…

  15. Do project management and network governance contribute to inter-organisational collaboration in primary care? A mixed methods study.

    Science.gov (United States)

    Schepman, Sanneke; Valentijn, Pim; Bruijnzeels, Marc; Maaijen, Marlies; de Bakker, Dinny; Batenburg, Ronald; de Bont, Antoinette

    2018-06-07

    The need for organisational development in primary care has increased as it is accepted as a means of curbing rising costs and responding to demographic transitions. It is only within such inter-organisational networks that small-scale practices can offer treatment to complex patients and continuity of care. The aim of this paper is to explore, through the experience of professionals and patients, whether, and how, project management and network governance can improve the outcomes of projects which promote inter-organisational collaboration in primary care. This paper describes a study of projects aimed at improving inter-organisational collaboration in Dutch primary care. The projects' success in project management and network governance was monitored by interviewing project leaders and board members on the one hand, and improvement in the collaboration by surveying professionals and patients on the other. Both qualitative and quantitative methods were applied to assess the projects. These were analysed, finally, using multi-level models in order to account for the variation in the projects, professionals and patients. Successful network governance was associated positively with the professionals' satisfaction with the collaboration; but not with improvements in the quality of care as experienced by patients. Neither patients nor professionals perceived successful project management as associated with the outcomes of the collaboration projects. This study shows that network governance in particular makes a difference to the outcomes of inter-organisational collaboration in primary care. However, project management is not a predictor for successful inter-organisational collaboration in primary care.

  16. Spectrum Sensing and Primary User Localization in Cognitive Radio Networks via Sparsity

    Directory of Open Access Journals (Sweden)

    Lanchao Liu

    2016-01-01

    Full Text Available The theory of compressive sensing (CS has been employed to detect available spectrum resource in cognitive radio (CR networks recently. Capitalizing on the spectrum resource underutilization and spatial sparsity of primary user (PU locations, CS enables the identification of the unused spectrum bands and PU locations at a low sampling rate. Although CS has been studied in the cooperative spectrum sensing mechanism in which CR nodes work collaboratively to accomplish the spectrum sensing and PU localization task, many important issues remain unsettled. Does the designed compressive spectrum sensing mechanism satisfy the Restricted Isometry Property, which guarantees a successful recovery of the original sparse signal? Can the spectrum sensing results help the localization of PUs? What are the characteristics of localization errors? To answer those questions, we try to justify the applicability of the CS theory to the compressive spectrum sensing framework in this paper, and propose a design of PU localization utilizing the spectrum usage information. The localization error is analyzed by the Cramér-Rao lower bound, which can be exploited to improve the localization performance. Detail analysis and simulations are presented to support the claims and demonstrate the efficacy and efficiency of the proposed mechanism.

  17. 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.

  18. Head-circumference distribution in a large primary care network differs from CDC and WHO curves.

    Science.gov (United States)

    Daymont, Carrie; Hwang, Wei-Ting; Feudtner, Chris; Rubin, David

    2010-10-01

    To compare currently available head-circumference growth curves to curves constructed from clinical measurements from patients in a large US primary care network (PCN). We performed a retrospective cohort study of 75 412 patients in an urban-suburban PCN. Patients with a birth weight of curves. The PCN curves were most similar to the National Center for Health Statistics (NCHS) curves and were substantially different from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) curves. The overall proportion of observations above the 95th percentile was 4.9% (PCN), 6.2% (NCHS), 8.6% (CDC), and 14.0% (WHO). The proportion below the 5th percentile was 4.4% (PCN), 5.1% (NCHS), 2.9% (CDC), and 2.3% (WHO). When using the CDC curves, the proportion above the 95th percentile increased from 0.2% for children younger than 2 weeks to 11.8% for children 12 months old. When using the WHO curves, the proportion above the 95th percentile was >5% at all ages, with a maximum of 18.0% for children older than 24 months. The CDC and WHO head-circumference curves describe different distributions than the clinical measurements in our PCN population, especially for children with larger heads. The resulting percentile misclassification may delay diagnosis in children with intracranial pathology in very young infants and spur unnecessary evaluation of healthy children older than 6 months.

  19. Meningococcal vaccination in primary care amongst adolescents in North West England: an ecological study investigating associations with general practice characteristics.

    Science.gov (United States)

    Blagden, Sarah; Hungerford, Daniel; Limmer, Mark

    2018-01-27

    In 2015 the meningococcal ACWY (MenACWY) vaccination was introduced amongst adolescents in England following increased incidence and mortality associated with meningococcal group W. MenACWY vaccination uptake data for 17-18 years old and students delivered in primary care were obtained for 20 National Health Service clinical commissioning groups (CCGs) via the ImmForm vaccination system. Data on general practice characteristics, encompassing demographics and patient satisfaction variables, were extracted from the National General Practice Profiles resource. Univariable analysis of the associations between practice characteristics and vaccination was performed, followed by multivariable negative binomial regression. Data were utilized from 587 general practices, accounting for ~8% of all general practices in England. MenACWY vaccination uptake varied from 20.8% to 46.8% across the CCGs evaluated. Upon multivariable regression, vaccination uptake increased with increasing percentage of patients from ethnic minorities, increasing percentage of patients aged 15-24 years, increasing percentage of patients that would recommend their practice and total Quality and Outcomes Framework achievement for the practice. Conversely, vaccination uptake decreased with increasing deprivation. This study has identified several factors independently associated with MenACWY vaccination in primary care. These findings will enable a targeted approach to improve general practice-level vaccination uptake. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. 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.

  1. 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

  2. Algorithmic Optimal Management of a Potable Water Distribution System: Application to the Primary Network of Bonaberi (Douala, Cameroon

    Directory of Open Access Journals (Sweden)

    Zineb Simeu-Abazi

    2009-11-01

    Full Text Available The optimal management of a potable water distribution system requires the control of the reference (standard data, the control points, control of the drainage parameters (pressure, flow, etc. and maintenance parameters. The control of the mentioned data defines the network learning process [1]. Besides classic IT functions of acquisition, storage and data processing, a geographical information system (GIS can be used as the basis for an alarm system, allowing one to identify and to localize the presence of water leaks in the network [2]. In this article we propose an algorithm coupling the various drainage parameters for the management of the network. The algorithm leads to an optimal management of leaks. An application is in progress on the primary network in the region of Bonaberi in Douala, the largest city of Cameroon.

  3. Prediction of the temperature of the atmosphere of the primary containment: comparison between neural networks and polynomial regression

    International Nuclear Information System (INIS)

    Alvarez Huerta, A.; Gonzalez Miguelez, R.; Garcia Metola, D.; Noriega Gonzalez, A.

    2011-01-01

    The modelization is carried out through two different techniques, a conventional polynomial regression and other based on an approach by neural networks artificial. He is a comparison between the quality of the forecast would make different models based on the polynomial regression and neural network with generalization by Bayesian regulation, using the indicators of the root of the mean square error and the coefficient of determination, in view of the results, the neural network generates a prediction more accurate and reliable than the polynomial regression.

  4. Trends in diabetes incidence from 1992 to 2015 and projections for 2024: A Portuguese General Practitioner's Network study.

    Science.gov (United States)

    de Sousa-Uva, Mafalda; Antunes, L; Nunes, B; Rodrigues, A P; Simões, J A; Ribeiro, R T; Boavida, J M; Matias-Dias, C

    2016-10-01

    Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is known as the European country with the highest prevalence of this disease. While diabetes prevalence data is updated annually in Portugal, the General Practitioner's (GP) Sentinel Network represents the only data source on diabetes incidence. This study describes the trends in Diabetes incidence, between 1992 and 2015, and estimate projections for the future incidence rates in Portugal until 2024. An ecological time-series study was conducted using data from GP Sentinel Network between 1992 and 2015. Family doctors reported all new cases of Diabetes in their patients' lists. Annual trends were estimated through Poisson regression models as well as the future incidence rates (until 2024), sex and age group stratified. Incidence rate projections were adjusted to the distribution of the resident Portuguese population given Statistics Portugal projections. The average increase in Diabetes incidence rate was in total 4.29% (CI95% 3.80-4.80) per year under study. Until 1998-2000, the annual incidence rate was higher in women, and from 1998-2000 to 2013-2015 turn out to be higher in men. The incidence rate projected for 2022-2024 was 972.77/10(5) inhabitants in total, and 846.74/10(5) and 1114.42/10(5), respectively, in women and men. This is the first study in Portugal to estimate diabetes incidence rate projections. The disturbing reported projections seem realistic if things continue as in the past. Actually, effective public health policies will need to be undertaken to minimize this alarming future scenario. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  5. Improving outcomes for patients with type 2 diabetes using general practice networks: a quality improvement project in east London.

    Science.gov (United States)

    Hull, Sally; Chowdhury, Tahseen A; Mathur, Rohini; Robson, John

    2014-02-01

    Structured diabetes care can improve outcomes and reduce risk of complications, but improving care in a deprived, ethnically diverse area can prove challenging. This report evaluates a system change to enhance diabetes care delivery in a primary care setting. All 35 practices in one inner London Primary Care Trust were geographically grouped into eight networks of four to five practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary team developed a 'care package' for type 2 diabetes management, with financial incentives based on network achievement of targets. Monthly electronic performance dashboards enabled networks to track and improve performance. Network multidisciplinary team meetings including the diabetic specialist team supported case management and education. Key measures for improvement included the number of diabetes care plans completed, proportion of patients attending for digital retinal screen and proportions of patients achieving a number of biomedical indices (blood pressure, cholesterol, glycated haemoglobin). Between 2009 and 2012, completed care plans rose from 10% to 88%. The proportion of patients attending for digital retinal screen rose from 72% to 82.8%. The proportion of patients achieving a combination of blood pressure ≤ 140/80 mm Hg and cholesterol ≤ 4 mmol/L rose from 35.3% to 46.1%. Mean glycated haemoglobin dropped from 7.80% to 7.66% (62-60 mmol/mol). Investment of financial, organisational and education resources into primary care practice networks can achieve clinically important improvements in diabetes care in deprived, ethnically diverse communities. This success is predicated on collaborative working between practices, purposively designed high-quality information on network performance and engagement between primary and secondary care clinicians.

  6. 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.

  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. 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.

  10. Predicting mastitis in dairy cows using neural networks and generalized additive models

    DEFF Research Database (Denmark)

    Anantharama Ankinakatte, Smitha; Norberg, Elise; Løvendahl, Peter

    2013-01-01

    The aim of this paper is to develop and compare methods for early detection of oncoming mastitis with automated recorded data. The data were collected at the Danish Cattle Research Center (Tjele, Denmark). As indicators of mastitis, electrical conductivity (EC), somatic cell scores (SCS), lactate...... that combines residual components into a score to improve the model. To develop and verify the model, the data are randomly divided into training and validation data sets. To predict the occurrence of mastitis, neural network models (NNs) and generalized additive models (GAMs) are developed using the training...... classification with all indicators, using individual residuals rather than factor scores. When SCS is excluded, GAMs shows better classification result when milk yield is also excluded. In conclusion, the study shows that NNs and GAMs are similar in their ability to detect mastitis, a sensitivity of almost 75...

  11. 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.

  12. Exponential H(infinity) synchronization of general discrete-time chaotic neural networks with or without time delays.

    Science.gov (United States)

    Qi, Donglian; Liu, Meiqin; Qiu, Meikang; Zhang, Senlin

    2010-08-01

    This brief studies exponential H(infinity) synchronization of a class of general discrete-time chaotic neural networks with external disturbance. On the basis of the drive-response concept and H(infinity) control theory, and using Lyapunov-Krasovskii (or Lyapunov) functional, state feedback controllers are established to not only guarantee exponential stable synchronization between two general chaotic neural networks with or without time delays, but also reduce the effect of external disturbance on the synchronization error to a minimal H(infinity) norm constraint. The proposed controllers can be obtained by solving the convex optimization problems represented by linear matrix inequalities. Most discrete-time chaotic systems with or without time delays, such as Hopfield neural networks, cellular neural networks, bidirectional associative memory networks, recurrent multilayer perceptrons, Cohen-Grossberg neural networks, Chua's circuits, etc., can be transformed into this general chaotic neural network to be H(infinity) synchronization controller designed in a unified way. Finally, some illustrated examples with their simulations have been utilized to demonstrate the effectiveness of the proposed methods.

  13. 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.

  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)

    DSouza, Adora M; Abidin, Anas Zainul; Nagarajan, Mahesh B; Wismüller, Axel

    2016-03-29

    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. 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.

  16. 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...

  17. 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

  18. How primary care reforms influenced health indicators in Manisa district in Turkey: Lessons for general practitioners.

    Science.gov (United States)

    Cevik, Celalettin; Sozmen, Kaan; Kilic, Bulent

    2018-12-01

    Turkish health reforms began in 2003 and brought some significant changes in primary care services. Few studies in Turkey compare the shift from health centres (HC) to family physicians (FP) approach, which was initiated by reforms. This study compares health status indicators during the HC period before reforms (2003-2007) and the FP period after reforms (2008-2012) in Turkey. This study encompasses time series data consisting of the results of a 10-year assessment (2003-2012) in Manisa district. All the data were obtained electronically and by month. The intersection points of the regression curves of these two periods and the beta coefficients were compared using segmented linear regression analysis. The mean number of follow-up per person/year during the HC period in infants (10.5), pregnant women (6.6) and women (1.8) was significantly higher than the mean number of follow-up during the FP period in infants (6.7), pregnant women (5.6) and women (0.9). Rates of BCG and measles vaccinations were significantly higher during the FP period; however, rates of HBV and DPT were same. The mean number of outpatient services per person/year during the FP period (3.3) was significantly higher than HC period (2.8). Within non-communicable diseases, no difference was detected for hypertension prevalence. Within communicable diseases, there was no difference for rabies suspected bites but acute haemorrhagic gastroenteritis significantly decreased. The infant mortality rate and under five-year child mortality rate significantly increased during the FP period. Primary care services should be reorganized and integrated with public health services.

  19. 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

  20. 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

  1. Risk of Post-Discharge Venous Thromboembolism and Associated Mortality in General Surgery: A Population-Based Cohort Study Using Linked Hospital and Primary Care Data in England.

    Science.gov (United States)

    Bouras, George; Burns, Elaine Marie; Howell, Ann-Marie; Bottle, Alex; Athanasiou, Thanos; Darzi, Ara

    2015-01-01

    Trends towards day case surgery and enhanced recovery mean that postoperative venous thromboembolism (VTE) may increasingly arise after hospital discharge. However, hospital data alone are unable to capture adverse events that occur outside of the hospital setting. The National Institute for Health and Care Excellence has suggested the use of primary care data to quantify hospital care-related VTE. Data in surgical patients using these resources is lacking. The aim of this study was to measure VTE risk and associated mortality in general surgery using linked primary care and hospital databases, to improve our understanding of harm from VTE that arises beyond hospital stay. This was a longitudinal cohort study using nationally linked primary care (Clinical Practice Research Datalink, CPRD), hospital administrative (Hospital Episodes Statistics, HES), population statistics (Office of National Statistics, ONS) and National Cancer Intelligence Network databases. Routinely collected information was used to quantify 90-day in-hospital VTE, 90-day post-discharge VTE and 90-day mortality in adults undergoing one of twelve general surgical procedures between 1st April 1997 and 31st March 2012. The earliest postoperative recording of deep vein thrombosis or pulmonary embolism in CPRD, HES and ONS was counted in each patient. Covariates from multiple datasets were combined to derive detailed prediction models for VTE and mortality. Limitation included the capture of VTE presenting to healthcare only and the lack of information on adherence to pharmacological thromboprophylaxis as there was no data linkage to hospital pharmacy records. There were 981 VTE events captured within 90 days of surgery in 168005 procedures (23.7/1000 patient-years). Overall, primary care data increased the detection of postoperative VTE by a factor of 1.38 (981/710) when compared with using HES and ONS only. Total VTE rates ranged between 3.2/1000 patient-years in haemorrhoidectomy to 118

  2. 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.

  3. Healthcare utilization in general practice before and after psychological treatment: a follow-up data linkage study in primary care.

    Science.gov (United States)

    Prins, Marijn A; Verhaak, Peter F M; Smit, Dineke; Verheij, Robert A

    2014-09-01

    Literature suggests that serious mental health problems increase the use of health services and psychological interventions can reduce this effect. This study investigates whether this effect is also found in primary care patients with less serious mental health problems. Routine electronic health records (EHR) from a representative sample of 128 general practices were linked to patient files from 150 primary care psychologists participating in the NIVEL Primary Care Database, using a trusted third party. Data were linked using the date of birth, gender, and postcode. This yielded 503 unique data pairs that were listed in one of the participating GP practices in 2008-2010, for people who had psychological treatment from a psychologist that ended in 2009. The number of contacts, health problems presented, and prescribed medication in general practice were analysed before and after the psychological treatment. Nearly all 503 patients consulted their GP during the six months preceding the psychological treatment (90.9%) and also in the six months after this treatment had ended (83.7%). The frequency of contacts was significantly higher before than after the psychological treatment (6.1 vs. 4.8). Fewer patients contacted their GPs specifically for psychological or social problems (46.3% vs. 38.8%) and fewer patients had anxiolytic drug prescriptions (15.5% vs. 7.6%) after psychological treatment. After psychological treatment, patients contact their GPs less often and present fewer psychological or social problems. Although contact rates seem to decrease, clients of psychologists are still frequent GP attenders.

  4. 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.

  5. 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.

  6. Feature extraction with deep neural networks by a generalized discriminant analysis.

    Science.gov (United States)

    Stuhlsatz, André; Lippel, Jens; Zielke, Thomas

    2012-04-01

    We present an approach to feature extraction that is a generalization of the classical linear discriminant analysis (LDA) on the basis of deep neural networks (DNNs). As for LDA, discriminative features generated from independent Gaussian class conditionals are assumed. This modeling has the advantages that the intrinsic dimensionality of the feature space is bounded by the number of classes and that the optimal discriminant function is linear. Unfortunately, linear transformations are insufficient to extract optimal discriminative features from arbitrarily distributed raw measurements. The generalized discriminant analysis (GerDA) proposed in this paper uses nonlinear transformations that are learnt by DNNs in a semisupervised fashion. We show that the feature extraction based on our approach displays excellent performance on real-world recognition and detection tasks, such as handwritten digit recognition and face detection. In a series of experiments, we evaluate GerDA features with respect to dimensionality reduction, visualization, classification, and detection. Moreover, we show that GerDA DNNs can preprocess truly high-dimensional input data to low-dimensional representations that facilitate accurate predictions even if simple linear predictors or measures of similarity are used.

  7. Artificial neural network models for prediction of cardiovascular autonomic dysfunction in general Chinese population

    Science.gov (United States)

    2013-01-01

    Background The present study aimed to develop an artificial neural network (ANN) based prediction model for cardiovascular autonomic (CA) dysfunction in the general population. Methods We analyzed a previous dataset based on a population sample consisted of 2,092 individuals aged 30–80 years. The prediction models were derived from an exploratory set using ANN analysis. Performances of these prediction models were evaluated in the validation set. Results Univariate analysis indicated that 14 risk factors showed statistically significant association with CA dysfunction (P < 0.05). The mean area under the receiver-operating curve was 0.762 (95% CI 0.732–0.793) for prediction model developed using ANN analysis. The mean sensitivity, specificity, positive and negative predictive values were similar in the prediction models was 0.751, 0.665, 0.330 and 0.924, respectively. All HL statistics were less than 15.0. Conclusion ANN is an effective tool for developing prediction models with high value for predicting CA dysfunction among the general population. PMID:23902963

  8. Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study.

    Science.gov (United States)

    Ghosh, Abhijeet; McCarthy, Sandra; Halcomb, Elizabeth

    2016-04-26

    Technological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable. We aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical software used in primary care settings of regional NSW. Focus groups were conducted with general practitioners, practice nurses and practice administrative staff from 17 practices in the Illawarra-Shoalhaven region of the state of New South Wales (NSW) in Australia that had participated in the Sentinel Practices Data Sourcing (SPDS) project - a general practice based chronic disease surveillance and data quality improvement study. A total of 25 respondents that included 12 general practitioners (GPs) and 13 practice staff participated in the 6 focus groups. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis of the data was undertaken. Five key themes emerged from the data. Firstly, the theme of resourcing data management raised issues of time constraints, the lack of a dedicated data management role and the importance of multidisciplinary involvement, including a data champion. The need for incentives was identified as being important to motivate ongoing commitment to maintaining data quality. However, quality of software packages, including coding issues and software limitations and information technology skills were seen as key barriers. The final theme provided insight into the lessons learnt from the project and the increased awareness of the importance of data quality amongst practice staff. The move towards electronic methods of maintaining general practice patient records offers significant potential benefits in terms of both patient care and monitoring of health

  9. 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.)

  10. 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.)

  11. 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.

  12. 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...... 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....... 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...

  13. 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

  14. 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.

  15. Effects of primary care team social networks on quality of care and costs for patients with cardiovascular disease.

    Science.gov (United States)

    Mundt, Marlon P; Gilchrist, Valerie J; Fleming, Michael F; Zakletskaia, Larissa I; Tuan, Wen-Jan; Beasley, John W

    2015-03-01

    Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Primary care teams can be best suited to improve quality of care and lower costs for patients with cardiovascular disease. This study evaluates the associations between primary care team communication, interaction, and coordination (ie, social networks); quality of care; and costs for patients with cardiovascular disease. Using a sociometric survey, 155 health professionals from 31 teams at 6 primary care clinics identified with whom they interact daily about patient care. Social network analysis calculated variables of density and centralization representing team interaction structures. Three-level hierarchical modeling evaluated the link between team network density, centralization, and number of patients with a diagnosis of cardiovascular disease for controlled blood pressure and cholesterol, counts of urgent care visits, emergency department visits, hospital days, and medical care costs in the previous 12 months. Teams with dense interactions among all team members were associated with fewer hospital days (rate ratio [RR] = 0.62; 95% CI, 0.50-0.77) and lower medical care costs (-$556; 95% CI, -$781 to -$331) for patients with cardiovascular disease. Conversely, teams with interactions revolving around a few central individuals were associated with increased hospital days (RR = 1.45; 95% CI, 1.09-1.94) and greater costs ($506; 95% CI, $202-$810). Team-shared vision about goals and expectations mediated the relationship between social network structures and patient quality of care outcomes. Primary care teams that are more interconnected and less centralized and that have a shared team vision are better positioned to deliver high-quality cardiovascular disease care at a lower cost. © 2015 Annals of Family Medicine, Inc.

  16. Optimizing the District Heating Primary Network from the Perspective of Economic-Specific Pressure Loss

    Directory of Open Access Journals (Sweden)

    Haichao Wang

    2017-07-01

    Full Text Available A district heating (DH system is one of the most important components of infrastructures in cold areas. Proper DH network design should balance the initial investment and the heat distribution cost of the DH network. Currently, this design is often based on a recommended value for specific pressure loss (R = ∆P/L in the main lines. This will result in a feasible network design, but probably not be optimal in most cases. The paper develops a novel optimization model to facilitate the design by considering the initial investment in the pipes and the heat distribution costs. The model will generate all possible network scenarios consisting of different series of diameters for each pipe in the flow direction of the network. Then, the annuity on the initial investment, the heat distribution cost, and the total annual cost will be calculated for each network scenario, taking into account the uncertainties of the material prices and the yearly operating time levels. The model is applied to a sample DH network and the results indicate that the model works quite well, clearly identifying the optimal network design and demonstrating that the heat distribution cost is more important than the initial investment in DH network design.

  17. 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.

  18. Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

    Science.gov (United States)

    Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

    2018-01-01

    General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

  19. Treatment of primary hypertriglyceridemia states--General approach and the role of extracorporeal methods.

    Science.gov (United States)

    Stefanutti, Claudia; Julius, Ulrich

    2015-05-01

    Hypertriglyceridemia (HTG) is a common metabolic disorder in which the concentration of very low density lipoproteins (VLDL) and of chylomicrons (CMs) is elevated in the plasma. HTG may be caused by primary and/or secondary causes and affected subjects may express HTG when children or in adulthood. In children and adults a genetic cause may underlie HTG which can be expressed as CMs a severe clinical picture known as Familial Hyperchylomicronemia due to lipoprotein lipase (LPL) or apolipoprotein (apo) CII deficiencies. Genetically determined HTG includes Familial Dysbetalipoproteinemia due to deficiency of apolipoprotein EIII of VLDL and Familial HTG. However, recent data suggest that classical Fredrickson phenotypes describing clinically HTG, which were once considered to be distinct based on biochemical features, have a shared genetic set up. The HTG has been classified according to a recent international paper: mild HTG: 2-10 mmol/L (176-882 mg/dL); severe HTG: > 10 mmol/L (>882 mg/dL) associated to CMs remnants, or Intermediate Density lipoprotein (IDL) like particles, and/or CMs. The treatment includes limitation of dietary content of saturated fat and alcohol, fibrates and omega3 fatty acids. When TG are severely elevated and associated to CMs the risk of acute pancreatitis suggests the use of more drastic therapeutic option such as therapeutic plasma exchange. This paper summarizes the experience with conventional plasmapheresis (Plasma-Exchange, PEX) and different Lipoprotein Apheresis methods with respect to acutely lowering TG levels in patients with normal TG, with mild and severe HTG. Upcoming promising therapies are gene therapy, novel apolipoprotein CIII inhibitors and lomitapide. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. 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.

  1. 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

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

    KAUST Repository

    Shakir, Muhammad; Tabassum, Hina; Alouini, Mohamed-Slim

    2014-01-01

    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

  3. 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

  4. General Practitioner trainers prescribe fewer antibiotics in primary care: Evidence from France.

    Science.gov (United States)

    Devillers, Louise; Sicsic, Jonathan; Delbarre, Angelique; Le Bel, Josselin; Ferrat, Emilie; Saint Lary, Olivier

    2018-01-01

    Antibiotic prescription is a central public health issue. Overall, 90% of antibiotic prescriptions are delivered to patients in ambulatory care, and a substantial proportion of these prescriptions could be avoided. General Practitioner (GP) trainers are similar to other GPs in terms of sociodemographic and medical activities, but they may have different prescription patterns. Our aim was to compare the antibiotic prescribing rates between GP trainers and non-trainers. This observational cross-sectional study was conducted on administrative data claims from the French National Health Insurance. The antibiotic prescribing rate was calculated. The main independent variable was the training status of the GPs. Prescribing rates were adjusted for the various GPs' characteristics (gender, age, location of the practice, number of visits per GP and the case-mix) in a multiple linear regression analysis. Between June 2014 and July 2015 the prescribing patterns of 860 GPs were analysed, among which 102 were GP trainers (12%). Over the year 363,580 patients were prescribed an antibiotic out of 3,499,248 visits for 1,299,308 patients seen over the year thus representing around 27.5% of patients. In the multivariate analyses, being a trainer resulted in a significant difference of 6.62 percentage points (IC 95%: [-8.55; -4.69]; prole of GP trainers in antibiotic prescriptions. By prescribing fewer antibiotics and influencing the next generations of GPs, the human and economic burden of antibiotics could be reduced.

  5. 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

  6. Association of general psychological factors with frequent attendance in primary care: a population-based cross-sectional observational study.

    Science.gov (United States)

    Hajek, André; Bock, Jens-Oliver; König, Hans-Helmut

    2017-03-24

    Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors. Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446). Positive and negative affect, life satisfaction, optimism, self-esteem, self-efficacy, and self-regulation were included as general psychological factors. The number of self-reported GP visits in the past twelve months was used to quantify frequency of attendance; individuals with more than 9 visits (highest decile) were defined as frequent attenders. Multiple logistic regressions showed that being a frequent attender was positively associated with less life satisfaction [OR: 0.79 (0.70-0.89)], higher negative affect [OR: 1.38 (1.17-1.62)], less self-efficacy [OR: 0.74 (0.63-0.86)], less self-esteem [OR: 0.65 (0.54-0.79)], less self-regulation [OR: 0.74 (0.60-0.91)], and higher perceived stress [OR: 1.46 (1.28-1.66)], after adjusting for sociodemographic factors, morbidity and lifestyle factors. However, frequent attendance was not significantly associated with positive affect and self-regulation. The present study highlights the association between general psychological factors and frequent attendance. As frequent GP visits produce high health care costs and are potentially associated with increased referrals and use of secondary health care services, this knowledge might help to address these individuals with high needs.

  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. 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

  9. 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.

  10. 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.

  11. An Improved Method for Sizing Standalone Photovoltaic Systems Using Generalized Regression Neural Network

    Directory of Open Access Journals (Sweden)

    Tamer Khatib

    2014-01-01

    Full Text Available In this research an improved approach for sizing standalone PV system (SAPV is presented. This work is an improved work developed previously by the authors. The previous work is based on the analytical method which faced some concerns regarding the difficulty of finding the model’s coefficients. Therefore, the proposed approach in this research is based on a combination of an analytical method and a machine learning approach for a generalized artificial neural network (GRNN. The GRNN assists to predict the optimal size of a PV system using the geographical coordinates of the targeted site instead of using mathematical formulas. Employing the GRNN facilitates the use of a previously developed method by the authors and avoids some of its drawbacks. The approach has been tested using data from five Malaysian sites. According to the results, the proposed method can be efficiently used for SAPV sizing whereas the proposed GRNN based model predicts the sizing curves of the PV system accurately with a prediction error of 0.6%. Moreover, hourly meteorological and load demand data are used in this research in order to consider the uncertainty of the solar energy and the load demand.

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

    KAUST Repository

    Sorour, Sameh; Aboutorab, Neda; Sadeghi, Parastoo; Karim, Mohammad Shahriar; Al-Naffouri, Tareq Y.; Alouini, Mohamed-Slim

    2013-01-01

    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.

  13. Diagnostics for generalized linear hierarchical models in network meta-analysis.

    Science.gov (United States)

    Zhao, Hong; Hodges, James S; Carlin, Bradley P

    2017-09-01

    Network meta-analysis (NMA) combines direct and indirect evidence comparing more than 2 treatments. Inconsistency arises when these 2 information sources differ. Previous work focuses on inconsistency detection, but little has been done on how to proceed after identifying inconsistency. The key issue is whether inconsistency changes an NMA's substantive conclusions. In this paper, we examine such discrepancies from a diagnostic point of view. Our methods seek to detect influential and outlying observations in NMA at a trial-by-arm level. These observations may have a large effect on the parameter estimates in NMA, or they may deviate markedly from other observations. We develop formal diagnostics for a Bayesian hierarchical model to check the effect of deleting any observation. Diagnostics are specified for generalized linear hierarchical NMA models and investigated for both published and simulated datasets. Results from our example dataset using either contrast- or arm-based models and from the simulated datasets indicate that the sources of inconsistency in NMA tend not to be influential, though results from the example dataset suggest that they are likely to be outliers. This mimics a familiar result from linear model theory, in which outliers with low leverage are not influential. Future extensions include incorporating baseline covariates and individual-level patient data. Copyright © 2017 John Wiley & Sons, Ltd.

  14. PERAMALAN BEBAN JANGKA PENDEK PADA HARI LIBUR DI BALI MENGGUNAKAN METODE GENERALIZED REGRESSION NEURAL NETWORK (GRNN

    Directory of Open Access Journals (Sweden)

    Juniar Doan Wihardono

    2016-12-01

    Full Text Available Peramalan beban merupakan suatu kegiatan untuk memperkirakan kondisi beban pada hari yang akan datang. Kondisi beban pada saat hari libur merupakan suatu fenomena yang sangat menarik untuk diketahui. Fenomena ini terjadi di Bali yaitu pada saat hari Raya Nyepi. Karena, kondisi beban pada hari Raya Nyepi akan mengalami penurunan yang sangat drastis. Kondisi tersebut perlu diketahui agar operasi sistem tenaga listrik dapat berjalan secara optimal. Metode peramalan beban pada penelitian ini menggunakan metode Generalized Regression Neural Nework (GRNN yang dibandingkan dengan metode Radial Basis Function Neural Network (RBFNN. Data pada proses peramalan menggunakan data beban puncak harian pada hari libur di Bali antara tahun 2010 sampai 2014. Pemilihan data difokuskan pada data beban puncak pada 5 hari sebelum hari libur (h-4 sampai hari libur (h. Metode GRNN menghasilkan Mean Square Error (MSE sebesar 0.020089 dan Mean Absolute Percentage Error (MAPE sebesar 2.01%. sedangkan metode RBFNN menghasilkan MSE sebesar 0.022757 dan MAPE sebesar 2,28%.

  15. Mortality after hemorrhagic stroke: data from general practice (The Health Improvement Network).

    Science.gov (United States)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann; McFeat, Gillian; García-Rodríguez, Luis A

    2013-08-06

    To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. Thirty-day case fatality was stratified by age, sex, and calendar year after ICH and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients during the first year of follow-up compared with controls (ICH: hazard ratio [HR] 2.60, 95% confidence interval [CI] 2.09-3.24, p hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated risk of death compared with matched individuals from the general population.

  16. 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

    2018-05-01

    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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

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

    KAUST Repository

    Khan, Fahd Ahmed; Tourki, Kamel; Alouini, Mohamed-Slim; Qaraqe, Khalid A.

    2014-01-01

    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

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

    DEFF Research Database (Denmark)

    Maham, Behrouz; Popovski, Petar

    2015-01-01

    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 interfer...

  3. A Neural Network Controller for Variable-Speed Variable-Pitch Wind Energy Conversion Systems Using Generalized Minimum Entropy Criterion

    Directory of Open Access Journals (Sweden)

    Mifeng Ren

    2014-01-01

    Full Text Available This paper considers the neural network controller design problem for variable pitch wind energy conversion systems (WECS with non-Gaussian wind speed disturbances in the stochastic distribution control framework. The approach here is used to directly model the unknown control law based on a fixed neural network (the number of layers and nodes in a neural network is fixed without the need to construct a separate model for the WECS. In order to characterize the randomness of the WECS, a generalized minimum entropy criterion is established to train connection weights of the neural network. For the train purpose, both kernel density estimation method and sliding window technique are adopted to estimate the PDF of tracking error and entropies. Due to the unknown process dynamics, the gradient of the objective function in a gradient-descent-type algorithm is estimated using an incremental perturbation method. The proposed approach is illustrated on a simulated WECS with non-Gaussian wind speed.

  4. Surgery under general anaesthesia in severe hidradenitis suppurativa: a study of 363 primary operations in 113 patients.

    Science.gov (United States)

    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; Horváth, B

    2015-08-01

    Treatment 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. To investigate characteristics, surgical outcomes and patient satisfaction of HS patients who underwent deroofing or STEEP under general anaesthesia. A clinical records-based retrospective analysis was conducted of all patients who had surgery under general anaesthesia between 1999 and 2013. Patient satisfaction was retrospectively investigated with questionnaires. A total of 482 operations (363 primary operations and 119 re-operations) were performed during the study period. The proportion of women in the included population was 68%. The median diagnostic delay (patient's and doctor's delay) was 6.5 years. Relapses occurred after 29.2% of primary operations. Women had higher relapse rates than men [odds ratio 2.85 (1.07;7.61)]. Hypergranulation of the wound was the most common complication and occurred in 7% of all operations. The median score patients attributed to the medical effect of surgery was eight of 10 (zero corresponding to very dissatisfied and 10 to very satisfied). The diagnostic delay in HS is long due to a lack of knowledge in both patients and health care professionals, indicating that there is a need for education. Deroofing and the STEEP are effective surgical procedures in severe cases of HS and lead to a relatively high patient satisfaction. The postoperative relapse risk is higher in women. Prospective studies are required for the development of clear guidelines on the appropriate choice of surgery. © 2015 European Academy of Dermatology and Venereology.

  5. Smuggling Networks in the Gulf of Honduras and their Prosecution through the Captaincy General of Guatemala during the Eighteenth Century

    Directory of Open Access Journals (Sweden)

    Rafal Reichert

    2014-04-01

    Full Text Available This work demonstrates the existence of smuggling within the Captaincy General of Guatemala during the eighteenth century, explaining its local origins and development. The author analyzes illegal commerce not only as an economic event, but also as a social phenomenon grounded in networks of individuals from different social classes, both Hispanic and foreign.

  6. 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

  7. 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.

  8. Paediatric Obesity Research in Early Childhood and the Primary Care Setting: The TARGet Kids! Research Network

    OpenAIRE

    Morinis, Julia; Maguire, Jonathon; Khovratovich, Marina; McCrindle, Brian W.; Parkin, Patricia C.; Birken, Catherine S.

    2012-01-01

    Primary paediatric health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention and subsequent translation of this evidence into practice are critically needed. This paper explores the role of primary care in obesity prevention and introduces a novel application and de...

  9. 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.

  10. Risk of Post-Discharge Venous Thromboembolism and Associated Mortality in General Surgery: A Population-Based Cohort Study Using Linked Hospital and Primary Care Data in England.

    Directory of Open Access Journals (Sweden)

    George Bouras

    Full Text Available Trends towards day case surgery and enhanced recovery mean that postoperative venous thromboembolism (VTE may increasingly arise after hospital discharge. However, hospital data alone are unable to capture adverse events that occur outside of the hospital setting. The National Institute for Health and Care Excellence has suggested the use of primary care data to quantify hospital care-related VTE. Data in surgical patients using these resources is lacking. The aim of this study was to measure VTE risk and associated mortality in general surgery using linked primary care and hospital databases, to improve our understanding of harm from VTE that arises beyond hospital stay.This was a longitudinal cohort study using nationally linked primary care (Clinical Practice Research Datalink, CPRD, hospital administrative (Hospital Episodes Statistics, HES, population statistics (Office of National Statistics, ONS and National Cancer Intelligence Network databases. Routinely collected information was used to quantify 90-day in-hospital VTE, 90-day post-discharge VTE and 90-day mortality in adults undergoing one of twelve general surgical procedures between 1st April 1997 and 31st March 2012. The earliest postoperative recording of deep vein thrombosis or pulmonary embolism in CPRD, HES and ONS was counted in each patient. Covariates from multiple datasets were combined to derive detailed prediction models for VTE and mortality. Limitation included the capture of VTE presenting to healthcare only and the lack of information on adherence to pharmacological thromboprophylaxis as there was no data linkage to hospital pharmacy records.There were 981 VTE events captured within 90 days of surgery in 168005 procedures (23.7/1000 patient-years. Overall, primary care data increased the detection of postoperative VTE by a factor of 1.38 (981/710 when compared with using HES and ONS only. Total VTE rates ranged between 3.2/1000 patient-years in haemorrhoidectomy to 118

  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. Together Everyone Achieves More: Leadership Networks and Interagency Relationships of the Judge Advocate Generals Corps

    Science.gov (United States)

    2017-02-22

    leadership networks may be formal or informal in nature, but share the trait that all of the nodes of the network create products or perform services...Employment and Reemployment Rights Act (“USERRA”), voting rights by enforcing the Uniformed and Overseas Citizens Absentee Voting Act of 1986

  14. 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.

  15. What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.

    Science.gov (United States)

    Philips, Hilde; Remmen, Roy; Van Royen, Paul; Teblick, Marc; Geudens, Leo; Bronckaers, Marc; Meeuwis, Herman

    2010-07-30

    Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice. We used a prospective before/after interventional study design. The intervention was the implementation of a GPC. One year after the implementation of a GPC, the number of patient contacts in the intervention region significantly increased at the GPC (OR: 1.645; 95% CI: 1.439-1.880), while there were no significant changes in patient contacts at the Emergency Department (ED) or in other regions where a simultaneous registration was performed. Although home visits decreased in all general practitioner registrations, the difference was more pronounced in the intervention region (intervention region: OR: 0.515; 95% CI: 0.411-0.646, other regions: OR: 0.743; 95% CI: 0.608-0.908). At the ED we observed a decrease in the number of trauma cases (OR: 0.789; 95% CI: 0.648-0.960) and of patients who came to hospital by ambulance (OR: 0.687; 95% CI: 0.565-0.836). One year after its implementation more people seek help at the GPC, while the number of contacts at the ED remains the same. The most prominent changes in caseload are found in the trauma cases. Establishing a GPC in an open health care system, might redirect some patients with particular medical problems to primary care. This could lead to a lowering of costs or a more cost-effective out of hours care, but further research should focus on effective usage to divert patient flows and on quality and outcome of care.

  16. 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

  17. Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice.

    Science.gov (United States)

    MacKichan, Fiona; Brangan, Emer; Wye, Lesley; Checkland, Kath; Lasserson, Daniel; Huntley, Alyson; Morris, Richard; Tammes, Peter; Salisbury, Chris; Purdy, Sarah

    2017-05-04

    To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). Ethnographic case study combining non-participant observation, informal and formal interviewing. Six general practitioner (GP) practices located in three commissioning organisations in England. Reception areas at each practice were observed over the course of a working week (73 hours in total). Practice documents were collected and clinical and non-clinical staff were interviewed (n=19). Patients with recent ED use, or a carer if aged 16 and under, were interviewed (n=29). Past experience of accessing GP care recursively informed patient decisions about where to seek urgent care, and difficulties with access were implicit in patient accounts of ED use. GP practices had complicated, changeable systems for appointments. This made navigating appointment booking difficult for patients and reception staff, and engendered a mistrust of the system. Increasingly, the telephone was the instrument of demand management, but there were unintended consequences for access. Some patient groups, such as those with English as an additional language, were particularly disadvantaged, and the varying patient and staff semantic of words like 'urgent' and 'emergency' was exacerbated during telephone interactions. Poor integration between in-hours and out-of-hours care and patient perceptions of the quality of care accessible at their GP practice also informed ED use. This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around 'inappropriate' patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups. © Article author(s) (or

  18. Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory.

    Science.gov (United States)

    Jordan, Pascal; Shedden-Mora, Meike C; Löwe, Bernd

    2017-01-01

    The Generalized Anxiety Disorder scale (GAD-7) is one of the most frequently used diagnostic self-report scales for screening, diagnosis and severity assessment of anxiety disorder. Its psychometric properties from the view of the Item Response Theory paradigm have rarely been investigated. We aimed to close this gap by analyzing the GAD-7 within a large sample of primary care patients with respect to its psychometric properties and its implications for scoring using Item Response Theory. Robust, nonparametric statistics were used to check unidimensionality of the GAD-7. A graded response model was fitted using a Bayesian approach. The model fit was evaluated using posterior predictive p-values, item information functions were derived and optimal predictions of anxiety were calculated. The sample included N = 3404 primary care patients (60% female; mean age, 52,2; standard deviation 19.2) The analysis indicated no deviations of the GAD-7 scale from unidimensionality and a decent fit of a graded response model. The commonly suggested ultra-brief measure consisting of the first two items, the GAD-2, was supported by item information analysis. The first four items discriminated better than the last three items with respect to latent anxiety. The information provided by the first four items should be weighted more heavily. Moreover, estimates corresponding to low to moderate levels of anxiety show greater variability. The psychometric validity of the GAD-2 was supported by our analysis.

  19. Views of general practitioners on the use of STOPP&START in primary care: a qualitative study.

    Science.gov (United States)

    Dalleur, O; Feron, J-M; Spinewine, A

    2014-08-01

    STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment) criteria aim at detecting potentially inappropriate prescribing in older people. The objective was to explore general practitioners' (GPs) perceptions regarding the use of the STOPP&START tool in their practice. We conducted three focus groups which were conveniently sampled. Vignettes with clinical cases were provided for discussion as well as a full version of the STOPP&START tool. Knowledge, strengths and weaknesses of the tool and its implementation were discussed. Two researchers independently performed content analysis, classifying quotes and creating new categories for emerging themes. Discussions highlighted incentives (e.g. systematic procedure for medication review) and barriers (e.g. time-consuming application) influencing the use of STOPP&START in primary care. Usefulness, comprehensiveness, and relevance of the tool were also questioned. Another important category emerging from the content analysis was the projected use of the tool. The GPs imagined key elements for the implementation in daily practice: computerized clinical decision support system, education, and multidisciplinary collaborations, especially at care transitions and in nursing homes. Despite variables views on the usefulness, comprehensiveness, and relevance of STOPP&START, GPs suggest the implementation of this tool in primary care within computerized clinical decision support systems, through education, and used as part of multidisciplinary collaborations.

  20. 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.

  1. 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.

  2. 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

  3. Primary School Teachers and Outdoor Education: Varying Levels of Teacher Leadership in Informal Networks of Peers

    Science.gov (United States)

    Hovardas, Tasos

    2016-01-01

    The study concentrated on an area in Greece with a multiplicity of sites for outdoor education. Informal networks of teachers were detected through a snowball technique and data were collected by means of a questionnaire and semi-structured interviews. A typology was first enriched to account for teacher interaction. This typology was then…

  4. 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

  5. Contribution by primary health nurses and general practitioners to the Diabetes Annual Review (Get Checked) programme in Auckland, New Zealand.

    Science.gov (United States)

    Daly, Barbara; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert

    2013-08-16

    To describe primary health care (practice and specialist) nurses involvement in the government-funded annual diabetes review 'Get Checked' programme and the division of care between nurses and general practitioners in Auckland, New Zealand. Of the total 911 practice and specialist nurses identified and working in the greater Auckland region, 276 (30%) were randomly selected and invited to undertake a self-administered questionnaire and telephone interview in 2006-8. An 86% response rate was achieved. Over 60% of practice nurses and over half of specialist nurses participate in 'Get Checked' reviews. Of those nurses, 40% of practice and 70% specialist nurses, reported completing over half of the total number of 'Get Checked' reviews at their practice. Of the nurses sampled who work in general practice (n=198), 38% reported that 'nurses mostly complete' the reviews, 45% stated that 'nurses and doctors equally complete' them and 17% reported that only 'doctors' did so. For the nurses who reported that 'nurses and doctors equally complete' the reviews (n=89), most nurses undertake blood pressure measurements (90%), weigh patients (88%), give lifestyle advice (87%), examine patient's feet (73%), and 44% carried out the complete review of the patients they consult. These findings show the 'Get Checked' programme was successful in engaging practice and community-based specialist nurses in the community management of diabetes and has revealed positive relationships between nurses and doctors, extended roles for nurses and the importance of engaging nurses in the design of health care programmes.

  6. 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

    2016-06-01

    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. 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. 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. 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. 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. Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care

  7. 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

  8. A mechanistic model for predicting flow-assisted and general corrosion of carbon steel in reactor primary coolants

    Energy Technology Data Exchange (ETDEWEB)

    Lister, D. [University of New Brunswick, Fredericton, NB (Canada). Dept. of Chemical Engineering; Lang, L.C. [Atomic Energy of Canada Ltd., Chalk River Lab., ON (Canada)

    2002-07-01

    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

  9. 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

  10. 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.

  11. 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

    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...... seem to have a significant influence on the dihedral angles adopted by the individual amino acids in coil segments. In this work we attempt to predict a probability distribution of these dihedral angles based on the flanking residues. While attempts to predict dihedral angles of coil segments have been...... 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...

  12. Improving Image Segmentation with Adaptive, Recurrent, Spiking Neural Network Models of the Primary Visual Cortex

    Science.gov (United States)

    2017-05-19

    Vijay Singh, Martin Tchernookov, Rebecca Butterfield, Ilya Nemenman, Rongrong Ji. Director Field Model of the Primary Visual Cortex for Contour...FTE Equivalent: Total Number: DISCIPLINE Vijay Singh 40 Physics 0.40 1 PERCENT_SUPPORTEDNAME FTE Equivalent: Total Number: Martin Tchernookov 0.20

  13. Using online learning networks to promote self-regulated learning in primary teacher education

    NARCIS (Netherlands)

    Vrieling, Emmy; Bastiaens, Theo; Stijnen, Sjef

    2017-01-01

    Many recent studies have stressed the importance of students’ self-regulated learning (SRL) skills for successful learning. Consequently, teacher educators have begun to increase student teachers’ SRL opportunities in educational pre-service programs. Although primary teacher educators are aware of

  14. 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.

  15. 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)

  16. 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

  17. 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.

  18. Analysis of Survival Rates Following Primary Surgery of 178 Consecutive Patients with Oral Cancer in a Large District General Hospital.

    Science.gov (United States)

    Stathopoulos, Panagiotis; Smith, William P

    2017-06-01

    The aim of this study is to present the survival rates in patients treated for oral cancer with primary surgery in a large district general hospital. We discuss the influence of the most significant prognostic factors on survival and compare our results with larger centres specializing in the management of oral cancer. All patients diagnosed with oral cancer from 1995 to 2006 and were treated in the Department had their details entered prospectively onto a computerized database. Demographic details of patients, type of treatment, pathological stage of tumor (TNM), local and regional recurrence rate, overall survival, disease specific survival and incidence of involved margins were recorded and calculated. Of the 178 patients, 96 (54 %) were alive and free of oral cancer 5 years after surgery. Forty-four patients died of oral cancer (24.7 %) but 38 (21.3 %) died of other causes. The overall survival rate after primary surgery in relation to stage was: I 84 %, II 71 %, III 36 % and IV 28 %. As almost half of our patients presented with advanced cancer and had discouraging survival rates, we emphasize the need for early recognition of the disease. Advanced disease signifies difficulty in obtaining clear margins which actually indicates a higher recurrence rate. 25 % of our patients died of oral cancer within 5 years of surgery which highlights the poor prognosis that recurrence carries after treatment. Effective educational campaign with purpose to raise oral cancer awareness and earlier referral may result in improvement of survival.

  19. 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

  20. 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.

  1. Optimal source coding, removable noise elimination, and natural coordinate system construction for general vector sources using replicator neural networks

    Science.gov (United States)

    Hecht-Nielsen, Robert

    1997-04-01

    A new universal one-chart smooth manifold model for vector information sources is introduced. Natural coordinates (a particular type of chart) for such data manifolds are then defined. Uniformly quantized natural coordinates form an optimal vector quantization code for a general vector source. Replicator neural networks (a specialized type of multilayer perceptron with three hidden layers) are the introduced. As properly configured examples of replicator networks approach minimum mean squared error (e.g., via training and architecture adjustment using randomly chosen vectors from the source), these networks automatically develop a mapping which, in the limit, produces natural coordinates for arbitrary source vectors. The new concept of removable noise (a noise model applicable to a wide variety of real-world noise processes) is then discussed. Replicator neural networks, when configured to approach minimum mean squared reconstruction error (e.g., via training and architecture adjustment on randomly chosen examples from a vector source, each with randomly chosen additive removable noise contamination), in the limit eliminate removable noise and produce natural coordinates for the data vector portions of the noise-corrupted source vectors. Consideration regarding selection of the dimension of a data manifold source model and the training/configuration of replicator neural networks are discussed.

  2. 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

  3. A Model for Hourly Solar Radiation Data Generation from Daily Solar Radiation Data Using a Generalized Regression Artificial Neural Network

    OpenAIRE

    Khatib, Tamer; Elmenreich, Wilfried

    2015-01-01

    This paper presents a model for predicting hourly solar radiation data using daily solar radiation averages. The proposed model is a generalized regression artificial neural network. This model has three inputs, namely, mean daily solar radiation, hour angle, and sunset hour angle. The output layer has one node which is mean hourly solar radiation. The training and development of the proposed model are done using MATLAB and 43800 records of hourly global solar radiation. The results show that...

  4. 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

  5. Results of the Croatian Primary Percutaneous Coronary Intervention Network for patients with ST-segment elevation acute myocardial infarction.

    Science.gov (United States)

    Nikolić Heitzler, Vjeran; Babic, Zdravko; Milicic, Davor; Bergovec, Mijo; Raguz, Miroslav; Mirat, Jure; Strozzi, Maja; Plazonic, Zeljko; Giunio, Lovel; Steiner, Robert; Starcevic, Boris; Vukovic, Ivica

    2010-05-01

    The Republic of Croatia, with a gross domestic product per capita of US$11,554 in 2008, is an economically less-developed Western country. The goal of the present investigation was to prove that a well-organized primary percutaneous coronary intervention network in an economically less-developed country equalizes the prospects of all patients with acute ST-segment elevation myocardial infarction at a level comparable to that of more economically developed countries. We prospectively investigated 1,190 patients with acute ST-segment elevation myocardial infarction treated with primary PCI in 8 centers across Croatia (677 nontransferred and 513 transferred). The postprocedural Thrombolysis In Myocardial Infarction flow, in-hospital mortality, and incidence of major adverse cardiovascular events (ie, mortality, pectoral angina, restenosis, reinfarction, coronary artery bypass graft, and cerebrovascular accident rate) during 6 months of follow-up were compared between the nontransferred and transferred subgroups and in the subgroups of older patients, women, and those with cardiogenic shock. In all investigated patients, the average door-to-balloon time was 108 minutes, and the total ischemic time was 265 minutes. Postprocedural Thrombolysis In Myocardial Infarction 3 flow was established in 87.1% of the patients, and the in-hospital mortality rate was 4.4%. No statistically significant difference was found in the results of treatment between the transferred and nontransferred patients overall or in the subgroups of patients >75 years, women, and those with cardiogenic shock. In conclusion, the Croatian Primary Percutaneous Coronary Intervention Network has ensured treatment results of acute ST-segment elevation myocardial infarction comparable to those of randomized studies and registries of more economically developed countries. Copyright 2010 Elsevier Inc. All rights reserved.

  6. General practitioner advice on physical activity: Analyses in a cohort of older primary health care patients (getABI

    Directory of Open Access Journals (Sweden)

    Thiem Ulrich

    2011-05-01

    Full Text Available Abstract Background Although the benefits of physical activity for health and functioning are recognized to extend throughout life, the physical activity level of most older people is insufficient with respect to current guidelines. The primary health care setting may offer an opportunity to influence and to support older people to become physically active on a regular basis. Currently, there is a lack of data concerning general practitioner (GP advice on physical activity in Germany. Therefore, the aim of this study was to evaluate the rate and characteristics of older patients receiving advice on physical activity from their GP. Methods This is a cross-sectional study using data collected at 7 years of follow-up of a prospective cohort study (German epidemiological trial on ankle brachial index, getABI. 6,880 unselected patients aged 65 years and above in the primary health care setting in Germany were followed up since October 2001. During the 7-year follow-up telephone interview, 1,937 patients were asked whether their GP had advised them to get regular physical activity within the preceding 12 months. The interview also included questions on socio-demographic and lifestyle variables, medical conditions, and physical activity. Logistic regression analysis (unadjusted and adjusted for all covariables was used to examine factors associated with receiving advice. Analyses comprised only complete cases with regard to the analysed variables. Results are expressed as odds ratios (ORs with 95% confidence intervals (95% CI. Results Of the 1,627 analysed patients (median age 77; range 72-93 years; 52.5% women, 534 (32.8% stated that they had been advised to get regular physical activity. In the adjusted model, those more likely to receive GP advice on physical activity were men (OR [95% CI] 1.34 [1.06-1.70], patients suffering from pain (1.43 [1.13-1.81], coronary heart disease and/or myocardial infarction (1.56 [1.21-2.01], diabetes mellitus (1

  7. Re-initiating professional working activity after myocardial infarction in primary percutaneous coronary intervention networks era

    OpenAIRE

    Zdravko Babić; Marin Pavlov; Mirjana Oštrić; Milan Milošević; Marjeta Misigoj Duraković; Hrvoje Pintarić

    2015-01-01

    Objectives: To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Material and Methods: During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of...

  8. 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.

  9. 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.

  10. [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

  11. 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

  12. 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)

  13. Local and global synchronization in general complex dynamical networks with delay coupling

    International Nuclear Information System (INIS)

    Lu Jianquan; Ho, Daniel W.C.

    2008-01-01

    Local and global synchronization of complex dynamical networks are studied in this paper. Some simple yet generic criteria ensuring delay-independent and delay-dependent synchronization are derived in terms of linear matrix inequalities (LMIs), which can be verified easily via interior-point algorithm. The assumption that the coupling configuration matrix is symmetric and irreducible, which is frequently used in other literatures, is removed. A network with a fixed delay and a special coupling scheme is given as an example to illustrate the theoretical results and the effectiveness of the proposed synchronization scheme

  14. 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.)

  15. Consumer satisfaction among patients and their general practitioners about involving nurse specialists in primary care for patients with urinary incontinence.

    Science.gov (United States)

    Albers-Heitner, Pytha; Winkens, Ron; Berghmans, Bary; Joore, Manuela; Nieman, Fred; Severens, Johan; Lagro-Janssen, Toine

    2013-06-01

    Urinary incontinence (UI) is a very common problem, but existing guidelines on UI are not followed. To bring care in line with guidelines, we planned an intervention to involve nurse specialists on UI in primary care and assessed this in a randomised controlled trial. Alongside this intervention, we assessed consumer satisfaction among patients and general practitioners (GPs). Patients' satisfaction with the care provided by either nurse specialists (intervention group) or GPs (control group), respectively, was measured with a self-completed questionnaire. GPs' views on the involvement of nurse specialists were measured in a structured telephone interview. The patient satisfaction score on the care offered by nurse specialists was 8.4 (scale 1-10), vs. 6.7 for care-as-usual by GPs. Over 85% of patients would recommend nurse specialist care to their best friends and 77% of the GPs considered the role of the nurse specialist to be beneficial, giving it a mean score of 7.2. Although the sample was relatively small and the stability of the results only provisionally established, substituting UI care from GP to nurse specialist appears to be welcomed by both patients and GPs. Small changes like giving additional UI-specific information and devoting more attention to UI (which had been given little attention before) would provide a simple instrument to stimulate patients to change their behaviour in the right direction. © 2012 Nordic College of Caring Science.

  16. Parents’ Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice

    Directory of Open Access Journals (Sweden)

    Pauline Paterson

    2018-03-01

    Full Text Available The purpose of this study was to gain an in-depth understanding of parents’ experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP. A cross-sectional qualitative study was conducted between March–June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia. The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents’ perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents’ view and given that influenza vaccination coverage is higher when delivered through schools than GPs.

  17. Parents’ Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice

    Science.gov (United States)

    Schulz, Will; Larson, Heidi J.

    2018-01-01

    The purpose of this study was to gain an in-depth understanding of parents’ experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP). A cross-sectional qualitative study was conducted between March–June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia). The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents’ perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents’ view and given that influenza vaccination coverage is higher when delivered through schools than GPs. PMID:29597341

  18. Parents' Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice.

    Science.gov (United States)

    Paterson, Pauline; Schulz, Will; Utley, Martin; Larson, Heidi J

    2018-03-28

    The purpose of this study was to gain an in-depth understanding of parents' experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP). A cross-sectional qualitative study was conducted between March-June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia). The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents' perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents' view and given that influenza vaccination coverage is higher when delivered through schools than GPs.

  19. 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.

  20. 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.

  1. 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...

  2. Recent progresses of neural network unsupervised learning: I. Independent component analyses generalizing PCA

    Science.gov (United States)

    Szu, Harold H.

    1999-03-01

    The early vision principle of redundancy reduction of 108 sensor excitations is understandable from computer vision viewpoint toward sparse edge maps. It is only recently derived using a truly unsupervised learning paradigm of artificial neural networks (ANN). In fact, the biological vision, Hubel- Wiesel edge maps, is reproduced seeking the underlying independent components analyses (ICA) among 102 image samples by maximizing the ANN output entropy (partial)H(V)/(partial)[W] equals (partial)[W]/(partial)t. When a pair of newborn eyes or ears meet the bustling and hustling world without supervision, they seek ICA by comparing 2 sensory measurements (x1(t), x2(t))T equalsV X(t). Assuming a linear and instantaneous mixture model of the external world X(t) equals [A] S(t), where both the mixing matrix ([A] equalsV [a1, a2] of ICA vectors and the source percentages (s1(t), s2(t))T equalsV S(t) are unknown, we seek the independent sources approximately equals [I] where the approximated sign indicates that higher order statistics (HOS) may not be trivial. Without a teacher, the ANN weight matrix [W] equalsV [w1, w2] adjusts the outputs V(t) equals tanh([W]X(t)) approximately equals [W]X(t) until no desired outputs except the (Gaussian) 'garbage' (neither YES '1' nor NO '-1' but at linear may-be range 'origin 0') defined by Gaussian covariance G equals [I] equals [W][A] the internal knowledge representation [W], as the inverse of the external world matrix [A]-1. To unify IC, PCA, ANN & HOS theories since 1991 (advanced by Jutten & Herault, Comon, Oja, Bell-Sejnowski, Amari-Cichocki, Cardoso), the LYAPONOV function L(v1,...,vn, w1,...wn,) equals E(v1,...,vn) - H(w1,...wn) is constructed as the HELMHOTZ free energy to prove both convergences of supervised energy E and unsupervised entropy H learning. Consequently, rather using the faithful but dumb computer: 'GARBAGE-IN, GARBAGE-OUT,' the smarter neurocomputer will be equipped with an unsupervised learning that extracts

  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. 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 is to de......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...... 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...... are simplified to be the final multi-variable linear functions. Furthermore, an accelerating factor is applied to the outer-layer reactive power compensation for improving the convergence procedure. Finally, the proposed power flow method is performed in program language VC++ 6.0, and numerical tests have been...

  5. 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......-handed subjects to test if this procedure could modulate M1 excitability and PPC–M1 connectivity. One hundred and eighty paired transcranial magnetic stimuli to the PPC and M1 at an interstimulus interval (ISI) of 8 ms were delivered at 0.2 Hz. We found that parietal ccPAS in the left hemisphere increased...... 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...

  6. Optimization of Multiresonant Wireless Power Transfer Network Based on Generalized Coupled Matrix

    Directory of Open Access Journals (Sweden)

    Qiang Zhao

    2017-01-01

    Full Text Available Magnetic coupling resonant wireless power transfer network (MCRWPTN system can realize wireless power transfer for some electrical equipment real-time and high efficiency in a certain spatial scale, which resolves the contradiction between power transfer efficiency and the power transfer distance of the wireless power transfer. A fully coupled resonant energy transfer model for multirelay coils and ports is established. A dynamic adaptive impedance matching control based on fully coupling matrix and particle swarm optimization algorithm based on annealing is developed for the MCRWPTN. Furthermore, as an example, the network which has twenty nodes is analyzed, and the best transmission coefficient which has the highest power transfer efficiency is found using the optimization algorithm, and the coupling constraints are considered simultaneously. Finally, the effectiveness of the proposed method is proved by the simulation results.

  7. 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.

  8. Altered resting-state effective connectivity of fronto-parietal motor control systems on the primary motor network following stroke

    Science.gov (United States)

    Inman, Cory S.; James, G. Andrew; Hamann, Stephan; Rajendra, Justin K.; Pagnoni, Giuseppe; Butler, Andrew J.

    2011-01-01

    Previous brain imaging work suggests that stroke alters the effective connectivity (the influence neural regions exert upon each other) of motor execution networks. The present study examines the intrinsic effective connectivity of top-down motor control in stroke survivors (n=13) relative to healthy participants (n=12). Stroke survivors exhibited significant deficits in motor function, as assessed by the Fugl-Meyer Motor Assessment. We used structural equation modeling (SEM) of resting-state fMRI data to investigate the relationship between motor deficits and the intrinsic effective connectivity between brain regions involved in motor control and motor execution. An exploratory adaptation of SEM determined the optimal model of motor execution effective connectivity in healthy participants, and confirmatory SEM assessed stroke survivors’ fit to that model. We observed alterations in spontaneous resting-state effective connectivity from fronto-parietal guidance systems to the motor network in stroke survivors. More specifically, diminished connectivity was found in connections from the superior parietal cortex to primary motor cortex and supplementary motor cortex. Furthermore, the paths demonstrated large individual variance in stroke survivors but less variance in healthy participants. These findings suggest that characterizing the deficits in resting-state connectivity of top-down processes in stroke survivors may help optimize cognitive and physical rehabilitation therapies by individually targeting specific neural pathway. PMID:21839174

  9. 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.

  10. 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.

  11. Odors pulsed at wing beat frequencies are tracked by primary olfactory networks and enhance odor detection

    Directory of Open Access Journals (Sweden)

    Shreejoy Tripathy

    2010-03-01

    Full Text Available Each down stroke of an insect’s wings accelerates axial airflow over the antennae. Modeling studies suggest that this can greatly enhance penetration of air and air-born odorants through the antennal sensilla thereby periodically increasing odorant-receptor interactions. Do these periodic changes result in entrainment of neural responses in the antenna and antennal lobe (AL? Does this entrainment affect olfactory acuity? To address these questions, we monitored antennal and AL responses in the moth Manduca sexta while odorants were pulsed at frequencies from 10-72 Hz, encompassing the natural wingbeat frequency. Power spectral density (PSD analysis was used to identify entrainment of neural activity. Statistical analysis of PSDs indicates that the antennal nerve tracked pulsed odor up to 30 Hz. Furthermore, at least 50% of AL local field potentials (LFPs and between 7-25% of unitary spiking responses also tracked pulsed odor up to 30 Hz in a frequency-locked manner. Application of bicuculline (200µM abolished pulse tracking in both LFP and unitary responses suggesting that GABAA receptor activation is necessary for pulse tracking within the AL. Finally, psychophysical measures of odor detection establish that detection thresholds are lowered when odor is pulsed at 20 Hz. These results suggest that AL networks can respond to the oscillatory dynamics of stimuli such as those imposed by the wing beat in a manner analogous to mammalian sniffing.

  12. Superior Generalization Capability of Hardware-Learing Algorithm Developed for Self-Learning Neuron-MOS Neural Networks

    Science.gov (United States)

    Kondo, Shuhei; Shibata, Tadashi; Ohmi, Tadahiro

    1995-02-01

    We have investigated the learning performance of the hardware backpropagation (HBP) algorithm, a hardware-oriented learning algorithm developed for the self-learning architecture of neural networks constructed using neuron MOS (metal-oxide-semiconductor) transistors. The solution to finding a mirror symmetry axis in a 4×4 binary pixel array was tested by computer simulation based on the HBP algorithm. Despite the inherent restrictions imposed on the hardware-learning algorithm, HBP exhibits equivalent learning performance to that of the original backpropagation (BP) algorithm when all the pertinent parameters are optimized. Very importantly, we have found that HBP has a superior generalization capability over BP; namely, HBP exhibits higher performance in solving problems that the network has not yet learnt.

  13. 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.)

  14. 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 ...

  15. Evidence, Engagement, and Technology: Themes of and the State of Primary Care Practice-based Network Research.

    Science.gov (United States)

    Nease, Donald E

    2016-01-01

    Practice-based research supported by practice-based research network (PBRN) infrastructure has historically provided an important method for challenging guidelines and evidence arising from secondary and tertiary care settings. This sample of current practice-based research in this issue of the JABFM provides an opportunity to ask whether practice-based research continues to address questions relevant to primary care practices and clinicians and whether a PBRN infrastructure is instrumental to maintaining the relevance and feasibility of practice-based research. Based on this issue's articles, the current state of practice-based research seems to be good, at face value addressing relevant issues for primary care practices. Less clear is the degree to which PBRN infrastructures and relationships informed the questions asked and facilitated the implementation of the studies presented. Practice-based research-related articles that routinely report about how study questions arose-from practices and their clinicians, staff and communities, or elsewhere-could help directly answer questions of relevance. In addition, reporting how practices are recruited to practice-based research studies could inform the degree to which ongoing relationships central to PBRNs facilitate the recruitment and conduct of practice-based research. © Copyright 2016 by the American Board of Family Medicine.

  16. Audit of primary care electrocardiograms sent as emergency to a telehealth service - the Telehealth Network of Minas Gerais, Brazil.

    Science.gov (United States)

    Marcolino, Milena S; Carvalho, Bárbara C; Lucena, Aline M; França, Ana Luiza N; Pessoa, Cristiane G; Neves, Daniel S; Alkmim, Maria Beatriz M

    2015-01-01

    The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that has performed electrocardiogram (ECG) analysis since 2005. From February to March 2014, 28% of ECGs were classified as "emergency" by the primary care tele-health sites. This quasi-experimental study aimed to investigate the reasons behind the high number of emergency ECGs being sent in, the implementation of corrective actions, and an assessment of the impact of these actions. In the 1st phase, primary care units that sent >70% of ECGs as emergency from February to March 2014 were selected. The 2nd phase consisted of the intervention. In the 3rd phase, the proportion of ECGs sent as an emergency during the 1st and 2nd months post intervention were assessed. Of the 63 cities selected during the 1st phase, 50% of the practitioners did not know the proper definition of emergency. After the intervention, 67% of the cities had a significant reduction in the proportion of ECGs sent as an emergency during the 1st month, and 17% had a significant reduction during the 2nd month.

  17. 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.

  18. Systematic survey reveals general applicability of "guilt-by-association" within gene coexpression networks

    Directory of Open Access Journals (Sweden)

    Kohane Isaac S

    2005-09-01

    Full Text Available Abstract Background Biological processes are carried out by coordinated modules of interacting molecules. As clustering methods demonstrate that genes with similar expression display increased likelihood of being associated with a common functional module, networks of coexpressed genes provide one framework for assigning gene function. This has informed the guilt-by-association (GBA heuristic, widely invoked in functional genomics. Yet although the idea of GBA is accepted, the breadth of GBA applicability is uncertain. Results We developed methods to systematically explore the breadth of GBA across a large and varied corpus of expression data to answer the following question: To what extent is the GBA heuristic broadly applicable to the transcriptome and conversely how broadly is GBA captured by a priori knowledge represented in the Gene Ontology (GO? Our study provides an investigation of the functional organization of five coexpression networks using data from three mammalian organisms. Our method calculates a probabilistic score between each gene and each Gene Ontology category that reflects coexpression enrichment of a GO module. For each GO category we use Receiver Operating Curves to assess whether these probabilistic scores reflect GBA. This methodology applied to five different coexpression networks demonstrates that the signature of guilt-by-association is ubiquitous and reproducible and that the GBA heuristic is broadly applicable across the population of nine hundred Gene Ontology categories. We also demonstrate the existence of highly reproducible patterns of coexpression between some pairs of GO categories. Conclusion We conclude that GBA has universal value and that transcriptional control may be more modular than previously realized. Our analyses also suggest that methodologies combining coexpression measurements across multiple genes in a biologically-defined module can aid in characterizing gene function or in characterizing

  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. 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.

  1. 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.

  2. 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.

  3. Anisotropic generalization of Stinchcombe's solution for the conductivity of random resistor networks on a Bethe lattice

    Science.gov (United States)

    Semeriyanov, F.; Saphiannikova, M.; Heinrich, G.

    2009-11-01

    Our study is based on the work of Stinchcombe (1974 J. Phys. C: Solid State Phys. 7 179) and is devoted to the calculations of average conductivity of random resistor networks placed on an anisotropic Bethe lattice. The structure of the Bethe lattice is assumed to represent the normal directions of the regular lattice. We calculate the anisotropic conductivity as an expansion in powers of the inverse coordination number of the Bethe lattice. The expansion terms retained deliver an accurate approximation of the conductivity at resistor concentrations above the percolation threshold. We make a comparison of our analytical results with those of Bernasconi (1974 Phys. Rev. B 9 4575) for the regular lattice.

  4. Anisotropic generalization of Stinchcombe's solution for the conductivity of random resistor networks on a Bethe lattice

    International Nuclear Information System (INIS)

    Semeriyanov, F; Saphiannikova, M; Heinrich, G

    2009-01-01

    Our study is based on the work of Stinchcombe (1974 J. Phys. C: Solid State Phys. 7 179) and is devoted to the calculations of average conductivity of random resistor networks placed on an anisotropic Bethe lattice. The structure of the Bethe lattice is assumed to represent the normal directions of the regular lattice. We calculate the anisotropic conductivity as an expansion in powers of the inverse coordination number of the Bethe lattice. The expansion terms retained deliver an accurate approximation of the conductivity at resistor concentrations above the percolation threshold. We make a comparison of our analytical results with those of Bernasconi (1974 Phys. Rev. B 9 4575) for the regular lattice.

  5. Re-initiating professional working activity after myocardial infarction in primary percutaneous coronary intervention networks era

    Directory of Open Access Journals (Sweden)

    Zdravko Babić

    2015-12-01

    Full Text Available Objectives: To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Material and Methods: During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of quality of life after myocardial infarction were obtained after follow-up (mean: 836±242 days. Results: Average sick leave was 126±125 days. Following myocardial infarction, 3.4% of patients were discharged from their jobs while 31.7% retired. Lower salary was reported in 17.9% patients, major life events in 9.7%, while 40.7% estimated quality of life as worse following the event. Longer hospitalization was reported in patients transferred from surrounding counties, those with inferior myocardial wall and right coronary artery affected. Age, hyperlipoproteinemia and lower education degree were connected to permanent working cessation. Significant salary decrease was observed in male patients. Employer type was related to sick leave duration. Impaired quality of life was observed in patients who underwent in-hospital rehabilitation and those from surrounding counties. Longer sick leave was observed in patients with lower income before and after myocardial infarction. These patients reported lower quality of life after myocardial infarction. Conclusions: Inadequate health policy and delayed cardiac rehabilitation after myocardial infarction may lead to prolonged hospitalization and sick leave as well as lower quality of life after the event, regardless of optimal treatment in acute phase of disease.

  6. Re-initiating professional working activity after myocardial infarction in primary percutaneous coronary intervention networks era.

    Science.gov (United States)

    Babić, Zdravko; Pavlov, Marin; Oštrić, Mirjana; Milošević, Milan; Misigoj Duraković, Marjeta; Pintarić, Hrvoje

    2015-01-01

    To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of quality of life after myocardial infarction were obtained after follow-up (mean: 836±242 days). Average sick leave was 126±125 days. Following myocardial infarction, 3.4% of patients were discharged from their jobs while 31.7% retired. Lower salary was reported in 17.9% patients, major life events in 9.7%, while 40.7% estimated quality of life as worse following the event. Longer hospitalization was reported in patients transferred from surrounding counties, those with inferior myocardial wall and right coronary artery affected. Age, hyperlipoproteinemia and lower education degree were connected to permanent working cessation. Significant salary decrease was observed in male patients. Employer type was related to sick leave duration. Impaired quality of life was observed in patients who underwent in-hospital rehabilitation and those from surrounding counties. Longer sick leave was observed in patients with lower income before and after myocardial infarction. These patients reported lower quality of life after myocardial infarction. Inadequate health policy and delayed cardiac rehabilitation after myocardial infarction may lead to prolonged hospitalization and sick leave as well as lower quality of life after the event, regardless of optimal treatment in acute phase of disease. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. 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.

  8. 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...... complicated fault situation which has not been treated before for traditional transient stability analysis...

  9. 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…

  10. 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.

  11. A generalized voter model with time-decaying memory on a multilayer network

    Science.gov (United States)

    Zhong, Li-Xin; Xu, Wen-Juan; Chen, Rong-Da; Zhong, Chen-Yang; Qiu, Tian; Shi, Yong-Dong; Wang, Li-Liang

    2016-09-01

    By incorporating a multilayer network and time-decaying memory into the original voter model, we investigate the coupled effects of spatial and temporal accumulation of peer pressure on the consensus. Heterogeneity in peer pressure and the time-decaying mechanism are both shown to be detrimental to the consensus. We find the transition points below which a consensus can always be reached and above which two opposed opinions are more likely to coexist. Our mean-field analysis indicates that the phase transitions in the present model are governed by the cumulative influence of peer pressure and the updating threshold. We find a functional relation between the consensus threshold and the decay rate of the influence of peer is found. As to the pressure. The time required to reach a consensus is governed by the coupling of the memory length and the decay rate. An intermediate decay rate may greatly reduce the time required to reach a consensus.

  12. [Reform steps toward networking sheltered workshops and the general labour market].

    Science.gov (United States)

    Wendt, S

    2010-02-01

    Only 0.16% of disabled employees are enabled to change from sheltered workshops to the general labour market. At the same time the number of disabled employees in sheltered workshops is increasing more than anticipated. Investigations into the growing admissions to sheltered workshops resulted in recommendations to improve the practice of change over. More and more admissions of students having finished special schools could be reduced by improved cooperation between special schools and the local employment market. Special schools should offer suitable job trainings and support students to develop an understanding of the requirements of specific jobs and of their opportunities to develop their skills to do these jobs. In 2009, supported employment has been regulated in social security law, lasting up to three years and aimed at qualifying disabled youngsters for employment in the general labour market instead of entering sheltered workshops. The majority of admissions to sheltered workshops in the meantime concern people with psychological handicaps, with more than 30% however leaving the workshops later on. For this population, "virtual sheltered workshops" are offering more suitable means for reintegration in the general labour market, such as temporary employment in the general labour market or in occupations with small earnings. The personal budget for work is meant to be a model project within the German Länder, to transfer personal support from the sheltered workshop into the general labour market. The conference of German Länder Ministers of Social Affairs has been active since 2007 to develop a concept for reform of the social security law concerning integration assistance for disabled people, which in future is to concentrate on individual needs, removal of obstacles in the law to facilitate the transition from sheltered workshops into the general labour market. The "Deutsche Verein für öffentliche und private Fürsorge" (German association for public

  13. 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.

  14. 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.

  15. 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

  16. 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

  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.

    Science.gov (United States)

    Mazza, Danielle; Pearce, Christopher; Turner, Lyle Robert; De Leon-Santiago, Maria; McLeod, Adam; Ferriggi, Jason; Shearer, Marianne

    2016-07-04

    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. 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.

  19. 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)

  20. 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%

  1. Screening for Cardiovascular Risk in Asymptomatic Users of the Primary Health Care Network in Lebanon, 2012–2013

    Science.gov (United States)

    Adib, Salim M.; Hamadeh, Randa; Freidi, Alia; Ammar, Walid

    2014-01-01

    Introduction In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. Methods A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Results Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese. Conclusion The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up. PMID:25032835

  2. Screening for cardiovascular risk in asymptomatic users of the primary health care network in Lebanon, 2012-2013.

    Science.gov (United States)

    Yamout, Rouham; Adib, Salim M; Hamadeh, Randa; Freidi, Alia; Ammar, Walid

    2014-07-17

    In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese. The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up.

  3. A logic model framework for evaluation and planning in a primary care practice-based research network (PBRN)

    Science.gov (United States)

    Hayes, Holly; Parchman, Michael L.; Howard, Ray

    2012-01-01

    Evaluating effective growth and development of a Practice-Based Research Network (PBRN) can be challenging. The purpose of this article is to describe the development of a logic model and how the framework has been used for planning and evaluation in a primary care PBRN. An evaluation team was formed consisting of the PBRN directors, staff and its board members. After the mission and the target audience were determined, facilitated meetings and discussions were held with stakeholders to identify the assumptions, inputs, activities, outputs, outcomes and outcome indicators. The long-term outcomes outlined in the final logic model are two-fold: 1.) Improved health outcomes of patients served by PBRN community clinicians; and 2.) Community clinicians are recognized leaders of quality research projects. The Logic Model proved useful in identifying stakeholder interests and dissemination activities as an area that required more attention in the PBRN. The logic model approach is a useful planning tool and project management resource that increases the probability that the PBRN mission will be successfully implemented. PMID:21900441

  4. 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.

  5. Dissecting the calcium-induced differentiation of human primary keratinocytes stem cells by integrative and structural network analyses.

    Directory of Open Access Journals (Sweden)

    Kiana Toufighi

    2015-05-01

    Full Text Available The molecular details underlying the time-dependent assembly of protein complexes in cellular networks, such as those that occur during differentiation, are largely unexplored. Focusing on the calcium-induced differentiation of primary human keratinocytes as a model system for a major cellular reorganization process, we look at the expression of genes whose products are involved in manually-annotated protein complexes. Clustering analyses revealed only moderate co-expression of functionally related proteins during differentiation. However, when we looked at protein complexes, we found that the majority (55% are composed of non-dynamic and dynamic gene products ('di-chromatic', 19% are non-dynamic, and 26% only dynamic. Considering three-dimensional protein structures to predict steric interactions, we found that proteins encoded by dynamic genes frequently interact with a common non-dynamic protein in a mutually exclusive fashion. This suggests that during differentiation, complex assemblies may also change through variation in the abundance of proteins that compete for binding to common proteins as found in some cases for paralogous proteins. Considering the example of the TNF-α/NFκB signaling complex, we suggest that the same core complex can guide signals into diverse context-specific outputs by addition of time specific expressed subunits, while keeping other cellular functions constant. Thus, our analysis provides evidence that complex assembly with stable core components and competition could contribute to cell differentiation.

  6. Using Generalized Entropies and OC-SVM with Mahalanobis Kernel for Detection and Classification of Anomalies in Network Traffic

    Directory of Open Access Journals (Sweden)

    Jayro Santiago-Paz

    2015-09-01

    Full Text Available Network anomaly detection and classification is an important open issue in network security. Several approaches and systems based on different mathematical tools have been studied and developed, among them, the Anomaly-Network Intrusion Detection System (A-NIDS, which monitors network traffic and compares it against an established baseline of a “normal” traffic profile. Then, it is necessary to characterize the “normal” Internet traffic. This paper presents an approach for anomaly detection and classification based on Shannon, Rényi and Tsallis entropies of selected features, and the construction of regions from entropy data employing the Mahalanobis distance (MD, and One Class Support Vector Machine (OC-SVM with different kernels (Radial Basis Function (RBF and Mahalanobis Kernel (MK for “normal” and abnormal traffic. Regular and non-regular regions built from “normal” traffic profiles allow anomaly detection, while the classification is performed under the assumption that regions corresponding to the attack classes have been previously characterized. Although this approach allows the use of as many features as required, only four well-known significant features were selected in our case. In order to evaluate our approach, two different data sets were used: one set of real traffic obtained from an Academic Local Area Network (LAN, and the other a subset of the 1998 MIT-DARPA set. For these data sets, a True positive rate up to 99.35%, a True negative rate up to 99.83% and a False negative rate at about 0.16% were yielded. Experimental results show that certain q-values of the generalized entropies and the use of OC-SVM with RBF kernel improve the detection rate in the detection stage, while the novel inclusion of MK kernel in OC-SVM and k-temporal nearest neighbors improve accuracy in classification. In addition, the results show that using the Box-Cox transformation, the Mahalanobis distance yielded high detection rates with

  7. Selective Attention is a Primary Determinant of the Relationship between Working Memory and General Learning Ability in Outbred Mice

    Science.gov (United States)

    Kolata, Stefan; Light, Kenneth; Grossman, Henya C.; Hale, Gregory; Matzel, Louis D.

    2007-01-01

    A single factor (i.e., general intelligence) can account for much of an individuals' performance across a wide variety of cognitive tests. However, despite this factor's robustness, the underlying process is still a matter of debate. To address this question, we developed a novel battery of learning tasks to assess the general learning abilities…

  8. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

    Science.gov (United States)

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-09-01

    The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects.

  9. Exploring the opinions and perspectives of general practitioners towards the use of social networking sites for concussion management.

    Science.gov (United States)

    Ahmed, Osman; Sullivan, S John; Schneiders, Anthony; Moon, Sam; McCrory, Paul

    2013-03-01

    Social networking sites (SNSs) are increasingly being used for health-related purposes. Many patients now use sites such as Facebook to discuss symptoms, seek support, and search for advice on health conditions, including concussion. Innovative methods of delivering health information using these technologies are starting to emerge and it is important to seek the input of key stakeholder groups (including general practitioners) to establish their feasibility and to highlight areas of concern. This study aimed to seek the opinions of general practitioners towards the use of SNSs in concussion management. Semi-structured interviews were captured with a digital voice recorder and analysed using interpretative description methodology. Participants were general practitioners whose caseload included persons with a concussion between the ages of 16 and 30 years, and who had treated a patient with a concussion in the past 12 months. The clinical experience of the participants ranged from 3 to 35 years and 50% of the participants had a Facebook account themselves. While all participants were positive towards the use of SNSs for this purpose, concerns were raised regarding the issues of privacy and moderation. SNSs, particularly Facebook, have the potential (if correctly utilised) to be a viable adjunct to traditional concussion management programmes. In order for SNSs to be successfully used in this manner, the quality of information shared needs to be accurate and patients using them need to ensure that they get adequate cognitive rest.

  10. 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

  11. 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

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

    KAUST Repository

    Hussain, Syed Imtiaz; Alouini, Mohamed-Slim; Qaraqe, Khalid A.; Hasna, Mazen Omar

    2012-01-01

    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

  13. Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

    Science.gov (United States)

    Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

    2015-02-17

    For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of

  14. 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

  15. 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.

  16. A General Self-Organized Tree-Based Energy-Balance Routing Protocol for Wireless Sensor Network

    Science.gov (United States)

    Han, Zhao; Wu, Jie; Zhang, Jie; Liu, Liefeng; Tian, Kaiyun

    2014-04-01

    Wireless sensor network (WSN) is a system composed of a large number of low-cost micro-sensors. This network is used to collect and send various kinds of messages to a base station (BS). WSN consists of low-cost nodes with limited battery power, and the battery replacement is not easy for WSN with thousands of physically embedded nodes, which means energy efficient routing protocol should be employed to offer a long-life work time. To achieve the aim, we need not only to minimize total energy consumption but also to balance WSN load. Researchers have proposed many protocols such as LEACH, HEED, PEGASIS, TBC and PEDAP. In this paper, we propose a General Self-Organized Tree-Based Energy-Balance routing protocol (GSTEB) which builds a routing tree using a process where, for each round, BS assigns a root node and broadcasts this selection to all sensor nodes. Subsequently, each node selects its parent by considering only itself and its neighbors' information, thus making GSTEB a dynamic protocol. Simulation results show that GSTEB has a better performance than other protocols in balancing energy consumption, thus prolonging the lifetime of WSN.

  17. Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network

    OpenAIRE

    Chan, KTY; Wong, SYS; Chiu, BCF; Chin, WY; Lam, TP; Lam, CLK; Fong, DYT; Lo, YCY

    2014-01-01

    Background This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong. Methods A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PHQ-9 scores reported whether they thought their patients had depression and their management. Results 10,179 patients completed the survey (response rate 81%). The prevalence of PHQ-9 positive screeni...

  18. 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

  19. Using a million cell simulation of the cerebellum: network scaling and task generality.

    Science.gov (United States)

    Li, Wen-Ke; Hausknecht, Matthew J; Stone, Peter; Mauk, Michael D

    2013-11-01

    Several factors combine to make it feasible to build computer simulations of the cerebellum and to test them in biologically realistic ways. These simulations can be used to help understand the computational contributions of various cerebellar components, including the relevance of the enormous number of neurons in the granule cell layer. In previous work we have used a simulation containing 12000 granule cells to develop new predictions and to account for various aspects of eyelid conditioning, a form of motor learning mediated by the cerebellum. Here we demonstrate the feasibility of scaling up this simulation to over one million granule cells using parallel graphics processing unit (GPU) technology. We observe that this increase in number of granule cells requires only twice the execution time of the smaller simulation on the GPU. We demonstrate that this simulation, like its smaller predecessor, can emulate certain basic features of conditioned eyelid responses, with a slight improvement in performance in one measure. We also use this simulation to examine the generality of the computation properties that we have derived from studying eyelid conditioning. We demonstrate that this scaled up simulation can learn a high level of performance in a classic machine learning task, the cart-pole balancing task. These results suggest that this parallel GPU technology can be used to build very large-scale simulations whose connectivity ratios match those of the real cerebellum and that these simulations can be used guide future studies on cerebellar mediated tasks and on machine learning problems. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. Comparison of Occupational Stress in Response to Challenging Behaviours between General and Special Education Primary Teachers in Northern Italy

    Science.gov (United States)

    Pepe, A.; Addimando, L.

    2013-01-01

    In the Italian education system, pupils with special education needs (SEN) are fully included in mainstream education and receive extra support from special education teachers (SET). Starting from this point, it is reasonable to expect some degree of difference between special education teachers (SETs) and general education teachers (GETs) in term…

  5. 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

    Directory of Open Access Journals (Sweden)

    Veen Robert ER

    2011-07-01

    Full Text Available Abstract Background 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. Method 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. Results 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; and iii 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

  6. Communication at the interface between hospitals and primary care - a general practice audit of hospital discharge summaries.

    Science.gov (United States)

    Belleli, Esther; Naccarella, Lucio; Pirotta, Marie

    2013-12-01

    Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. We audited receipt rates, timeliness and the quality of discharge summaries for 49 admissions among 38 patients in an urban general practice. For missing discharge summaries, a hospital medical record search was performed. Discharge summaries were received for 92% of identified admissions; 73% were received within three days and 55% before the first post-discharge visit to the general practitioner (GP). Administrative information and clinical content, including diagnosis, treatment and follow-up plans, were well reported. However, information regarding tests, referrals and discharge medication was often missing; 57% of summaries were entirely typed and 13% had legibility issues. Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.

  7. Paget's disease of jaw bones as primary manifestation: A case report of a proper diagnosis made by general dentist.

    Science.gov (United States)

    Campolongo, Martin G; Cabras, Marco; Bava, Luca; Arduino, Paolo G; Carbone, Mario

    2018-06-01

    To present a case of early diagnosis mandibular Paget's disease of bone (PDB), recognised by a general dentist. PDB is responsible of rapid bone resorption and disorganised bone formation. The patient was a 72-year-old female patient complaining of dental malposition and blatant prognathism. Clinicians should consider PDB in differential diagnosis for an elderly patient undergoing unexplained alteration in face profile and occlusion. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  8. 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

  9. A survey of the assessment and management of gout in general practitioners and medical officers within the Illawarra Network, Australia.

    Science.gov (United States)

    Terrill, Matthew; Riordan, John

    2017-08-01

    To review the assessment and management of gout by general practitioners (GPs) and medical officers (MOs) within the Illawarra Network, Australia. A survey was sent to GPs and MOs within the Illawarra Network. Of 110 GPs, 45 responded. Of 129 MOs, 42 responded. The overall response was 32.6%. On analysis, 65.1% felt their knowledge of gout to be adequate and 61.6% thought they had been educated well. In acute assessment, 59.1% of GPs responded that the diagnosis of gout best be confirmed with a joint aspiration and 36.4% clinical suspicion. Differing, 85.7% of MOs chose a joint aspiration. In acute management, if colchicine were used, 59.1% of GPs would give 1 mg followed by 0.5 mg an hour later, then 0.5 mg twice daily, compared to 9.5% of MOs, while 20.5% of GPs would use 1 mg twice daily. Chronic management was answered poorly. After an acute attack, urate lowering therapy (ULT) would be started 14 days after by 47.7% of GPs, compared to 69.0% of MOs. GPs were more likely to start ULT within 7 days (52.3% vs. 31.0%). With dosing of ULT, 45.3% would treat to target, while 46.5% would dose to the creatinine clearance. Prophylactic therapy with ULT would be started by 81.8%, although only 17.4% would continue it for 3-6 months. There is poor adherence to recommended practice for dosing of colchicine in acute gout. Also in the management of chronic gout, in particular, the timing of starting ULT and the use of prophylaxis when initiating ULT. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  10. Adaptive generalized function matrix projective lag synchronization between fractional-order and integer-order complex networks with delayed coupling and different dimensions

    International Nuclear Information System (INIS)

    Dai, Hao; Si, Gangquan; Jia, Lixin; Zhang, Yanbin

    2013-01-01

    This paper investigates generalized function matrix projective lag synchronization between fractional-order and integer-order complex networks with delayed coupling, non-identical topological structures and different dimensions. Based on Lyapunov stability theory, generalized function matrix projective lag synchronization criteria are derived by using the adaptive control method. In addition, the three-dimensional fractional-order chaotic system and the four-dimensional integer-order hyperchaotic system as the nodes of the drive and the response networks, respectively, are analyzed in detail, and numerical simulation results are presented to illustrate the effectiveness of the theoretical results. (paper)

  11. Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

    Science.gov (United States)

    van Avendonk, Mariëlle J P; Mensink, Paul A J S; Drenthen, A J M Ton; van Binsbergen, Jaap J

    2012-04-01

    The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines. But in the field of nutrition and other lifestyle-related interventions, there are many direct and indirect interfaces for over- as well as undernutrition. The Dutch College of General Practitioners (NHG) published the Practice Guideline Obesity in adults and children to lead GPs in this process and to bridge the gap with public health. The same applies for the recently published National Primary Care Cooperation Agreement Undernutrition on the collaboration of primary care workers to enhance awareness and early intervention in case of nutritional impairment. This article goes into the background as well as the content of these two NHG products and the implications for daily practice. An attempt is made to connect primary care and public health in this matter. Particularly in the case of obesity, a close relationship with public health is of vital importance.

  12. Network Centrality of Resting-State fMRI in Primary Angle-Closure Glaucoma Before and After Surgery.

    Directory of Open Access Journals (Sweden)

    Fengqin Cai

    Full Text Available Using voxel-wise degree centrality (DC, as measured by resting-state fMRI, we aimed to study alterations in the brain functional networks in patients with primary angle-closure glaucoma (PACG and to reveal the plastic trajectories of surgery.A total of 23 preoperative PACG patients (49.48 ± 14.37 years old were recruited to undergo a resting-state fMRI scan, and 9 of them were rescanned 3 months after surgery. All PACG patients underwent a complete ophthalmologic examination, including intraocular pressure (IOP, retinal nerve fiber layer (RNFL thickness, vertical cup to disc ratio (V C/D, and average cup to disc ratio (A C/D. Another 23 gender- and age-matched healthy controls (48.18 ± 9.40 years old underwent scanning once for comparison. The group difference in DC was calculated in each voxel, and the correlations between the DC value and each of the clinical variables were analyzed in the PACG patients.Preoperative PACG (pre-PACG patients showed significantly decreased DC in the bilateral visual cortices but increased DC in the left anterior cingulate cortex (ACC and caudate (p < 0.05, corrected compared with the controls. Statistical analysis showed a significantly negative correlation between DC in the bilateral visual cortices and the IOP score and between DC in the anterior cingulate cortex (ACC and both the A C/D and V C/D scores in the pre-PACG patients. Three months after surgery, these postoperative PACG (post-PACG patients showed a significantly increased DC in both the bilateral visual cortices and the left precentral gyrus compared with the pre-PACG patients.Our results suggest that PACG may contribute to decreased functional centrality in the visual system and to increased degree centrality in cognition-emotional processing regions. Alterations in visual areas seem to parallel the cup to disc ratio, but not the duration of angle closure. The changes of functional centrality in PACG patients after operation may reveal the

  13. [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.

  14. Influenza sentinel surveillance network: a public health-primary care collaborative action to assess influenza A(H1N1)pmd09 in Catalonia, Spain.

    Science.gov (United States)

    Torner, Nuria; Baricot, Maretva; Martínez, Ana; Toledo, Diana; Godoy, Pere; Dominguez, Ángela

    2013-03-01

    The aim of this study was to evaluate the outcome of a collaborative action between Public Health services and Primary Care in the context of a case-control study on effectiveness of pharmaceutical and non-pharmaceutical measures to prevent hospitalization in a pandemic situation. To carry out this research the collaborative action of the primary care physicians members of the Influenza surveillance network was needed, they had to recall clinical information from influenza A(H1N1)pmd09 confirmed outpatient cases and negative outpatient controls matching their corresponding hospitalized confirmed case.   A survey questionnaire to assess involvement of Influenza Sentinel Surveillance Primary care physicians' Network of Catalonia (PIDIRAC) regarding the outpatient case and control outreach during the pandemic influenza season was performed. A total of 71,1% of completed surveys were received. Perception of pandemic activity was considered to be similar to seasonal influenza activity in 43.8% or higher but not unbearable in 37.5% of the replies. There was no nuisance reported from patients regarding neither the questions nor the surveyor. Collaborative research between Public Health services and Primary Care physicians enhances Public Health actions and research.

  15. Fostering clinical engagement and medical leadership and aligning cultural values: an evaluation of a general practice specialty trainee integrated training placement in a primary care trust.

    Science.gov (United States)

    Ruston, Annmarie; Tavabie, Abdol

    2010-01-01

    To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. A case study method was used in a Kent primary care trust (PCT). Sources of data included face-to-face and telephone interviews (three GPSTRs, three PCT clinical supervisors, three general practitioner (GP) clinical supervisors and three Deanery/PCT managers), reflective diaries, documentary sources and observation. Interview data were transcribed and analysed using the constant comparative method. All respondents were positive about the value and success of the ITP in developing the leadership skills of the GPSTRs covering three dimensions: leadership of self, leadership of teams and leadership of organisations within systems. The ITP had enabled GP trainees to understand the context for change, to develop skills to set the direction for change and to collect and apply evidence to decision making. The ITP was described as an effective means of breaking down cultural barriers between general practice and the PCT and as having the potential for improving clinical engagement. The ITP provided a model to enable the effective exchange of knowledge and understanding of differing cultures between GPSTRs, general practice and the PCT. It provided a sound basis for effective, dispersed clinical engagement and leadership.

  16. 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.

  17. 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...

  18. Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study.

    Science.gov (United States)

    van der Biezen, Mieke; Derckx, Emmy; Wensing, Michel; Laurant, Miranda

    2017-02-07

    Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation. A qualitative study was conducted in 2014 in which 7 managers of out-of-hours primary care services and 32 GPs who owned a general practice were interviewed. Three main topic areas were covered in the interviews: the decision-making process in the organisation, considerations and arguments to train and employ a PA/NP, and the tasks and responsibilities of a PA/NP. Employment of PAs/NPs in out-of-hours services was intended to substitute care for minor ailments in order to decrease GPs' caseload or to increase service capacity. Mangers formulated long-term planning and role definitions when changing workforce skill mix. Lastly, out-of-hours services experienced difficulties with creating team support among their members regarding the employment of PAs/NPs. In general practices during office hours, GPs indented both substitution and supplementation for minor ailments and/or target populations through changing the skill mix. Supplementation was aimed at improving quality of care and extending the range of services to patients. The decision-making in general practices was accompanied with little planning and role definition. The willingness to employ PAs/NPs was highly influenced by an employees' motivation to start the master's programme and GPs' prior experience with PAs/NPs. Knowledge about

  19. 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. F