Multi-label learning with fuzzy hypergraph regularization for protein subcellular location prediction.

Science.gov (United States)

Chen, Jing; Tang, Yuan Yan; Chen, C L Philip; Fang, Bin; Lin, Yuewei; Shang, Zhaowei

2014-12-01

Protein subcellular location prediction aims to predict the location where a protein resides within a cell using computational methods. Considering the main limitations of the existing methods, we propose a hierarchical multi-label learning model FHML for both single-location proteins and multi-location proteins. The latent concepts are extracted through feature space decomposition and label space decomposition under the nonnegative data factorization framework. The extracted latent concepts are used as the codebook to indirectly connect the protein features to their annotations. We construct dual fuzzy hypergraphs to capture the intrinsic high-order relations embedded in not only feature space, but also label space. Finally, the subcellular location annotation information is propagated from the labeled proteins to the unlabeled proteins by performing dual fuzzy hypergraph Laplacian regularization. The experimental results on the six protein benchmark datasets demonstrate the superiority of our proposed method by comparing it with the state-of-the-art methods, and illustrate the benefit of exploiting both feature correlations and label correlations.

Location-based restoration mechanism for multi-domain GMPLS networks

DEFF Research Database (Denmark)

Manolova, Anna Vasileva; Calle, Eusibi; Ruepp, Sarah Renée

2009-01-01

In this paper we propose and evaluate the efficiency of a location-based restoration mechanism in a dynamic multi-domain GMPLS network. We focus on inter-domain link failures and utilize the correlation between the actual position of a failed link along the path with the applied restoration...

Universal correlators for multi-arc complex matrix models

International Nuclear Information System (INIS)

Akemann, G.

1997-01-01

The correlation functions of the multi-arc complex matrix model are shown to be universal for any finite number of arcs. The universality classes are characterized by the support of the eigenvalue density and are conjectured to fall into the same classes as the ones recently found for the Hermitian model. This is explicitly shown to be true for the case of two arcs, apart from the known result for one arc. The basic tool is the iterative solution of the loop equation for the complex matrix model with multiple arcs, which provides all multi-loop correlators up to an arbitrary genus. Explicit results for genus one are given for any number of arcs. The two-arc solution is investigated in detail, including the double-scaling limit. In addition universal expressions for the string susceptibility are given for both the complex and Hermitian model. (orig.)

CLINICAL SURFACES - Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

Science.gov (United States)

Bardram, Jakob E.; Bunde-Pedersen, Jonathan; Doryab, Afsaneh; Sørensen, Steffen

A multi-display environment (MDE) is made up of co-located and networked personal and public devices that form an integrated workspace enabling co-located group work. Traditionally, MDEs have, however, mainly been designed to support a single “smart room”, and have had little sense of the tasks and activities that the MDE is being used for. This paper presents a novel approach to support activity-based computing in distributed MDEs, where displays are physically distributed across a large building. CLINICAL SURFACES was designed for clinical work in hospitals, and enables context-sensitive retrieval and browsing of patient data on public displays. We present the design and implementation of CLINICAL SURFACES, and report from an evaluation of the system at a large hospital. The evaluation shows that using distributed public displays to support activity-based computing inside a hospital is very useful for clinical work, and that the apparent contradiction between maintaining privacy of medical data in a public display environment can be mitigated by the use of CLINICAL SURFACES.

Paediatric Inflammatory Bowel Disease: Clinical Presentation and Disease Location.

Science.gov (United States)

Aziz, Danish Abdul; Moin, Maryum; Majeed, Atif; Sadiq, Kamran; Biloo, Abdul Gaffar

2017-01-01

To determine different clinical presentationsand disease location demarcatedby upper and lower gastrointestinal endoscopyand relevant histopathologyin children diagnosed with inflammatory bowel disease (IBD). This is 5 years (2010 to 2015) retrospective studyconducted at the Aga Khan University Hospitalenrolling65admitted children between 6 months to 15years from either gender, diagnosed with IBD on clinical presentation, endoscopy and biopsy. Different clinical presentations at the time of diagnosis were noted in different categories of the disease. All patients underwent upper and lower (up to the terminal ileum) endoscopy with multiple punch biopsies and histologic assessment of mucosal specimens. All endoscopies were done by paediatric gastroenterologists at endoscopy suite of the hospital and all specimens were reported by the pathology department. ESPGHAN revised criteria for the diagnosis of inflammatory bowel disease in children and an adolescent was used to standardize our diagnosis. Extent of disease on endoscopy and relevant histopathology of the biopsy samples were noted at the time of diagnosis. Data was summarized using mean, standard deviation, numbers and percentages for different variables. Total 56 children were enrolled according to inclusion criteria. There were 34children (61.53%) diagnosed with ulcerative colitis (UC), 10 patients (16.92%) had Crohn'sDisease (CD) and 11 (21.53%) patients were labeled as Indeterminate colitis (IC). Mean age at onset of symptoms was10.03±2.44 and mean age at diagnosis was11.10±2.36. Abdominal pain (80%) and chronic diarrhea (70%) were common symptoms in CD whereas bloody diarrhea (79.41%) and rectal bleeding(64.70%)were common presentation in UC. Patients diagnosed with indeterminate colitis(IC) had similar clinical features as in UC patients. Only 7% patients had some extra-intestinal features in the form of joint pain and/or uveitis. Aspartate aminotransferase level (95.18 ±12.89) was relatively high in

Bees do not use nearest-neighbour rules for optimization of multi-location routes.

Science.gov (United States)

Lihoreau, Mathieu; Chittka, Lars; Le Comber, Steven C; Raine, Nigel E

2012-02-23

Animals collecting patchily distributed resources are faced with complex multi-location routing problems. Rather than comparing all possible routes, they often find reasonably short solutions by simply moving to the nearest unvisited resources when foraging. Here, we report the travel optimization performance of bumble-bees (Bombus terrestris) foraging in a flight cage containing six artificial flowers arranged such that movements between nearest-neighbour locations would lead to a long suboptimal route. After extensive training (80 foraging bouts and at least 640 flower visits), bees reduced their flight distances and prioritized shortest possible routes, while almost never following nearest-neighbour solutions. We discuss possible strategies used during the establishment of stable multi-location routes (or traplines), and how these could allow bees and other animals to solve complex routing problems through experience, without necessarily requiring a sophisticated cognitive representation of space.

Multi-Level Interval Estimation for Locating damage in Structures by Using Artificial Neural Networks

International Nuclear Information System (INIS)

Pan Danguang; Gao Yanhua; Song Junlei

2010-01-01

A new analysis technique, called multi-level interval estimation method, is developed for locating damage in structures. In this method, the artificial neural networks (ANN) analysis method is combined with the statistics theory to estimate the range of damage location. The ANN is multilayer perceptron trained by back-propagation. Natural frequencies and modal shape at a few selected points are used as input to identify the location and severity of damage. Considering the large-scale structures which have lots of elements, multi-level interval estimation method is developed to reduce the estimation range of damage location step-by-step. Every step, estimation range of damage location is obtained from the output of ANN by using the method of interval estimation. The next ANN training cases are selected from the estimation range after linear transform, and the output of new ANN estimation range of damage location will gained a reduced estimation range. Two numerical example analyses on 10-bar truss and 100-bar truss are presented to demonstrate the effectiveness of the proposed method.

Comparison of the accuracies of multi-frequency electronic apex locators in teeth with enlarged apical foramina: ex vivo

Directory of Open Access Journals (Sweden)

Mügem Aslı Ekici

2018-01-01

Full Text Available Objective: The aim of this study was to compare the accuracy of a newly developed multi-frequency electronic apex locator iPex II with three different multi-frequency electronic apex locators in teeth with different sizes of apical foramina. Materials and Method: Twenty-six extracted mandibular premolars were used in this study. The teeth were decoronated, and the root canals were coronally flared. Actual working length was determined by inserting a #15 K-file until the tip was visualized just within apical foramen. Actual working length was established 0.5 mm short of the distance between the rubber stopper and the file tip. Using Protaper F1, F2 and F3 files (Dentsply Maillefer, over-instrumentation 1 mm beyond the apical foramen was done. The teeth were embedded in teflon molds with alginate exposing the coronal 5 mm. Electronic working length measurements were done by using Raypex 5 (VDW, Raypex 6 (VDW, iPex (NSK Inc. and iPex II (NSK Inc. electronic apex locators. Differences between the electronic and actual working lengths were calculated. One-way analysis of variance (ANOVA was used for the statistical analysis of the accuracies of the electronic apex locators (α=0.05. Results: Inter-group comparisons revealed that there was no statistically significant difference between the accuracies of the different electronic apex locators (p>0.05. Intra-group comparisons also revealed that there was no statistically significant difference between different apical foramen sizes (p>0.05. Conclusion: iPex II and the other electronic apex locators provided similar endodontic working length measurements in teeth with enlarged apical foramina. All electronic apex locators tested in this study were found clinically acceptable for working length determination.

University Environment Experience of the First Two Years of University Graduates at a Newly Established Small University Located in Suburban Area in Taiwan

Science.gov (United States)

Lin, Yii-Nii

2011-01-01

The purpose of this study is to describe students' university environment experience from the perspectives of the first two years of university graduates of a newly established small university located in suburban area in Taiwan. A qualitative method of phenomenology with in-depth interviews is adopted. Fourteen male and sixteen female seniors,…

Stochastic integer programming for multi-disciplinary outpatient clinic planning

NARCIS (Netherlands)

Leeftink, A. G.; Vliegen, I. M.H.; Hans, E. W.

2017-01-01

Scheduling appointments in a multi-disciplinary clinic is complex, since coordination between disciplines is required. The design of a blueprint schedule for a multi-disciplinary clinic with open access requirements requires an integrated optimization approach, in which all appointment schedules are

HPSLPred: An Ensemble Multi-Label Classifier for Human Protein Subcellular Location Prediction with Imbalanced Source.

Science.gov (United States)

Wan, Shixiang; Duan, Yucong; Zou, Quan

2017-09-01

Predicting the subcellular localization of proteins is an important and challenging problem. Traditional experimental approaches are often expensive and time-consuming. Consequently, a growing number of research efforts employ a series of machine learning approaches to predict the subcellular location of proteins. There are two main challenges among the state-of-the-art prediction methods. First, most of the existing techniques are designed to deal with multi-class rather than multi-label classification, which ignores connections between multiple labels. In reality, multiple locations of particular proteins imply that there are vital and unique biological significances that deserve special focus and cannot be ignored. Second, techniques for handling imbalanced data in multi-label classification problems are necessary, but never employed. For solving these two issues, we have developed an ensemble multi-label classifier called HPSLPred, which can be applied for multi-label classification with an imbalanced protein source. For convenience, a user-friendly webserver has been established at http://server.malab.cn/HPSLPred. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Optimization of warehouse location through fuzzy multi-criteria decision making methods

Directory of Open Access Journals (Sweden)

C. L. Karmaker

2015-07-01

Full Text Available Strategic warehouse location-allocation problem is a multi-staged decision-making problem having both numerical and qualitative criteria. In order to survive in the global business scenario by improving supply chain performance, companies must examine the cross-functional drivers in the optimization of logistic systems. A meticulous observation makes evident that strategy warehouse location selection has become challenging as the number of alternatives and conflicting criteria increases. The issue becomes particularly problematic when the conventional concept has been applied in dealing with the imprecise nature of the linguistic assessment. The qualitative decisions for selection process are often complicated by the fact that often it is imprecise for the decision makers. Such problem must be overcome with defined efforts. Fuzzy multi-criteria decision making methods have been used in this research as aids in making location-allocation decisions. The anticipated methods in this research consist of two steps at its core. In the first step, the criteria of the existing problem are inspected and identified and then the weights of the sector and subsector are determined that have come to light by using Fuzzy AHP. In the second step, eligible alternatives are ranked by using TOPSIS and Fuzzy TOPSIS comparatively. A demonstration of the application of these methodologies in a real life problem is presented.

Quality assurance in clinical trials : a multi-disciplinary approach

International Nuclear Information System (INIS)

Cornes, D.

2001-01-01

Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

Promoting Workforce Development for the Transportation Profession Through a Multi-University/Agency Partnership

Science.gov (United States)

2010-12-15

The objective of this multi-university/agency partnership between Prairie View A&M University (PVAMU), : Texas Transportation Institute (TTI), and Texas A&M University (TAMU) is to build on the progress made : through the UTCM seed funding to produce...

Head ballistocardiogram based on wireless multi-location sensors.

Science.gov (United States)

Onizuka, Kohei; Sodini, Charles G

2015-08-01

Recently a wearable BCG monitoring technique based on an accelerometer worn at the ear was demonstrated to replace a conventional bulky BCG acquisition system. In this work, a multi-location wireless vital signs monitor was developed, and at least two common acceleration vectors correlating to sitting-BCG were found in the supine position by using head PPG signal as a reference for eight healthy human subjects. The head side amplitude in the supine position is roughly proportional to the sitting amplitude that is in turn proportional to the stroke volume. Signal processing techniques to identify J-waves in a subject having small amplitude was also developed based on the two common vectors at the head side and top.

Location choice in the context of multi-day activity-travel patterns : model development and empirical results

NARCIS (Netherlands)

Arentze, T.A.; Ettema, D.F.; Timmermans, H.J.P.

2013-01-01

Multi-day activity-based models of travel demand are receiving increasing interest recently as successors of existing single-day activity-based models. In this article, we argue that predicting activity location choice-sets can no longer be ignored when multi-day time frames are adopted in these

Instrument separation analysis of multi-used ProTaper Universal rotary system during root canal therapy.

Science.gov (United States)

Wu, Jintao; Lei, Gang; Yan, Ming; Yu, Yan; Yu, Jinhua; Zhang, Guangdong

2011-06-01

The purpose of this study was to identify the influential factors responsible for clinical instrument separation of reused ProTaper Universal rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland). Six thousand one hundred fifty-four root canals in 2,654 teeth were prepared using ProTaper Universal files in endodontic clinics. Separation incidence was determined based on the number of treated teeth or canals. Data were collected including the size of fractured instrument, the length and location of a broken segment within the root canal, and the curvature of canal. The chi-square test and independent samples t test were used to determine the statistical significance. The overall instrument separation incidences were 2.6% according to the number of teeth and 1.1% according to the canal number, respectively. Separation incidences according to the number of teeth or canals were significantly higher (P molars than those in premolars or anterior teeth. Because of its largest diameter, F3 file presented the highest separation incidence according to the number of teeth (1.0%) or canals (0.4%); 47.5% instrument separation of mandibular molars and 61.5% instrument separation of maxillary molars happened in the mesiobuccal canals. Moreover, 91.4% fragments were located in the apical third of root canals, and 54.2% instrument separation occurred in severely curved canals. There was a significant difference (P < .05) in the mean fracture length between shaping (2.42 ± 0.73 mm) and finishing files (3.32 ± 0.73 mm). Separation incidence according to the canal number is more reliable than that according to the number of teeth because of the variable canal number in different teeth. The tooth type, rotary file size, canal location, and anatomy were correlated with the instrument separation of reused ProTaper Universal files. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Universality Results for Multi-phase Hele-Shaw Flows

Science.gov (United States)

Daripa, Prabir

2013-03-01

Saffman-Taylor instability is a well known viscosity driven instability of an interface separating two immiscible fluids. We study linear stability of displacement processes in a Hele-Shaw cell involving an arbitrary number of immiscible fluid phases. This is a problem involving many interfaces. Universal stability results have been obtained for this multi-phase immiscible flow in the sense that the results hold for arbitrary number of interfaces. These stability results have been applied to design displacement processes that are considerably less unstable than the pure Saffman-Taylor case. In particular, we derive universal formula which gives specific values of the viscosities of the fluid layers corresponding to smallest unstable band. Other similar universal results will also be presented. The talk is based on the following paper. This work was supported by the Qatar National Research Fund (a member of The Qatar Foundation).

Multi-layer universal correction magnet

International Nuclear Information System (INIS)

Parzen, G.

1981-08-01

This paper presents an approach for constructing a universal correction magnet in which the return currents play an active role in determining the field. The return currents are not hidden by the iron shield. The coil is wound in many layers, instead of just one layer. Each layer has a particular symmetry, and generates a particular class of field multipoles such that the location of the return current for each independently excited current block is clear. Three layers may be sufficient in many cases. This approach is applied to the ISABELLE storage accelerator correction system

Segmentation of age-related white matter changes in a clinical multi-center study

DEFF Research Database (Denmark)

Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.

2008-01-01

Age-related white matter changes (WMC) are thought to be a marker of vascular pathology, and have been associated with motor and cognitive deficits. In the present study, an optimized artificial neural network was used as an automatic segmentation method to produce probabilistic maps of WMC...... in a clinical multi-center study. The neural network uses information from T1- and T2-weighted and fluid attenuation inversion recovery (FLAIR) magnetic resonance (MR) scans, neighboring voxels and spatial location. Generalizability of the neural network was optimized by including the Optimal Brain Damage (OBD......) pruning method in the training stage. Six optimized neural networks were produced to investigate the impact of different input information on WMC segmentation. The automatic segmentation method was applied to MR scans of 362 non-demented elderly subjects from 11 centers in the European multi-center study...

Sexual Violence Screening Practices of Student Health Centers Located on Universities in Florida

Science.gov (United States)

Halstead, Valerie; Williams, Jessica R.; Gattamorta, Karina; Gonzalez-Guarda, Rosa

2017-01-01

Objective: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. Participants: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private…

The right view from the wrong location: depth perception in stereoscopic multi-user virtual environments.

Science.gov (United States)

Pollock, Brice; Burton, Melissa; Kelly, Jonathan W; Gilbert, Stephen; Winer, Eliot

2012-04-01

Stereoscopic depth cues improve depth perception and increase immersion within virtual environments (VEs). However, improper display of these cues can distort perceived distances and directions. Consider a multi-user VE, where all users view identical stereoscopic images regardless of physical location. In this scenario, cues are typically customized for one "leader" equipped with a head-tracking device. This user stands at the center of projection (CoP) and all other users ("followers") view the scene from other locations and receive improper depth cues. This paper examines perceived depth distortion when viewing stereoscopic VEs from follower perspectives and the impact of these distortions on collaborative spatial judgments. Pairs of participants made collaborative depth judgments of virtual shapes viewed from the CoP or after displacement forward or backward. Forward and backward displacement caused perceived depth compression and expansion, respectively, with greater compression than expansion. Furthermore, distortion was less than predicted by a ray-intersection model of stereo geometry. Collaboration times were significantly longer when participants stood at different locations compared to the same location, and increased with greater perceived depth discrepancy between the two viewing locations. These findings advance our understanding of spatial distortions in multi-user VEs, and suggest a strategy for reducing distortion.

Demonstration of SLUMIS: a clinical database and management information system for a multi organ transplant program.

OpenAIRE

Kurtz, M.; Bennett, T.; Garvin, P.; Manuel, F.; Williams, M.; Langreder, S.

1991-01-01

Because of the rapid evolution of the heart, heart/lung, liver, kidney and kidney/pancreas transplant programs at our institution, and because of a lack of an existing comprehensive database, we were required to develop a computerized management information system capable of supporting both clinical and research requirements of a multifaceted transplant program. SLUMIS (ST. LOUIS UNIVERSITY MULTI-ORGAN INFORMATION SYSTEM) was developed for the following reasons: 1) to comply with the reportin...

Multi-location model for the estimation of the horizontal daily diffuse fraction of solar radiation in Europe

International Nuclear Information System (INIS)

Bortolini, Marco; Gamberi, Mauro; Graziani, Alessandro; Manzini, Riccardo; Mora, Cristina

2013-01-01

Highlights: ► A multi-location model to estimate solar radiation components is proposed. ► Proposed model joins solar radiation data from several weather stations. ► Clearness index is correlated to the diffuse component through analytic functions. ► Third degree polynomial function best fits data for annual and seasonal scenarios. ► A quality control procedure and independent datasets strength model performances. - Abstract: Hourly and daily solar radiation data are crucial for the design of energy systems based on the solar source. Global irradiance, measured on the horizontal plane, is, generally, available from weather station databases. The direct and diffuse fractions are measured rarely and should be analytically calculated for many geographical locations. Aim of this paper is to present a multi-location model to estimate the expected profiles of the horizontal daily diffuse component of solar radiation. It focuses on the European (EU) geographical area joining data from 44 weather stations located in 11 countries. Data are collected by the World Radiation Data Centre (WRDC) between 2004 and 2007. Different analytic functions, correlating the daily diffuse fraction of solar radiation to the clearness index, are calculated and compared to outline the analytic expressions of the best fitting curves. The effect of seasonality on solar irradiance is considered developing summer and winter scenarios together with annual models. Similarities among the trends for the 4 years are, further, discussed. The most adopted statistical indices are used as key performance factors. Finally, data from three locations not included in the dataset considered for model development allow to test the proposed approach against an independent dataset. Obtained results show the effectiveness of adopting a multi-location approach to estimate solar radiation components on the horizontal surface instead of developing several single location models. This is due to the increase

Application of MultiStem® allogeneic cells for immunomodulatory therapy: clinical progress and pre-clinical challenges in prophylaxis for graft vs host disease

Directory of Open Access Journals (Sweden)

Bart eVaes

2012-11-01

Full Text Available The last decade has seen much progress in adjunctive cell therapy for immune disorders. Both corporate and institutional Phase III studies have been run using mesenchymal stromal cells (MSC for treatment of Graft vs Host Disease (GvHD, and product approval has been achieved for treatment of pediatric GvHD in Canada and New Zealand (Prochymal®; Osiris Therapeutics. This effectiveness has prompted the prophylactic use of adherent stem cells at the time of allogeneic hematopoietic stem cell transplantation (HSCT to prevent occurrence of GvHD and possibly provide stromal support for hematopoietic recovery. The MultiStem® product is an adult adherent stem cell product derived from bone marrow which has significant clinical exposure. MultiStem cells are currently in phase II clinical studies for treatment of ischemic stroke and ulcerative colitis, with Phase I studies completed in acute myocardial infarction and for GvHD prophylaxis in allogeneic HSCT, demonstrating that MultiStem administration was well tolerated while the incidence and severity of GvHD was reduced. In advancing this clinical approach, it is important to recognize that alternate models exist based on clinical manufacturing strategies. Corporate sponsors exploit the universal donor properties of adherent stem cells and manufacture at large scale, with many products obtained from one or limited donors and used across many patients. In Europe, institutional sponsors often produce allogeneic product in a patient designated context. For this approach, disposable bioreactors producing <10 products per donor in a closed system manner are very well suited. In this review, the use of adherent stem cells for GvHD prophylaxis is summarized and the suitability of disposable bioreactors for MultiStem production is presented, with an emphasis on quality control parameters, which are critical with a multiple donor approach for manufacturing.

Universality Results for Multi-layer Radial Hele-Shaw Flows

Science.gov (United States)

Daripa, Prabir; Gin, Craig; Daripa Research Team

2014-03-01

Saffman-Taylor instability is a well known viscosity driven instability of an interface separating two immiscible fluids. We study linear stability of this displacement process in multi-layer radial Hele-Shaw geometry involving an arbitrary number of immiscible fluid phases. Universal stability results have been obtained and applied to design displacement processes that are considerably less unstable than the pure Saffman-Taylor case. In particular, we derive universal formula which gives specific values of the viscosities of the fluid layers corresponding to smallest unstable band. Other similar universal results will also be presented. The talk is based on ongoing work. Supported by an NPRP Grant # 08-777-1-141 from the Qatar National Research Fund (a member of the Qatar Foundation). The statements made herein are solely the responsibility of the authors.

Multi criteria decision making methods for location selection of distribution centers

Directory of Open Access Journals (Sweden)

Romita Chakraborty

2013-10-01

Full Text Available In recent years, major challenges such as, increase in inflexible consumer demands and to improve the competitive advantage, it has become necessary for various industrial organizations all over the world to focus on strategies that will help them achieve cost reduction, continual quality improvement, increased customer satisfaction and on time delivery performance. As a result, selection of the most suitable and optimal facility location for a new organization or expansion of an existing location is one of the most important strategic issues, required to fulfill all of these above mentioned objectives. In order to sustain in the global competitive market of 21st century, many industrial organizations have begun to concentrate on the proper selection of the plant site or best facility location. The best location is that which results in higher economic benefits through increased productivity and good distribution network. When a choice is to be made from among several alternative facility locations, it is necessary to compare their performance characteristics in a decisive way. As the facility location selection problem involves multiple conflicting criteria and a finite set of potential candidate alternatives, different multi-criteria decision-making (MCDM methods can be effectively applied to solve such type of problem. In this paper, four well known MCDM methods have been applied on a facility location selection problem and their relative ranking performances are compared. Because of disagreement in the ranks obtained by the four different MCDM methods a final ranking method based on REGIME has been proposed by the authors to facilitate the decision making process.

Location, Location, Location: Does Place Provide the Opportunity for Differentiation for Universities?

Science.gov (United States)

Winter, Emma; Thompson-Whiteside, Helen

2017-01-01

The fiercely competitive HE market has led HEIs to invest significant resources in building a distinct identity. An HEI's location forms an inherent part of its identity and the uniqueness of location offers an opportunity to differentiate. However there has been limited examination of how location is used by HEIs and little consideration of how…

Approximate evaluation of multi-location inventory models with lateral transshipments and hold back levels

NARCIS (Netherlands)

Wijk, van A.C.C.; Adan, I.J.B.F.; Houtum, van G.J.J.A.N.

2011-01-01

We consider a continuous-time, single-echelon, multi-location inventory model with Poisson demand processes. In case of a stock-out at a local warehouse, a demand can be ful??lled via a lateral transshipment (LT). Each warehouse is assigned a predetermined sequence of other warehouses where it will

Approximate evaluation of multi-location inventory models with lateral transshipments and hold back levels

NARCIS (Netherlands)

Wijk, van A.C.C.; Adan, I.J.B.F.; Houtum, van G.J.J.A.N.

2012-01-01

We consider a continuous-time, single-echelon, multi-location inventory model with Poisson demand processes. In case of a stock-out at a local warehouse, a demand can be fulfilled via a lateral transshipment (LT). Each warehouse is assigned a pre-determined sequence of other warehouses where it will

Expression of endogenous proteins in maize hybrids in a multi-location field trial in India.

Science.gov (United States)

Gutha, Linga R; Purushottam, Divakar; Veeramachaneni, Aruna; Tigulla, Sarita; Kodappully, Vikas; Enjala, Chandana; Rajput, Hitendrasinh; Anderson, Jennifer; Hong, Bonnie; Schmidt, Jean; Bagga, Shveta

2018-05-17

Genetically modified (GM) crops undergo large scale multi-location field trials to characterize agronomics, composition, and the concentration of newly expressed protein(s) [herein referred to as transgenic protein(s)]. The concentration of transgenic proteins in different plant tissues and across the developmental stages of the plant is considered in the safety assessment of GM crops. Reference or housekeeping proteins are expected to maintain a relatively stable expression pattern in healthy plants given their role in cellular functions. Understanding the effects of genotype, growth stage and location on the concentration of endogenous housekeeping proteins may provide insight into the contribution these factors could have on transgenic protein concentrations in GM crops. The concentrations of three endogenous proteins (actin, elongation factor 1-alpha, and glyceraldehyde 3-phosphate dehydrogenase) were measured in several different maize hybrids grown across multiple field locations over 2 years. Leaf samples were collected from healthy plants at three developmental stages across the growing seasons, and protein concentrations were quantified by indirect enzyme-linked immunosorbent assay (ELISA) for each protein. In general, the concentrations of these three endogenous proteins were relatively consistent across hybrid backgrounds, when compared within one growth stage and location (2-26%CV), whereas the concentrations of proteins in the same hybrid and growth stage across different locations were more variable (12-64%CV). In general, the protein concentrations in 2013 and 2014 show similar trends in variability. Some degree of variability in protein concentrations should be expected for both transgenic and endogenous plant-expressed proteins. In the case of GM crops, the potential variation in protein concentrations due to location effects is captured in the current model of multi-location field testing.

An automated multi-scale network-based scheme for detection and location of seismic sources

Science.gov (United States)

Poiata, N.; Aden-Antoniow, F.; Satriano, C.; Bernard, P.; Vilotte, J. P.; Obara, K.

2017-12-01

We present a recently developed method - BackTrackBB (Poiata et al. 2016) - allowing to image energy radiation from different seismic sources (e.g., earthquakes, LFEs, tremors) in different tectonic environments using continuous seismic records. The method exploits multi-scale frequency-selective coherence in the wave field, recorded by regional seismic networks or local arrays. The detection and location scheme is based on space-time reconstruction of the seismic sources through an imaging function built from the sum of station-pair time-delay likelihood functions, projected onto theoretical 3D time-delay grids. This imaging function is interpreted as the location likelihood of the seismic source. A signal pre-processing step constructs a multi-band statistical representation of the non stationary signal, i.e. time series, by means of higher-order statistics or energy envelope characteristic functions. Such signal-processing is designed to detect in time signal transients - of different scales and a priori unknown predominant frequency - potentially associated with a variety of sources (e.g., earthquakes, LFE, tremors), and to improve the performance and the robustness of the detection-and-location location step. The initial detection-location, based on a single phase analysis with the P- or S-phase only, can then be improved recursively in a station selection scheme. This scheme - exploiting the 3-component records - makes use of P- and S-phase characteristic functions, extracted after a polarization analysis of the event waveforms, and combines the single phase imaging functions with the S-P differential imaging functions. The performance of the method is demonstrated here in different tectonic environments: (1) analysis of the one year long precursory phase of 2014 Iquique earthquake in Chile; (2) detection and location of tectonic tremor sources and low-frequency earthquakes during the multiple episodes of tectonic tremor activity in southwestern Japan.

The multi-depot electric vehicle location routing problem with time windows

Directory of Open Access Journals (Sweden)

Juan Camilo Paz

2018-01-01

Full Text Available In this paper, the Multi-Depot Electric Vehicle Location Routing Problem with Time Windows (MDVLRP is addressed. This problem is an extension of the MDVLRP, where electric vehicles are used instead of internal combustion engine vehicles. The recent development of this model is explained by the advantages of this technology, such as the diminution of carbon dioxide emissions, and the support that they can provide to the design of the logistic and energy-support structure of electric vehicle fleets. There are many models that extend the classical VRP model to take electric vehicles into consideration, but the multi-depot case for location-routing models has not been worked out yet. Moreover, we consider the availability of two energy supply technologies: the “Plug-in” Conventional Charge technology, and Battery Swapping Stations; options in which the recharging time is a function of the amount of energy to charge and a fixed time, respectively. Three models are proposed: one for each of the technologies mentioned above, and another in which both options are taken in consideration. The models were solved for small scale instances using C++ and Cplex 12.5. The results show that the models can be used to design logistic and energy-support structures, and compare the performance of the different options of energy supply, as well as measure the impact of these decisions on the overall distance traveled or other optimization objectives that could be worked on in the future.

A heuristic algorithm for a multi-product four-layer capacitated location-routing problem

Directory of Open Access Journals (Sweden)

Mohsen Hamidi

2014-01-01

Full Text Available The purpose of this study is to solve a complex multi-product four-layer capacitated location-routing problem (LRP in which two specific constraints are taken into account: 1 plants have limited production capacity, and 2 central depots have limited capacity for storing and transshipping products. The LRP represents a multi-product four-layer distribution network that consists of plants, central depots, regional depots, and customers. A heuristic algorithm is developed to solve the four-layer LRP. The heuristic uses GRASP (Greedy Randomized Adaptive Search Procedure and two probabilistic tabu search strategies of intensification and diversification to tackle the problem. Results show that the heuristic solves the problem effectively.

MULTI-OBJECTIVE OPTIMAL NUMBER AND LOCATION FOR STEEL OUTRIGGER-BELT TRUSS SYSTEM

Directory of Open Access Journals (Sweden)

MEHDI BABAEI

2017-10-01

Full Text Available During the past two decades, outrigger-belt truss system has been investigated and used in design of tall buildings. Most of the studies focused on the optimization of the system for minimum displacement and some of them proposed the best locations. In this study, however, multi-objective optimization of tall steel frames with belt trusses is investigated to minimize displacement and weight of the structure. For this purpose, structures with 20, 30, 40, and 50 stories are considered as models, based on the suggestions in the literature. The location and number of trusses and cross section of all structural elements are considered as design variables. After sizing of the structure for a specific topology and shape, weight and displacement of the structure are obtained and plotted in a diagram to illustrate trade-off between two objective functions. The results show the optimal Pareto-front solutions for different stories. Smooth trade-off and optimal number of trusses and their locations obtained.

Design and testing of a multi-sensor pedestrian location and navigation platform.

Science.gov (United States)

Morrison, Aiden; Renaudin, Valérie; Bancroft, Jared B; Lachapelle, Gérard

2012-01-01

Navigation and location technologies are continually advancing, allowing ever higher accuracies and operation under ever more challenging conditions. The development of such technologies requires the rapid evaluation of a large number of sensors and related utilization strategies. The integration of Global Navigation Satellite Systems (GNSSs) such as the Global Positioning System (GPS) with accelerometers, gyros, barometers, magnetometers and other sensors is allowing for novel applications, but is hindered by the difficulties to test and compare integrated solutions using multiple sensor sets. In order to achieve compatibility and flexibility in terms of multiple sensors, an advanced adaptable platform is required. This paper describes the design and testing of the NavCube, a multi-sensor navigation, location and timing platform. The system provides a research tool for pedestrian navigation, location and body motion analysis in an unobtrusive form factor that enables in situ data collections with minimal gait and posture impact. Testing and examples of applications of the NavCube are provided.

Application Research of Horn Array Multi-Beam Antenna in Reference Source System for Satellite Interference Location

Science.gov (United States)

Zhou, Ping; Lin, Hui; Zhang, Qi

2018-01-01

The reference source system is a key factor to ensure the successful location of the satellite interference source. Currently, the traditional system used a mechanical rotating antenna which leaded to the disadvantages of slow rotation and high failure-rate, which seriously restricted the system’s positioning-timeliness and became its obvious weaknesses. In this paper, a multi-beam antenna scheme based on the horn array was proposed as a reference source for the satellite interference location, which was used as an alternative to the traditional reference source antenna. The new scheme has designed a small circularly polarized horn antenna as an element and proposed a multi-beamforming algorithm based on planar array. Moreover, the simulation analysis of horn antenna pattern, multi-beam forming algorithm and simulated satellite link cross-ambiguity calculation have been carried out respectively. Finally, cross-ambiguity calculation of the traditional reference source system has also been tested. The comparison between the results of computer simulation and the actual test results shows that the scheme is scientific and feasible, obviously superior to the traditional reference source system.

Object-Location-Aware Hashing for Multi-Label Image Retrieval via Automatic Mask Learning.

Science.gov (United States)

Huang, Chang-Qin; Yang, Shang-Ming; Pan, Yan; Lai, Han-Jiang

2018-09-01

Learning-based hashing is a leading approach of approximate nearest neighbor search for large-scale image retrieval. In this paper, we develop a deep supervised hashing method for multi-label image retrieval, in which we propose to learn a binary "mask" map that can identify the approximate locations of objects in an image, so that we use this binary "mask" map to obtain length-limited hash codes which mainly focus on an image's objects but ignore the background. The proposed deep architecture consists of four parts: 1) a convolutional sub-network to generate effective image features; 2) a binary "mask" sub-network to identify image objects' approximate locations; 3) a weighted average pooling operation based on the binary "mask" to obtain feature representations and hash codes that pay most attention to foreground objects but ignore the background; and 4) the combination of a triplet ranking loss designed to preserve relative similarities among images and a cross entropy loss defined on image labels. We conduct comprehensive evaluations on four multi-label image data sets. The results indicate that the proposed hashing method achieves superior performance gains over the state-of-the-art supervised or unsupervised hashing baselines.

Using location tracking data to assess efficiency in established clinical workflows.

Science.gov (United States)

Meyer, Mark; Fairbrother, Pamela; Egan, Marie; Chueh, Henry; Sandberg, Warren S

2006-01-01

Location tracking systems are becoming more prevalent in clinical settings yet applications still are not common. We have designed a system to aid in the assessment of clinical workflow efficiency. Location data is captured from active RFID tags and processed into usable data. These data are stored and presented visually with trending capability over time. The system allows quick assessments of the impact of process changes on workflow, and isolates areas for improvement.

MULTI-OBJECTIVE OPTIMAL NUMBER AND LOCATION FOR STEEL OUTRIGGER-BELT TRUSS SYSTEM

OpenAIRE

MEHDI BABAEI

2017-01-01

During the past two decades, outrigger-belt truss system has been investigated and used in design of tall buildings. Most of the studies focused on the optimization of the system for minimum displacement and some of them proposed the best locations. In this study, however, multi-objective optimization of tall steel frames with belt trusses is investigated to minimize displacement and weight of the structure. For this purpose, structures with 20, 30, 40, and 50 stories are considered as ...

A multi-objective possibilistic programming approach for locating distribution centers and allocating customers demands in supply chains

Directory of Open Access Journals (Sweden)

Seyed Ahmad Yazdian

2011-01-01

Full Text Available In this paper, we present a multi-objective possibilistic programming model to locate distribution centers (DCs and allocate customers' demands in a supply chain network design (SCND problem. The SCND problem deals with determining locations of facilities (DCs and/or plants, and also shipment quantities between each two consecutive tier of the supply chain. The primary objective of this study is to consider different risk factors which are involved in both locating DCs and shipping products as an objective function. The risk consists of various components: the risks related to each potential DC location, the risk associated with each arc connecting a plant to a DC and the risk of shipment from a DC to a customer. The proposed method of this paper considers the risk phenomenon in fuzzy forms to handle the uncertainties inherent in these factors. A possibilistic programming approach is proposed to solve the resulted multi-objective problem and a numerical example for three levels of possibility is conducted to analyze the model.

Challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials

Directory of Open Access Journals (Sweden)

Yunbo Chu

2016-10-01

Full Text Available Economic evaluation in the form of cost-effectiveness analysis has become a popular means to inform decisions in healthcare. With multi-regional clinical trials in a global development program becoming a new venue for drug efficacy testing in recent decades, questions in methods for cost-effectiveness analysis in the multi-regional clinical trials setting also emerge. This paper addresses some challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials. Several discussion points are raised for further attention and a multi-regional clinical trial example is presented to illustrate the implications in industrial application. A general message is delivered to call for a depth discussion by all stakeholders to reach an agreement on a good practice in cost-effectiveness analysis in the multi-regional clinical trials. Meanwhile, we recommend an additional consideration of cost-effectiveness analysis results based on the clinical evidence from a certain homogeneous population as sensitivity or scenario analysis upon data availability.

Integrating GIS with fuzzy multi-criteria decision making for suitable wind farm locations

Energy Technology Data Exchange (ETDEWEB)

Iyappan, L.; Pandian, P.K. [Tagore Engineering College. Dept. of Civil Engineering, Tamil Nadu (India)

2012-07-01

Wind Energy is spatial in nature and the degree of potential wind farm locations are fuzzy i.e., the boundaries among highly, moderate and least suitable is not clear cut. The study area of this research covers entire taluk of Tirumangalam, Madurai District (India). In this study, to help wind energy companies, policy-makers and investors in evaluating potential wind farm locations in the Tirumangalam Taluk (Tamil Nadu, India), an adaptation of a Geographical Information System (GIS) and Fuzzy Multi-criteria Decision Making(FMDM) approach is attended. The entire processes were completed by using open source GIS software (Quantum GIS and GRASS GIS) with help of freely available data. The software tool takes inputs such as wind power density, Slope, Transmission lines, environmental factors, and economic factors to provide an in-depth analysis for suitable location options. (Author)

Universality Results for Multi-Layer Hele-Shaw and Porous Media Flows

Science.gov (United States)

Daripa, Prabir

2012-11-01

Saffman-Taylor instability is a well known viscosity driven instability of an interface. Motivated by a need to understand the effect of various injection policies currently in practice for chemical enhanced oil recovery, we study linear stability of displacement processes in a Hele-Shaw cell involving injection of an arbitrary number of immiscible fluid phases in succession. This is a problem involving many interfaces. Universal stability results have been obtained for this multi-layer (multi-region) flow in the sense that the results hold with arbitrary number of interfaces. These stability results have been applied to design injection policies that are considerably less unstable than the pure Saffman-Taylor case. In particular, we determine specific values of the viscosity of the fluid layers corresponding to smallest unstable band. Moreover, we discuss universal selection principle of optimal viscous profiles. The talk is based on following papers. Qatar National Fund (a member of the Qatar Foundation).

Authorship issues in multi-centre clinical trials

DEFF Research Database (Denmark)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

2015-01-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for th...

A business planning model to identify new safety net clinic locations.

Science.gov (United States)

Langabeer, James; Helton, Jeffrey; DelliFraine, Jami; Dotson, Ebbin; Watts, Carolyn; Love, Karen

2014-01-01

Community health clinics serving the poor and underserved are geographically expanding due to changes in U.S. health care policy. This paper describes the experience of a collaborative alliance of health care providers in a large metropolitan area who develop a conceptual and mathematical decision model to guide decisions on expanding its network of community health clinics. Community stakeholders participated in a collaborative process that defined constructs they deemed important in guiding decisions on the location of community health clinics. This collaboration also defined key variables within each construct. Scores for variables within each construct were then totaled and weighted into a community-specific optimal space planning equation. This analysis relied entirely on secondary data available from published sources. The model built from this collaboration revolved around the constructs of demand, sustainability, and competition. It used publicly available data defining variables within each construct to arrive at an optimal location that maximized demand and sustainability and minimized competition. This is a model that safety net clinic planners and community stakeholders can use to analyze demographic and utilization data to optimize capacity expansion to serve uninsured and Medicaid populations. Communities can use this innovative model to develop a locally relevant clinic location-planning framework.

Therapeutic drug monitoring in epilepsy clinic: a multi-disciplinary approach

Directory of Open Access Journals (Sweden)

Sunee Lertsinudom

2014-12-01

Full Text Available Epilepsy is a common public health problem and needs multi-disciplinary treatment. Therapeutic drug monitoring (TDM is one of step of the multi-disciplinary treatment in epilepsy at Epilepsy clinic, Khon Kaen University (Thailand. The TDM service has been established since 2008. Here, we aimed to study the roles of TDM order and epilepsy control. This is a prospective descriptive study in which data collection was done from January 1 to December 31, 2010, the period when pharmacists took part in assessing the appropriateness in measurement and interpretation of TDM in order to provide suggestions for physicians. The 112 patients under study had an average age of 38.21±15.36 years; 254 samples were collected for therapeutic drug monitoring; phenytoin was submitted mostly for drug monitoring at 46.46%; 44.49% of sub-missions for drug level monitoring were made owing to a suspected sub-therapeutic level. Associations were found between reasons of sending samples for drug level monitoring and the measured drug levels, i.e., 66.67% of drug levels found was so low that they were undetectable in sample for patients’ compliance investigation and 38.94% of the drug levels were found to be sub-therapeutic as for the case where submission of samples was done because of suspected sub-therapeutic level, 40% of the cases were found to be in toxicity range in the cases with suspected over-therapeutic levels and monitoring levels, 58.25% were found to be within the therapeutic range. Pharmacists used the interpreted results in patients’ care by recommending physicians to monitor therapeutic drug closely, to adjust the dosage of drugs, and to recommend checking patients’ compliance in their use of drugs at 56.5, 38.9, and 4.3%, respectively. Physicians’ responses were found to be absolute follow, partial follow and not follow at 77.95, 11.03, and 7.48%, respectively. In conclusion, associations were found between reasons of TDM order and measured drug

CLINICAL SURFACES -- Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

DEFF Research Database (Denmark)

Bardram, Jakob Eyvind; Bunde-Pedersen, Jonathan; Doryab, Afsaneh

2009-01-01

A multi-display environment (MDE) is made up of co-located and networked personal and public devices that form an integrated workspace enabling co-located group work. Traditionally, MDEs have, however, mainly been designed to support a single “smart room”, and have had little sense of the tasks...

[Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

Science.gov (United States)

Yokota, Hiromitsu; Yatomi, Yutaka

2013-08-01

Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

A multiobjective modeling approach to locate multi-compartment containers for urban-sorted waste

International Nuclear Information System (INIS)

Tralhao, Lino; Coutinho-Rodrigues, Joao; Alcada-Almeida, Luis

2010-01-01

The location of multi-compartment sorted waste containers for recycling purposes in cities is an important problem in the context of urban waste management. The costs associated with those facilities and the impacts placed on populations are important concerns. This paper introduces a mixed-integer, multiobjective programming approach to identify the locations and capacities of such facilities. The approach incorporates an optimization model in a Geographical Information System (GIS)-based interactive decision support system that includes four objectives. The first objective minimizes the total investment cost; the second one minimizes the average distance from dwellings to the respective multi-compartment container; the last two objectives address the 'pull' and 'push' characteristics of the decision problem, one by minimizing the number of individuals too close to any container, and the other by minimizing the number of dwellings too far from the respective multi-compartment container. The model determines the number of facilities to be opened, the respective container capacities, their locations, their respective shares of the total waste of each type to be collected, and the dwellings assigned to each facility. The approach proposed was tested with a case study for the historical center of Coimbra city, Portugal, where a large urban renovation project, addressing about 800 buildings, is being undertaken. This paper demonstrates that the models and techniques incorporated in the interactive decision support system (IDSS) can be used to assist a decision maker (DM) in analyzing this complex problem in a realistically sized urban application. Ten solutions consisting of different combinations of underground containers for the disposal of four types of sorted waste in 12 candidate sites, were generated. These solutions and tradeoffs among the objectives are presented to the DM via tables, graphs, color-coded maps and other graphics. The DM can then use this

Systematic data ingratiation of clinical trial recruitment locations for geographic-based query and visualization.

Science.gov (United States)

Luo, Jake; Chen, Weiheng; Wu, Min; Weng, Chunhua

2017-12-01

Prior studies of clinical trial planning indicate that it is crucial to search and screen recruitment sites before starting to enroll participants. However, currently there is no systematic method developed to support clinical investigators to search candidate recruitment sites according to their interested clinical trial factors. In this study, we aim at developing a new approach to integrating the location data of over one million heterogeneous recruitment sites that are stored in clinical trial documents. The integrated recruitment location data can be searched and visualized using a map-based information retrieval method. The method enables systematic search and analysis of recruitment sites across a large amount of clinical trials. The location data of more than 1.4 million recruitment sites of over 183,000 clinical trials was normalized and integrated using a geocoding method. The integrated data can be used to support geographic information retrieval of recruitment sites. Additionally, the information of over 6000 clinical trial target disease conditions and close to 4000 interventions was also integrated into the system and linked to the recruitment locations. Such data integration enabled the construction of a novel map-based query system. The system will allow clinical investigators to search and visualize candidate recruitment sites for clinical trials based on target conditions and interventions. The evaluation results showed that the coverage of the geographic location mapping for the 1.4 million recruitment sites was 99.8%. The evaluation of 200 randomly retrieved recruitment sites showed that the correctness of geographic information mapping was 96.5%. The recruitment intensities of the top 30 countries were also retrieved and analyzed. The data analysis results indicated that the recruitment intensity varied significantly across different countries and geographic areas. This study contributed a new data processing framework to extract and integrate

Systematic data ingratiation of clinical trial recruitment locations for geographic-based query and visualization

Science.gov (United States)

Luo, Jake; Chen, Weiheng; Wu, Min; Weng, Chunhua

2018-01-01

Background Prior studies of clinical trial planning indicate that it is crucial to search and screen recruitment sites before starting to enroll participants. However, currently there is no systematic method developed to support clinical investigators to search candidate recruitment sites according to their interested clinical trial factors. Objective In this study, we aim at developing a new approach to integrating the location data of over one million heterogeneous recruitment sites that are stored in clinical trial documents. The integrated recruitment location data can be searched and visualized using a map-based information retrieval method. The method enables systematic search and analysis of recruitment sites across a large amount of clinical trials. Methods The location data of more than 1.4 million recruitment sites of over 183,000 clinical trials was normalized and integrated using a geocoding method. The integrated data can be used to support geographic information retrieval of recruitment sites. Additionally, the information of over 6000 clinical trial target disease conditions and close to 4000 interventions was also integrated into the system and linked to the recruitment locations. Such data integration enabled the construction of a novel map-based query system. The system will allow clinical investigators to search and visualize candidate recruitment sites for clinical trials based on target conditions and interventions. Results The evaluation results showed that the coverage of the geographic location mapping for the 1.4 million recruitment sites was 99.8%. The evaluation of 200 randomly retrieved recruitment sites showed that the correctness of geographic information mapping was 96.5%. The recruitment intensities of the top 30 countries were also retrieved and analyzed. The data analysis results indicated that the recruitment intensity varied significantly across different countries and geographic areas. Conclusion This study contributed a new

Maintenance of Clinical Expertise and Clinical Research by the Clinical Professors at Gifu Pharmaceutical University.

Science.gov (United States)

Tachi, Tomoya; Noguchi, Yoshihiro; Teramachi, Hitomi

2017-01-01

The clinical professors at Gifu Pharmaceutical University (GPU) provide pharmaceutical services at GPU Pharmacy, Gifu University Hospital, and Gifu Municipal Hospital to keep their clinical skills up-to-date; they also perform clinical research in collaboration with many clinical institutes. The Laboratory of Clinical Pharmacy is part of the Department of Pharmacy Practice and Science, to which the clinical professors belong, and is composed of three clinical professors (a professor, an associate professor, and an assistant professor). The professor administers the GPU Pharmacy as its director, while the associate professor and assistant professor provide pharmaceutical services to patients at Gifu Municipal Hospital, and also provide practical training for students in the GPU Pharmacy. Collectively, they have performed research on such topics as medication education for students, clinical communication education, and analysis of clinical big data. They have also conducted research in collaboration with clinical institutes, hospitals, and pharmacies. Here, we introduce the collaborative research between the Laboratory of Clinical Pharmacy and Gifu Municipal Hospital. These studies include "Risk factors contributing to urinary protein expression resulting from bevacizumab combination chemotherapy", "Hyponatremia and hypokalemia as risk factors for falls", "Economic evaluation of adjustments of levofloxacin dosage by dispensing pharmacists for patients with renal dysfunction", and "Effect of patient education upon discharge for use of a medication notebook on purchasing over-the-counter drugs and health foods". In this symposium, we would like to demonstrate one model of the association and collaborative research between these clinical professors and clinical institutes.

Intensity correction method customized for multi-animal abdominal MR imaging with 3 T clinical scanner and multi-array coil

International Nuclear Information System (INIS)

Mitsuda, Minoru; Yamaguchi, Masayuki; Nakagami, Ryutaro; Furuta, Toshihiro; Fujii, Hirofumi; Sekine, Norio; Niitsu, Mamoru; Moriyama, Noriyuki

2013-01-01

Simultaneous magnetic resonance (MR) imaging of multiple small animals in a single session increases throughput of preclinical imaging experiments. Such imaging using a 3-tesla clinical scanner with multi-array coil requires correction of intensity variation caused by the inhomogeneous sensitivity profile of the coil. We explored a method for correcting intensity that we customized for multi-animal MR imaging, especially abdominal imaging. Our institutional committee for animal experimentation approved the protocol. We acquired high resolution T 1 -, T 2 -, and T 2 * -weighted images and low resolution proton density-weighted images (PDWIs) of 4 rat abdomens simultaneously using a 3T clinical scanner and custom-made multi-array coil. For comparison, we also acquired T 1 -, T 2 -, and T 2 * -weighted volume coil images in the same rats in 4 separate sessions. We used software created in-house to correct intensity variation. We applied thresholding to the PDWIs to produce binary images that displayed only a signal-producing area, calculated multi-array coil sensitivity maps by dividing low-pass filtered PDWIs by low-pass filtered binary images pixel by pixel, and divided uncorrected T 1 -, T 2 -, or T 2 * -weighted images by those maps to obtain intensity-corrected images. We compared tissue contrast among the liver, spinal canal, and muscle between intensity-corrected multi-array coil images and volume coil images. Our intensity correction method performed well for all pulse sequences studied and corrected variation in original multi-array coil images without deteriorating the throughput of animal experiments. Tissue contrasts were comparable between intensity-corrected multi-array coil images and volume coil images. Our intensity correction method customized for multi-animal abdominal MR imaging using a 3T clinical scanner and dedicated multi-array coil could facilitate image interpretation. (author)

A multi-objective model for locating distribution centers in a supply chain network considering risk and inventory decisions

Directory of Open Access Journals (Sweden)

Sara Gharegozloo Hamedani

2013-04-01

Full Text Available This paper presents a multi-objective location problem in a three level supply chain network under uncertain environment considering inventory decisions. The proposed model of this paper considers uncertainty for different parameters including procurement, transportation costs, supply, demand and the capacity of various facilities. The proposed model presents a robust optimization model, which specifies locations of distribution centers to be opened, inventory control parameters (r, Q, and allocation of supply chain components, concurrently. The resulted mixed-integer nonlinear programming minimizes the expected total cost of such a supply chain network comprising location, procurement, transportation, holding, ordering, and shortage costs. The model also minimizes the variability of the total cost of relief chain and minimizes the financial risk or the probability of not meeting a certain budget. We use the ε-constraint method, which is a multi-objective technique with implicit trade-off information given, to solve the problem and using a couple of numerical instances, we examine the performance of the proposed approach.

Multi-dimensional indoor location information model

NARCIS (Netherlands)

Xiong, Q.; Zhu, Q.; Zlatanova, S.; Huang, L.; Zhou, Y.; Du, Z.

2013-01-01

Aiming at the increasing requirements of seamless indoor and outdoor navigation and location service, a Chinese standard of Multidimensional Indoor Location Information Model is being developed, which defines ontology of indoor location. The model is complementary to 3D concepts like CityGML and

University of Limpopo student nurses' clinical learning experiences ...

African Journals Online (AJOL)

University of Limpopo student nurses' clinical learning experiences in a public hospital at ... was applied to explore and describe the experiences of student nurses' clinical learning ... The ethical principles relevant to the study were observed.

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

International Nuclear Information System (INIS)

Mellado, J.M.; Calmet, J.; Ballabriga, J.; Gine, J.; Olona, M.; Camins, A.; Perez del Palomar, L.

2006-01-01

The objectives of this study were to use magnetic resonance (MR) imaging to evaluate the prevalence, size, location, and clinical relevance of tendon rerupture following complete repair of full-thickness rotator cuff tear (RCT). A total of 78 surgically proven full-thickness rotator cuff tears in 74 patients were retrospectively included in the study. Clinical assessment was performed using the University of California at Los Angeles score. Postoperative MR imaging was evaluated to determine prevalence, size, and location of tendon rerupture. At a mean 48.4 months' follow-up, 62 shoulders (79.5%) had favorable outcomes and 45 shoulders (57.6%) showed rerupture on MR imaging studies. Reruptures were significantly more prevalent among patients with intermediate-to-bad outcomes (81.3%), with surgically demonstrated two-tendon tears (78.9%) or three-tendon tears (100%), and with preoperative fatty degeneration of the supraspinatus muscle greater than 1 (91.6%). Reruptures were also significantly larger in those subgroups. Complete repair of RCT of all sizes may have favorable outcomes in a significant proportion of patients in spite of a high prevalence of reruptures. Preoperative tear size and degree of muscle fatty degeneration influence the prevalence and rerupture size. After repair of supraspinatus tears, reruptures tend to invade the posterior aspect of the tendon. (orig.)

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

Energy Technology Data Exchange (ETDEWEB)

Mellado, J.M. [Hospital Reina Sofia de Tudela, Servicio de Radiodiagnostico, Tudela, Navarra (Spain); Calmet, J.; Ballabriga, J.; Gine, J. [Hospital Universitari de Tarragona Joan XXIII, Servei de Cirurgia Ortopedica i Traumatologia, Tarragona (Spain); Olona, M. [Hospital Universitari de Tarragona Joan XXIII, Servei de Medicina Preventiva i Epidemiologia, Tarragona (Spain); Camins, A. [Hospital Universitari de Tarragona Joan XXIII, Institut de Diagnostic per la Imatge, Tarragona (Spain); Perez del Palomar, L. [Hospital Ernest Lluch, Servicio de Radiologia, Calatayud, Zaragoza (Spain)

2006-10-15

The objectives of this study were to use magnetic resonance (MR) imaging to evaluate the prevalence, size, location, and clinical relevance of tendon rerupture following complete repair of full-thickness rotator cuff tear (RCT). A total of 78 surgically proven full-thickness rotator cuff tears in 74 patients were retrospectively included in the study. Clinical assessment was performed using the University of California at Los Angeles score. Postoperative MR imaging was evaluated to determine prevalence, size, and location of tendon rerupture. At a mean 48.4 months' follow-up, 62 shoulders (79.5%) had favorable outcomes and 45 shoulders (57.6%) showed rerupture on MR imaging studies. Reruptures were significantly more prevalent among patients with intermediate-to-bad outcomes (81.3%), with surgically demonstrated two-tendon tears (78.9%) or three-tendon tears (100%), and with preoperative fatty degeneration of the supraspinatus muscle greater than 1 (91.6%). Reruptures were also significantly larger in those subgroups. Complete repair of RCT of all sizes may have favorable outcomes in a significant proportion of patients in spite of a high prevalence of reruptures. Preoperative tear size and degree of muscle fatty degeneration influence the prevalence and rerupture size. After repair of supraspinatus tears, reruptures tend to invade the posterior aspect of the tendon. (orig.)

Multi-organ segmentation from multi-phase abdominal CT via 4D graphs using enhancement, shape and location optimization.

Science.gov (United States)

Linguraru, Marius George; Pura, John A; Chowdhury, Ananda S; Summers, Ronald M

2010-01-01

The interpretation of medical images benefits from anatomical and physiological priors to optimize computer-aided diagnosis (CAD) applications. Diagnosis also relies on the comprehensive analysis of multiple organs and quantitative measures of soft tissue. An automated method optimized for medical image data is presented for the simultaneous segmentation of four abdominal organs from 4D CT data using graph cuts. Contrast-enhanced CT scans were obtained at two phases: non-contrast and portal venous. Intra-patient data were spatially normalized by non-linear registration. Then 4D erosion using population historic information of contrast-enhanced liver, spleen, and kidneys was applied to multi-phase data to initialize the 4D graph and adapt to patient specific data. CT enhancement information and constraints on shape, from Parzen windows, and location, from a probabilistic atlas, were input into a new formulation of a 4D graph. Comparative results demonstrate the effects of appearance and enhancement, and shape and location on organ segmentation.

[Multi-facetted clinical presentation of thrombotic thrombocytopenic purpura

DEFF Research Database (Denmark)

Niemann, C.U.; Jurlander, J.; Daugaard, G.

2009-01-01

smears. Determination of the ADAMTS13-activity is now becoming available as a routine analysis. We present two cases that illustrate the multi-facetted clinical presentation under which TTP occurs. The importance of access to ADAMTS13 measurements is stressed Udgivelsesdato: 2009/1/26...

Abdominal multi-organ segmentation from CT images using conditional shape-location and unsupervised intensity priors.

Science.gov (United States)

Okada, Toshiyuki; Linguraru, Marius George; Hori, Masatoshi; Summers, Ronald M; Tomiyama, Noriyuki; Sato, Yoshinobu

2015-12-01

This paper addresses the automated segmentation of multiple organs in upper abdominal computed tomography (CT) data. The aim of our study is to develop methods to effectively construct the conditional priors and use their prediction power for more accurate segmentation as well as easy adaptation to various imaging conditions in CT images, as observed in clinical practice. We propose a general framework of multi-organ segmentation which effectively incorporates interrelations among multiple organs and easily adapts to various imaging conditions without the need for supervised intensity information. The features of the framework are as follows: (1) A method for modeling conditional shape and location (shape-location) priors, which we call prediction-based priors, is developed to derive accurate priors specific to each subject, which enables the estimation of intensity priors without the need for supervised intensity information. (2) Organ correlation graph is introduced, which defines how the conditional priors are constructed and segmentation processes of multiple organs are executed. In our framework, predictor organs, whose segmentation is sufficiently accurate by using conventional single-organ segmentation methods, are pre-segmented, and the remaining organs are hierarchically segmented using conditional shape-location priors. The proposed framework was evaluated through the segmentation of eight abdominal organs (liver, spleen, left and right kidneys, pancreas, gallbladder, aorta, and inferior vena cava) from 134 CT data from 86 patients obtained under six imaging conditions at two hospitals. The experimental results show the effectiveness of the proposed prediction-based priors and the applicability to various imaging conditions without the need for supervised intensity information. Average Dice coefficients for the liver, spleen, and kidneys were more than 92%, and were around 73% and 67% for the pancreas and gallbladder, respectively. Copyright © 2015

Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI.

Science.gov (United States)

Turkbey, Baris; Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Shah, Vijay; Bernardo, Marcelino; Baccala, Angelo; Rastinehad, Ardeshir; Benjamin, Compton; Merino, Maria J; Wood, Bradford J; Choyke, Peter L; Pinto, Peter A

2011-03-29

During transrectal ultrasound (TRUS)-guided prostate biopsies, the actual location of the biopsy site is rarely documented. Here, we demonstrate the capability of TRUS-magnetic resonance imaging (MRI) image fusion to document the biopsy site and correlate biopsy results with multi-parametric MRI findings. Fifty consecutive patients (median age 61 years) with a median prostate-specific antigen (PSA) level of 5.8 ng/ml underwent 12-core TRUS-guided biopsy of the prostate. Pre-procedural T2-weighted magnetic resonance images were fused to TRUS. A disposable needle guide with miniature tracking sensors was attached to the TRUS probe to enable fusion with MRI. Real-time TRUS images during biopsy and the corresponding tracking information were recorded. Each biopsy site was superimposed onto the MRI. Each biopsy site was classified as positive or negative for cancer based on the results of each MRI sequence. Sensitivity, specificity, and receiver operating curve (ROC) area under the curve (AUC) values were calculated for multi-parametric MRI. Gleason scores for each multi-parametric MRI pattern were also evaluated. Six hundred and 5 systemic biopsy cores were analyzed in 50 patients, of whom 20 patients had 56 positive cores. MRI identified 34 of 56 positive cores. Overall, sensitivity, specificity, and ROC area values for multi-parametric MRI were 0.607, 0.727, 0.667, respectively. TRUS-MRI fusion after biopsy can be used to document the location of each biopsy site, which can then be correlated with MRI findings. Based on correlation with tracked biopsies, T2-weighted MRI and apparent diffusion coefficient maps derived from diffusion-weighted MRI are the most sensitive sequences, whereas the addition of delayed contrast enhancement MRI and three-dimensional magnetic resonance spectroscopy demonstrated higher specificity consistent with results obtained using radical prostatectomy specimens.

A Multi-Criteria Approach to Dry Port Location in Developing Economies with Application to Vietnam

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Lam Canh Nguyen

2016-03-01

Full Text Available This paper presents a conceptual framework for the inclusion of multiple criteria in the evaluation of dry port location in developing countries from a multiple stakeholder perspective. We present the framework in four steps. The first step encompasses preliminary research to filter the alternative locations for dry port development. In the second step, the stakeholders are clustered in three groups: dry port users, dry port service providers and the wider community. Then, we present the sub-criteria related to dry port location including the associated measuring methods. The third step includes an explanation on the methods used for weighing these criteria and sub-criteria. A multi-criteria analysis is carried out in the final step. We apply the methodological framework to Vietnam. The location of a new dry port project in Vinh Phuc province will be evaluated against two existing inland clearance depots (ICD in Lao Cai and Phu Tho province.

Clinical profile of patients with myasthenia gravis followed at the University Hospital, Federal University of Minas Gerais

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Aline Mansueto Mourão

2015-04-01

Full Text Available Summary Objective: to determine the clinical profile of patients with myasthenia gravis (MG; followed at the Neuromuscular Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, and to compare it with other Brazilian case series. Methods: sociodemographic and clinical data were collected from patients, and a systematic literature review performed, focusing on national studies on the clinical profile of MG patients. Results: sixty nine patients were enrolled in the study. Fifty five (91% subjects were female and the mean age (SD was 37.6 (±11.4 years. The mean disease duration was 14.1 years. Regarding treatment, prednisone was the most used strategy (64%, followed by the use of azathioprine (43%. There was no difference between thymectomized (42 and non-thymectomized (27 patients regarding disease severity and medication use. Conclusion: clinical and socio-demographic features of this MG sample from a University-based clinic resemble those reported in other Brazilian series and in the international literature.

Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

Science.gov (United States)

Marović, Ivan; Hanak, Tomaš

2017-10-01

In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

The problem of windfarm location: A social multi-criteria evaluation framework

International Nuclear Information System (INIS)

Gamboa, Gonzalo; Munda, Giuseppe

2007-01-01

Although wind energy has the green image, the location of windfarms is always a source of local conflicts. Opposition may depend on the extensive land use of windfarms, their possible impacts on tourism or their visual impact, as well as NIMBY (Never In My Back-Yard) behavior. On the other hand, some social actors are normally in favor of wind parks because they perceive them as a possibility of development or simply a source of income. In these situations, the management of the energy policy process involves many layers and kinds of decisions, and requires the construction of a dialogue process among many social actors, individual and collective, formal and informal, local and non-local. This implies that the political and social framework must find a place in evaluation exercises. This is the objective of social multi-criteria evaluation (SMCE). In this article, SMCE is proposed as a general framework for dealing with the problem of wind park location. The major strength of SMCE is the possibility of integrating both socio-economic and technical dimensions inside a coherent framework. A real-world case study is used as an illustrative example

A Multi-Element Approach to Location Inference of Twitter: A Case for Emergency Response

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Farhad Laylavi

2016-04-01

Full Text Available Since its inception, Twitter has played a major role in real-world events—especially in the aftermath of disasters and catastrophic incidents, and has been increasingly becoming the first point of contact for users wishing to provide or seek information about such situations. The use of Twitter in emergency response and disaster management opens up avenues of research concerning different aspects of Twitter data quality, usefulness and credibility. A real challenge that has attracted substantial attention in the Twitter research community exists in the location inference of twitter data. Considering that less than 2% of tweets are geotagged, finding location inference methods that can go beyond the geotagging capability is undoubtedly the priority research area. This is especially true in terms of emergency response, where spatial aspects of information play an important role. This paper introduces a multi-elemental location inference method that puts the geotagging aside and tries to predict the location of tweets by exploiting the other inherently attached data elements. In this regard, textual content, users’ profile location and place labelling, as the main location-related elements, are taken into account. Location-name classes in three granularity levels are defined and employed to look up the location references from the location-associated elements. The inferred location of the finest granular level is assigned to a tweet, based on a novel location assignment rule. The location assigned by the location inference process is considered to be the inferred location of a tweet, and is compared with the geotagged coordinates as the ground truth of the study. The results show that this method is able to successfully infer the location of 87% of the tweets at the average distance error of 12.2 km and the median distance error of 4.5 km, which is a significant improvement compared with that of the current methods that can predict the location

An improved hybrid multi-criteria/multidimensional model for strategic industrial location selection: Casablanca industrial zones as a case study.

Science.gov (United States)

Boutkhoum, Omar; Hanine, Mohamed; Agouti, Tarik; Tikniouine, Abdessadek

2015-01-01

In this paper, we examine the issue of strategic industrial location selection in uncertain decision making environments for implanting new industrial corporation. In fact, the industrial location issue is typically considered as a crucial factor in business research field which is related to many calculations about natural resources, distributors, suppliers, customers, and most other things. Based on the integration of environmental, economic and social decisive elements of sustainable development, this paper presents a hybrid decision making model combining fuzzy multi-criteria analysis with analytical capabilities that OLAP systems can provide for successful and optimal industrial location selection. The proposed model mainly consists in three stages. In the first stage, a decision-making committee has been established to identify the evaluation criteria impacting the location selection process. In the second stage, we develop fuzzy AHP software based on the extent analysis method to assign the importance weights to the selected criteria, which allows us to model the linguistic vagueness, ambiguity, and incomplete knowledge. In the last stage, OLAP analysis integrated with multi-criteria analysis employs these weighted criteria as inputs to evaluate, rank and select the strategic industrial location for implanting new business corporation in the region of Casablanca, Morocco. Finally, a sensitivity analysis is performed to evaluate the impact of criteria weights and the preferences given by decision makers on the final rankings of strategic industrial locations.

SU-F-J-21: Clinical Evaluation of Surface Scanning Systems in Different Treatment Locations

Energy Technology Data Exchange (ETDEWEB)

Moser, T; Karger, C [German Cancer Research Center (DKFZ), Heidelberg (Germany); Stefanowicz, S; Rhein, B; Oetzel, D; Adeberg, S; Koenig, L; Wolf, R; Rieken, S [Heidelberg University, Heidelberg (Germany)

2016-06-15

Purpose: To reduce imaging dose in fractionated IGRT, the ability of optical surface imaging systems (OSIS) to detect setup errors was tested. Therefore, clinical studies to evaluate for different treatment locations setup corrections derived by OSIS in comparison with x-ray image guidance in fractionated radiation therapy was performed. Methods: The setup correction accuracy of an OSIS system (AlignRT, VisionRT, London, UK) will be analysed for the 4 tumour locations Pelvis, Upper Abdomen, Thorax and Breast, 20 patients for each location in comparison to a different system (Sentinel, C-RAD, SE). For each patient, the setup corrections of the cone-beam computed tomography (CBCT) of an Elekta Versa HD linear accelerator (Elekta, Crawley, UK) is considered as gold-standard and then compared with those of the OSIS for the first ten fractions retrospectively. There were no clinical decisions made based on the surrogate system. For the OSIS, the reference surface is highly important as it represents the actual ground truth. It can be obtained either with the system itself or the surface structure delineated in the planning CT can be imported via DICOM interface. In this paper, the first results for the treatment region thorax are presented. The reference image modalities were compared. Results: Table 1 displays the difference between the setup corrections obtained with OSIS and CBCT in lateral (LAT), longitudinal (LNG) and vertical (VRT) direction for the DICOM reference image. While the median deviations are within a few millimeters, some outliers showed large deviations. Generally, the mean deviation as well as the spread was smallest in lateral and largest in vertical direction. Conclusion: Although the system allows fast, simple and non-invasive determination of setup corrections, it should be evaluated treatment region dependant. Therefore, the study is ongoing. The application of OSIS may help to reduce the imaging dose for the patient. We gratefully acknowledge

Clinical application of multi-shot diffusion EPI in neurological disease

International Nuclear Information System (INIS)

Ishihara, Tetsuya; Hirata, Koichi; Kubo, Jin; Yamazaki, Kaoru; Sato, Toshihiko

1998-01-01

Using the multi-shot EPI method we investigated the clinical application of diffusion weighted imaging (DWI) in the diagnosis of neurological disease. The multi-shot method provided better susceptibility artifact-free DWI than the single-shot method particularly in the region of the posterior cranial fossa. DWI using the multi-shot EPI method readily shows the pyramidal tract extending from the internal capsule to the brainstems which is inaccessible by the conventional single-shot EPI method, and providing three-dimensional and distinct images of pyramidal tract changes in amyotrophic lateral sclerosis or cerebral infarction with pyramidal tract disturbance. Our findings suggest that the use of DWI with the multi-shot EPI method would provide a technique for the easy diagnosis and evaluation of various neurological diseases. (author)

Clinical application of multi-shot diffusion EPI in neurological disease

Energy Technology Data Exchange (ETDEWEB)

Ishihara, Tetsuya; Hirata, Koichi; Kubo, Jin; Yamazaki, Kaoru [Dokkyo Univ., Mibu, Tochigi (Japan). School of Medicine; Sato, Toshihiko

1998-05-01

Using the multi-shot EPI method we investigated the clinical application of diffusion weighted imaging (DWI) in the diagnosis of neurological disease. The multi-shot method provided better susceptibility artifact-free DWI than the single-shot method particularly in the region of the posterior cranial fossa. DWI using the multi-shot EPI method readily shows the pyramidal tract extending from the internal capsule to the brainstems which is inaccessible by the conventional single-shot EPI method, and providing three-dimensional and distinct images of pyramidal tract changes in amyotrophic lateral sclerosis or cerebral infarction with pyramidal tract disturbance. Our findings suggest that the use of DWI with the multi-shot EPI method would provide a technique for the easy diagnosis and evaluation of various neurological diseases. (author)

ABMapper: a suffix array-based tool for multi-location searching and splice-junction mapping.

Science.gov (United States)

Lou, Shao-Ke; Ni, Bing; Lo, Leung-Yau; Tsui, Stephen Kwok-Wing; Chan, Ting-Fung; Leung, Kwong-Sak

2011-02-01

Sequencing reads generated by RNA-sequencing (RNA-seq) must first be mapped back to the genome through alignment before they can be further analyzed. Current fast and memory-saving short-read mappers could give us a quick view of the transcriptome. However, they are neither designed for reads that span across splice junctions nor for repetitive reads, which can be mapped to multiple locations in the genome (multi-reads). Here, we describe a new software package: ABMapper, which is specifically designed for exploring all putative locations of reads that are mapped to splice junctions or repetitive in nature. The software is freely available at: http://abmapper.sourceforge.net/. The software is written in C++ and PERL. It runs on all major platforms and operating systems including Windows, Mac OS X and LINUX.

Facility Location Modeling in Multi-Echelon Distribution System: A Case Study of Indonesian Liquefied Petroleum Gas Supply Chain

Directory of Open Access Journals (Sweden)

Ilyas Masudin

2013-04-01

Full Text Available This paper presents model of Indonesian LPG supply chain by opening new facilities (new echelon taking into account the current facilities. The objective is to investigate the relation between distribution costs such as transportation, inventory cost and facility location in Indonesian multi-echelon LPG supply chain. Fixed-charged capacitated facility location problem is used to determine the optimal solution of the proposed model. In the sensitivity analysis, it is reported that the trade-offs between facility locations and distribution costs are exist. Results report that as the number of facility increases, total transportation and inventory cost also increase.

49 CFR Figure 2b to Subpart B of... - Example of an Intermediate Level Seating Area of a Multi-Level Car Complying With Window Location...

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Example of an Intermediate Level Seating Area of a Multi-Level Car Complying With Window Location Requirements-§§ 238.113 and 238.114 2B Figure 2B to... Intermediate Level Seating Area of a Multi-Level Car Complying With Window Location Requirements—§§ 238.113 and...

49 CFR Figure 2a to Subpart B of... - Example of an Intermediate Level Seating Area of a Multi-Level Car Complying With Window Location...

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Example of an Intermediate Level Seating Area of a Multi-Level Car Complying With Window Location Requirements-§§ 238.113 and 238.114 2A Figure 2A to... Intermediate Level Seating Area of a Multi-Level Car Complying With Window Location Requirements—§§ 238.113 and...

Location and multi-depot vehicle routing for emergency vehicles using tour coverage and random sampling

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Alireza Goli

2015-09-01

Full Text Available Distribution and optimum allocation of emergency resources are the most important tasks, which need to be accomplished during crisis. When a natural disaster such as earthquake, flood, etc. takes place, it is necessary to deliver rescue efforts as quickly as possible. Therefore, it is important to find optimum location and distribution of emergency relief resources. When a natural disaster occurs, it is not possible to reach some damaged areas. In this paper, location and multi-depot vehicle routing for emergency vehicles using tour coverage and random sampling is investigated. In this study, there is no need to visit all the places and some demand points receive their needs from the nearest possible location. The proposed study is implemented for some randomly generated numbers in different sizes. The preliminary results indicate that the proposed method was capable of reaching desirable solutions in reasonable amount of time.

Application of Multi-Objective Optimization on the Basis of Ratio Analysis (MOORA Method for Bank Branch Location Selection

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Ali Gorener

2013-04-01

Full Text Available Location selection problem in banking is an important issue for the commercial success in competitive environment. There is a strategic fit between the location selection decision and overall performance of a new branch. Providing physical service in requested location as well as alternative distribution channels to meet profitable client needs is the current problematic to achieve the competitive advantage over the rivalry in financial system. In this paper, an integrated model has been developed to support in the decision of branch location selection for a new bank branch. Analytic Hierarchy Process (AHP technique has been conducted to prioritize of evaluation criteria, and multi-objective optimization on the basis of ratio analysis (MOORA method has been applied to rank location alternatives of bank branch.   

Interest in rural clinical school is not enough: Participation is necessary to predict an ultimate rural practice location.

Science.gov (United States)

Playford, Denese; Puddey, Ian B

2017-08-01

Rural exposure during medical school is associated with increased rural work after graduation. How much of the increase in rural workforce by these graduates is due to pre-existing interest and plans to work rurally and how much is related to the extended clinical placement is not known. This cohort study compared the employment location of medical graduates who professed no rural interest as undergraduates (negative control), with those who applied but did not participate in Rural Clinical School of Western Australia (RCSWA) (positive control), and those who applied and participated in RCSWA (participants). All 1026 University of Western Australia students who had an opportunity to apply for a year-long rotation in RCSWA from 2004 to 2010, and who had subsequently graduated by the end of 2011, were included. Graduates' principal workplace location (AHPRA, Feb 2014). The three groups differed significantly in their graduate work locations (χ 2 = 39.2, P rural background (OR 2.99 (95% CI 1.85, 4.85), P Rural Bonded Scholarship (OR 3.36 (95% CI 1.68, 6.73, P = 0.001) and actually participating in the RCSWA remained significantly related to rural work (OR 3.10 (95% CI 1.95, 4.93), P rural work, RCSWA graduates were three times more likely to work rurally than either control group. These data suggest that RCSWA has a significant independent effect on rural workforce. © 2016 National Rural Health Alliance Inc.

Building a Multi-centre Clinical Research Facilitation Network: The ARC Experience

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Ian Nicholson

2017-06-01

Full Text Available Introduction: In order to practice evidence-based veterinary medicine, good quality clinical evidence needs to be produced, in order that it can be apprasied systematically by the EBVM network, and used by vets. There is very little good-quality veterinary evidence for most of the veterinary procedures carried out every day across the world. Very few, if any, individuals have all the necessary qualities (case-load, time, research expertise, financial support to be able to systematically produce good-quality, and relevant, clinical research on their own, in a timely manner. The Association for Veterinary Soft Tissue Surgery (AVSTS www.avsts.org.uk is an affiliate group with the British Small Animal Veterinary Association (BSAVA, and functions as a clinical network of like-minded individuals. In 2013 AVSTS sought to create a role for itself in facilitating the production (by its members of multi-centre clinical research of relevance to its members.Materials and methods: Members of AVSTS were asked to join the AVSTS Research Cooperative (ARC, with a veterinary epidemiologist and an experienced multi-centre veterinary clinical researcher (to help with study design and statistical planning, and the Animal Health Trust clinical research ethics committee. An email list was established, and a page was set up on the AVSTS website, to allow information to be disseminated. The AVSTS spring and autumn meetings were used as a regular forum by ARC, to discuss its direction, to generate interest, to create and promote specific studies (in order to widen participation amongst different centres, and to update members about previous studies.Results: Membership of ARC has grown to 224 people, although the epidemiologist left. One multi-centre study has been published, two have been presented and await publication, one has been accepted for presentation, two other studies are gathering data at present, and further studies are in the pipeline. There has been

Controlled, prospective, randomized, clinical split-mouth evaluation of partial ceramic crowns luted with a new, universal adhesive system/resin cement: results after 18 months.

Science.gov (United States)

Vogl, Vanessa; Hiller, Karl-Anton; Buchalla, Wolfgang; Federlin, Marianne; Schmalz, Gottfried

2016-12-01

A new universal adhesive with corresponding luting composite was recently marketed which can be used both, in a self-etch or in an etch-and-rinse mode. In this study, the clinical performance of partial ceramic crowns (PCCs) inserted with this adhesive and the corresponding luting material used in a self-etch or selective etch approach was compared with a self-adhesive universal luting material. Three PCCs were placed in a split-mouth design in 50 patients. Two PCCs were luted with a combination of a universal adhesive/resin cement (Scotchbond Universal/RelyX Ultimate, 3M ESPE) with (SB+E)/without (SB-E) selective enamel etching. Another PCC was luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE). Forty-eight patients were evaluated clinically according to FDI criteria at baseline and 6, 12 and 18 months. For statistical analyses, the chi-square test (α = 0.05) and Kaplan-Meier analysis were applied. Clinically, no statistically significant differences between groups were detected over time. Within groups, clinically significant increase for criterion "marginal staining" was detected for SB-E over 18 months. Kaplan-Meier analysis revealed significantly higher retention rates for SB+E (97.8 %) and SB-E (95.6 %) in comparison to RXU2 (75.6 %). The 18-month clinical performance of a new universal adhesive/composite combination showed no differences with respect to bonding strategy and may be recommended for luting PCCs. Longer-term evaluation is needed to confirm superiority of SB+E over SB-E. At 18 months, the new multi-mode adhesive, Scotchbond Universal, showed clinically reliable results when used for luting PCCs.

An Improved Multi-Objective Programming with Augmented ε-Constraint Method for Hazardous Waste Location-Routing Problems.

Science.gov (United States)

Yu, Hao; Solvang, Wei Deng

2016-05-31

Hazardous waste location-routing problems are of importance due to the potential risk for nearby residents and the environment. In this paper, an improved mathematical formulation is developed based upon a multi-objective mixed integer programming approach. The model aims at assisting decision makers in selecting locations for different facilities including treatment plants, recycling plants and disposal sites, providing appropriate technologies for hazardous waste treatment, and routing transportation. In the model, two critical factors are taken into account: system operating costs and risk imposed on local residents, and a compensation factor is introduced to the risk objective function in order to account for the fact that the risk level imposed by one type of hazardous waste or treatment technology may significantly vary from that of other types. Besides, the policy instruments for promoting waste recycling are considered, and their influence on the costs and risk of hazardous waste management is also discussed. The model is coded and calculated in Lingo optimization solver, and the augmented ε-constraint method is employed to generate the Pareto optimal curve of the multi-objective optimization problem. The trade-off between different objectives is illustrated in the numerical experiment.

An Improved Multi-Objective Programming with Augmented ε-Constraint Method for Hazardous Waste Location-Routing Problems

Directory of Open Access Journals (Sweden)

Hao Yu

2016-05-01

Full Text Available Hazardous waste location-routing problems are of importance due to the potential risk for nearby residents and the environment. In this paper, an improved mathematical formulation is developed based upon a multi-objective mixed integer programming approach. The model aims at assisting decision makers in selecting locations for different facilities including treatment plants, recycling plants and disposal sites, providing appropriate technologies for hazardous waste treatment, and routing transportation. In the model, two critical factors are taken into account: system operating costs and risk imposed on local residents, and a compensation factor is introduced to the risk objective function in order to account for the fact that the risk level imposed by one type of hazardous waste or treatment technology may significantly vary from that of other types. Besides, the policy instruments for promoting waste recycling are considered, and their influence on the costs and risk of hazardous waste management is also discussed. The model is coded and calculated in Lingo optimization solver, and the augmented ε-constraint method is employed to generate the Pareto optimal curve of the multi-objective optimization problem. The trade-off between different objectives is illustrated in the numerical experiment.

Brand Coherence at a Major Multi-Campus Public Research University: An Exploratory Case Study

Science.gov (United States)

Zinkan, Rob

2016-01-01

With increased competition and other market forces affecting higher education, branding has emerged as a strategic imperative for colleges and universities. Branding in academia faces many inherent challenges, including institutions' multi-pronged missions and decentralized organizational structures. In some cases, branding is not widely…

Providing a USSD location based clinic finder in South Africa: did it work?

Science.gov (United States)

Parsons, Annie Neo; Timler, Dagmar

2014-01-01

A new mHealth service, Clinic Finder, was designed to provide a location-based service for any cellphone user in South Africa dialing a dedicated USSD string to find the nearest public primary health care facility. The service was funded by a European Union grant to Cell-Life to support the National Department of Health. Clinic Finder's aims were to provide a reliable and accurate service, and to assess both the most effective means of advertising the service as well as interest in the service. Users dialing the USSD string are asked to agree to geo-location (Vodacom and MTN users) or asked to enter their province, town and street (virtual network users and those choosing not to geo-locate). The service provider, AAT, sends the data to Cell-Life where an SMS with details of the nearest public primary health care facility is sent to the user by Cell-Life's open-source Communicate platform. The service was advertised on 3 days in 2014 using two different means: a newspaper ad on 20 May 2014 and Please Call Me ads on 30 July 2014 and 14 August 2014. 28.2% of unique users on 20 May 2014, 10.5% of unique users on 30 July 2014 and 92.8% of unique users on 14 August 2014 who agreed to geo-location successfully received SMSs. However, only 4.2%, 0.5%, and 2.4% of unique users responding to each advertisement who did not geo-locate then received an SMS. A small survey of users following the 20 May 2014 newspaper ad found overall interest in the idea of Clinic Finder, though unsuccessful users were more likely to dislike the service. The overall experience of using location based services and USSD for Clinic Finder suggests a need in the field of mHealth for wider availability of data on service usability and effectiveness.

NCC-AUC: an AUC optimization method to identify multi-biomarker panel for cancer prognosis from genomic and clinical data.

Science.gov (United States)

Zou, Meng; Liu, Zhaoqi; Zhang, Xiang-Sun; Wang, Yong

2015-10-15

systematically reveal multi-biomarker panel from genomic and clinical data. It can serve as a useful tool to identify prognostic biomarkers for survival analysis. NCC-AUC is available at http://doc.aporc.org/wiki/NCC-AUC. ywang@amss.ac.cn Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Evolution of a Multi-Instructional Teaching Center (MITC) in a Metropolitan University System.

Science.gov (United States)

Bell, David P.; Hayes, Edward J.; Hugetz, Edward T.; Ivancevich, John M.; Smith, Don N.; Woods, Molly R.

1998-01-01

The University of Houston (Texas) and its four campuses have adopted a "co-opetition" approach to create a multi-instructional teaching center to deliver educational programs and courses in the Houston metropolitan area. It has been found that citizens, legislators, administrators, faculty, and students all benefit, without sacrificing…

Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

OpenAIRE

Buçaj, Emine; Puca, Edmond; Namani, Sadie; Bajrami, Muharem; Krasniqi, Valbon; Berisha, Lindita; Jakupi, Xhevat; Halili, Bahrie; Kraja, Dhimiter

2015-01-01

Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about pidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo.Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, cl...

Workshop for Open Source Universal Picture Archiving and Communication Systems (PACS)

National Research Council Canada - National Science Library

Tohme, Walid G

2006-01-01

.... The "Open Source Universal PACS Archive" workshop focused on current challenges of and open source solutions to the management of images and other clinical information in multi-center settings...

Automated nodule location and size estimation using a multi-scale Laplacian of Gaussian filtering approach.

Science.gov (United States)

Jirapatnakul, Artit C; Fotin, Sergei V; Reeves, Anthony P; Biancardi, Alberto M; Yankelevitz, David F; Henschke, Claudia I

2009-01-01

Estimation of nodule location and size is an important pre-processing step in some nodule segmentation algorithms to determine the size and location of the region of interest. Ideally, such estimation methods will consistently find the same nodule location regardless of where the the seed point (provided either manually or by a nodule detection algorithm) is placed relative to the "true" center of the nodule, and the size should be a reasonable estimate of the true nodule size. We developed a method that estimates nodule location and size using multi-scale Laplacian of Gaussian (LoG) filtering. Nodule candidates near a given seed point are found by searching for blob-like regions with high filter response. The candidates are then pruned according to filter response and location, and the remaining candidates are sorted by size and the largest candidate selected. This method was compared to a previously published template-based method. The methods were evaluated on the basis of stability of the estimated nodule location to changes in the initial seed point and how well the size estimates agreed with volumes determined by a semi-automated nodule segmentation method. The LoG method exhibited better stability to changes in the seed point, with 93% of nodules having the same estimated location even when the seed point was altered, compared to only 52% of nodules for the template-based method. Both methods also showed good agreement with sizes determined by a nodule segmentation method, with an average relative size difference of 5% and -5% for the LoG and template-based methods respectively.

Is it possible to design universal multi-phase flow analyzer?

International Nuclear Information System (INIS)

Ivanov Kolev, N.

2005-01-01

Transient 3D-multiphase flows consisting of many chemical constituents in nature and technology (Figs. 1 and 2) are the common case of flows. In many technical applications we have to do with particular realization of the multi-phase flows like steady state flows, or single component flows or single phase flows etc. Engineers and scientists created hundreds of computer codes for description of more or less specific realizations of multi-phase flows. If one compares the structure of these codes one is astonished by the waste of the human resources for programming repeating model elements like equations of state, friction lows in variety of geometry, heat transfer coefficients, mathematical equation solvers, data handling procedures, graphical environment etc. It is hardly to expect, that the best solution for the specific sub-phenomenon is available in all codes. Looking in other branches of the technology like computer chips production we realize that the revolutionary idea of having common ''chips'' within complex applications is very far from its practical realization in the computational multi-phase flow dynamics. Following this line of arguments I expressed several times in my publications explicitly or implicitly the idea, that it is possible to create a universal multi-phase flow analyzer in the sense of computer architecture, that is capable to absorb the adequate multi-phase knowledge data base specified in Appendix 1. The subject of this paper is to summarize some of the main ideas, some of them already realized by this author, on the way of creating such computer code architecture, to illustrate haw they work, and to make an outlook regarding what are the challenges in the future developments. We confine deliberately our attention to the solution of the so called local volume and time averaged system of PDE's for a simple reason: Direct numerical resolution of interacting fluids is possible as demonstrated for small scales by many researchers, but for

[The application of universal adhesives in dental bonding].

Science.gov (United States)

Guo, Jingmei; Lei, Wenlong; Yang, Hongye; Huang, Cui

2016-03-01

The bonding restoration has become an important clinical technique for the development of dental bonding technology. Because of its easy operation and the maximum preservation of tooth tissues, bonding repair is widely used in dental restoration. The recent multi-mode universal adhesives have brought new progress in dental bonding restoration. In this article the universal adhesives were reviewed according to its definition, development, improvement, application features and possible problems.

Prefrontal rTMS for treating depression: location and intensity results from the OPT-TMS multi-site clinical trial.

Science.gov (United States)

Johnson, Kevin A; Baig, Mirza; Ramsey, Dave; Lisanby, Sarah H; Avery, David; McDonald, William M; Li, Xingbao; Bernhardt, Elisabeth R; Haynor, David R; Holtzheimer, Paul E; Sackeim, Harold A; George, Mark S; Nahas, Ziad

2013-03-01

Motor cortex localization and motor threshold determination often guide Transcranial Magnetic Stimulation (TMS) placement and intensity settings for non-motor brain stimulation. However, anatomic variability results in variability of placement and effective intensity. Post-study analysis of the OPT-TMS Study reviewed both the final positioning and the effective intensity of stimulation (accounting for relative prefrontal scalp-cortex distances). We acquired MRI scans of 185 patients in a multi-site trial of left prefrontal TMS for depression. Scans had marked motor sites (localized with TMS) and marked prefrontal sites (5 cm anterior of motor cortex by the "5 cm rule"). Based on a visual determination made before the first treatment, TMS therapy occurred either at the 5 cm location or was adjusted 1 cm forward. Stimulation intensity was 120% of resting motor threshold. The "5 cm rule" would have placed stimulation in premotor cortex for 9% of patients, which was reduced to 4% with adjustments. We did not find a statistically significant effect of positioning on remission, but no patients with premotor stimulation achieved remission (0/7). Effective stimulation ranged from 93 to 156% of motor threshold, and no seizures were induced across this range. Patients experienced remission with effective stimulation intensity ranging from 93 to 146% of motor threshold, and we did not find a significant effect of effective intensity on remission. Our data indicates that individualized positioning methods are useful to reduce variability in placement. Stimulation at 120% of motor threshold, unadjusted for scalp-cortex distances, appears safe for a broad range of patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Research and Teaching Efficiencies of Turkish Universities with Heterogeneity Considerations: Application of Multi-Activity DEA and DEA by Sequential Exclusion of Alternatives Methods

OpenAIRE

Çinar, Y.

2016-01-01

The research and teaching efficiencies of 45 Turkish state universities are evaluated by using Multi-Activity Data Envelopment Analysis (MA-DEA) model developed by Beasley (1995). Universities are multi-purpose institutions, therefore they face multiple production functions simultaneously associated with research and teaching activities. MA-DEA allows assigning priorities and allocating shared resources to these activities.

A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital

DEFF Research Database (Denmark)

Andersen, Stig Ejdrup; Knudsen, Inge Jenny Dahl

2013-01-01

BACKGROUND: Bacteria-producing extended spectrum β-lactamase (ESBL) enzymes are resistant to commonly used antimicrobials. In 2008, routine monitoring revealed a clonal hospital outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-KP). METHODS: At a 510-bed Danish university hospital...... the application of a managed, multi-faceted intervention that does not require ongoing antibiotic stewardship....

University psychiatry in Italy: organisation and integration of university clinics and the National Health Service

Directory of Open Access Journals (Sweden)

Pier Maria Furlan

2013-09-01

Full Text Available INTRODUCTION: In the Italian psychiatric system, community-based care has become increasingly important and widespread since the national reform of 1978. This report aims to provide an overview of the involvement of university medical schools in this process, considering their responsibility for teaching and training specialist practitioners and professionals. METHODS: The study was carried out between early 2010 and February 2011. An 18-items, self-administered, questionnaire was designed to investigate the number of faculty members that are responsible both for running a clinical ward and for providing community-based healthcare. RESULTS: Nine out of 53 faculty members (17% manage a Mental Health Department, 9 (17% manage a University Department, and 2 (3.8% manage both types of department. Less than half of the teachers have full responsibility (hospital and community; however the percentage reaches 73.2% if we include the hospital wards open to the community emergencies. The remaining 26.8% have no responsibility for community psychiatry. Moreover there were undoubtedly still too many universities with specialisation schools that are without an appropriate network of facilities enabling them to offer complex psychiatric training. DISCUSSION: As expected, there were several types of healthcare management that were not uniformly distributed throughout Italy and there were also marked differences between mental health care provision in the North, Centre, and South of Italy. The university involvement in clinical responsibility was great, but at the management level there was a lack of equality in terms of clinical care, which risks being reflected also on the institutional functions of teaching and research.

Location of Road Emergency Stations in Fars Province, Using Spatial Multi-Criteria Decision Making.

Science.gov (United States)

Goli, Ali; Ansarizade, Najmeh; Barati, Omid; Kavosi, Zahra

2015-01-01

To locate the road emergency stations in Fars province based on using spatial multi-criteria decision making (Delphi method). In this study, the criteria affecting the location of road emergency stations have been identified through Delphi method and their importance was determined using Analytical Hierarchical Process (AHP). With regard to the importance of the criteria and by using Geographical Information System (GIS), the appropriateness of the existing stations with the criteria and the way of their distribution has been explored, and the appropriate arenas for creating new emergency stations were determined. In order to investigate the spatial distribution pattern of the stations, Moran's Index was used. The accidents (0.318), placement position (0.235), time (0.198), roads (0.160), and population (0.079) were introduced as the main criteria in location road emergency stations. The findings showed that the distribution of the existing stations was clustering (Moran's I=0.3). Three priorities were introduced for establishing new stations. Some arenas including Abade, north of Eghlid and Khoram bid, and small parts of Shiraz, Farashband, Bavanat, and Kazeroon were suggested as the first priority. GIS is a useful and applicable tool in investigating spatial distribution and geographical accessibility to the setting that provide health care, including emergency stations.

The Ordered Capacitated Multi-Objective Location-Allocation Problem for Fire Stations Using Spatial Optimization

Directory of Open Access Journals (Sweden)

Samira Bolouri

2018-01-01

Full Text Available Determining the positions of facilities, and allocating demands to them, is a vitally important problem. Location-allocation problems are optimization NP-hard procedures. This article evaluates the ordered capacitated multi-objective location-allocation problem for fire stations, using simulated annealing and a genetic algorithm, with goals such as minimizing the distance and time as well as maximizing the coverage. After tuning the parameters of the algorithms using sensitivity analysis, they were used separately to process data for Region 11, Tehran. The results showed that the genetic algorithm was more efficient than simulated annealing, and therefore, the genetic algorithm was used in later steps. Next, we increased the number of stations. Results showed that the model can successfully provide seven optimal locations and allocate high demands (280,000 to stations in a discrete space in a GIS, assuming that the stations’ capacities are known. Following this, we used a weighting program so that in each repetition, we could allot weights to each target randomly. Finally, by repeating the model over 10 independent executions, a set of solutions with the least sum and the highest number of non-dominated solutions was selected from among many non-dominated solutions as the best set of optimal solutions.

Substation Location in Offshore Wind Farms - A Planar Multi-Facility Location-Routing Problem

OpenAIRE

Amland, Thomas

2014-01-01

In offshore wind farms, two important parts of the design are to determine locations for substations and a cabling layout that connects every turbine to a substation. These problems are interconnected, as the cable layout depends on the choice of location for the substation. In this thesis we investigate how to set the location of substations such that the total cable cost is minimized.

Multi-regional clinical trials and global drug development

Directory of Open Access Journals (Sweden)

Premnath Shenoy

2016-01-01

Full Text Available Drug development has been globalized, and multi-regional clinical trial (MRCT for regulatory submission has widely been conducted by many discovery based global pharmaceutical companies with the objective of reducing the time lag of launch in key markets and improve patient access to new and innovative treatments. Sponsors are facing several challenges while conducting multiregional clinical trials. Challenges under the heads statistics, clinical, regulatory operational, and ethics have been discussed. Regulators in different countries such as USA, EU-Japan, and China have issued guidance documents in respect of MRCT's. Lack of harmonization in the design and planning of MRCT is perceived to create a difficult situation to sponsors adversely affecting progressing MRCT in more and more discoveries. International conference on hormonisation (ICH has initiated the process for having a harmonized guidance document on MRCT. This document is likely to be issued in early 2017.

The cost utility of a multi-disciplinary foot protection clinic (MDFPC) in an Irish hospital setting.

LENUS (Irish Health Repository)

Nason, G J

2012-04-21

BACKGROUND: Foot ulceration which may result in lower limb amputation is one of the most feared complications among patients with diabetes and the prevention of both ulceration and amputation is a major challenge facing the health service. Many studies have proposed dedicated diabetic foot teams as the future of diabetic foot care. AIMS: We aimed to quantify the cost benefit and sustainability of a multi-disciplinary foot protection clinic (MDFPC) in an Irish university hospital setting. METHODS: A dedicated bi-weekly consultant-led MDFPC including Vascular Surgery, Endocrinology, Orthopaedic Surgery, Podiatry, Orthotics and Tissue Viability was established in June 2008. RESULTS: Between 2006 and 2010, a total of 221 lower limb procedures (major\\/minor amputations and debridement) were performed. The number of major amputations decreased from 12 during the control period (2 years before the clinic) to 7 in the study period (2 years after the clinic). After costing all activity associated with the clinic, there was an overall saving of 114,063 per year associated with the introduction of the MDFPC. CONCLUSION: This is the first study in an Irish context, and one of few international studies, to demonstrate that an aggressive-coordinated approach to diabetic foot care is both cost effective and clinically efficient in reducing the burden of foot-related complications in a diabetic population.

Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

Science.gov (United States)

Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

2011-01-01

New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

Social Pharmacy and Clinical Pharmacy-Joining Forces.

Science.gov (United States)

Almarsdottir, Anna Birna; Granas, Anne Gerd

2015-12-22

This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking) differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, "What's in a name?" and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large.

3D Buried Utility Location Using A Marching-Cross-Section Algorithm for Multi-Sensor Data Fusion.

Science.gov (United States)

Dou, Qingxu; Wei, Lijun; Magee, Derek R; Atkins, Phil R; Chapman, David N; Curioni, Giulio; Goddard, Kevin F; Hayati, Farzad; Jenks, Hugo; Metje, Nicole; Muggleton, Jennifer; Pennock, Steve R; Rustighi, Emiliano; Swingler, Steven G; Rogers, Christopher D F; Cohn, Anthony G

2016-11-02

We address the problem of accurately locating buried utility segments by fusing data from multiple sensors using a novel Marching-Cross-Section (MCS) algorithm. Five types of sensors are used in this work: Ground Penetrating Radar (GPR), Passive Magnetic Fields (PMF), Magnetic Gradiometer (MG), Low Frequency Electromagnetic Fields (LFEM) and Vibro-Acoustics (VA). As part of the MCS algorithm, a novel formulation of the extended Kalman Filter (EKF) is proposed for marching existing utility tracks from a scan cross-section (scs) to the next one; novel rules for initializing utilities based on hypothesized detections on the first scs and for associating predicted utility tracks with hypothesized detections in the following scss are introduced. Algorithms are proposed for generating virtual scan lines based on given hypothesized detections when different sensors do not share common scan lines, or when only the coordinates of the hypothesized detections are provided without any information of the actual survey scan lines. The performance of the proposed system is evaluated with both synthetic data and real data. The experimental results in this work demonstrate that the proposed MCS algorithm can locate multiple buried utility segments simultaneously, including both straight and curved utilities, and can separate intersecting segments. By using the probabilities of a hypothesized detection being a pipe or a cable together with its 3D coordinates, the MCS algorithm is able to discriminate a pipe and a cable close to each other. The MCS algorithm can be used for both post- and on-site processing. When it is used on site, the detected tracks on the current scs can help to determine the location and direction of the next scan line. The proposed "multi-utility multi-sensor" system has no limit to the number of buried utilities or the number of sensors, and the more sensor data used, the more buried utility segments can be detected with more accurate location and orientation.

Algorithm for locating the extremum of a multi-dimensional constrained function and its application to the PPPL Hybrid Study

International Nuclear Information System (INIS)

Bathke, C.

1978-03-01

A description is presented of a general algorithm for locating the extremum of a multi-dimensional constrained function. The algorithm employs a series of techniques dominated by random shrinkage, steepest descent, and adaptive creeping. A discussion follows of the algorithm's application to a ''real world'' problem, namely the optimization of the price of electricity, P/sub eh/, from a hybrid fusion-fission reactor. Upon the basis of comparisons with other optimization schemes of a survey nature, the algorithm is concluded to yield a good approximation to the location of a function's optimum

Predictors of Early Termination in a University Counseling Training Clinic

Science.gov (United States)

Lampropoulos, Georgios K.; Schneider, Mercedes K.; Spengler, Paul M.

2009-01-01

Despite the existence of counseling dropout research, there are limited predictive data for counseling in training clinics. Potential predictor variables were investigated in this archival study of 380 client files in a university counseling training clinic. Multinomial logistic regression, predictive discriminant analysis, and classification and…

Solving multi-objective facility location problem using the fuzzy analytical hierarchy process and goal programming: a case study on infectious waste disposal centers

Directory of Open Access Journals (Sweden)

Narong Wichapa

Full Text Available The selection of a suitable location for infectious waste disposal is one of the major problems in waste management. Determining the location of infectious waste disposal centers is a difficult and complex process because it requires combining social and environmental factors that are hard to interpret, and cost factors that require the allocation of resources. Additionally, it depends on several regulations. Based on the actual conditions of a case study, forty hospitals and three candidate municipalities in the sub-Northeast region of Thailand, we considered multiple factors such as infrastructure, geological and social & environmental factors, calculating global priority weights using the fuzzy analytical hierarchy process (FAHP. After that, a new multi-objective facility location problem model which combines FAHP and goal programming (GP, namely the FAHP-GP model, was tested. The proposed model can lead to selecting new suitable locations for infectious waste disposal by considering both total cost and final priority weight objectives. The novelty of the proposed model is the simultaneous combination of relevant factors that are difficult to interpret and cost factors, which require the allocation of resources. Keywords: Multi-objective facility location problem, Fuzzy analytic hierarchy process, Infectious waste disposal centers

Multi-wavelength emission from 3C 66A: clues to its redshift and gamma-ray emission location

International Nuclear Information System (INIS)

Yan Da-Hai; Fan Zhong-Hui; Zhou Yao; Dai Ben-Zhong

2013-01-01

The quasi-simultaneous multi-wavelength emission of TeV blazar 3C 66A is studied by using a one-zone multi-component leptonic jet model. It is found that the quasi-simultaneous spectral energy distribution of 3C 66A can be well reproduced; in particular, the first three months of its average Fermi-LAT spectrum can be well reproduced by the synchrotron self-Compton component plus external Compton component of the broad line region (BLR). Clues to its redshift and gamma-ray emission location are obtained. The results indicate the following. (i) On the redshift: The theoretical intrinsic TeV spectra can be predicted by extrapolating the reproduced GeV spectra. Through comparing these extrapolated TeV spectra with the corrected observed TeV spectra from extragalactic background light, it is suggested that the redshift of 3C 66A could be between 0.1 and 0.3, with the most likely value being ∼ 0.2. (ii) On the gamma-ray emission location: To well reproduce the GeV emission of 3C 66A under different assumptions on the BLR, the gamma-ray emission region is always required to be beyond the inner zone of the BLR. The BLR absorption effect on gamma-ray emission confirms this point.

Eighteen-month Clinical Study of Universal Adhesives in Noncarious Cervical Lesions.

Science.gov (United States)

Ruschel, V C; Shibata, S; Stolf, S C; Chung, Y; Baratieri, L N; Heymann, H O; Walter, R

To evaluate the clinical performance of Scotchbond Universal (3M Oral Care) and Prime & Bond Elect (Dentsply Sirona) in the restoration of noncarious cervical lesions (NCCLs). This was a randomized controlled clinical trial involving 63 subjects. Two hundred and three NCCLs were restored using Scotchbond Universal and Prime & Bond Elect using both an etch-and-rinse and a self-etch technique. Lesions were notch-shaped NCCLs, and the restorations were placed without any mechanical retention. Restorations were finished immediately after placement and scored with regard to retention, marginal discoloration, marginal adaptation, and secondary caries. Similar assessment of the restorations was performed 18 months after placement. Logistic regression was performed for each outcome separately with a compound symmetric variance-covariance structure assumed to consider a correlation of restorations within subjects. All analyses were conducted using SAS version 9.4 (SAS Inc). One hundred and fifty-eight teeth (77.8% of the restorations placed) in 46 subjects (73% of subjects enrolled) were available for the 18-month follow-up. A statistically significant difference was reached only for the comparison Scotchbond Universal/self-etch (SU_SE) and Prime & Bond Elect/etch-and-rinse (PBE_E&R) groups ( p=0.01), where a restoration with SU_SE was 66% less likely to maintain a score of Alpha for marginal discoloration than a restoration performed with PBE_E&R. Scotchbond Universal and Prime & Bond Elect presented acceptable clinical performance after 18 months of clinical service. However, Scotchbond Universal, when applied with a self-etch approach, did demonstrate a relatively high level of marginal discoloration when compared to the other groups.

Specific Clinical Profile and Risk Factors for Mortality in General Surgery Patients with Infections by Multi-Drug-Resistant Gram-Negative Bacteria.

Science.gov (United States)

Rubio-Perez, Ines; Martin-Perez, Elena; Domingo-García, Diego; Garcia-Olmo, Damian

2017-07-01

The incidence of gram-negative multi-drug-resistant (MDR) infections is increasing worldwide. This study sought to determine the incidence, clinical profiles, risk factors, and mortality of these infections in general surgery patients. All general surgery patients with a clinical infection by gram-negative MDR bacteria were studied prospectively for a period of five years (2007-2011). Clinical, surgical, and microbiologic parameters were recorded, with a focus on the identification of risk factors for MDR infection and mortality. Incidence of MDR infections increased (5.6% to 15.2%) during the study period; 106 patients were included, 69.8% presented nosocomial infections. Mean age was 65 ± 15 years, 61% male. Extended-spectrum β-lactamases (ESBL) Escherichia coli was the most frequent MDR bacteria. Surgical site infections and abscesses were the most common culture locations. The patients presented multiple pre-admission risk factors and invasive measures during hospitalization. Mortality was 15%, and related to older age (odds ratio [OR] 1.07), malnutrition (OR 13.5), chronic digestive conditions (OR 4.7), chronic obstructive pulmonary disease (OR 3.9), and surgical re-intervention (OR 9.2). Multi-drug resistant infections in the surgical population are increasing. The most common clinical profile is a 65-year-old male, with previous comorbidities, who has undergone a surgical intervention, intensive care unit (ICU) admission, and invasive procedures and who has acquired the MDR infection in the nosocomial setting.

Managing University Clinical Partnership: Learning from International Experience

Science.gov (United States)

Davies, Stephen; Smith, Tom

2004-01-01

Dialogue between the leaders of academic clinical organisations in different countries has revealed that the core elements of the partnership between universities and health care systems are remarkably consistent across national boundaries. There is now an impetus to move beyond analysis of common challenges and towards strategies for success that…

49 CFR Figure 2 to Subpart B of... - Example of a Multi-Level Car Complying with Window Location and Staggering Requirements-§§ 238...

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Example of a Multi-Level Car Complying with Window Location and Staggering Requirements-§§ 238.113 and 238.114 2 Figure 2 to Subpart B of Part 238.... 238, Subpt. B, Fig. 2 Figure 2 to Subpart B of Part 238—Example of a Multi-Level Car Complying with...

Multiple criteria facility location probems : a survey

NARCIS (Netherlands)

Farahani, R.Z.; Steadie Seifi, M.; Asgari, N.

2010-01-01

This paper provides a review on recent efforts and development in multi-criteria location problems in three categories including bi-objective, multi-objective and multi-attribute problems and their solution methods. Also, it provides an overview on various criteria used. While there are a few

Emerging medical informatics with case-based reasoning for aiding clinical decision in multi-agent system.

Science.gov (United States)

Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai

2015-08-01

This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts. Copyright © 2015 Elsevier Inc. All rights reserved.

Location capability of a sparse regional network (RSTN) using a multi-phase earthquake location algorithm (REGLOC)

Energy Technology Data Exchange (ETDEWEB)

Hutchings, L.

1994-01-01

The Regional Seismic Test Network (RSTN) was deployed by the US Department of Energy (DOE) to determine whether data recorded by a regional network could be used to detect and accurately locate seismic events that might be clandestine nuclear tests. The purpose of this paper is to evaluate the location capability of the RSTN. A major part of this project was the development of the location algorithm REGLOC and application of Basian a prior statistics for determining the accuracy of the location estimates. REGLOC utilizes all identifiable phases, including backazimuth, in the location. Ninty-four events, distributed throughout the network area, detected by both the RSTN and located by local networks were used in the study. The location capability of the RSTN was evaluated by estimating the location accuracy, error ellipse accuracy, and the percentage of events that could be located, as a function of magnitude. The location accuracy was verified by comparing the RSTN results for the 94 events with published locations based on data from the local networks. The error ellipse accuracy was evaluated by determining whether the error ellipse includes the actual location. The percentage of events located was assessed by combining detection capability with location capability to determine the percentage of events that could be located within the study area. Events were located with both an average crustal model for the entire region, and with regional velocity models along with station corrections obtained from master events. Most events with a magnitude <3.0 can only be located with arrivals from one station. Their average location errors are 453 and 414 km for the average- and regional-velocity model locations, respectively. Single station locations are very unreliable because they depend on accurate backazimuth estimates, and backazimuth proved to be a very unreliable computation.

Clinical Engeneering Experience at the Hospital of the State University of Londrina

OpenAIRE

Ernesto Fernando Ferreyra Ramírez

2002-01-01

This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL). It was performed by the Electrical Engineering Department (DEEL), through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare service...

Assessment of Morphological Variations and its Specific Location on the Surface of Adult Human Liver in Ethiopian Cadavers University of Gondar, Bahir Dar University, Addis Ababa University, St. Paulos Medical School and Hawassa University, Ethiopia

Directory of Open Access Journals (Sweden)

Tsegaye Mehare

2017-10-01

Full Text Available Background: Liver is the second largest organ next to skin and located in right hypochondrium, epigastrium and may extend to left hypochondrium in upper abdominal cavity. It accounts 2% to 3% of total body weight of individual. Land marking for interpreting different diagnostic image and localizing lesions in the liver is commonly done by major fissures. Sound knowledge about different morphological variations which are found on the surface of liver is mandatory to have safe surgical outcome. Segments of liver were extensively researched but there are only few studies dealt with the surface variation of the liver. Therefore, this study aims to assess morphological variations and its specific location on the surface of adult human liver in Ethiopian cadaver. Methodology: Institutional based cross sectional descriptive study design was conducted in 33 formalin fixed Ethiopian cadaveric livers in the Anatomy department of University of Gondar, Bahir Dar University, Addis Ababa University, St. Paulos Medical School and Hawassa University. Results: 45.45% of the liver was normal but 54.55% showed one or more variations. Additional fissures and very small left lobe with deep costal impressions were seen 27.27% and 21.21% cases respectively. Pons hepatis connecting left lobe with quadrate lobe and very deep renal impression with corset constriction were noted in 9.09% cases each. Additional lobes and absence of quadrate lobes were found in 6.06% cases each. Conclusion and Recommendation: Morphological variations on the liver surface were accessory fissure, very small left lobe with deep costal impressions, pons hepatis, shape variation and absence of quadrate lobe. The most common one among the variations was accessory fissure on the visceral and diaphragmatic surface.

First clinical and microbiological characterization of Clostridium difficile infection in a Croatian University Hospital.

Science.gov (United States)

Novak, Anita; Spigaglia, Patrizia; Barbanti, Fabrizio; Goic-Barisic, Ivana; Tonkic, Marija

2014-12-01

Clinical background and molecular epidemiology of Clostridium difficile infection (CDI) in the University Hospital Centre Split were investigated from January 2010 to December 2011. In total, 54 patients with first episode of CDI were consecutively included in the study based on the positive EIA test specific for A and B toxins. Demographic and clinical data were prospectively analyzed from medical records. CDI incidence rate was 0.6 per 10,000 patient-days. Thirty six cases (70.6%) were healthcare-associated, twelve cases (23.5%) were community-associated and three (5.9%) were indeterminate. Six patients (11.7%) had suffered one or more recurrences and 37 patients (72.5%) showed severe CDI. Prior therapy with third generation cephalosporin was significantly associated with severe CDI (Pdifficile strains were isolated and 50 of them were available for PCR-ribotyping. Sixteen different PCR-ribotypes were identified. The most prevalent were PCR-ribotype 001 (27.8%) and 014/020 (24.1%). Twenty three strains were resistant to at least one of the antibiotics tested. Among resistant strains, three (13.0%)--all PCR-ribotype 001--were multi-resistant. Resistance to fluoroquinolones was significantly higher in strains that caused infection after previous use of fluoroquinolones (P=0.04). Copyright © 2014 Elsevier Ltd. All rights reserved.

[Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

Science.gov (United States)

Liu, X; Wen, M K; Liu, H Y; Sun, D W; Lang, J H; Fan, Q B; Shi, H H

2017-10-25

Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group ( n= 40) and the multi-port group ( n= 41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P> 0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P< 0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.

Expansive learning in the university setting: the case for simulated clinical experience.

Science.gov (United States)

Haigh, Jacquelyn

2007-03-01

This paper argues that simulated practice in the university setting is not just a second best to learning in the clinical area but one which offers the potential for deliberation and deep learning [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136]. The context of student learning in an undergraduate midwifery programme is analysed using human activity theory [Engeström, Y., 2001. Expansive learning at work: toward an activity theoretical reconceptualization. Journal of Education and Work, 14, 133-156]. The advantages of this approach to student learning as opposed to situated learning theory and the concept of legitimate peripheral participation [Lave, J., Wenger, E., 1991. Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, New York] are discussed. An activity system changes as a result of contradictions and tensions between what it purports to produce and the views of stakeholders (multi-voicedness) as well as its historical context (Historicity of activity). A focus group with students highlights their expressed need for more simulated practice experience. The views of midwifery lecturers are sought as an alternative voice on this tension in the current programme. Qualitative differences in types of simulated experience are explored and concerns about resources are raised in the analysis. Discussion considers the value of well planned simulations in encouraging the expression of tacit understanding through a group deliberative learning process [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136].

Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis

Energy Technology Data Exchange (ETDEWEB)

Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Shostrom, Valerie K. [Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska (United States); Zhen, Weining; Zhang, Mutian [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Braunstein, Steve E. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Holland, John [Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Harkenrider, Matthew M. [Department of Radiation Oncology, Loyola University Stritch School of Medicine, Maywood, Illinois (United States); Iskhanian, Adrian [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida (United States); Jabbour, Salma K. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey (United States); Attia, Albert [Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Wang, Kyle [Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina (United States); Decker, Roy H. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); McGarry, Ronald C. [Department of Radiation Oncology, University of Kentucky, Lexington, Kentucky (United States); Simone, Charles B., E-mail: charlessimone@umm.edu [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States)

2017-03-15

Purpose: To describe the impact of fractionation scheme and tumor location on toxicities in stereotactic body radiation therapy (SBRT) for ≥5-cm non-small cell lung cancer (NSCLC), as part of a multi-institutional analysis. Methods: Patients with primary ≥5-cm N0 M0 NSCLC who underwent ≤5-fraction SBRT were examined across multiple high-volume SBRT centers. Collected data included clinical/treatment parameters; toxicities were prospectively assessed at each institution according to the Common Terminology Criteria for Adverse Events. Patients treated daily were compared with those treated every other day (QOD)/other nondaily regimens. Stratification between central and peripheral tumors was also performed. Results: Ninety-two patients from 12 institutions were evaluated (2004-2016), with median follow-up of 12 months. In total there were 23 (25%) and 6 (7%) grade ≥2 and grade ≥3 toxicities, respectively. Grades 2 and 3 pulmonary toxicities occurred in 9% and 4%, respectively; 1 patient treated daily experienced grade 5 radiation pneumonitis. Of the entire cohort, 46 patients underwent daily SBRT, and 46 received QOD (n=40)/other nondaily (n=6) regimens. Clinical/treatment parameters were similar between groups; the QOD/other group was more likely to receive 3-/4-fraction schemas. Patients treated QOD/other experienced significantly fewer grade ≥2 toxicities as compared with daily treatment (7% vs 43%, P<.001). Patients treated daily also had higher rates of grade ≥2 pulmonary toxicities (P=.014). Patients with peripheral tumors (n=66) were more likely to receive 3-/4-fraction regimens than those with central tumors (n=26). No significant differences in grade ≥2 toxicities were identified according to tumor location (P>.05). Conclusions: From this multi-institutional study, toxicity of SBRT for ≥5-cm lesions is acceptable, and daily treatment was associated with a higher rate of toxicities.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

OpenAIRE

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are ...

Social Pharmacy and Clinical Pharmacy—Joining Forces

Directory of Open Access Journals (Sweden)

Anna Birna Almarsdottir

2015-12-01

Full Text Available This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, “What’s in a name?” and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large.

Location of brain lesions predicts conversion of clinically isolated syndromes to multiple sclerosis

DEFF Research Database (Denmark)

Giorgio, Antonio; Battaglini, Marco; Rocca, Maria Assunta

2013-01-01

OBJECTIVES: To assess in a large population of patients with clinically isolated syndrome (CIS) the relevance of brain lesion location and frequency in predicting 1-year conversion to multiple sclerosis (MS). METHODS: In this multicenter, retrospective study, clinical and MRI data at onset......: In CIS patients with hemispheric, multifocal, and brainstem/cerebellar onset, lesion probability map clusters were seen in clinically eloquent brain regions. Significant lesion clusters were not found in CIS patients with optic nerve and spinal cord onset. At 1 year, clinically definite MS developed...... in the converting group in projection, association, and commissural WM tracts, with larger clusters being in the corpus callosum, corona radiata, and cingulum. CONCLUSIONS: Higher frequency of lesion occurrence in clinically eloquent WM tracts can characterize CIS subjects with different types of onset...

Tools in a clinical information system supporting clinical trials at a Swiss University Hospital.

Science.gov (United States)

Weisskopf, Michael; Bucklar, Guido; Blaser, Jürg

2014-12-01

Issues concerning inadequate source data of clinical trials rank second in the most common findings by regulatory authorities. The increasing use of electronic clinical information systems by healthcare providers offers an opportunity to facilitate and improve the conduct of clinical trials and the source documentation. We report on a number of tools implemented into the clinical information system of a university hospital to support clinical research. In 2011/2012, a set of tools was developed in the clinical information system of the University Hospital Zurich to support clinical research, including (1) a trial registry for documenting metadata on the clinical trials conducted at the hospital, (2) a patient-trial-assignment-tool to tag patients in the electronic medical charts as participants of specific trials, (3) medical record templates for the documentation of study visits and trial-related procedures, (4) online queries on trials and trial participants, (5) access to the electronic medical records for clinical monitors, (6) an alerting tool to notify of hospital admissions of trial participants, (7) queries to identify potentially eligible patients in the planning phase as trial feasibility checks and during the trial as recruitment support, and (8) order sets to facilitate the complete and accurate performance of study visit procedures. The number of approximately 100 new registrations per year in the voluntary trial registry in the clinical information system now matches the numbers of the existing mandatory trial registry of the hospital. Likewise, the yearly numbers of patients tagged as trial participants as well as the use of the standardized trial record templates increased to 2408 documented trial enrolments and 190 reports generated/month in the year 2013. Accounts for 32 clinical monitors have been established in the first 2 years monitoring a total of 49 trials in 16 clinical departments. A total of 15 months after adding the optional feature of

Narratives of location: School science identities and scientific discourse among Navajo women at the University of New Mexico

Science.gov (United States)

Brandt, Carol B.

This research examines the interplay of scientific discourse and students' sense of self among four Navajo (Dine) women as they major in science at a university in the southwestern United States. This dissertation research is an ethnographic case study of Navajo women as they were completing their final year of undergraduate study in the life sciences at a university. How do Navajo women express their identity in Western science at the university? What role does scientific discourse play in this process? This research employs a feminist poststructural approach to language and expands the way discourse has typically been addressed in science education. I expand the notion of discourse through poststructuralism by recognizing the co-constitutive role of language in fashioning realities and generating meaning. Data sources in this study included transcripts from one-on-one interviews, electronic correspondence (e-mail), observations of social contexts on campus, students' writing for science courses, university policy statements, departmental outcomes assessments, web profiles of student research in science, and a researcher's reflective journal. This study took place beginning in January 2002 and continued through May of 2003 at the University of New Mexico. After completing the thematic (constant comparative analysis) and an analysis of metaphors, I "retold" or "restoried" the narratives collected during interviews. In the cross case analysis, I compared each participant's description of those discursive spaces that afforded engagement with science, and those locations where their awareness of academic language was heightened in a process of metadiscourse. I identified these spaces as locations of possibility in which students and their mentors (or instructors) valued connected knowing, acknowledged each other's history, culture, and knowledge, and began speaking to each other subject-to-subject to challenge normative views of schooling. The participants in this

A hybrid flower pollination algorithm based modified randomized location for multi-threshold medical image segmentation.

Science.gov (United States)

Wang, Rui; Zhou, Yongquan; Zhao, Chengyan; Wu, Haizhou

2015-01-01

Multi-threshold image segmentation is a powerful image processing technique that is used for the preprocessing of pattern recognition and computer vision. However, traditional multilevel thresholding methods are computationally expensive because they involve exhaustively searching the optimal thresholds to optimize the objective functions. To overcome this drawback, this paper proposes a flower pollination algorithm with a randomized location modification. The proposed algorithm is used to find optimal threshold values for maximizing Otsu's objective functions with regard to eight medical grayscale images. When benchmarked against other state-of-the-art evolutionary algorithms, the new algorithm proves itself to be robust and effective through numerical experimental results including Otsu's objective values and standard deviations.

Coordination Costs for School-Located Influenza Vaccination Clinics, Maine, 2009 H1N1 Pandemic

Science.gov (United States)

Asay, Garrett R. Beeler; Cho, Bo-Hyun; Lorick, Suchita A.; Tipton, Meredith L.; Dube, Nancy L.; Messonnier, Mark L.

2012-01-01

School nurses played a key role in Maine's school-located influenza vaccination (SLV) clinics during the 2009-2010 pandemic season. The objective of this study was to determine, from the school district perspective, the labor hours and costs associated with outside-clinic coordination activities (OCA). The authors defined OCA as labor hours spent…

Clinical Engeneering Experience at the Hospital of the State University of Londrina

Directory of Open Access Journals (Sweden)

Ernesto Fernando Ferreyra Ramírez

2002-01-01

Full Text Available This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL. It was performed by the Electrical Engineering Department (DEEL, through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare services offered by the HURNP for the community in the surroundings of Londrina – Paraná State – Brazil.

A Comparative Study of Deep Neck Abscess with Regards to Anatomical Location and Age Groups Using CT and Clinical Data

International Nuclear Information System (INIS)

Park, Chan Ho; Han, Jong Kyu; Kim, Young Tong; Shin, Hyeong Cheol; Kim, Hyung Hwan; Jou, Sung Shick

2012-01-01

To evaluate differences anatomical location and age groups on CT and clinical data in deep neck abscess. This study included 200 patients who underwent CT and were diagnosed with a deep neck abscess, from December 2005 to July 2010. Patients were divided into four groups by age (children, adolescent, adult, elderly). Next, the anatomic location, location multiplicity and clinical data regarding the deep neck abscesses were analyzed retrospectively. The deep neck abscesses observed were defined as superficial or deep and partitioned into sub-groups, with further analysis of their clinical data. The incidence of the parapharyngeal abscess was more frequent in children and elderly groups (p < 0.05). The masticator abscess was only observed among patients in the elderly group (p < 0.05). Multiple locations were observed with increased frequency in children and elderly groups (p < 0.05). Swelling in the neck was more frequently observed in children and elderly groups (p < 0.05), cervical lymphadenitis was frequently seen in children and adolescent groups (p < 0.05), and the incidence of symptoms including sore throat were significantly increased in adolescent and adult groups (p < 0.05). Location multiplicity was significantly higher in parapharyngeal, retropharyngeal, submandibular, danger, visceral and masticator spaces than other spaces (p < 0.05). With regards to anatomic location, neck swelling was more frequent in superficial group and sore throat was more frequent in deep group (p < 0.05). Deep neck abscess would show significant differences with regards to the abscess location, location multiplicity, and clinical symptoms according to age. The clinical symptoms observed are dependent on the anatomic location as defined by a superficial or deep abscess.

A multi-subject evaluation of uncertainty in anatomical landmark location on shoulder kinematic description.

Science.gov (United States)

Langenderfer, Joseph E; Rullkoetter, Paul J; Mell, Amy G; Laz, Peter J

2009-04-01

An accurate assessment of shoulder kinematics is useful for understanding healthy normal and pathological mechanics. Small variability in identifying and locating anatomical landmarks (ALs) has potential to affect reported shoulder kinematics. The objectives of this study were to quantify the effect of landmark location variability on scapular and humeral kinematic descriptions for multiple subjects using probabilistic analysis methods, and to evaluate the consistency in results across multiple subjects. Data from 11 healthy subjects performing humeral elevation in the scapular plane were used to calculate Euler angles describing humeral and scapular kinematics. Probabilistic analyses were performed for each subject to simulate uncertainty in the locations of 13 upper-extremity ALs. For standard deviations of 4 mm in landmark location, the analysis predicted Euler angle envelopes between the 1 and 99 percentile bounds of up to 16.6 degrees . While absolute kinematics varied with the subject, the average 1-99% kinematic ranges for the motion were consistent across subjects and sensitivity factors showed no statistically significant differences between subjects. The description of humeral kinematics was most sensitive to the location of landmarks on the thorax, while landmarks on the scapula had the greatest effect on the description of scapular elevation. The findings of this study can provide a better understanding of kinematic variability, which can aid in making accurate clinical diagnoses and refining kinematic measurement techniques.

Internet Geo-Location

Science.gov (United States)

2017-12-01

INTERNET GEO-LOCATION DUKE UNIVERSITY DECEMBER 2017 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED STINFO COPY AIR...REPORT TYPE FINAL TECHNICAL REPORT 3. DATES COVERED (From - To) MAY 2014 – MAY 2017 4. TITLE AND SUBTITLE INTERNET GEO-LOCATION 5a. CONTRACT...of SpeedTest servers that are used by end users to measure the speed of their Internet connection. The servers log the IP address and the location

Integrated optimization of location assignment and sequencing in multi-shuttle automated storage and retrieval systems under modified 2n-command cycle pattern

Science.gov (United States)

Yang, Peng; Peng, Yongfei; Ye, Bin; Miao, Lixin

2017-09-01

This article explores the integrated optimization problem of location assignment and sequencing in multi-shuttle automated storage/retrieval systems under the modified 2n-command cycle pattern. The decision of storage and retrieval (S/R) location assignment and S/R request sequencing are jointly considered. An integer quadratic programming model is formulated to describe this integrated optimization problem. The optimal travel cycles for multi-shuttle S/R machines can be obtained to process S/R requests in the storage and retrieval request order lists by solving the model. The small-sized instances are optimally solved using CPLEX. For large-sized problems, two tabu search algorithms are proposed, in which the first come, first served and nearest neighbour are used to generate initial solutions. Various numerical experiments are conducted to examine the heuristics' performance and the sensitivity of algorithm parameters. Furthermore, the experimental results are analysed from the viewpoint of practical application, and a parameter list for applying the proposed heuristics is recommended under different real-life scenarios.

Existing data sources for clinical epidemiology: Aarhus University Clinical Trial Candidate Database, Denmark.

Science.gov (United States)

Nørrelund, Helene; Mazin, Wiktor; Pedersen, Lars

2014-01-01

Denmark is facing a reduction in clinical trial activity as the pharmaceutical industry has moved trials to low-cost emerging economies. Competitiveness in industry-sponsored clinical research depends on speed, quality, and cost. Because Denmark is widely recognized as a region that generates high quality data, an enhanced ability to attract future trials could be achieved if speed can be improved by taking advantage of the comprehensive national and regional registries. A "single point-of-entry" system has been established to support collaboration between hospitals and industry. When assisting industry in early-stage feasibility assessments, potential trial participants are identified by use of registries to shorten the clinical trial startup times. The Aarhus University Clinical Trial Candidate Database consists of encrypted data from the Danish National Registry of Patients allowing an immediate estimation of the number of patients with a specific discharge diagnosis in each hospital department or outpatient specialist clinic in the Central Denmark Region. The free access to health care, thorough monitoring of patients who are in contact with the health service, completeness of registration at the hospital level, and ability to link all databases are competitive advantages in an increasingly complex clinical trial environment.

Architecture for multi-technology real-time location systems.

Science.gov (United States)

Rodas, Javier; Barral, Valentín; Escudero, Carlos J

2013-02-07

The rising popularity of location-based services has prompted considerable research in the field of indoor location systems. Since there is no single technology to support these systems, it is necessary to consider the fusion of the information coming from heterogeneous sensors. This paper presents a software architecture designed for a hybrid location system where we can merge information from multiple sensor technologies. The architecture was designed to be used by different kinds of actors independently and with mutual transparency: hardware administrators, algorithm developers and user applications. The paper presents the architecture design, work-flow, case study examples and some results to show how different technologies can be exploited to obtain a good estimation of a target position.

Prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, south west Ethiopia.

Science.gov (United States)

Toru, Milkiyas; Beyene, Getnet; Kassa, Tesfaye; Gizachew, Zeleke; Howe, Rawleigh; Yeshitila, Biruk

2018-05-08

This study was done to determine the prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, Southwest Ethiopia. The overall prevalence of Enterococci species was 5.5% (22/403). Five (22.7%) of Enterococci species were vancomycin resistant. Haemolysin, gelatinase and biofilm production was seen among 45.5, 68.2 and 77.3% of isolates respectively. The overall rate of antibiotic resistance was 95.5% (21/22). High resistance was observed against norfloxacin (87.5%), and tetracycline (77.3%). Whereas, low resistance (36.5%) was observed against ciprofloxacin and eighteen (80.8%) of the isolates were multi-drug resistant.

Development of quality control and instrumentation performance metrics for diffuse optical spectroscopic imaging instruments in the multi-center clinical environment

Science.gov (United States)

Keene, Samuel T.; Cerussi, Albert E.; Warren, Robert V.; Hill, Brian; Roblyer, Darren; Leproux, AnaÑ--s.; Durkin, Amanda F.; O'Sullivan, Thomas D.; Haghany, Hosain; Mantulin, William W.; Tromberg, Bruce J.

2013-03-01

Instrument equivalence and quality control are critical elements of multi-center clinical trials. We currently have five identical Diffuse Optical Spectroscopic Imaging (DOSI) instruments enrolled in the American College of Radiology Imaging Network (ACRIN, #6691) trial located at five academic clinical research sites in the US. The goal of the study is to predict the response of breast tumors to neoadjuvant chemotherapy in 60 patients. In order to reliably compare DOSI measurements across different instruments, operators and sites, we must be confident that the data quality is comparable. We require objective and reliable methods for identifying, correcting, and rejecting low quality data. To achieve this goal, we developed and tested an automated quality control algorithm that rejects data points below the instrument noise floor, improves tissue optical property recovery, and outputs a detailed data quality report. Using a new protocol for obtaining dark-noise data, we applied the algorithm to ACRIN patient data and successfully improved the quality of recovered physiological data in some cases.

Empirical Model for Mobile Learning and their Factors. Case Study: Universities Located in the Urban City of Guadalajara, México

Directory of Open Access Journals (Sweden)

Juan Mejía Trejo

2015-10-01

Full Text Available Information and communication technologies (ICT are producing new and innovative teaching-learning processes. The research question we focused on is: Which is the empirical model and the factors for mobile learning at universities located within the Metropolitan Zone of Guadalajara, in Jalisco, México? Our research is grounded on a documentary study that chose variables used by specialists in m-learning using Analytic Hierarchy Process (AHP. The factors discovered were three: Technology (TECH; Contents Teaching-Learning Management and Styles (CTLMS; and Professor and Student Role (PSR. We used 13 dimensions and 60 variables. 20 professors and 800 students in social sciences courses participated in the study; they came from 7 universities located in the Urban City of Guadalajara, during 2013-2014 school cycles (24 months. We applied questionnaires and the data were analyzed by structural equations modeling (SEM, using EQS 6.1 software. The results suggest that there are 9/60 variables that have the most influence to improve the interaction with m-Learning model within the universities.

Multi-Aspect Group Formation using Facility Location Analysis

NARCIS (Netherlands)

Neshati, Mahmood; Beigy, Hamid; Hiemstra, Djoerd

2012-01-01

In this paper, we propose an optimization framework to retrieve an optimal group of experts to perform a given multi-aspect task/project. Each task needs a diverse set of skills and the group of assigned experts should be able to collectively cover all required aspects of the task. We consider three

Architecture for Multi-Technology Real-Time Location Systems

Science.gov (United States)

Rodas, Javier; Barral, Valentín; Escudero, Carlos J.

2013-01-01

The rising popularity of location-based services has prompted considerable research in the field of indoor location systems. Since there is no single technology to support these systems, it is necessary to consider the fusion of the information coming from heterogeneous sensors. This paper presents a software architecture designed for a hybrid location system where we can merge information from multiple sensor technologies. The architecture was designed to be used by different kinds of actors independently and with mutual transparency: hardware administrators, algorithm developers and user applications. The paper presents the architecture design, work-flow, case study examples and some results to show how different technologies can be exploited to obtain a good estimation of a target position. PMID:23435050

Enhancing community based health programs in Iran: a multi-objective location-allocation model.

Science.gov (United States)

Khodaparasti, S; Maleki, H R; Jahedi, S; Bruni, M E; Beraldi, P

2017-12-01

Community Based Organizations (CBOs) are important health system stakeholders with the mission of addressing the social and economic needs of individuals and groups in a defined geographic area, usually no larger than a county. The access and success efforts of CBOs vary, depending on the integration between health care providers and CBOs but also in relation to the community participation level. To achieve widespread results, it is important to carefully design an efficient network which can serve as a bridge between the community and the health care system. This study addresses this challenge through a location-allocation model that deals with the hierarchical nature of the system explicitly. To reflect social welfare concerns of equity, local accessibility, and efficiency, we develop the model in a multi-objective framework, capturing the ambiguity in the decision makers' aspiration levels through a fuzzy goal programming approach. This study reports the findings for the real case of Shiraz city, Fars province, Iran, obtained by a thorough analysis of the results.

pLoc-mVirus: Predict subcellular localization of multi-location virus proteins via incorporating the optimal GO information into general PseAAC.

Science.gov (United States)

Cheng, Xiang; Xiao, Xuan; Chou, Kuo-Chen

2017-09-10

Knowledge of subcellular locations of proteins is crucially important for in-depth understanding their functions in a cell. With the explosive growth of protein sequences generated in the postgenomic age, it is highly demanded to develop computational tools for timely annotating their subcellular locations based on the sequence information alone. The current study is focused on virus proteins. Although considerable efforts have been made in this regard, the problem is far from being solved yet. Most existing methods can be used to deal with single-location proteins only. Actually, proteins with multi-locations may have some special biological functions. This kind of multiplex proteins is particularly important for both basic research and drug design. Using the multi-label theory, we present a new predictor called "pLoc-mVirus" by extracting the optimal GO (Gene Ontology) information into the general PseAAC (Pseudo Amino Acid Composition). Rigorous cross-validation on a same stringent benchmark dataset indicated that the proposed pLoc-mVirus predictor is remarkably superior to iLoc-Virus, the state-of-the-art method in predicting virus protein subcellular localization. To maximize the convenience of most experimental scientists, a user-friendly web-server for the new predictor has been established at http://www.jci-bioinfo.cn/pLoc-mVirus/, by which users can easily get their desired results without the need to go through the complicated mathematics involved. Copyright © 2017 Elsevier B.V. All rights reserved.

pLoc-mPlant: predict subcellular localization of multi-location plant proteins by incorporating the optimal GO information into general PseAAC.

Science.gov (United States)

Cheng, Xiang; Xiao, Xuan; Chou, Kuo-Chen

2017-08-22

One of the fundamental goals in cellular biochemistry is to identify the functions of proteins in the context of compartments that organize them in the cellular environment. To realize this, it is indispensable to develop an automated method for fast and accurate identification of the subcellular locations of uncharacterized proteins. The current study is focused on plant protein subcellular location prediction based on the sequence information alone. Although considerable efforts have been made in this regard, the problem is far from being solved yet. Most of the existing methods can be used to deal with single-location proteins only. Actually, proteins with multi-locations may have some special biological functions. This kind of multiplex protein is particularly important for both basic research and drug design. Using the multi-label theory, we present a new predictor called "pLoc-mPlant" by extracting the optimal GO (Gene Ontology) information into the Chou's general PseAAC (Pseudo Amino Acid Composition). Rigorous cross-validation on the same stringent benchmark dataset indicated that the proposed pLoc-mPlant predictor is remarkably superior to iLoc-Plant, the state-of-the-art method for predicting plant protein subcellular localization. To maximize the convenience of most experimental scientists, a user-friendly web-server for the new predictor has been established at , by which users can easily get their desired results without the need to go through the complicated mathematics involved.

Location Systems An Introduction to the Technology Behind Location Awareness

CERN Document Server

LaMarca, Anthony

2008-01-01

Advances in electronic location technology and the coming of age of mobile computing have opened the door for location-aware applications to permeate all aspects of everyday life. Location is at the core of a large number of high-value applications ranging from the life-and-death context of emergency response to serendipitous social meet-ups. For example, the market for GPS products and services alone is expected to grow to US200 billion by 2015. Unfortunately, there is no single location technology that is good for every situation and exhibits high accuracy, low cost, and universal coverage.

The application of a multi-parameter analysis in choosing the location of a new solid waste landfill in Serbia.

Science.gov (United States)

Milosevic, Igor; Naunovic, Zorana

2013-10-01

This article presents a process of evaluation and selection of the most favourable location for a sanitary landfill facility from three alternative locations, by applying a multi-criteria decision-making (MCDM) method. An incorrect choice of location for a landfill facility can have a significant negative economic and environmental impact, such as the pollution of air, ground and surface waters. The aim of this article is to present several improvements in the practical process of landfill site selection using the VIKOR MCDM compromise ranking method integrated with a fuzzy analytic hierarchy process approach for determining the evaluation criteria weighing coefficients. The VIKOR method focuses on ranking and selecting from a set of alternatives in the presence of conflicting and non-commensurable (different units) criteria, and on proposing a compromise solution that is closest to the ideal solution. The work shows that valuable site ranking lists can be obtained using the VIKOR method, which is a suitable choice when there is a large number of relevant input parameters.

Development of a Clinical Pharmacology Graduate Program at the University of Kentucky.

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Blouin, Robert A.; And Others

1994-01-01

The structure, components, and anticipated outcomes of a University of Kentucky doctoral program in pharmacology are described. The program is designed to develop pharmacy-trained specialists who are interested in rigorous, intensive clinical experience, state-of-the-art coursework, and integrated laboratory-based and clinical dissertation…

Enterobiasis in Ectopic Locations Mimicking Tumor-Like Lesions

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Silvio Pampiglione

2009-01-01

Full Text Available Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered “out-of-fashion.”

Time-location patterns of a diverse population of older adults: the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air).

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Spalt, Elizabeth W; Curl, Cynthia L; Allen, Ryan W; Cohen, Martin; Adar, Sara D; Stukovsky, Karen H; Avol, Ed; Castro-Diehl, Cecilia; Nunn, Cathy; Mancera-Cuevas, Karen; Kaufman, Joel D

2016-06-01

The primary aim of this analysis was to present and describe questionnaire data characterizing time-location patterns of an older, multiethnic population from six American cities. We evaluated the consistency of results from repeated administration of this questionnaire and between this questionnaire and other questionnaires collected from participants of the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Participants reported spending most of their time inside their homes (average: 121 h/week or 72%). More than 50% of the participants reported spending no time in several of the location options, including at home outdoors, at work/volunteer/school locations indoors or outdoors, or in "other" locations outdoors. We observed consistency between self-reported time-location patterns from repeated administration of the time-location questionnaire and compared with other survey instruments. Comparisons with national cohorts demonstrated the differences in time-location patterns in the MESA Air cohort due to differences in demographics, but the data showed similar trends in patterns by age, gender, season, and employment status. This study was the first to explicitly examine the time-location patterns in an older, multiethnic population and the first to add data on Chinese participants. These data can be used to inform future epidemiological research of MESA Air and other studies that include diverse populations.

Multi-Criteria Analysis for Solar Farm Location Suitability

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Mierzwiak, Michal; Calka, Beata

2017-12-01

Currently the number of solar farms, as a type of renewable sources of energy, is growing rapidly. Photovoltaic power stations have many advantages, which is an incentive for their building and development. Solar energy is readily available and inexhaustible, and its production is environmentally friendly. In the present study multiple environmental and economic criteria were taken into account to select a potential photovoltaic farm location, with particular emphasis on: protected areas, land cover, solar radiation, slope angle, proximity to roads, built-up areas, and power lines. Advanced data analysis were used because of the multiplicity of criteria and their diverse influence on the choice of a potential location. They included the spatial analysis, the Weighted Linear Combination Technique (WLC), and the Analytic Hierarchy Process (AHP) as a decisionmaking method. The analysis was divided into two stages. In the first one, the areas where the location of solar farms was not possible were excluded. In the second one, the best locations meeting all environmental and economic criteria were selected. The research was conducted for the Legionowo District, using data from national surveying and mapping resources such as: BDOT10k (Database of Topographic Objects), NMT (Numerical Terrain Model), and lands and buildings register. Finally, several areas meeting the criteria were chosen. The research deals with solar farms with up to 40 kW power. The results of the study are presented as thematic maps. The advantage of the method is its versatility. It can be used not only for any area, but with little modification of the criteria, it can also be applied to choose a location for wind farms.

Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

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Mekonnen AB

2013-03-01

Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

Analysing barriers to service improvement using a multi-level theory of innovation: the case of glaucoma outpatient clinics.

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Turner, Simon; Vasilakis, Christos; Utley, Martin; Foster, Paul; Kotecha, Aachal; Fulop, Naomi J

2018-05-01

The development and implementation of innovation by healthcare providers is understood as a multi-determinant and multi-level process. Theories at different analytical levels (i.e. micro and organisational) are needed to capture the processes that influence innovation by providers. This article combines a micro theory of innovation, actor-network theory, with organisational level processes using the 'resource based view of the firm'. It examines the influence of, and interplay between, innovation-seeking teams (micro) and underlying organisational capabilities (meso) during innovation processes. We used ethnographic methods to study service innovations in relation to ophthalmology services run by a specialist English NHS Trust at multiple locations. Operational research techniques were used to support the ethnographic methods by mapping the care process in the existing and redesigned clinics. Deficiencies in organisational capabilities for supporting innovation were identified, including manager-clinician relations and organisation-wide resources. The article concludes that actor-network theory can be combined with the resource-based view to highlight the influence of organisational capabilities on the management of innovation. Equally, actor-network theory helps to address the lack of theory in the resource-based view on the micro practices of implementing change. © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

A Virtual Mental Health Clinic for University Students: A Qualitative Study of End-User Service Needs and Priorities

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Gulliver, Amelia; Chan, Jade KY; Bennett, Kylie; Griffiths, Kathleen M

2015-01-01

Background Help seeking for mental health problems among university students is low, and Internet-based interventions such as virtual clinics have the potential to provide private, streamlined, and high quality care to this vulnerable group. Objective The objective of this study was to conduct focus groups with university students to obtain input on potential functions and features of a university-specific virtual clinic for mental health. Methods Participants were 19 undergraduate students from an Australian university between 19 and 24 years of age. Focus group discussion was structured by questions that addressed the following topics: (1) the utility and acceptability of a virtual mental health clinic for students, and (2) potential features of a virtual mental health clinic. Results Participants viewed the concept of a virtual clinic for university students favorably, despite expressing concerns about privacy of personal information. Participants expressed a desire to connect with professionals through the virtual clinic, for the clinic to provide information tailored to issues faced by students, and for the clinic to enable peer-to-peer interaction. Conclusions Overall, results of the study suggest the potential for virtual clinics to play a positive role in providing students with access to mental health support. PMID:26543908

The role of dosimetry audit in lung SBRT multi-centre clinical trials.

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Clark, Catharine H; Hurkmans, Coen W; Kry, Stephen F

2017-12-01

Stereotactic Body Radiotherapy (SBRT) in the lung is a challenging technique which requires high quality clinical trials to answer the un-resolved clinical questions. Quality assurance of these clinical trials not only ensures the safety of the treatment of the participating patients but also minimises the variation in treatment, thus allowing the lowest number of patient treatments to answer the trial question. This review addresses the role of dosimetry audits in the quality assurance process and considers what can be done to ensure the highest accuracy of dose calculation and delivery and it's assessment in multi-centre trials. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

A Multi-Case Study of University Students' Language-Learning Experience Mediated by Mobile Technologies: A Socio-Cultural Perspective

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Ma, Qing

2017-01-01

Emerging mobile technologies can be considered a new form of social and cultural artefact that mediates people's language learning. This multi-case study investigates how mobile technologies mediate a group of Hong Kong university students' L2 learning, which serves as a lens with which to capture the personalised, unique, contextual and…

Line-Constrained Camera Location Estimation in Multi-Image Stereomatching.

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Donné, Simon; Goossens, Bart; Philips, Wilfried

2017-08-23

Stereomatching is an effective way of acquiring dense depth information from a scene when active measurements are not possible. So-called lightfield methods take a snapshot from many camera locations along a defined trajectory (usually uniformly linear or on a regular grid-we will assume a linear trajectory) and use this information to compute accurate depth estimates. However, they require the locations for each of the snapshots to be known: the disparity of an object between images is related to both the distance of the camera to the object and the distance between the camera positions for both images. Existing solutions use sparse feature matching for camera location estimation. In this paper, we propose a novel method that uses dense correspondences to do the same, leveraging an existing depth estimation framework to also yield the camera locations along the line. We illustrate the effectiveness of the proposed technique for camera location estimation both visually for the rectification of epipolar plane images and quantitatively with its effect on the resulting depth estimation. Our proposed approach yields a valid alternative for sparse techniques, while still being executed in a reasonable time on a graphics card due to its highly parallelizable nature.

Identification of multi-drug resistant Pseudomonas aeruginosa clinical isolates that are highly disruptive to the intestinal epithelial barrier

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Shevchenko Olga

2006-06-01

Full Text Available Abstract Background Multi-drug resistant Pseudomonas aeruginosa nosocomial infections are increasingly recognized worldwide. In this study, we focused on the virulence of multi-drug resistant clinical strains P. aeruginosa against the intestinal epithelial barrier, since P. aeruginosa can cause lethal sepsis from within the intestinal tract of critically ill and immuno-compromised patients via mechanisms involving disruption of epithelial barrier function. Methods We screened consecutively isolated multi-drug resistant P. aeruginosa clinical strains for their ability to disrupt the integrity of human cultured intestinal epithelial cells (Caco-2 and correlated these finding to related virulence phenotypes such as adhesiveness, motility, biofilm formation, and cytotoxicity. Results Results demonstrated that the majority of the multi-drug resistant P. aeruginosa clinical strains were attenuated in their ability to disrupt the barrier function of cultured intestinal epithelial cells. Three distinct genotypes were found that displayed an extreme epithelial barrier-disrupting phenotype. These strains were characterized and found to harbor the exoU gene and to display high swimming motility and adhesiveness. Conclusion These data suggest that detailed phenotypic analysis of the behavior of multi-drug resistant P. aeruginosa against the intestinal epithelium has the potential to identify strains most likely to place patients at risk for lethal gut-derived sepsis. Surveillance of colonizing strains of P. aeruginosa in critically ill patients beyond antibiotic sensitivity is warranted.

Burnout Among the Clinical Dental Students in the Jordanian Universities

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Amin, Wala Majid; Al-Ali, Muna H.; Duaibis, Ramzi B.; Oweis, Tamara; Badran, Darwish H.

2009-01-01

Background The study aimed to evaluate the level of burnout among the clinical dental students in two Jordanian universities. Methods A total of 307 students from the two schools were surveyed using Maslach Burnout Inventory survey. Scores for the inventory’s subscales were calculated and the mean values for the students’ groups were computed separately. Kruskal-Wallis and Mann-Whitney tests were carried out and the results were compared at 95% confidence level. Results The results showed that the dental students in both Jordanian universities suffered high levels of emotional exhaustion and depersonalization compared to reported levels for dental students in other countries. The dental students of the University of Jordan demonstrated a significantly higher (p < 0.05) level of emotional exhaustion than their counterparts in the Jordan University of Science and Technology. Conclusions The findings indicated that dental students in the Jordanian universities presented considerable degrees of burnout manifested by high levels of emotional exhaustion and depersonalization. Studies targeting students health and psychology should be carried out to determine the causes of burnout among dental students. The curricula of the dental schools in the two universities should be accordingly improved to minimize burnout among the students. Keywords Burnout; Emotional exhaustion; Depersonalization; Personal accomplishment; Maslach Burnout Inventory PMID:22461870

Privacy Issues in the Development of a Virtual Mental Health Clinic for University Students: A Qualitative Study.

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Gulliver, Amelia; Bennett, Kylie; Bennett, Anthony; Farrer, Louise M; Reynolds, Julia; Griffiths, Kathleen M

2015-01-01

There is a growing need to develop online services for university students with the capacity to complement existing services and efficiently address student mental health problems. Previous research examining the development and acceptability of online interventions has revealed that issues such as privacy critically impact user willingness to engage with these services. To explore university student perspectives on privacy issues related to using an online mental health service within the context of the development of an online, university-based virtual mental health clinic. There were two stages of data collection. The first stage consisted of four 1.5-hour focus groups conducted with university students (n=19; 10 female, 9 male, mean age = 21.6 years) to determine their ideas about the virtual clinic including privacy issues. The second stage comprised three 1-hour prototype testing sessions conducted with university students (n=6; 3 male, 3 female, mean age = 21.2 years) using participatory design methods to develop and refine a service model for the virtual clinic and determine student views on privacy within this context. The students raised a number of issues related to privacy in relation to the development of the university virtual clinic. Major topics included the types of personal information they would be willing to provide (minimal information and optional mental health data), concern about potential access to their personal data by the university, the perceived stigma associated with registering for the service, and privacy and anonymity concerns related to online forums contained within the virtual clinic. Students would be more comfortable providing personal information and engaging with the virtual clinic if they trust the privacy and security of the service. Implications of this study include building the clinic in a flexible way to accommodate user preferences.

Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

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YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

2010-01-01

Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

Comparison of fuzzy AHP and fuzzy TODIM methods for landfill location selection.

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Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

2016-01-01

Landfill location selection is a multi-criteria decision problem and has a strategic importance for many regions. The conventional methods for landfill location selection are insufficient in dealing with the vague or imprecise nature of linguistic assessment. To resolve this problem, fuzzy multi-criteria decision-making methods are proposed. The aim of this paper is to use fuzzy TODIM (the acronym for Interactive and Multi-criteria Decision Making in Portuguese) and the fuzzy analytic hierarchy process (AHP) methods for the selection of landfill location. The proposed methods have been applied to a landfill location selection problem in the region of Casablanca, Morocco. After determining the criteria affecting the landfill location decisions, fuzzy TODIM and fuzzy AHP methods are applied to the problem and results are presented. The comparisons of these two methods are also discussed.

Evaluation of radiological service of Dental Clinic, Uberlandia Federal University (MG-Brazil)

International Nuclear Information System (INIS)

Vieira, C.D.V.T.

1985-01-01

The management related problems and the quality of dental radiographs of the Radiographic Service of the Dental Clinic, Uberlandia Federal University (MG-Brazil) are evaluated. The results are based on the examinations of 404 dental files from patients atending the Dental Clinic in 1983. Frequency distribution, mean and percentages were computed for the variables studied. (M.A.C.) [pt

Residential Location Preferences. The Significance of Socio-Cultural and Religious Attributes

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Gobi Krishna Sinniah

2014-07-01

Full Text Available The objective of this paper is to explore residential location preferences and how they are related to travel behavior. The literature focuses on the preferences in relation to physical and demographic aspects, such as land uses, facilities, transportation facilities, transportation services, car ownership, income, household size and travel accessibility. However, this study suggests social and cultural issue such as racial diversity which is literally to be a significance context. The case study reported here is based on Iskandar Malaysia’s development region. Reliability Analysis and Factor Analysis are applied to determine that religious and culture are influential in terms of residential location preferences. These findings add a different perspective on travel behavior studies, which are heavily dominated by researches from Western Europe, North America and Australasia. It is suggested that transport researchers need to reject universal conclusions and be clearer about the contexts in which their findings most applied and in multi-cultural scenarios to consider cultural and religious factors more extensively.

A Search for universal extra dimensions in the multi-lepton channel from proton anti-proton collisions at √s = 1.8 TeV

Energy Technology Data Exchange (ETDEWEB)

Lin, Chun [Yale Univ., New Haven, CT (United States)

2005-12-01

In this thesis we present the results of a search for Universal Extra Dimensions (UED) with compactification radius near the TeV scale in the multi-lepton channel from proton-antiproton collisions at center-of-mass energy of 1.8 TeV at the Fermi National Accelerator Laboratory. This is the first UED search in the multi-lepton channel performed at the Tevatron.

Clinical Features, Complications and Treatment Outcome of Brucella ...

African Journals Online (AJOL)

Purpose: Brucellosis is a multi-systemic infection that is endemic in some parts of the world. The purpose of this study was to examine the epidemiology as well as the clinical and haematological characteristics, complications, and treatment outcome of patients with brucellosis at the King Fahd Hospital of the University ...

Authorship issues in multi-centre clinical trials: the importance of making an authorship contract.

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Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian; Vinther, Siri

2015-02-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

A New Clinical HIFU System (Teleson II)

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Ma, Yixin; Symonds-Tayler, Richard; Rivens, Ian H.; ter Haar, Gail R.

2007-05-01

Previous clinical trials with our first prototype HIFU system (Teleson I) for the treatment of liver tumors, demonstrated a major challenge to be treatment of those tumors located behind the ribs. We have designed a new multi-element transducer for rib sparing. Initial simulation and experimental results (using a single channel power amplifier) are very encouraging. A new clinical HIFU system which can drive the multi-element transducer and control each channel independently is being designed and constructed. This second version of a clinical prototype HIFU system consists of a 3D motorised gantry, a multi-channel signal generator, a multi-channel power amplifier, a user interface PC, an embedded controller and auxiliary circuits for real-time interleaving/synchronization control and a to-be-implemented safety monitoring and data logging unit. For multi-element transducers, each element can be individually switched on and off for rib sparing, and phase and amplitude modulated for potential phased array applications. The multi-channel power amplifier can be switched on/off very rapidly at required intervals to interleave with ultrasound B-Scan imaging for HIFU monitoring or radiation force elastography imaging via a dedicated interleaving/timing module. The gantry movement can also be synchronised with power amplifier on/off and phase/amplitude updating for lesion generation under a wide variety of conditions including single lesions, lesion arrays and lesions "tracks" created whilst translating the active transducer. Results from testing the system using excised tissue will be presented.

A multi-objective optimization problem for multi-state series-parallel systems: A two-stage flow-shop manufacturing system

International Nuclear Information System (INIS)

Azadeh, A.; Maleki Shoja, B.; Ghanei, S.; Sheikhalishahi, M.

2015-01-01

This research investigates a redundancy-scheduling optimization problem for a multi-state series parallel system. The system is a flow shop manufacturing system with multi-state machines. Each manufacturing machine may have different performance rates including perfect performance, decreased performance and complete failure. Moreover, warm standby redundancy is considered for the redundancy allocation problem. Three objectives are considered for the problem: (1) minimizing system purchasing cost, (2) minimizing makespan, and (3) maximizing system reliability. Universal generating function is employed to evaluate system performance and overall reliability of the system. Since the problem is in the NP-hard class of combinatorial problems, genetic algorithm (GA) is used to find optimal/near optimal solutions. Different test problems are generated to evaluate the effectiveness and efficiency of proposed approach and compared to simulated annealing optimization method. The results show the proposed approach is capable of finding optimal/near optimal solution within a very reasonable time. - Highlights: • A redundancy-scheduling optimization problem for a multi-state series parallel system. • A flow shop with multi-state machines and warm standby redundancy. • Objectives are to optimize system purchasing cost, makespan and reliability. • Different test problems are generated and evaluated by a unique genetic algorithm. • It locates optimal/near optimal solution within a very reasonable time

The Effect of Clinical Care Location on Clinical Outcomes After Peripheral Vascular Intervention in Medicare Beneficiaries.

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Turley, Ryan S; Mi, Xiaojuan; Qualls, Laura G; Vemulapalli, Sreekanth; Peterson, Eric D; Patel, Manesh R; Curtis, Lesley H; Jones, W Schuyler

2017-06-12

Modifications in reimbursement rates by Medicare in 2008 have led to peripheral vascular interventions (PVI) being performed more commonly in outpatient and office-based clinics. The objective of this study was to determine the effects of this shift in clinical care setting on clinical outcomes after PVI. Modifications in reimbursement have led to peripheral vascular intervention (PVI) being more commonly performed in outpatient hospital settings and office-based clinics. Using a 100% national sample of Medicare beneficiaries from 2010 to 2012, we examined 30-day and 1-year rates of all-cause mortality, major lower extremity amputation, repeat revascularization, and all-cause hospitalization by clinical care location of index PVI. A total of 218,858 Medicare beneficiaries underwent an index PVI between 2010 and 2012. Index PVIs performed in inpatient settings were associated with higher 1-year rates of all-cause mortality (23.6% vs. 10.4% and 11.7%; p index revascularization and geographic region on the occurrence of all-cause hospitalization, repeat revascularization, and lower extremity amputation. Index PVI performed in office-based settings was associated with a higher hazard of repeat revascularization when compared with other settings. Differences in clinical outcomes across treatment settings and geographic regions suggest that inconsistent application of PVI may exist and highlights the need for studies to determine optimal delivery of PVI in clinical practice. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis.

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Verma, Vivek; Shostrom, Valerie K; Zhen, Weining; Zhang, Mutian; Braunstein, Steve E; Holland, John; Hallemeier, Christopher L; Harkenrider, Matthew M; Iskhanian, Adrian; Jabbour, Salma K; Attia, Albert; Lee, Percy; Wang, Kyle; Decker, Roy H; McGarry, Ronald C; Simone, Charles B

2017-03-15

To describe the impact of fractionation scheme and tumor location on toxicities in stereotactic body radiation therapy (SBRT) for ≥5-cm non-small cell lung cancer (NSCLC), as part of a multi-institutional analysis. Patients with primary ≥5-cm N0 M0 NSCLC who underwent ≤5-fraction SBRT were examined across multiple high-volume SBRT centers. Collected data included clinical/treatment parameters; toxicities were prospectively assessed at each institution according to the Common Terminology Criteria for Adverse Events. Patients treated daily were compared with those treated every other day (QOD)/other nondaily regimens. Stratification between central and peripheral tumors was also performed. Ninety-two patients from 12 institutions were evaluated (2004-2016), with median follow-up of 12 months. In total there were 23 (25%) and 6 (7%) grade ≥2 and grade ≥3 toxicities, respectively. Grades 2 and 3 pulmonary toxicities occurred in 9% and 4%, respectively; 1 patient treated daily experienced grade 5 radiation pneumonitis. Of the entire cohort, 46 patients underwent daily SBRT, and 46 received QOD (n=40)/other nondaily (n=6) regimens. Clinical/treatment parameters were similar between groups; the QOD/other group was more likely to receive 3-/4-fraction schemas. Patients treated QOD/other experienced significantly fewer grade ≥2 toxicities as compared with daily treatment (7% vs 43%, Plocation (P>.05). From this multi-institutional study, toxicity of SBRT for ≥5-cm lesions is acceptable, and daily treatment was associated with a higher rate of toxicities. Copyright © 2016 Elsevier Inc. All rights reserved.

pLoc-mHum: predict subcellular localization of multi-location human proteins via general PseAAC to winnow out the crucial GO information.

Science.gov (United States)

Cheng, Xiang; Xiao, Xuan; Chou, Kuo-Chen

2018-05-01

For in-depth understanding the functions of proteins in a cell, the knowledge of their subcellular localization is indispensable. The current study is focused on human protein subcellular location prediction based on the sequence information alone. Although considerable efforts have been made in this regard, the problem is far from being solved yet. Most existing methods can be used to deal with single-location proteins only. Actually, proteins with multi-locations may have some special biological functions that are particularly important for both basic research and drug design. Using the multi-label theory, we present a new predictor called 'pLoc-mHum' by extracting the crucial GO (Gene Ontology) information into the general PseAAC (Pseudo Amino Acid Composition). Rigorous cross-validations on a same stringent benchmark dataset have indicated that the proposed pLoc-mHum predictor is remarkably superior to iLoc-Hum, the state-of-the-art method in predicting the human protein subcellular localization. To maximize the convenience of most experimental scientists, a user-friendly web-server for the new predictor has been established at http://www.jci-bioinfo.cn/pLoc-mHum/, by which users can easily get their desired results without the need to go through the complicated mathematics involved. xcheng@gordonlifescience.org. Supplementary data are available at Bioinformatics online.

Nurse awareness of clinical research: a survey in a Japanese University Hospital

Science.gov (United States)

2014-01-01

Background Clinical research plays an important role in establishing new treatments and improving the quality of medical practice. Since the introduction of the concept of clinical research coordinators (CRC) in Japan, investigators and CRC work as a clinical research team that coordinates with other professionals in clinical trials leading to drug approval (registration trials). Although clinical nurses collaborate with clinical research teams, extended clinical research teams that include clinical nurses may contribute to the ethical and scientific pursuit of clinical research. Methods As knowledge of clinical research is essential for establishing an extended clinical research team, we used questionnaires to survey the knowledge of clinical nurses at Tokushima University Hospital. Five-point and two-point scales were used. Questions as for various experiences were also included and the relationship between awareness and experiences were analyzed. Results Among the 597 nurses at Tokushima University Hospital, 453 (75.9%) responded to the questionnaires. In Japan, registration trials are regulated by pharmaceutical affairs laws, whereas other types of investigator-initiated research (clinical research) are conducted based on ethical guidelines outlined by the ministries of Japan. Approximately 90% of respondents were aware of registration trials and clinical research, but less than 40% of the nurses were aware of their difference. In clinical research terminology, most respondents were aware of informed consent and related issues, but ≤50% were aware of other things, such as the Declaration of Helsinki, ethical guidelines, Good Clinical Practice, institutional review boards, and ethics committees. We found no specific tendency in the relationship between awareness and past experiences, such as nursing patients who were participating in registration trials and/or clinical research or taking a part in research involving patients as a nursing student or a nurse

The Multi-Universe Cosmos. The Origin and Fate of our Universe

Science.gov (United States)

Velan, Karel

18 billion yers ago our Universe, one of many in the Cosmos, emerged from a hot, dense fireball of matter and energy created in the 4-dimensional cosmic space-time from virtual particles receiving their rest mass from a powerful primordial radiation field, the missing link to any viable theory of creation. The cloud of elementary particles and radiation collapsed by gravity into a fireball until its trappped thermal radiation caused a titanic explosion that initiated the expansion and evolution of ours universe. As the universe expanded and cooled it spawned galaxies, stars, planets and life. Proven laws of physics, observationsl data and mathematical computations support the new cosmological model which proposes a large number of universes in the cosmos in varying stages of evolution

Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme

Science.gov (United States)

Miani, Celine; Marjanovic, Sonja; Jones, Molly Morgan; Marshall, Martin; Meikle, Samantha; Nolte, Ellen

2013-01-01

Abstract Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust. We assessed impacts of the Programme on individual and organisational change, alongside core enablers and barriers for Programme success. Analyses drew on the principles of a theory-of-change-led realist evaluation, using logic modelling to specify the underlying causal mechanisms of the Programme. Data collection involved a stakeholder workshop, online questionnaires of programme participants, senior managers and support staff (n=114), and follow-up in-depth semi-structured interviews with a subsample of survey participants (n=15). We observed that the Programme had notable impacts at individual and organisational levels. Examples of individual impact included enhanced communication and negotiation skills or increased confidence as a result of multi-modal leadership training. At the organisational level, participants reported indications of behaviour change among staff, with evidence of spill-over effects to non-participants towards a greater focus on patient-centred care. Our findings suggest that there is potential for combined leadership training and quality improvement programmes to contribute to strengthening a culture of care quality in healthcare organisations. Our study provides useful insights into strategies seeking to achieve sustainable improvement in NHS organisations. PMID:28083304

Impact of Strategically Located White Matter Hyperintensities on Cognition in Memory Clinic Patients with Small Vessel Disease.

Science.gov (United States)

Biesbroek, J Matthijs; Weaver, Nick A; Hilal, Saima; Kuijf, Hugo J; Ikram, Mohammad Kamran; Xu, Xin; Tan, Boon Yeow; Venketasubramanian, Narayanaswamy; Postma, Albert; Biessels, Geert Jan; Chen, Christopher P L H

2016-01-01

Studies on the impact of small vessel disease (SVD) on cognition generally focus on white matter hyperintensity (WMH) volume. The extent to which WMH location relates to cognitive performance has received less attention, but is likely to be functionally important. We examined the relation between WMH location and cognition in a memory clinic cohort of patients with sporadic SVD. A total of 167 patients with SVD were recruited from memory clinics. Assumption-free region of interest-based analyses based on major white matter tracts and voxel-wise analyses were used to determine the association between WMH location and executive functioning, visuomotor speed and memory. Region of interest-based analyses showed that WMHs located particularly within the anterior thalamic radiation and forceps minor were inversely associated with both executive functioning and visuomotor speed, independent of total WMH volume. Memory was significantly associated with WMH volume in the forceps minor, independent of total WMH volume. An independent assumption-free voxel-wise analysis identified strategic voxels in these same tracts. Region of interest-based analyses showed that WMH volume within the anterior thalamic radiation explained 6.8% of variance in executive functioning, compared to 3.9% for total WMH volume; WMH volume within the forceps minor explained 4.6% of variance in visuomotor speed and 4.2% of variance in memory, compared to 1.8% and 1.3% respectively for total WMH volume. Our findings identify the anterior thalamic radiation and forceps minor as strategic white matter tracts in which WMHs are most strongly associated with cognitive impairment in memory clinic patients with SVD. WMH volumes in individual tracts explained more variance in cognition than total WMH burden, emphasizing the importance of lesion location when addressing the functional consequences of WMHs.

Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi® system: from cadaveric models to clinical cases.

Science.gov (United States)

Yeo, Shen Ann; Noh, Gyoung Tae; Han, Jeong Hee; Cheong, Chinock; Stein, Hubert; Kerdok, Amy; Min, Byung Soh

2017-12-01

There has been little enthusiasm for performing robotic colectomy for colon cancer in recent years due to multiple factors, one being that the previous robotic systems such as the da Vinci Si ® (dVSi) were poorly designed for multi-quadrant surgery. The new da Vinci Xi ® (dVXi) system enables colectomy with central mesocolic excision to be performed easily in a single docking procedure. We developed a universal port placement strategy to allow right and left hemicolectomies to be performed via a suprapubic approach and a Pfannensteil extraction site. This proof of concept paper describes the development and subsequent clinical application of this setup. After extensive training on the dVXi system concepts in collaboration with clinical development engineers, we developed a port placement strategy which was tested and adapted after performing experimental surgery in three cadaveric models. Subsequently our port placement was used for two clinical cases of suprapubic right and left hemicolectomy. With some modifications of port placements after the initial cadaveric colectomies, we have developed a potentially universal suprapubic port placement strategy for robotic colectomy with complete mesocolic excision and central vascular ligation using the dVXi robotic system. This port placement strategy was applied successfully in our first two clinical cases. Based on our cadaveric laboratory as well as our initial clinical application, the suprapubic port placement strategy for the dVXi system with its improved features over the dVSi can feasibly perform right and left hemicolectomy with complete mesocolic excision and central vascular ligation. Further studies will be required to establish efficacy as well as safety profile of these procedures.

Solving a multi-objective location routing problem for infectious waste disposal using hybrid goal programming and hybrid genetic algorithm

Directory of Open Access Journals (Sweden)

Narong Wichapa

2018-01-01

Full Text Available Infectious waste disposal remains one of the most serious problems in the medical, social and environmental domains of almost every country. Selection of new suitable locations and finding the optimal set of transport routes for a fleet of vehicles to transport infectious waste material, location routing problem for infectious waste disposal, is one of the major problems in hazardous waste management. Determining locations for infectious waste disposal is a difficult and complex process, because it requires combining both intangible and tangible factors. Additionally, it depends on several criteria and various regulations. This facility location problem for infectious waste disposal is complicated, and it cannot be addressed using any stand-alone technique. Based on a case study, 107 hospitals and 6 candidate municipalities in Upper-Northeastern Thailand, we considered criteria such as infrastructure, geology and social & environmental criteria, evaluating global priority weights using the fuzzy analytical hierarchy process (Fuzzy AHP. After that, a new multi-objective facility location problem model which hybridizes fuzzy AHP and goal programming (GP, namely the HGP model, was tested. Finally, the vehicle routing problem (VRP for a case study was formulated, and it was tested using a hybrid genetic algorithm (HGA which hybridizes the push forward insertion heuristic (PFIH, genetic algorithm (GA and three local searches including 2-opt, insertion-move and interexchange-move. The results show that both the HGP and HGA can lead to select new suitable locations and to find the optimal set of transport routes for vehicles delivering infectious waste material. The novelty of the proposed methodologies, HGP, is the simultaneous combination of relevant factors that are difficult to interpret and cost factors in order to determine new suitable locations, and HGA can be applied to determine the transport routes which provide a minimum number of vehicles

Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

Science.gov (United States)

Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

2016-03-01

This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

Modeling a four-layer location-routing problem

Directory of Open Access Journals (Sweden)

Mohsen Hamidi

2012-01-01

Full Text Available Distribution is an indispensable component of logistics and supply chain management. Location-Routing Problem (LRP is an NP-hard problem that simultaneously takes into consideration location, allocation, and vehicle routing decisions to design an optimal distribution network. Multi-layer and multi-product LRP is even more complex as it deals with the decisions at multiple layers of a distribution network where multiple products are transported within and between layers of the network. This paper focuses on modeling a complicated four-layer and multi-product LRP which has not been tackled yet. The distribution network consists of plants, central depots, regional depots, and customers. In this study, the structure, assumptions, and limitations of the distribution network are defined and the mathematical optimization programming model that can be used to obtain the optimal solution is developed. Presented by a mixed-integer programming model, the LRP considers the location problem at two layers, the allocation problem at three layers, the vehicle routing problem at three layers, and a transshipment problem. The mathematical model locates central and regional depots, allocates customers to plants, central depots, and regional depots, constructs tours from each plant or open depot to customers, and constructs transshipment paths from plants to depots and from depots to other depots. Considering realistic assumptions and limitations such as producing multiple products, limited production capacity, limited depot and vehicle capacity, and limited traveling distances enables the user to capture the real world situations.

Managing out of hours clinical photography at the University Hospitals Bristol.

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Brinkworth, Simon; Kenny, Alice; Knights, Christina

2018-04-01

In recent years, Medical Illustration at University Hospitals Bristol (UHBristol) NHS Foundation Trust has seen a steady increase in photography requests, including the need for out of hours photography provision. This paper details how Medical Illustration at UHBristol decided to manage an out of hours clinical photography service.

Own-Group Face Recognition Bias: The Effects of Location and Reputation

Directory of Open Access Journals (Sweden)

Linlin Yan

2017-10-01

Full Text Available In the present study, we examined whether social categorization based on university affiliation can induce an advantage in recognizing faces. Moreover, we investigated how the reputation or location of the university affected face recognition performance using an old/new paradigm. We assigned five different university labels to the faces: participants’ own university and four other universities. Among the four other university labels, we manipulated the academic reputation and geographical location of these universities relative to the participants’ own university. The results showed that an own-group face recognition bias emerged for faces with own-university labels comparing to those with other-university labels. Furthermore, we found a robust own-group face recognition bias only when the other university was located in a different city far away from participants’ own university. Interestingly, we failed to find the influence of university reputation on own-group face recognition bias. These results suggest that categorizing a face as a member of one’s own university is sufficient to enhance recognition accuracy and the location will play a more important role in the effect of social categorization on face recognition than reputation. The results provide insight into the role of motivational factors underlying the university membership in face perception.

[Clinical pharmacy practice education in master's course of Meijo University in affiliation with medical school].

Science.gov (United States)

Matsuba, Kazuhisa

2009-08-01

In 2003, Meijo University has developed a new program to train students in master's degree in the field of clinical practice. This new curriculum has three big pillars of educational goal: Problem-Based Learning (PBL), communication skill and clinical pharmacy practice training. Before exposing students to clinical training, they must learn first how to solve various patients' problems through PBL and enhance their communication skill. To provide a clinical environment, education and training, the Faculty of Pharmacy cooperated with the School of Medicine of Fujita Health University. Master's students together with other members of the healthcare team observe patient's disease state and most especially monitor pharmacotherapy. At first, students will be trained for a month at the pharmacy division and experience one week-nursing job. Next, they will be trained at the clinical divisions such as General Internal Medicine, Cardiology, Endocrinology, Gastroenterology, Respiratory Medicine, Hematology, Chemotherapy, Gastroenterological Surgery, Psychiatry, and Emergency Unit. Students rotate three-month training on four clinical divisions during one year. The head physicians of the medical department hold concurrent post as professors and share responsibility with the pharmacy faculty in training the students. To have its venue where students, faculty and physicians conduct their discussion on clinical cases, a pharmacy satellite seminar class room was set up at Fujita Health University hospital. Through this, pharmacy students and faculty had more opportunities to exchange knowledge on medicine and pharmacy. Master's students are expected to acquire professionalism, ethical knowledge and pharmaceutical care skills through the clinical pharmacy practice program.

Clinical significance of multi-leaf collimator calibration errors

International Nuclear Information System (INIS)

Norvill, Craig; Jenetsky, Guy

2016-01-01

This planning study investigates the clinical impact of multi-leaf collimator (MLC) calibration errors on three common treatment sites; head and neck (H&N), prostate and stereotactic body radiotherapy (SBRT) for lung. All plans used using either volumetric modulated adaptive therapy or dynamic MLC techniques. Five patient plans were retrospectively selected from each treatment site, and MLC errors intentionally introduced. MLC errors of 0.7, 0.4 and 0.2 mm were sufficient to cause major violations in the PTV planning criteria for the H&N, prostate and SBRT lung plans. Mean PTV dose followed a linear trend with MLC error, increasing at rates of 3.2–5.9 % per millimeter depending on treatment site. The results indicate that an MLC quality assurance program that provides sub-millimeter accuracy is an important component of intensity modulated radiotherapy delivery techniques.

HybridGO-Loc: mining hybrid features on gene ontology for predicting subcellular localization of multi-location proteins.

Science.gov (United States)

Wan, Shibiao; Mak, Man-Wai; Kung, Sun-Yuan

2014-01-01

Protein subcellular localization prediction, as an essential step to elucidate the functions in vivo of proteins and identify drugs targets, has been extensively studied in previous decades. Instead of only determining subcellular localization of single-label proteins, recent studies have focused on predicting both single- and multi-location proteins. Computational methods based on Gene Ontology (GO) have been demonstrated to be superior to methods based on other features. However, existing GO-based methods focus on the occurrences of GO terms and disregard their relationships. This paper proposes a multi-label subcellular-localization predictor, namely HybridGO-Loc, that leverages not only the GO term occurrences but also the inter-term relationships. This is achieved by hybridizing the GO frequencies of occurrences and the semantic similarity between GO terms. Given a protein, a set of GO terms are retrieved by searching against the gene ontology database, using the accession numbers of homologous proteins obtained via BLAST search as the keys. The frequency of GO occurrences and semantic similarity (SS) between GO terms are used to formulate frequency vectors and semantic similarity vectors, respectively, which are subsequently hybridized to construct fusion vectors. An adaptive-decision based multi-label support vector machine (SVM) classifier is proposed to classify the fusion vectors. Experimental results based on recent benchmark datasets and a new dataset containing novel proteins show that the proposed hybrid-feature predictor significantly outperforms predictors based on individual GO features as well as other state-of-the-art predictors. For readers' convenience, the HybridGO-Loc server, which is for predicting virus or plant proteins, is available online at http://bioinfo.eie.polyu.edu.hk/HybridGoServer/.

A new universal simplified adhesive: 6-month clinical evaluation.

Science.gov (United States)

Mena-Serrano, Alexandra; Kose, Carlos; De Paula, Eloisa Andrade; Tay, Lidia Yileng; Reis, Alessandra; Loguercio, Alessandro D; Perdigão, Jorge

2013-02-01

Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed. © 2012 Wiley Periodicals, Inc.

Retrieving clinically relevant diabetic retinopathy images using a multi-class multiple-instance framework

Science.gov (United States)

Chandakkar, Parag S.; Venkatesan, Ragav; Li, Baoxin

2013-02-01

Diabetic retinopathy (DR) is a vision-threatening complication from diabetes mellitus, a medical condition that is rising globally. Unfortunately, many patients are unaware of this complication because of absence of symptoms. Regular screening of DR is necessary to detect the condition for timely treatment. Content-based image retrieval, using archived and diagnosed fundus (retinal) camera DR images can improve screening efficiency of DR. This content-based image retrieval study focuses on two DR clinical findings, microaneurysm and neovascularization, which are clinical signs of non-proliferative and proliferative diabetic retinopathy. The authors propose a multi-class multiple-instance image retrieval framework which deploys a modified color correlogram and statistics of steerable Gaussian Filter responses, for retrieving clinically relevant images from a database of DR fundus image database.

Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

Science.gov (United States)

Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

2008-01-01

The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

Ubiquitous computing to support co-located clinical teams: using the semiotics of physical objects in system design.

Science.gov (United States)

Bang, Magnus; Timpka, Toomas

2007-06-01

Co-located teams often use material objects to communicate messages in collaboration. Modern desktop computing systems with abstract graphical user interface (GUIs) fail to support this material dimension of inter-personal communication. The aim of this study is to investigate how tangible user interfaces can be used in computer systems to better support collaborative routines among co-located clinical teams. The semiotics of physical objects used in team collaboration was analyzed from data collected during 1 month of observations at an emergency room. The resulting set of communication patterns was used as a framework when designing an experimental system. Following the principles of augmented reality, physical objects were mapped into a physical user interface with the goal of maintaining the symbolic value of those objects. NOSTOS is an experimental ubiquitous computing environment that takes advantage of interaction devices integrated into the traditional clinical environment, including digital pens, walk-up displays, and a digital desk. The design uses familiar workplace tools to function as user interfaces to the computer in order to exploit established cognitive and collaborative routines. Paper-based tangible user interfaces and digital desks are promising technologies for co-located clinical teams. A key issue that needs to be solved before employing such solutions in practice is associated with limited feedback from the passive paper interfaces.

IMPACT OF CLINICAL-TRIALS ON THE ADOPTION OF NEW DRUGS WITHIN A UNIVERSITY HOSPITAL

NARCIS (Netherlands)

DENIG, P; HAAIJER-RUSKAMP, FM; WESSELING, H

1991-01-01

To assess the influence that clinical trials may have on the introduction of new drugs into prescribing routines, the adoption of drugs has been studied in a university hospital in the Netherlands. A significant relation was found between the testing of semi-innovative drugs in clinical trials in

Universality Conjecture and Results for a Model of Several Coupled Positive-Definite Matrices

Science.gov (United States)

Bertola, Marco; Bothner, Thomas

2015-08-01

The paper contains two main parts: in the first part, we analyze the general case of matrices coupled in a chain subject to Cauchy interaction. Similarly to the Itzykson-Zuber interaction model, the eigenvalues of the Cauchy chain form a multi level determinantal point process. We first compute all correlations functions in terms of Cauchy biorthogonal polynomials and locate them as specific entries of a matrix valued solution of a Riemann-Hilbert problem. In the second part, we fix the external potentials as classical Laguerre weights. We then derive strong asymptotics for the Cauchy biorthogonal polynomials when the support of the equilibrium measures contains the origin. As a result, we obtain a new family of universality classes for multi-level random determinantal point fields, which include the Bessel universality for 1-level and the Meijer-G universality for 2-level. Our analysis uses the Deift-Zhou nonlinear steepest descent method and the explicit construction of a origin parametrix in terms of Meijer G-functions. The solution of the full Riemann-Hilbert problem is derived rigorously only for p = 3 but the general framework of the proof can be extended to the Cauchy chain of arbitrary length p.

Quantitative analytical hierarchy process to marketing store location selection

OpenAIRE

Harwati; Utami Intan

2018-01-01

The selection of Store to market the product is belong to Multi Criteria Decision Making problem. The criteria used have conflict of interest with each other to produce an optimal location. This research uses four important criteria to select new location of marketing store appropriate with the references: distance to location, competition level with competitor, number of potential customer, and location rent cost. Quantitative data is used to determine the optimum location with AHP method. Q...

THE INCIDENCE OF CAESAREAN SECTIONS IN THE UNIVERSITY CLINICAL CENTER OF KOSOVO

OpenAIRE

Elshani, Brikene; Daci, Armond; Gashi, Sanije; Lulaj, Shefqet

2012-01-01

Introduction: As in most countries of the world also at Kosovo the rate of Cesarean section from year to year is increasing. Aim: The main purpose of this paper was to present the incidence of births completed by Caesarean section at the Clinic of Gynecology and Obstetrics of University Clinical Center of Kosovo in Prishtin?. Material and methods: This study is retrospective, namely its made by collecting epidemiological data from patients? histories that completed birth by Caesarean section ...

Multi-location peak parking method: an important new tool for the study of mass transfer kinetics in liquid chromatography.

Science.gov (United States)

Gritti, Fabrice; Guiochon, Georges

2011-02-18

The peak parking (PP) method probes the longitudinal diffusion coefficient of a compound at a single location along the chromatographic column. We extended to a so-called multi-location peak parking (MLPP) method, in which a large number of axial locations along the column are selected in order to check the validity of the conventional PP method and to reveal possible defaults in the structure of the packed bed or pitfalls of the PP and the MLPP methods. MLPP was applied to a series of HILIC columns, including a 5.0 μm Venusil, a 3.0 μm Luna-diol, three 2.7 μm Halo, and a 1.7 μm Kinetex columns. The results demonstrate that the MLPP method may reveal local heterogeneities in the axial diffusion of small retained low molecular weight compounds along the column. Most importantly, experiments show that the sample zone should not be parked in the entrance of the column (i.e., at <1/10 th of the column length). The abrupt drop in the flow rate considerably affects the peak shape and prevents scientists from using the conventional PP method. Practical solutions to cope with that problem are proposed and their success/failure are discussed. Copyright © 2010 Elsevier B.V. All rights reserved.

Locating Supplemental Sources of Revenue to Finance Universities in Nigeria.

Science.gov (United States)

Ogunla, Akin L.

1989-01-01

Identifies possible sources of supplemental income to finance Nigerian universities, including households and commercial and industrial firms. A consumption tax imposed on certain goods and services would generate needed funds. Also, because firms employ university graduates to earn higher profits, their turnover income should be taxed to support…

Problems of university-based scientists associated with clinical trials.

Science.gov (United States)

Remington, R D

1979-05-01

University faculty members who participate in clinical trials face a number of difficulties in connection with this association. Publication opportunities are often limited, and individual scholarship is difficult to express and evaluate within the context of a cooperative trial. Merit increases, promotion, and the award of tenure will usually require evidence of scholarly achievement outside the trial setting. For this reason, it seems inadvisable to recommend that a young investigator devote a major portion of his scholarly and research time to such an activity. A possible exception may be a full-time appointment for 1 to 2 years. Nonetheless, cooperative clinical trials are an important investigative tool and they should continue to be associated with academic centers. If appropriate administrative arrangements can be made, it should be possible to solve the academic problems of the young investigator associated with such trials.

Sensor-Data Fusion for Multi-Person Indoor Location Estimation.

Science.gov (United States)

Mohebbi, Parisa; Stroulia, Eleni; Nikolaidis, Ioanis

2017-10-18

We consider the problem of estimating the location of people as they move and work in indoor environments. More specifically, we focus on the scenario where one of the persons of interest is unable or unwilling to carry a smartphone, or any other "wearable" device, which frequently arises in caregiver/cared-for situations. We consider the case of indoor spaces populated with anonymous binary sensors (Passive Infrared motion sensors) and eponymous wearable sensors (smartphones interacting with Estimote beacons), and we propose a solution to the resulting sensor-fusion problem. Using a data set with sensor readings collected from one-person and two-person sessions engaged in a variety of activities of daily living, we investigate the relative merits of relying solely on anonymous sensors, solely on eponymous sensors, or on their combination. We examine how the lack of synchronization across different sensing sources impacts the quality of location estimates, and discuss how it could be mitigated without resorting to device-level mechanisms. Finally, we examine the trade-off between the sensors' coverage of the monitored space and the quality of the location estimates.

SU-F-P-13: NRG Oncology Medical Physics Manpower Survey Quantifying Support Demands for Multi Institutional Clinical Trials

Energy Technology Data Exchange (ETDEWEB)

Monroe, J [St. Anthony’s Cancer Center, St. Louis, MO (United States); Case Western Reserve University (United States); Boparai, K [ACR, Reston, VA (United States); Xiao, Y [University of Pennsylvania, Philadelphia, PA (United States); Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States); Galvin, J [Thomas Jefferson University Hospital, Newtown, PA (United States); Sohn, J [Case Western University, Cleveland, OH (United States)

2016-06-15

Purpose: A survey was taken by NRG Oncology to assess Full Time Equivalent (FTE) contributions to multi institutional clinical trials by medical physicists.No current quantification of physicists’ efforts in FTE units associated with clinical trials is available. The complexity of multi-institutional trials increases with new technologies and techniques. Proper staffing may directly impact the quality of trial data and outcomes. The demands on physics time supporting clinical trials needs to be assessed. Methods: The NRG Oncology Medical Physicist Subcommittee created a sixteen question survey to obtain this FTE data. IROC Houston distributed the survey to their list of 1802 contact physicists. Results: After three weeks, 363 responded (20.1% response). 187 (51.5%) institutions reporting external beam participation were processed. There was a wide range in number of protocols active and supported at each institution. Of the 187 clinics, 134 (71.7%) participate in 0 to 10 trials, 28 (15%) in 11 to 20 trials, 10 (5.3%) in 21 to 30 trials, 9 (4.8%) had 40 to 75 trials. On average, physicist spent 2.7 hours (SD: 6.0) per week supervising or interacting with clinical trial staff. 1.25 hours (SD: 3.37), 1.83 hours (SD: 4.13), and 0.64 hours(SD: 1.13) per week were spent on patient simulation, reviewing treatment plans, and maintaining a DICOM server, respectively. For all protocol credentialing activities, physicist spent an average of 37.05 hours (SD: 96.94) yearly. To support dosimetrists, clinicians, and therapists, physicist spend on average 2.07 hours (SD: 3.52) per week just reading protocols. Physicist attended clinical trial meetings for on average 1.13 hours (SD: 1.85) per month. Conclusion: Responding physicists spend a nontrivial amount of time: 8.8 hours per week (0.22 FTE) supporting, on average, 9 active multi-institutional clinical trials.

Using geographical information systems (GIS to examine sanitary implications of rubbish dump locations at human activity centres

Directory of Open Access Journals (Sweden)

Lenos Koku Ankrah

2016-01-01

Full Text Available This study sought to investigate health risks that refuse dump locations have on people. The global positioning systems (GPS were used to take location coordinates of 28 rubbish dump centers and human activity centers (clinics, restaurants, markets etc spread across a university campus in Ghana. The ArcGIS software was used to plot the coordinates and draw a buffer of 50 meters around the rubbish dump locations (RDL to show the closeness between the dump sites and the human activity centers (HAC, and the sanitary implications of the closeness. More than 90% of the HACs fell within the 50 meters buffer zone of the rubbish dump sites. The findings indicated that some sensitive HACs like food joints, laundries etc. were less than 15 meters from rubbish dump sites. The findings confirmed that the location of rubbish dump sites pose serious threat to the health of the human community in the university. The findings of this study can be used to make evidence- based decisions about possible relocation of rubbish dump containers in the university. This study is also an initiative to set the tone for more detailed research work on the health implications of rubbish disposal management on Ghanaians.

HSIP Law Enforcement Locations in New Mexico

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — Law Enforcement Locations Any location where sworn officers of a law enforcement agency are regularly based or stationed. Law Enforcement agencies "are publicly...

The leak detection and location system design of petroleum pipeline

International Nuclear Information System (INIS)

Liu Lixia

2011-01-01

In order to improve the sensibility and location precision of petroleum pipeline leak with traditional negative pressure wave detection, a multi-point distributed detection and location monitoring system composed of detection nodes along pipeline, monitoring sub-stations and pressure monitoring center was designed using C/S structure. The detection node gets the pressure signal in pipeline, and sends it to monitoring center through CPRS network that achieves online monitoring for the whole pipeline in real time. The received data was analyzed and processed with multi-point distributed negative pressure wave detection and correlation analysis method. The system can rapidly detect the leak point in pipeline timely and locate accurately to avoid enormous economic loss and environment pollutions accidents. (author)

Abnormal Congenital Location of Stapes’ Superstructure: Clinical and Embryological Implications

Directory of Open Access Journals (Sweden)

Vânia Henriques

2016-01-01

Full Text Available Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes’ superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window. A stapes prosthesis was inserted and resulted in closure of the air-bone gap by 25 dB. A review of the literature was also performed using MEDLINE. Two theories diverge on the embryologic origin of the stapes. Our findings seem to be in favour of the theory that defines two different embryologic origins to the stapes.

Motor outcome and electrode location in deep brain stimulation in Parkinson's disease.

Science.gov (United States)

Koivu, Maija; Huotarinen, Antti; Scheperjans, Filip; Laakso, Aki; Kivisaari, Riku; Pekkonen, Eero

2018-05-30

To evaluate the efficacy and adverse effects of subthalamic deep brain stimulation (STN-DBS) in patients with advanced Parkinson's disease (PD) and the possible correlation between electrode location and clinical outcome. We retrospectively reviewed 87 PD-related STN-DBS operations at Helsinki University Hospital (HUH) from 2007 to 2014. The changes of Unified Parkinson's Disease Rating Scale (UPDRS) part III score, Hoehn & Yahr stage, antiparkinson medication, and adverse effects were studied. We estimated the active electrode location in three different coordinate systems: direct visual analysis of MRI correlated to brain atlas, location in relation to the nucleus borders and location in relation to the midcommisural point. At 6 months after operation, both levodopa equivalent doses (LEDs; 35%, Wilcoxon signed-rank test = 0.000) and UPDRS part III scores significantly decreased (38%, Wilcoxon signed-rank test = 0.000). Four patients (5%) suffered from moderate DBS-related dysarthria. The generator and electrodes had to be removed in one patient due to infection (1%). Electrode coordinates in the three coordinate systems correlated well with each other. On the left side, more ventral location of the active contact was associated with greater LED decrease. STN-DBS improves motor function and enables the reduction in antiparkinson medication with an acceptable adverse effect profile. More ventral location of the active contact may allow stronger LED reduction. Further research on the correlation between contact location, clinical outcome, and LED reduction is warranted. © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

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Putranti, A.; Asmarawati, T. P.; Rachman, B. E.; Hadi, U.; Nasronudin

2018-03-01

The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

Multi-disciplinary data organization and visualization models for clinical and pre-clinical studies: A case study in the application of proton beam radiosurgery for treating spinal cord injury related pain

Science.gov (United States)

Verma, Sneha K.; Liu, Brent J.

2016-03-01

An increasing adoption of electronic medical records has made information more accessible to clinicians and researchers through dedicated systems such as HIS, RIS and PACS. The speed and the amount at which information are generated in a multi-institutional clinical study make the problem complicated compared to day-to-day hospital workflow. Often, increased access to the information does not translate into the efficient use of that information. Therefore, it becomes crucial to establish models which can be used to organize and visualize multi-disciplinary data. Good visualization in turn makes it easy for clinical decision-makers to reach a conclusion within a small span of time. In a clinical study involving multi-disciplinary data and multiple user groups who need access to the same data and presentation states based on the stage of the clinical trial or the task are crucial within the workflow. Therefore, in order to demonstrate the conceptual system design and system workflow, we will be presenting a clinical trial based on application of proton beam for radiosurgery which will utilize our proposed system. For demonstrating user role and visualization design purposes, we will be focusing on three different user groups which are researchers involved in patient enrollment and recruitment, clinicians involved in treatment and imaging review and lastly the principle investigators involved in monitoring progress of clinical study. Also datasets for each phase of the clinical study including preclinical and clinical data as it related to subject enrollment, subject recruitment (classifier), treatment (DICOM), imaging, and pathological analysis (protein staining) of outcomes.

Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation seeking.

Science.gov (United States)

Sanbonmatsu, David M; Strayer, David L; Medeiros-Ward, Nathan; Watson, Jason M

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants' perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation--high levels of impulsivity and sensation seeking--reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control--low scorers on the Operation Span task and persons high in impulsivity--tended to report higher levels of multi-tasking activity.

Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation seeking.

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David M Sanbonmatsu

Full Text Available The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants' perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation--high levels of impulsivity and sensation seeking--reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control--low scorers on the Operation Span task and persons high in impulsivity--tended to report higher levels of multi-tasking activity.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

Science.gov (United States)

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants’ perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation – high levels of impulsivity and sensation seeking – reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control - low scorers on the Operation Span task and persons high in impulsivity - tended to report higher levels of multi-tasking activity. PMID:23372720

Hub location proplems under polyhedral demand uncertainty

OpenAIRE

Meraklı, Merve

2015-01-01

Cataloged from PDF version of thesis. Includes bibliographical references (leaves 69-74). Thesis (M.S.): Bilkent University, Department of Industrial Engineering, İhsan Doğramacı Bilkent University, 2015. Hubs are points of consolidation and transshipment in many-to-many distribution systems that bene t from economies of scale. In hub location problems, the aim is to locate hub facilities such that each pairwise demand is satis ed and the total cost is minimized. The problem...

Universal CNC platform motion control technology for industrial CT

International Nuclear Information System (INIS)

Cheng Senlin; Wang Yang

2011-01-01

According to the more scanning methods and the higher speed of industrial CT, the higher precision of the motion location and the data collection sync-control is required at present, a new motion control technology was proposed, which was established based on the universal CNC system with high precision of multi-axis control. Aiming at the second and the third generation of CT scanning motion, a control method was researched, and achieved the demands of the changeable parameters and network control, Through the simulation of the second and the third generation of CT scanning motion process, the control precision of the rotation axis reached 0.001° and the linear axis reached 0.002 mm, Practical tests showed this system can meet the requirements of the multi-axis motion integration and the sync signal control, it also have advantages in the control precision and the performance. (authors)

Sensor-Data Fusion for Multi-Person Indoor Location Estimation

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Parisa Mohebbi

2017-10-01

Full Text Available We consider the problem of estimating the location of people as they move and work in indoor environments. More specifically, we focus on the scenario where one of the persons of interest is unable or unwilling to carry a smartphone, or any other “wearable” device, which frequently arises in caregiver/cared-for situations. We consider the case of indoor spaces populated with anonymous binary sensors (Passive Infrared motion sensors and eponymous wearable sensors (smartphones interacting with Estimote beacons, and we propose a solution to the resulting sensor-fusion problem. Using a data set with sensor readings collected from one-person and two-person sessions engaged in a variety of activities of daily living, we investigate the relative merits of relying solely on anonymous sensors, solely on eponymous sensors, or on their combination. We examine how the lack of synchronization across different sensing sources impacts the quality of location estimates, and discuss how it could be mitigated without resorting to device-level mechanisms. Finally, we examine the trade-off between the sensors’ coverage of the monitored space and the quality of the location estimates.

Deep multi-scale location-aware 3D convolutional neural networks for automated detection of lacunes of presumed vascular origin

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Mohsen Ghafoorian

2017-01-01

In this paper, we propose an automated two-stage method using deep convolutional neural networks (CNN. We show that this method has good performance and can considerably benefit readers. We first use a fully convolutional neural network to detect initial candidates. In the second step, we employ a 3D CNN as a false positive reduction tool. As the location information is important to the analysis of candidate structures, we further equip the network with contextual information using multi-scale analysis and integration of explicit location features. We trained, validated and tested our networks on a large dataset of 1075 cases obtained from two different studies. Subsequently, we conducted an observer study with four trained observers and compared our method with them using a free-response operating characteristic analysis. Shown on a test set of 111 cases, the resulting CAD system exhibits performance similar to the trained human observers and achieves a sensitivity of 0.974 with 0.13 false positives per slice. A feasibility study also showed that a trained human observer would considerably benefit once aided by the CAD system.

An Evaluation Model of Quantitative and Qualitative Fuzzy Multi-Criteria Decision-Making Approach for Location Selection of Transshipment Ports

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Ji-Feng Ding

2013-01-01

Full Text Available The role of container logistics centre as home bases for merchandise transportation has become increasingly important. The container carriers need to select a suitable centre location of transshipment port to meet the requirements of container shipping logistics. In the light of this, the main purpose of this paper is to develop a fuzzy multi-criteria decision-making (MCDM model to evaluate the best selection of transshipment ports for container carriers. At first, some concepts and methods used to develop the proposed model are briefly introduced. The performance values of quantitative and qualitative subcriteria are discussed to evaluate the fuzzy ratings. Then, the ideal and anti-ideal concepts and the modified distance measure method are used in the proposed model. Finally, a step-by-step example is illustrated to study the computational process of the quantitative and qualitative fuzzy MCDM model. The proposed approach has successfully accomplished our goal. In addition, the proposed fuzzy MCDM model can be empirically employed to select the best location of transshipment port for container carriers in the future study.

Development of a method for estimating oesophageal temperature by multi-locational temperature measurement inside the external auditory canal

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Nakada, Hirofumi; Horie, Seichi; Kawanami, Shoko; Inoue, Jinro; Iijima, Yoshinori; Sato, Kiyoharu; Abe, Takeshi

2017-09-01

We aimed to develop a practical method to estimate oesophageal temperature by measuring multi-locational auditory canal temperatures. This method can be applied to prevent heatstroke by simultaneously and continuously monitoring the core temperatures of people working under hot environments. We asked 11 healthy male volunteers to exercise, generating 80 W for 45 min in a climatic chamber set at 24, 32 and 40 °C, at 50% relative humidity. We also exposed the participants to radiation at 32 °C. We continuously measured temperatures at the oesophagus, rectum and three different locations along the external auditory canal. We developed equations for estimating oesophageal temperatures from auditory canal temperatures and compared their fitness and errors. The rectal temperature increased or decreased faster than oesophageal temperature at the start or end of exercise in all conditions. Estimated temperature showed good similarity with oesophageal temperature, and the square of the correlation coefficient of the best fitting model reached 0.904. We observed intermediate values between rectal and oesophageal temperatures during the rest phase. Even under the condition with radiation, estimated oesophageal temperature demonstrated concordant movement with oesophageal temperature at around 0.1 °C overestimation. Our method measured temperatures at three different locations along the external auditory canal. We confirmed that the approach can credibly estimate the oesophageal temperature from 24 to 40 °C for people performing exercise in the same place in a windless environment.

Multi-Robot, Multi-Target Particle Swarm Optimization Search in Noisy Wireless Environments

Energy Technology Data Exchange (ETDEWEB)

Kurt Derr; Milos Manic

2009-05-01

Multiple small robots (swarms) can work together using Particle Swarm Optimization (PSO) to perform tasks that are difficult or impossible for a single robot to accomplish. The problem considered in this paper is exploration of an unknown environment with the goal of finding a target(s) at an unknown location(s) using multiple small mobile robots. This work demonstrates the use of a distributed PSO algorithm with a novel adaptive RSS weighting factor to guide robots for locating target(s) in high risk environments. The approach was developed and analyzed on multiple robot single and multiple target search. The approach was further enhanced by the multi-robot-multi-target search in noisy environments. The experimental results demonstrated how the availability of radio frequency signal can significantly affect robot search time to reach a target.

Enhancing clinical skills education: University of Virginia School of Medicine's Clerkship Clinical Skills Workshop Program.

Science.gov (United States)

Corbett, Eugene C; Payne, Nancy J; Bradley, Elizabeth B; Maughan, Karen L; Heald, Evan B; Wang, Xin Qun

2007-07-01

In 1993, the University of Virginia School of Medicine began a clinical skills workshop program in an effort to improve the preparation of all clerkship students to participate in clinical care. This program involved the teaching of selected basic clinical skills by interested faculty to small groups of third-year medical students. Over the past 14 years, the number of workshops has increased from 11 to 31, and they now involve clerkship faculty from family medicine, internal medicine, and pediatrics. Workshops include a variety of common skills from the communication, physical examination, and clinical test and procedure domains such as pediatric phone triage, shoulder examination, ECG interpretation, and suturing. Workshop sessions allow students to practice skills on each other, with standardized patients, or with models, with the goal of improving competence and confidence in the performance of basic clinical skills. Students receive direct feedback from faculty on their skill performance. The style and content of these workshops are guided by an explicit set of educational criteria.A formal evaluation process ensures that faculty receive regular feedback from student evaluation comments so that adherence to workshop criteria is continuously reinforced. Student evaluations confirm that these workshops meet their skill-learning needs. Preliminary outcome measures suggest that workshop teaching can be linked to student assessment data and may improve students' skill performance. This program represents a work-in-progress toward the goal of providing a more comprehensive and developmental clinical skills curriculum in the school of medicine.

Moral imperialism and multi-centric clinical trials in peripheral countries.

Science.gov (United States)

Garrafa, Volnei; Lorenzo, Claudio

2008-10-01

Moral imperialism is expressed in attempts to impose moral standards from one particular culture, geopolitical region or culture onto other cultures, regions or countries. Examples of Direct Moral Imperialism can be seen in various recurrent events involving multi-centric clinical trials promoted by developed (central) countries in poor and developing (peripheral) countries, particularly projects related to the theory of double standards in research. After the WMA General Assembly refused to change the Helsinki Declaration - which would have given moral recognition to the above mentioned theory - the USA abandoned the declaration and began to promote regional seminars in peripheral countries with the aim of "training" researchers on ethical perspectives that reflect America's best interests. Individuals who received such training became transmitters of these central countries' ideas across the peripheral countries, representing a form of Indirect Moral Imperialism. The paper proposes the establishment of regulatory and social control systems for clinical trials implemented in peripheral countries, through the formulation of ethical norms that reflect the specific contexts of these countries, along with the drawing up and validation of their own national norms.

Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

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Emine Qehaja Buçaj

2015-12-01

Full Text Available Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, clinical presentations, serological test, serum biochemistry and reatment were collected from hospital medical records. The diagnosis of brucellosis based on clinical and laboratory findings. Results: This descriptive study included 47 patients, who 33 of them (70.2% were males. The mean age was 37.9 ± 19.3 years. The route of transmission of the disease was known in 28 59.5% of them. Direct contact with livestock in 22 (46.8% and ingestion of dairy products in six cases (12.7% were reported as the transmission route. The majority of patients (27 patients, 57.4% were from rural area. The main presenting symptoms were atigue, fever and arthralgia. Osteoarticular manifestations were the common forms of localized disease. Regarding to the therapy, 45 (95.7% of patients were treated with streptomycin and doxycycline for the first three weeks. Conclusion: Human brucellosis is not a common in Kosovo but there is a potential risk. Osteoarticular symptoms were the most common presentation reasons. The most effective and preferred treatment regimen was Streptomycin plus Doxycycline for the first three weeks, and Doxycycline plus Rifampicin thereafter. J Microbiol Infect Dis 2015;5(4: 147-150

Transition from Clinical Manager to University Lecturer: A Self-Reflective Case Study

Science.gov (United States)

Oldland, Elizabeth

2011-01-01

This paper is a case study exploring the author's use of reflective practice to facilitate the transition in role from a clinical manager with teaching responsibilities in a critical care unit to university lecturer. The similarities and differences in the roles with respect to learner characteristics, teaching contexts and effective teaching…

Real-Time Multi-Target Localization from Unmanned Aerial Vehicles

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Xuan Wang

2016-12-01

Full Text Available In order to improve the reconnaissance efficiency of unmanned aerial vehicle (UAV electro-optical stabilized imaging systems, a real-time multi-target localization scheme based on an UAV electro-optical stabilized imaging system is proposed. First, a target location model is studied. Then, the geodetic coordinates of multi-targets are calculated using the homogeneous coordinate transformation. On the basis of this, two methods which can improve the accuracy of the multi-target localization are proposed: (1 the real-time zoom lens distortion correction method; (2 a recursive least squares (RLS filtering method based on UAV dead reckoning. The multi-target localization error model is established using Monte Carlo theory. In an actual flight, the UAV flight altitude is 1140 m. The multi-target localization results are within the range of allowable error. After we use a lens distortion correction method in a single image, the circular error probability (CEP of the multi-target localization is reduced by 7%, and 50 targets can be located at the same time. The RLS algorithm can adaptively estimate the location data based on multiple images. Compared with multi-target localization based on a single image, CEP of the multi-target localization using RLS is reduced by 25%. The proposed method can be implemented on a small circuit board to operate in real time. This research is expected to significantly benefit small UAVs which need multi-target geo-location functions.

University Clinic of Toxicology--historical note and present work.

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Bozinovska, C

2013-01-01

The University Clinic of Toxicology (UCT) in Skopje was founded as the Clinic for Toxicology and Emergency Internal Medicine on January 15th 1976. Today UCT has a modern building with office space of 1,300 m2 on 4 floors, 40 hospital beds and 72 employees including 18 doctors. UCT works in accordance with the public healthcare services in the Republic of Macedonia through the use of specialist/consultative and hospital healthcare for people over the age of 14 years. The Clinic also provides services in the field of emergency internal medicine, acute poisoning with medications, pesticides, corrosives, poisonous gases and mushrooms, heavy metals and other chemicals. The Clinic takes an active part in the detoxification programme for users of opiates and psychotropic substances, protocols for enteral and parenteral nutrition and guides for home treatment. Yearly there are more than 14,000 ambulance admissions, over 1,400 hospitalized patients, over 4,000 urgent EHO checks, more than 1,000 urgent upper endoscopies and over 700 other toxicological analyses and other interventions. The educational services and activities are realized through the chair for internal medicine. The Clinic offers undergraduate and graduate level education for medical students and dentists, for medical nurses, radiology technicians, speech therapists and physiotherapists. Over 300 papers and reports have been published to date by the medical staff at the UCT in the form of abstracts and integrated projects in the Republic of Macedonia and aboard. 8 doctorates have been successfully completed by employees from the Clinic as well as 4 master's theses and 1 in-depth project. UCT employees are the authors of some textbooks and monographs. UCT have undertaken some scientific projects. Employees from the Clinic of Toxicology are members taking an active part in many domestic and international associations.

A multi-objective location routing problem using imperialist competitive algorithm

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Amir Mohammad Golmohammadi

2016-06-01

Full Text Available Nowadays, most manufacturing units try to locate their requirements and the depot vehicle routing in order to transport the goods at optimum cost. Needless to mention that the locations of the required warehouses influence on the performance of vehicle routing. In this paper, a mathematical programming model to optimize the storage location and vehicle routing are presented. The first objective function of the model minimizes the total cost associated with the transportation and storage, and the second objective function minimizes the difference distance traveled by vehicles. The study uses Imperialist Competitive Algorithm (ICA to solve the resulted problems in different sizes. The preliminary results have indicated that the proposed study has performed better than NSGA-II and PAES methods in terms of Quality metric and Spacing metric.

Quantitative analytical hierarchy process to marketing store location selection

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Harwati

2018-01-01

Full Text Available The selection of Store to market the product is belong to Multi Criteria Decision Making problem. The criteria used have conflict of interest with each other to produce an optimal location. This research uses four important criteria to select new location of marketing store appropriate with the references: distance to location, competition level with competitor, number of potential customer, and location rent cost. Quantitative data is used to determine the optimum location with AHP method. Quantitative data are preferred to avoid inconsistency when using expert opinion. The AHP result optimum location among three alternatives places.

Impact of co-located general practitioner (GP) clinics and patient choice on duration of wait in the emergency department.

Science.gov (United States)

Sharma, Anurag; Inder, Brett

2011-08-01

To empirically model the determinants of duration of wait of emergency (triage category 2) patients in an emergency department (ED) focusing on two questions: (i) What is the effect of enhancing the degree of choice for non-urgent (triage category 5) patients on duration of wait for emergency (category 2) patients in EDs; and (ii) What is the effect of co-located GP clinics on duration of wait for emergency patients in EDs? The answers to these questions will help in understanding the effectiveness of demand management strategies, which are identified as one of the solutions to ED crowding. The duration of wait for each patient (difference between arrival time and time first seen by treating doctor) was modelled as a function of input factors (degree of choice, patient characteristics, weekend admission, metro/regional hospital, concentration of emergency (category 2) patients in hospital service area), throughput factors (availability of doctors and nurses) and output factor (hospital bed capacity). The unit of analysis was a patient episode and the model was estimated using a survival regression technique. The degree of choice for non-urgent (category 5) patients has a non-linear effect: more choice for non-urgent patients is associated with longer waits for emergency patients at lower values and shorter waits at higher values of degree of choice. Thus more choice of EDs for non-urgent patients is related to a longer wait for emergency (category 2) patients in EDs. The waiting time for emergency patients in hospital campuses with co-located GP clinics was 19% lower (1.5 min less) on average than for those waiting in campuses without co-located GP clinics. These findings suggest that diverting non-urgent (category 5) patients to an alternative model of care (co-located GP clinics) is a more effective demand management strategy and will reduce ED crowding.

Abdominal multi-organ CT segmentation using organ correlation graph and prediction-based shape and location priors.

Science.gov (United States)

Okada, Toshiyuki; Linguraru, Marius George; Hori, Masatoshi; Summers, Ronald M; Tomiyama, Noriyuki; Sato, Yoshinobu

2013-01-01

The paper addresses the automated segmentation of multiple organs in upper abdominal CT data. We propose a framework of multi-organ segmentation which is adaptable to any imaging conditions without using intensity information in manually traced training data. The features of the framework are as follows: (1) the organ correlation graph (OCG) is introduced, which encodes the spatial correlations among organs inherent in human anatomy; (2) the patient-specific organ shape and location priors obtained using OCG enable the estimation of intensity priors from only target data and optionally a number of untraced CT data of the same imaging condition as the target data. The proposed methods were evaluated through segmentation of eight abdominal organs (liver, spleen, left and right kidney, pancreas, gallbladder, aorta, and inferior vena cava) from 86 CT data obtained by four imaging conditions at two hospitals. The performance was comparable to the state-of-the-art method using intensity priors constructed from manually traced data.

Development of a cancer clinical trials multi-media intervention: clinical trials: are they right for you?

Science.gov (United States)

Wells, Kristen J; Quinn, Gwendolyn P; Meade, Cathy D; Fletcher, Michelle; Tyson, Dinorah Martinez; Jim, Heather; Jacobsen, Paul B

2012-08-01

To describe processes used to develop a multi-media psycho-educational intervention to prepare patients for a discussion about cancer clinical trials (CTs). Guided by a Steering Committee, formative research was conducted to develop an informative and engaging tool about cancer CTs. Twenty-three patients and caregivers participated in formative in-depth interviews to elicit information about perceptions of cancer CTs to inform production of a new media product. Formative research revealed participants had concerns about experimentation, held beliefs that cancer CTs were for patients who had no other treatment options, and wanted a balance of information about pros and cons of CT participation. The value of physicians as credible spokespersons and the use of patients as role-models were supported. Using iterative processes, the production team infused the results into creation of a multimedia psycho-educational intervention titled Clinical Trials: Are they Right for You? An intervention, developed through an iterative consumer-focused process involving multiple stakeholders and formative research, may result in an engaging informative product. If found to be efficacious, Clinical Trials: Are they Right for You? is a low-cost and easily disseminated multimedia psycho-educational intervention to assist cancer patients with making an informed decision about cancer CTs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Methodological Proposal for Optimal Location of Emergency Operation Centers through Multi-Criteria Approach

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Umberto Di Matteo

2016-01-01

Full Text Available Territorial vulnerability and risk analysis play a fundamental role in urban planning and emergency management. Requirements analysis of such aspects are possible to define more and more effective risk mitigation strategies providing efficient response plans to events. Many mitigation strategies as well as many response plans have in common the purpose of minimizing response time in order to decrease the level of vulnerability of the concerning area. The response time to a perturbing event is in fact an essential parameter to define the hazard of the considered site and literature is unanimous in considering it. In this context, the article proposes a methodology for the optimization of the location on the territory of emergency operation centers (EOCs, reducing response times and mitigating in this way the vulnerability of the area. The proposed methodology is based on a multi-criteria decision making (MCDM hybrid type AHP (Analytic Hierarchy Process-Electre. This method has been applied in the territory of Bressanone and Vipiteno (Bolzano-Italy, simulating the need to build a new barrack of Fire Department. A campaign of interviews with operators and industry experts and the collection of spatial data from the portals of the concerned authorities has been carried out in order to get the number of necessary data for the implementation of the proposed methodology.

Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

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Shah M

2013-09-01

Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

Multi-Wave Mixing Processes

CERN Document Server

Zhang, Yanpeng

2009-01-01

"Multi-Wave Mixing Processes - From Ultrafast Polarization Beats to Electromagnetically Induced Transparency" discusses the interactions of efficient multi-wave mixing (MWM) processes enhanced by atomic coherence in multilevel atomic systems. It covers topics in five major areas: attosecond and femtosecond polarization beats of four-wave mixing (FWM) processes; heterodyne detection of FWM, six-wave mixing (SWM) and eight-wave mixing (EWM) processes; Raman and Rayleigh enhanced polarization beats; coexistence and interactions of MWM processes via electromagnetically induced transparency(EIT); multi-dressing MWM processes. The book is intended for researchers, advanced undergraduate and graduate students in Nonlinear Optics. Dr. Yanpeng Zhang is a professor at the Key Laboratory for Physical Electronics and Devices of the Ministry of Education, Xi'an Jiaotong University. Dr. Min Xiao is a professor of Physics at University of Arkansas, Fayetteville, U.S.A.

Travelling educational workshops for clinical teachers: are they worthwhile?

Science.gov (United States)

Gallagher, Peter; Pullon, Sue

2011-03-01

The support of doctors who teach medical students in clinical settings is considered very important. In order to function as effectively as possible in their role as clinical teachers, these clinicians require educational support from faculty members. The most usual form that support takes is university staff offering face-to-face teaching on educational topics. It is estimated that in the course of 1 year, and across the Faculty of Medicine at the University of Otago, there could be up to 600 clinicians actively involved in the direct support of medical students. Many of these clinicians work in locations some considerable distance from the university campus. In 2009 the Medical Education Unit based at the Wellington Campus introduced a series of peripatetic face-to-face workshops for clinical teachers in several different geographical locations. Educational support of this nature is challenging to organise and potentially expensive, which begs the question: are travelling workshops worthwhile? Whereas the subject matter of the workshops was of interest to those who attended, of equal importance was the opportunity the workshops created to interact with colleagues in a relaxed atmosphere. In addition, the workshops were the catalyst for some clinicians to formally pursue their particular educational interests. © Blackwell Publishing Ltd 2011.

[Clinical electro-ophthalmology at the Max Planck Institute of the Frankfurt University Ophthalmology Clinic 1970-1991].

Science.gov (United States)

Lorenz, R; Baier, M; Eckl, G; Raile, A

1996-07-01

The survey shows the frequency and distribution of diseases evaluated by electroophthalmological methods. Patients with retinal diseases (51.2%) and those with diseases of the optic nerve (21.8%) were examined most frequently. In a high percentage these investigations lead to a clinically useful assessment: described as confirmation or exclusion of a clinical diagnosis, as establishing a possible differential diagnosis or clearing up formerly unknown aspects of a disease. In cases of hereditary retinal disorders only 11% remained unclear, with presumed optic neuritis only 6%. The importance of electroophthalmological investigations is there ability to assess functional deficits in the visual system especially in somehow more rare retinal and centrally located disorders, functional deficits of unknown origins or in general diseases including the visual system.

The Anxiety Disorder Clinic for Children and Adolescents (TADCCA) at Aarhus University in Denmark

DEFF Research Database (Denmark)

Thastum, Mikael

2013-01-01

for children with anxiety problems. The second case study is one of the total group of six families in which Erik was participating; as such it includes a summary of Erik's case in the context of the other five who participated. The group was conducted by a combination of a senior doctoral clinical...... psychologist and eight students. They were part of a training clinic, called The Anxiety Disorder Clinic for Children and Adolescents (TADCCA), in the Educational and Research Clinic of the Department of Psychology at Aarhus University in Aarhus, Denmark. This article describes the background and context...

Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme: An Evaluation.

Science.gov (United States)

Miani, Celine; Marjanovic, Sonja; Jones, Molly Morgan; Marshall, Martin; Meikle, Samantha; Nolte, Ellen

2013-01-01

Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust. We assessed impacts of the Programme on individual and organisational change, alongside core enablers and barriers for Programme success. Analyses drew on the principles of a theory-of-change-led realist evaluation, using logic modelling to specify the underlying causal mechanisms of the Programme. Data collection involved a stakeholder workshop, online questionnaires of programme participants, senior managers and support staff (n=114), and follow-up in-depth semi-structured interviews with a subsample of survey participants (n=15). We observed that the Programme had notable impacts at individual and organisational levels. Examples of individual impact included enhanced communication and negotiation skills or increased confidence as a result of multi-modal leadership training. At the organisational level, participants reported indications of behaviour change among staff, with evidence of spill-over effects to non-participants towards a greater focus on patient-centred care. Our findings suggest that there is potential for combined leadership training and quality improvement programmes to contribute to strengthening a culture of care quality in healthcare organisations. Our study provides useful insights into strategies seeking to achieve sustainable improvement in NHS organisations.

Variability in Multi-Tenant Enterprise Software

OpenAIRE

Kabbedijk, J.

2014-01-01

Enterprise software applications have changed significantly over the last decades. Increasingly, software is deployed in a central location to be accessed through the internet, instead of installing software at end-users. Having software in a central location enables multi-tenancy, where multiple customers transparently share a system’s resources. Currently, multi-tenancy is a popular way to offer functionality of a software product through the internet to numerous customers, offering many ad...

Factors influencing time-location patterns and their impact on estimates of exposure: the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air).

Science.gov (United States)

Spalt, Elizabeth W; Curl, Cynthia L; Allen, Ryan W; Cohen, Martin; Williams, Kayleen; Hirsch, Jana A; Adar, Sara D; Kaufman, Joel D

2016-06-01

We assessed time-location patterns and the role of individual- and residential-level characteristics on these patterns within the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) cohort and also investigated the impact of individual-level time-location patterns on individual-level estimates of exposure to outdoor air pollution. Reported time-location patterns varied significantly by demographic factors such as age, gender, race/ethnicity, income, education, and employment status. On average, Chinese participants reported spending significantly more time indoors and less time outdoors and in transit than White, Black, or Hispanic participants. Using a tiered linear regression approach, we predicted time indoors at home and total time indoors. Our model, developed using forward-selection procedures, explained 43% of the variability in time spent indoors at home, and incorporated demographic, health, lifestyle, and built environment factors. Time-weighted air pollution predictions calculated using recommended time indoors from USEPA overestimated exposures as compared with predictions made with MESA Air participant-specific information. These data fill an important gap in the literature by describing the impact of individual and residential characteristics on time-location patterns and by demonstrating the impact of population-specific data on exposure estimates.

Multi-faceted implementation strategy to increase use of a clinical guideline for the diagnosis of deep venous thrombosis in primary care.

Science.gov (United States)

Kingma, Anna E C; van Stel, Henk F; Oudega, Ruud; Moons, Karel G M; Geersing, Geert-Jan

2017-08-01

A clinical decision rule (CDR), combined with a negative D-dimer test, can safely rule out deep venous thrombosis (DVT) in primary care. This strategy is recommended by guidelines, yet uptake by GPs is low. To evaluate a multi-faceted implementation strategy aimed at increased use of the guideline recommended CDR plus D-dimer test in primary care patients with suspected DVT. This multi-faceted implementation strategy consisted of educational outreach visits, financial reimbursements and periodical newsletters. 217 Dutch GPs (implementation group) received this strategy and included patients. Effectiveness was measured through the following patient-level outcomes: (i) proportion of non-referred patients, (ii) proportion of missed DVT cases within this group and (iii) the proportion of patients in whom the guideline was applied incorrectly. Implementation outcomes ('acceptability', 'feasibility', 'fidelity' and 'sustainability') were assessed with an online questionnaire. Patient-level outcomes were compared with those of patients included by 450 GPs, uninformed about the study's purposes providing information about usual care. 336 (54%) of 619 analyzable implementation group patients were not referred, missing 6 [1.8% (95% confidence interval 0.7% to 3.9%)] DVT cases. Incorrect guideline use was observed in 199 patients (32%). Self-reported acceptability, feasibility and expected sustainability were high. Guideline use increased from 42% to an expected continuation of use of 91%. Only 32 usual care GPs included 62 patients, making formal comparison unreliable. This multi-faceted implementation strategy safely reduced patient referral to secondary care, despite frequently incorrect application of the guideline and resulted in high acceptability, feasibility and expected sustainability. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Developing a "clinical presentation" curriculum at the University of Calgary.

Science.gov (United States)

Mandin, H; Harasym, P; Eagle, C; Watanabe, M

1995-03-01

Currently, medical curricula are structured according to disciplines, body systems, or clinical problems. Beginning in 1988, the faculty of the University of Calgary Faculty of Medicine (U of C) carefully evaluated the advantages and disadvantages of each of these models in seeking to revise their school's curriculum. However, all three models fell short of a curricular structure based on current knowledge and principles of adult learning, clinical problem solving, community demands, and curriculum management. By 1991, the U of C had formulated a strategic plan for a revised curriculum structure based on the way patients present to physicians, and implementation of this plan has begun. In creating the new curriculum, 120 clinical presentations (e.g., "loss of consciousness/syncope") were defined and each was assigned to an individual or small group of faculty for development based on faculty expertise and interest. Terminal objectives (i.e., "what to do") were defined for each presentation to describe the appropriate clinical behaviors of a graduating physician. Experts developed schemes that outlined how they differentiated one cause (i.e., disease category) from another. The underlying enabling objectives (i.e., knowledge, skills, and attitudes) for reaching the terminal objectives for each clinical presentation were assigned as departmental responsibilities. A new administrative structure evolved in which there is a partnership between a centralized multidisciplinary curriculum committee and the departments. This new competency-based, clinical presentation curriculum is expected to significantly enhance students' development of clinical problem-solving skills and affirms the premise that prudent, continuous updating is essential for improving the quality of medical education.

Locating relevant patient information in electronic health record data using representations of clinical concepts and database structures.

Science.gov (United States)

Pan, Xuequn; Cimino, James J

2014-01-01

Clinicians and clinical researchers often seek information in electronic health records (EHRs) that are relevant to some concept of interest, such as a disease or finding. The heterogeneous nature of EHRs can complicate retrieval, risking incomplete results. We frame this problem as the presence of two gaps: 1) a gap between clinical concepts and their representations in EHR data and 2) a gap between data representations and their locations within EHR data structures. We bridge these gaps with a knowledge structure that comprises relationships among clinical concepts (including concepts of interest and concepts that may be instantiated in EHR data) and relationships between clinical concepts and the database structures. We make use of available knowledge resources to develop a reproducible, scalable process for creating a knowledge base that can support automated query expansion from a clinical concept to all relevant EHR data.

Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals

NARCIS (Netherlands)

Edward, G. M.; Biervliet, J. D.; Hollmann, M. W.; Schlack, W. S.; Preckel, B.

2008-01-01

The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables:

Assisted Living Facilities, Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation layer., Published in 2006, 1:1200 (1in=100ft) scale, Noble County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Assisted Living Facilities dataset current as of 2006. Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation...

Multi-office engineering

International Nuclear Information System (INIS)

Cowle, E.S.; Hall, L.D.; Koss, P.; Saheb, E.; Setrakian, V.

1995-01-01

This paper addresses the viability of multi-office project engineering as has been made possible in a large part by the computer age. Brief discussions are provided on two past projects describing the authors' initial efforts at multi-office engineering, and an in-depth discussion is provided on a current Bechtel project that demonstrates their multi-office engineering capabilities. Efficiencies and cost savings associated with executing an engineering project from multiple office locations was identified as a viable and cost-effective execution approach. The paper also discusses how the need for multi-office engineering came about, what is required to succeed, and where they are going from here. Furthermore, it summarizes the benefits to their clients and to Bechtel

Age-related location of manifest accessory pathway and clinical consequences.

Science.gov (United States)

Brembilla-Perrot, Béatrice; Huttin, Olivier; Olivier, Arnaud; Sellal, Jean Marc; Villemin, Thibaut; Manenti, Vladimir; Moulin-Zinsch, Anne; Marçon, François; Simon, Gauthier; Andronache, Marius; Beurrier, Daniel; de Chillou, Christian; Girerd, Nicolas

2015-01-01

Accessory pathway (AP) ablation is not always easy. Our purpose was to assess the age-related prevalence of AP location, electrophysiological and prognostic data according to this location. Electrophysiologic study (EPS) was performed in 994 patients for a pre-excitation syndrome. AP location was determined on a 12 lead ECG during atrial pacing at maximal preexcitation and confirmed at intracardiac EPS in 494 patients. AP location was classified as anteroseptal (AS)(96), right lateral (RL)(54), posteroseptal (PS)(459), left lateral (LL)(363), nodoventricular (NV)(22). Patients with ASAP or RLAP were younger than patients with another AP location. Poorly-tolerated arrhythmias were more frequent in patients with LLAP than in other patients (0.009 for ASAP, 0.0037 for RLAP, location was confirmed at intracardiac EPS. Among untreated patients, poorly-tolerated arrhythmia occurred in patients with LLAP (3) or PSAP (6). Failures of ablation were more frequent for AS or RL AP than for LL or PS AP. AS and RLAP location in pre-excitation syndrome was more frequent in young patients. Maximal rate conducted over AP was lower than in other locations. Absence of poorly-tolerated arrhythmias during follow-up and higher risk of ablation failure should be taken into account for indications of AP ablation in children with few symptoms.

An approach to evaluating alternatives for wind power plant locations

Directory of Open Access Journals (Sweden)

Rehman, Ateekh Ur

2016-12-01

Full Text Available Multi-criteria decision approaches are preferred for achieving multi-dimensional sustainable renewable energy goals. A more critical issue faced by the wind power industry is the selection of a location to tap prospective energy, which needs to be evaluated on multiple measures. In this paper, the aim is to assess and rank alternative wind power plant locations in Saudi Arabia. The approach presented here takes multiple criteria into consideration, such as wind speed, wind availability, site advantages, terrain details, risk and uncertainty, technology used, third party support, projected demand, types of customers, and government policies. A comparative analysis of feasible alternatives that satisfy all multi- criteria objectives is carried out. The results obtained are subjected to sensitivity analysis. Concepts such as ‘threshold values’ and ‘attribute weights’ make the approach more sensitive.

When the library is located in prime real estate: a case study on the loss of space from the Duke University Medical Center Library and Archives.

Science.gov (United States)

Thibodeau, Patricia L

2010-01-01

The Duke University Medical Center Library and Archives is located in the heart of the Duke Medicine campus, surrounded by Duke Hospital, ambulatory clinics, and numerous research facilities. Its location is considered prime real estate, given its adjacency to patient care, research, and educational activities. In 2005, the Duke University Library Space Planning Committee had recommended creating a learning center in the library that would support a variety of educational activities. However, the health system needed to convert the library's top floor into office space to make way for expansion of the hospital and cancer center. The library had only five months to plan the storage and consolidation of its journal and book collections, while working with the facilities design office and architect on the replacement of key user spaces on the top floor. Library staff worked together to develop plans for storing, weeding, and consolidating the collections and provided input into renovation plans for users spaces on its mezzanine level. The library lost 15,238 square feet (29%) of its net assignable square footage and a total of 16,897 (30%) gross square feet. This included 50% of the total space allotted to collections and over 15% of user spaces. The top-floor space now houses offices for Duke Medicine oncology faculty and staff. By storing a large portion of its collection off-site, the library was able to remove more stacks on the remaining stack level and convert them to user spaces, a long-term goal for the library. Additional space on the mezzanine level had to be converted to replace lost study and conference room spaces. While this project did not match the recommended space plans for the library, it underscored the need for the library to think creatively about the future of its facility and to work toward a more cohesive master plan.

Universal approximators for multi-objective direct policy search in water reservoir management problems: a comparative analysis

Science.gov (United States)

Giuliani, Matteo; Mason, Emanuele; Castelletti, Andrea; Pianosi, Francesca

2014-05-01

The optimal operation of water resources systems is a wide and challenging problem due to non-linearities in the model and the objectives, high dimensional state-control space, and strong uncertainties in the hydroclimatic regimes. The application of classical optimization techniques (e.g., SDP, Q-learning, gradient descent-based algorithms) is strongly limited by the dimensionality of the system and by the presence of multiple, conflicting objectives. This study presents a novel approach which combines Direct Policy Search (DPS) and Multi-Objective Evolutionary Algorithms (MOEAs) to solve high-dimensional state and control space problems involving multiple objectives. DPS, also known as parameterization-simulation-optimization in the water resources literature, is a simulation-based approach where the reservoir operating policy is first parameterized within a given family of functions and, then, the parameters optimized with respect to the objectives of the management problem. The selection of a suitable class of functions to which the operating policy belong to is a key step, as it might restrict the search for the optimal policy to a subspace of the decision space that does not include the optimal solution. In the water reservoir literature, a number of classes have been proposed. However, many of these rules are based largely on empirical or experimental successes and they were designed mostly via simulation and for single-purpose reservoirs. In a multi-objective context similar rules can not easily inferred from the experience and the use of universal function approximators is generally preferred. In this work, we comparatively analyze two among the most common universal approximators: artificial neural networks (ANN) and radial basis functions (RBF) under different problem settings to estimate their scalability and flexibility in dealing with more and more complex problems. The multi-purpose HoaBinh water reservoir in Vietnam, accounting for hydropower

Psychology at Chinese universities and in Chinese society: with special reference to clinical psychology

OpenAIRE

Yue, Guoan; Perrez, Meinrad; Han, Xiulan

2011-01-01

The following contribution gives a short introduction to Chinese psychology, history, psychological research and teaching institutions and student selection for universities. After a brief overview of the theoretical traditions and contemporary trends in general and experimental psychology it focuses in more detail on the recent developments in clinical and medical psychology. Research domains, academic training in clinical psychology and its applications in modern China are discussed with sp...

The need for reviewing log books in Birjand University of Medical Sciences clinical wards: Letter to Editor

Directory of Open Access Journals (Sweden)

Zoya Tahergorabi

2017-08-01

Furthermore, due to the pervasive use of electronic log books in recent years in medical universities across the country that are in line with developments and innovations in medical education, it is recommended that the log books at this university too, should be presented and evaluated electronically. Electronic log books with ongoing record of activities and clinical techniques based on educational objectives, in addition to learning consolidation, determine unavailable measures to achieve clinical objectives and, thus, cause regular monitoring and evaluation on the part of students.

Shared worlds: multi-sited ethnography and nursing research.

Science.gov (United States)

Molloy, Luke; Walker, Kim; Lakeman, Richard

2017-03-22

Background Ethnography, originally developed for the study of supposedly small-scale societies, is now faced with an increasingly mobile, changing and globalised world. Cultural identities can exist without reference to a specific location and extend beyond regional and national boundaries. It is therefore no longer imperative that the sole object of the ethnographer's practice should be a geographically bounded site. Aim To present a critical methodological review of multi-sited ethnography. Discussion Understanding that it can no longer be taken with any certainty that location alone determines culture, multi-sited ethnography provides a method of contextualising multi-sited social phenomena. The method enables researchers to examine social phenomena that are simultaneously produced in different locations. It has been used to undertake cultural analysis of diverse areas such as organ trafficking, global organisations, technologies and anorexia. Conclusion The authors contend that multi-sited ethnography is particularly suited to nursing research as it provides researchers with an ethnographic method that is more relevant to the interconnected world of health and healthcare services. Implications for practice Multi-sited ethnography provides nurse researchers with an approach to cultural analysis in areas such as the social determinants of health, healthcare services and the effects of health policies across multiple locations.

The location of cemento enamel junction for CAL measurement: A clinical crisis

Directory of Open Access Journals (Sweden)

Vandana K

2009-01-01

Full Text Available Background: We face various problems while measuring the Clinical attachment level (CAL from Cemento-enamel junction (CEJ. This study aims to record and compare the CEJ location measurements using a xed reference point (FRP [Custom made stent] before and after ap elevation. Materials and Methods: A custom made stent and UNC-15 probe were used. Recording of CEJ location was made using a UNC-15 (Hu-Friedy probe, before (close CEJ and after (Open CEJ the reflection of the flap from the lower edge of the stent in those subjects who were indicated for flap surgery, at baseline. Results: We used statistical analysis involving intra-group comparison done by Paired-′t′ test. The close and the open CEJ measurements demonstrated a, statistically, non-significant difference. The equi-measurements of close and open CEJ numerical data were remarkably lower than the under and overestimation of measurements. Thus, despite certain disadvantages of stent, the FRP provides a simple solution for CAL measurement. Conclusion: The results of this study confirms the objective of the study and strongly suggests that CAL measurements done without FRP is subjected to great variation and the diagnostic and prognostic interpretation of CAL should be viewed seriously in periodontics.

Techniques for heating eccentrically located tumors with the BSD annular phased array system (APAS): Clinical experience

International Nuclear Information System (INIS)

Samulski, T.V.; Kapp, D.S.; Bagshaw, M.A.; Fessenden, P.; Lee, E.R.; Lohrbach, A.W.

1985-01-01

The authors are currently investigating the potential for treatment optimization with the BSD APAS in tumors which are eccentrically located within the lower abdomen and pelvis. Attempts have been made to manipulate electric field (E-field) distribution during treatments through frequency changes and partial array activation (driving less than all four quadrants). Field shifts are qualitatively documented using the manufacturer's supplied diode array probes located at the patient/bolus interface in anterior, posterior and bilateral positions. Preliminary findings indicate that the internal E-field distributions can be manipulated to result in better treatment tolerance and better temperature distributions in selected target volumes. Phantom and clinical data are presented demonstrating the utility of these approaches

Using Computers for Intervention and Remediation of Severely Reading-Impaired Children in a University Literacy Clinic.

Science.gov (United States)

Balajthy, Ernest; Reuber, Kristin; Damon, Corrine J.

A study investigated software choices of graduate-level clinicians in a university reading clinic to determine computer use and effectiveness in literacy instruction. The clinic involved students of varying ability, ages 7-12, using 24 Power Macintosh computers equipped with "ClarisWorks,""Kid Pix,""Student Writing…

Improved quality monitoring of multi-center acupuncture clinical trials in China

Directory of Open Access Journals (Sweden)

Zheng Hui

2009-12-01

Full Text Available Abstract Background In 2007, the Chinese Science Division of the State Administration of Traditional Chinese Medicine(TCM convened a special conference to discuss quality control for TCM clinical research. Control and assurance standards were established to guarantee the quality of clinical research. This paper provides practical guidelines for implementing strict and reproducible quality control for acupuncture randomized controlled trials (RCTs. Methods A standard quality control program (QCP was established to monitor the quality of acupuncture trials. Case report forms were designed; qualified investigators, study personnel and data management personnel were trained. Monitors, who were directly appointed by the project leader, completed the quality control programs. They guaranteed data accuracy and prevented or detected protocol violations. Clinical centers and clinicians were audited, the randomization system of the centers was inspected, and the treatment processes were audited as well. In addition, the case report forms were reviewed for completeness and internal consistency, the eligibility and validity of the patients in the study was verified, and data was monitored for compliance and accuracy. Results and discussion The monitors complete their reports and submit it to quality assurance and the sponsors. Recommendations and suggestions are made for improving performance. By holding regular meetings to discuss improvements in monitoring standards, the monitors can improve quality and efficiency. Conclusions Supplementing and improving the existed guidelines for quality monitoring will ensure that large multi-centre acupuncture clinical trials will be considered as valid and scientifically stringent as pharmaceutical clinical trials. It will also develop academic excellence and further promote the international recognition of acupuncture.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

Science.gov (United States)

Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

2011-12-01

New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

OpenAIRE

Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

2010-01-01

New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

Location and distribution management of relief centers: a genetic algorithm approach

NARCIS (Netherlands)

Najafi, M.; Farahani, R.Z.; de Brito, M.; Dullaert, W.E.H.

2015-01-01

Humanitarian logistics is regarded as a key area for improved disaster management efficiency and effectiveness. In this study, a multi-objective integrated logistic model is proposed to locate disaster relief centers while taking into account network costs and responsiveness. Because this location

Locating of Series FACTS Devices for Multi-Objective Congestion Management Using Components of Nodal Prices

Directory of Open Access Journals (Sweden)

A. R. Moradi

2017-03-01

Full Text Available Congestion and overloading for lines are the main problems in the exploitation of power grids. The consequences of these problems in deregulated systems can be mentioned as sudden jumps in prices in some parts of the power system, lead to an increase in market power and reduction of competition in it. FACTS devices are efficient, powerful and economical tools in controlling power flows through transmission lines that play a fundamental role in congestion management. However, after removing congestion, power systems due to targeting security restrictions may be managed with a lower voltage or transient stability rather than before removing. Thus, power system stability should be considered within the construction of congestion management. In this paper, a multi-objective structure is presented for congestion management that simultaneously optimizes goals such as total operating cost, voltage and transient security. In order to achieve the desired goals, locating and sizing of series FACTS devices are done with using components of nodal prices and the newly developed grey wolf optimizer (GWO algorithm, respectively. In order to evaluate reliability of mentioned approaches, a simulation is done on the 39-bus New England network.

CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.

Science.gov (United States)

Hazlehurst, Brian L; Kurtz, Stephen E; Masica, Andrew; Stevens, Victor J; McBurnie, Mary Ann; Puro, Jon E; Vijayadeva, Vinutha; Au, David H; Brannon, Elissa D; Sittig, Dean F

2015-10-01

Comparative effectiveness research (CER) requires the capture and analysis of data from disparate sources, often from a variety of institutions with diverse electronic health record (EHR) implementations. In this paper we describe the CER Hub, a web-based informatics platform for developing and conducting research studies that combine comprehensive electronic clinical data from multiple health care organizations. The CER Hub platform implements a data processing pipeline that employs informatics standards for data representation and web-based tools for developing study-specific data processing applications, providing standardized access to the patient-centric electronic health record (EHR) across organizations. The CER Hub is being used to conduct two CER studies utilizing data from six geographically distributed and demographically diverse health systems. These foundational studies address the effectiveness of medications for controlling asthma and the effectiveness of smoking cessation services delivered in primary care. The CER Hub includes four key capabilities: the ability to process and analyze both free-text and coded clinical data in the EHR; a data processing environment supported by distributed data and study governance processes; a clinical data-interchange format for facilitating standardized extraction of clinical data from EHRs; and a library of shareable clinical data processing applications. CER requires coordinated and scalable methods for extracting, aggregating, and analyzing complex, multi-institutional clinical data. By offering a range of informatics tools integrated into a framework for conducting studies using EHR data, the CER Hub provides a solution to the challenges of multi-institutional research using electronic medical record data. Copyright © 2015. Published by Elsevier Ireland Ltd.

Academic Ranking of World Universities and the Performance of East Asian Universities. RIHE International Seminar Reports. No. 24

Science.gov (United States)

Liu, Nian Cai

2016-01-01

The first multi-indicator ranking of world universities, "Academic Ranking of World Universities (ARWU)", was published by the Institute of Higher Education of Shanghai Jiao Tong University in June 2003. Although the initial purpose of ARWU was to find the global standing of top Chinese universities, it has been attracting world-wide…

Algorithm development and verification of UASCM for multi-dimension and multi-group neutron kinetics model

International Nuclear Information System (INIS)

Si, S.

2012-01-01

The Universal Algorithm of Stiffness Confinement Method (UASCM) for neutron kinetics model of multi-dimensional and multi-group transport equations or diffusion equations has been developed. The numerical experiments based on transport theory code MGSNM and diffusion theory code MGNEM have demonstrated that the algorithm has sufficient accuracy and stability. (authors)

Auditing the frequency and the clinical and economic impact of testing for Fabry disease in patients under the age of 70 with a stroke admitted to Saint Vincent's University Hospital over a 6-month period.

Science.gov (United States)

Lambe, J; Noone, I; Lonergan, R; Tubridy, N

2018-02-01

Fabry disease is an X-linked recessive lysosomal storage disorder that provokes multi-organ morbidity, including early-onset stroke. Worldwide prevalence may be greater than previously estimated, with many experiencing first stroke prior to diagnosis of Fabry disease. The aim of this study is to screen a cohort of stroke patients under 70 years of age, evaluating the clinical and economic efficacy of such a broad screening programme for Fabry disease. All stroke patients under 70 years of age who were entered into the Saint Vincent's University Hospital stroke database over a 6-month period underwent enzyme analysis and/or genetic testing as appropriate for Fabry disease. Patients' past medical histories were analysed for clinical signs suggestive of Fabry disease. Cost-effectiveness analysis of testing was performed and compared to overall economic impact of young stroke in Ireland. Of 22 patients tested for Fabry disease, no new cases were detected. Few clinical indicators of Fabry disease were identified at the time of testing. Broad screening programmes for Fabry disease are highly unlikely to offset the cost of testing. The efficacy of future screening programmes will depend on careful selection of an appropriate patient cohort of young stroke patients with multi-organ morbidity and a positive family history.

Sensitivity analysis for missing dichotomous outcome data in multi-visit randomized clinical trial with randomization-based covariance adjustment.

Science.gov (United States)

Li, Siying; Koch, Gary G; Preisser, John S; Lam, Diana; Sanchez-Kam, Matilde

2017-01-01

Dichotomous endpoints in clinical trials have only two possible outcomes, either directly or via categorization of an ordinal or continuous observation. It is common to have missing data for one or more visits during a multi-visit study. This paper presents a closed form method for sensitivity analysis of a randomized multi-visit clinical trial that possibly has missing not at random (MNAR) dichotomous data. Counts of missing data are redistributed to the favorable and unfavorable outcomes mathematically to address possibly informative missing data. Adjusted proportion estimates and their closed form covariance matrix estimates are provided. Treatment comparisons over time are addressed with Mantel-Haenszel adjustment for a stratification factor and/or randomization-based adjustment for baseline covariables. The application of such sensitivity analyses is illustrated with an example. An appendix outlines an extension of the methodology to ordinal endpoints.

On multi-site damage identification using single-site training data

Science.gov (United States)

Barthorpe, R. J.; Manson, G.; Worden, K.

2017-11-01

This paper proposes a methodology for developing multi-site damage location systems for engineering structures that can be trained using single-site damaged state data only. The methodology involves training a sequence of binary classifiers based upon single-site damage data and combining the developed classifiers into a robust multi-class damage locator. In this way, the multi-site damage identification problem may be decomposed into a sequence of binary decisions. In this paper Support Vector Classifiers are adopted as the means of making these binary decisions. The proposed methodology represents an advancement on the state of the art in the field of multi-site damage identification which require either: (1) full damaged state data from single- and multi-site damage cases or (2) the development of a physics-based model to make multi-site model predictions. The potential benefit of the proposed methodology is that a significantly reduced number of recorded damage states may be required in order to train a multi-site damage locator without recourse to physics-based model predictions. In this paper it is first demonstrated that Support Vector Classification represents an appropriate approach to the multi-site damage location problem, with methods for combining binary classifiers discussed. Next, the proposed methodology is demonstrated and evaluated through application to a real engineering structure - a Piper Tomahawk trainer aircraft wing - with its performance compared to classifiers trained using the full damaged-state dataset.

PREFACE: 6th International Workshop on Multi-Rate Processes and Hysteresis (MURPHYS2012)

Science.gov (United States)

Dimian, Mihai; Rachinskii, Dmitrii

2015-02-01

The International Workshop on Multi-Rate Processes and Hysteresis (MURPHYS) conference series focuses on multiple scale systems, singular perturbation problems, phase transitions and hysteresis phenomena occurring in physical, biological, chemical, economical, engineering and information systems. The 6th edition was hosted by Stefan cel Mare University in the city of Suceava located in the beautiful multicultural land of Bukovina, Romania, from May 21 to 24, 2012. This continued the series of biennial multidisciplinary conferences organized in Cork, Ireland from 2002 to 2008 and in Pécs, Hungary in 2010. The MURPHYS 2012 Workshop brought together more than 50 researchers in hysteresis and multi-scale phenomena from the United State of America, the United Kingdom, France, Germany, Italy, Ireland, Czech Republic, Hungary, Greece, Ukraine, and Romania. Participants shared and discussed new developments of analytical techniques and numerical methods along with a variety of their applications in various areas, including material sciences, electrical and electronics engineering, mechanical engineering and civil structures, biological and eco-systems, economics and finance. The Workshop was sponsored by the European Social Fund through Sectoral Operational Program Human Resources 2007-2013 (PRO-DOCT) and Stefan cel Mare University, Suceava. The Organizing Committee was co-chaired by Mihai Dimian from Stefan cel Mare University, Suceava (Romania), Amalia Ivanyi from the University of Pecs (Hungary), and Dmitrii Rachinskii from the University College Cork (Ireland). All papers published in this volume of Journal of Physics: Conference Series have been peer reviewed through processes administered by the Editors. Reviews were conducted by expert referees to the professional and scientific standards expected of a proceedings journal published by IOP Publishing. The Guest Editors wish to place on record their sincere gratitude to Miss Sarah Toms for the assistance she provided

Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

Science.gov (United States)

van Oostveen, Catharina J; Goedhart, Nicole S; Francke, Anneke L; Vermeulen, Hester

2017-12-01

To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

Science.gov (United States)

Dolan, James G

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

Quality assessment of clinical education services in teaching hospitals located in Kerman, Iran.

Science.gov (United States)

Yazdi-Feyzabadi, Vahid; Gozashti, Mohammad Hossein; Komsari, Samane; Mohammadtaghizadeh, Sedigheh; Amiresmaili, Mohammadreza

2015-11-01

Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates' competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman's teaching hospitals located in southeastern Iran. This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman's teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate. In all five dimensions of quality, gaps were observed between students' perceptions and expectations as follows: Assurance (mean = -1.18), Responsiveness (-1.56), Empathy (-1.4), Reliability (-1.27), and Tangibles (-1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p < 0.001). A significant difference was observed between three educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p < 0.001). The clinical services provided by teaching hospitals in the study did not meet the students' expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do.

Combining clinical practice and academic work in nursing: a qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

NARCIS (Netherlands)

Oostveen, C.J. van; Goedhart, N.S.; Francke, A.L.; Vermeulen, H.

2017-01-01

Aims and objectives: To obtain in-depth insight into the perceptions of nurse aca- demics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Background: Combining clinical practice and academic work

The Pew National Dental Education Program at the University of Florida College of Dentistry.

Science.gov (United States)

McNeal, Donbald R.; And Others

1990-01-01

Strategic planning at the University of Florida College of Dentistry identified: the needs of the elderly population; the remote location of the dental school relative to the population in the state; the need to expand clinical research; the need to utilize computers; the reliance on state funding; etc. (MLW)

[Effectiveness of cognitive-behavioral therapy in childhood anxiety disorders in a university psychiatric outpatient clinic].

Science.gov (United States)

Goletz, Hildegard; Yang, Young-Im; Suhr-Dachs, Lydia; Walter, Daniel; Döpfner, Manfred

2013-07-01

Only few studies have examined whether the efficacy of cognitive-behavioral therapy for childhood anxiety disorders as demonstrated in randomized controlled trials (RCTs) generalizes to clinical practice. This study examines the effectiveness of cognitive-behavioral therapy for juvenile anxiety disorders under routine care conditions in a university-based psychiatric outpatient clinic. 92 children and adolescents with parent-ratings regarding anxiety and comorbid symptoms and 61 children and adolescents with self-ratings regarding anxiety and comorbid symptoms were treated with cognitive-behavioral interventions. Pre/post mean comparisons, effect sizes, and the clinical significance of changes in symptoms were examined. The effect size for reduction of anxiety symptoms was .81 for children whose parents had completed the rating scale and .79 for children who had filled in a self-rating scale. Effect sizes for reduction of comorbid symptoms varied between .37 and .84 for parent ratings and between .21 and .62 for self-ratings. The percentage of children and adolescents who achieved clinically significant improvements in anxiety symptoms was 55.1 % according to the parent ratings and 65.7 % according to the children's self-ratings. More than 50 % of parents and children reported clinically significant improvements in comorbid symptoms. Significant reductions in both anxiety and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile anxiety disorders in a university psychiatric outpatient clinic. The effect sizes for anxiety symptoms were found to be comparable to the effect sizes reported in RCTs. Similarly, clinically significant improvements were as frequent as the rates of remission of anxiety symptoms reported in RCTs.

Detection and location of leaking TRIGA fuel elements

International Nuclear Information System (INIS)

Bouchey, G.D.; Gage, S.J.

1970-01-01

Several TRIGA facilities have experienced difficulty resulting from cladding failures of aluminum clad TRIGA fuel elements. Recently, at the University of Texas at Austin reactor facility, fission product releases were observed during 250 kW operation and were attributed to a leaking fuel element. A rather extensive testing program has been undertaken to locate the faulty element. The used sniffer device is described, which provides a quick, easily constructed, and extremely sensitive means of locating leaking fuel elements. The difficulty at The University of Texas was compounded by extremely low levels and the sporadic nature of the releases. However, in the more typical situation, in which a faulty element consistently releases relatively large quantities of fission gas, such a device should locate the leak with little difficulty

Integrating data from multiple time-location measurement methods for use in exposure assessment: the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air).

Science.gov (United States)

Hazlehurst, Marnie F; Spalt, Elizabeth W; Curl, Cynthia L; Davey, Mark E; Vedal, Sverre; Burke, Gregory L; Kaufman, Joel D

2017-11-01

Tools to assess time-location patterns related to environmental exposures have expanded from reliance on time-location diaries (TLDs) and questionnaires to use of geospatial location devices such as data-logging Global Positioning System (GPS) equipment. The Multi-Ethnic Study of Atherosclerosis and Air Pollution obtained typical time-location patterns via questionnaire for 6424 adults in six US cities. At a later time (mean 4.6 years after questionnaire), a subset (n=128) participated in high-resolution data collection for specific 2-week periods resulting in concurrent GPS and detailed TLD data, which were aggregated to estimate time spent in various microenvironments. During these 2-week periods, participants were observed to spend the most time at home indoors (mean of 78%) and a small proportion of time in-vehicle (mean of 4%). Similar overall patterns were reported by these participants on the prior questionnaire (mean home indoors: 75%; mean in-vehicle: 4%). However, individual micro-environmental time estimates measured over specific 2-week periods were not highly correlated with an individual's questionnaire report of typical behavior (Spearman's ρ of 0.43 for home indoors and 0.39 for in-vehicle). Although questionnaire data about typical time-location patterns can inform interpretation of long-term epidemiological analyses and risk assessment, they may not reliably represent an individual's short-term experience.

Clinical trials of CAR-T cells in China.

Science.gov (United States)

Liu, Bingshan; Song, Yongping; Liu, Delong

2017-10-23

Novel immunotherapeutic agents targeting tumor-site microenvironment are revolutionizing cancer therapy. Chimeric antigen receptor (CAR)-engineered T cells are widely studied for cancer immunotherapy. CD19-specific CAR-T cells, tisagenlecleucel, have been recently approved for clinical application. Ongoing clinical trials are testing CAR designs directed at novel targets involved in hematological and solid malignancies. In addition to trials of single-target CAR-T cells, simultaneous and sequential CAR-T cells are being studied for clinical applications. Multi-target CAR-engineered T cells are also entering clinical trials. T cell receptor-engineered CAR-T and universal CAR-T cells represent new frontiers in CAR-T cell development. In this study, we analyzed the characteristics of CAR constructs and registered clinical trials of CAR-T cells in China and provided a quick glimpse of the landscape of CAR-T studies in China.

Solving a bi-objective mathematical model for location-routing problem with time windows in multi-echelon reverse logistics using metaheuristic procedure

Science.gov (United States)

Ghezavati, V. R.; Beigi, M.

2016-12-01

During the last decade, the stringent pressures from environmental and social requirements have spurred an interest in designing a reverse logistics (RL) network. The success of a logistics system may depend on the decisions of the facilities locations and vehicle routings. The location-routing problem (LRP) simultaneously locates the facilities and designs the travel routes for vehicles among established facilities and existing demand points. In this paper, the location-routing problem with time window (LRPTW) and homogeneous fleet type and designing a multi-echelon, and capacitated reverse logistics network, are considered which may arise in many real-life situations in logistics management. Our proposed RL network consists of hybrid collection/inspection centers, recovery centers and disposal centers. Here, we present a new bi-objective mathematical programming (BOMP) for LRPTW in reverse logistic. Since this type of problem is NP-hard, the non-dominated sorting genetic algorithm II (NSGA-II) is proposed to obtain the Pareto frontier for the given problem. Several numerical examples are presented to illustrate the effectiveness of the proposed model and algorithm. Also, the present work is an effort to effectively implement the ɛ-constraint method in GAMS software for producing the Pareto-optimal solutions in a BOMP. The results of the proposed algorithm have been compared with the ɛ-constraint method. The computational results show that the ɛ-constraint method is able to solve small-size instances to optimality within reasonable computing times, and for medium-to-large-sized problems, the proposed NSGA-II works better than the ɛ-constraint.

Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.

Science.gov (United States)

Unger, Elizabeth R; Lin, Jin-Mann S; Tian, Hao; Natelson, Benjamin H; Lange, Gudrun; Vu, Diana; Blate, Michelle; Klimas, Nancy G; Balbin, Elizabeth G; Bateman, Lucinda; Allen, Ali; Lapp, Charles W; Springs, Wendy; Kogelnik, Andreas M; Phan, Catrina C; Danver, Joan; Podell, Richard N; Fitzpatrick, Trisha; Peterson, Daniel L; Gottschalk, C Gunnar; Rajeevan, Mangalathu S

2017-04-15

In the Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM), we relied on expert clinician diagnoses to enroll patients from 7 specialty clinics in the United States in order to perform a systematic collection of data on measures of myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS). Healthy persons and those with other illnesses that share some features with ME/CFS were enrolled in comparison groups. The major objectives were to: 1) use standardized questionnaires to measure illness domains of ME/CFS and to evaluate patient heterogeneity overall and between clinics; 2) describe the course of illness, identify the measures that best correlate with meaningful clinical differences, and assess the performances of questionnaires as patient/person-reported outcome measures; 3) describe prescribed medications, orders for laboratory and other tests, and management tools used by expert clinicians to care for persons with ME/CFS; 4) collect biospecimens for future hypothesis testing and for evaluation of morning cortisol profiles; and 5) identify measures that best distinguish persons with ME/CFS from those in the comparison groups and detect subgroups of persons with ME/CFS who may have different underlying causes. Enrollment began in 2012 and is planned to continue in multiple stages through 2017. We present the MCAM methods in detail, along with an initial description of the 471 patients with ME/CFS who were enrolled in stage 1. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Certifying a university ENT clinic using the ISO 9001:2000 international standard.

Science.gov (United States)

Helbig, Matthias; Helbig, Silke; Kahla-Witzsch, Heike A; Kroll, Tobias; May, Angelika

2010-01-01

Against statutory duties to introduce quality management systems, the increased importance of this subject has led to numerous activities in various public health institutions. Following the International Standardization Organization (ISO 9001:2000) prerequisites, Frankfurt Goethe University Hospital ENT clinic staff introduced a quality management system. This paper aims to investigate this process. Designing, planning and implementing the quality management system is described. Under the supervision of an executive quality management board, clinic quality goals were defined. Thereafter, several quality management teams performed an actual state analysis as well as developing and realising improvement proposals. Finally a quality management manual containing binding standards and working instructions concerning all patient care, research and teaching aspects was written. Successful certification by a neutral body ascertained that the clinic's quality management system conformed to current national and international standards while restructuring and reform improved procedural efficiency. The paper shows that mplementing the quality management system requires considerable effort but patients as well as staff profit considerably from the innovation. On the whole, the positive impact on structure and workflow in a specialist clinic predominates. Therefore, implementing a quality management system in all the clinic's wards and departments is recommended.

VCT clinic HIV burden and its link with HIV care clinic at the University of Gondar hospital

Directory of Open Access Journals (Sweden)

Alemie Getahun

2012-11-01

Full Text Available Abstract Background Voluntary Counselling and Testing (VCT is an important component of any HIV/AIDS control and prevention activities. VCT makes people aware of their HIV serostatus and enables early identification of those who need care. It is an important link to HIV care and support. The main aim of this study is to describe the HIV burden at VCT and define the relationship between the VCT Center and the HIV Chronic Care Clinic of the University of Gondar (UoG Hospital. Methods It is a record based descriptive study undertaken by using data collected by health professionals at the VCT center and the HIV chronic care clinic of the UoG Hospital. Patient data collected from 2005/06 to 2008/09 was investigated. Analysis was carried out using the SPSS version 16.0. Results A total of 19,168 people were tested for HIV and a prevalence of 25.4% was obtained. 4298 HIV positive people were referred to the HIV chronic care clinic but only 27% actually registered at the clinic. Chi-square analyses showed residence, age and time of VCT visit showed significant relations with hospital care attendance. Conclusion The overall HIV prevalence is high. The data obtained at the HIV care clinic regarding patients’ clinical conditions at acceptance were incomplete. Improvements are required on the link between VCT and HIV care and documentation of data.

INCUBATORS WITHIN UNIVERSITY AND CLUSTERED CONTEXTS: CASES OF NATIONAL CHIAO TUNG UNIVERSITY (NCTU AND NATIONAL TSING HUA UNIVERSITY (NTHU INCUBATORS IN HSINCHU, TAIWAN

Directory of Open Access Journals (Sweden)

Khairul Akmaliah Adham

2008-01-01

Full Text Available Research literature on business incubators has highlighted the significance of clustered locational contexts and networking as key to an incubator's success. Using the case study approach, this study aimed to test the validity of this framework for explaining the level of success of the National Chiao Tung University (NCTU and National Tsing Hua University (NTHU Incubators in Hsinchu, Taiwan – both of which are highly-networked, cluster-centric and university-based. In-depth interviews were conducted with the managers of both incubators, and these were followed by information gathering on university patents and knowledge transfers from the research and development (R&D office at each university. Analysis found that the incubators' locational contexts determined the degree and manner of their networking, but their profitability and growth potential were influenced by many other factors working in combination. Satisfying their sponsors' requirements and serving their core functions through sound management and strategic planning appeared to be the key to achieving profitability and sustainability, with benefits for all stakeholders. These constructs provide directions for more research on the performance of incubators and other business entities that are located within university and clustered contexts.

Lake Beach Monitoring Locations in Iowa

Data.gov (United States)

Iowa State University GIS Support and Research Facility — Monitored state lake beach locations in Iowa. The Watershed Monitoring & Assessment Section of the Iowa DNR takes regular water samples at these listed beaches...

Multi-spectral imager

CSIR Research Space (South Africa)

Stolper, R

2006-02-01

Full Text Available channel are boresighted with two beamsplitter windows; and • The IR system is boresighted. APPLICATION High-voltage environment • Detecting loose strands, bolts and nuts; • Detecting Corona discharges on insulator discs; • Detecting... and locating spark gaps; • Detecting and locating RIV sources; • Audit sub-stations and transmission lines for audio noise and Corona activities. RECORDINGS / APPLICATIONS REPORTING TOOL: MultiSOFT • Image handling software for grabbing, processing...

Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008?2012

OpenAIRE

Mekaj, Agon Y.; Morina, Arsim A.; Mekaj, Ymer H.; Manxhuka-Kerliu, Suzana; Miftari, Ermira I.; Duci, Shkelzen B.; Hamza, Astrit R.; Gashi, Musli M.; Xhelaj, Mentor R.; Kelmendi, Fatos M.; Morina, Qamile Sh.

2015-01-01

Background: Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008-2012. The data were collected and analyzed from the archives and protocols of the University Clinical...

Ensemble Linear Neighborhood Propagation for Predicting Subchloroplast Localization of Multi-Location Proteins.

Science.gov (United States)

Wan, Shibiao; Mak, Man-Wai; Kung, Sun-Yuan

2016-12-02

In the postgenomic era, the number of unreviewed protein sequences is remarkably larger and grows tremendously faster than that of reviewed ones. However, existing methods for protein subchloroplast localization often ignore the information from these unlabeled proteins. This paper proposes a multi-label predictor based on ensemble linear neighborhood propagation (LNP), namely, LNP-Chlo, which leverages hybrid sequence-based feature information from both labeled and unlabeled proteins for predicting localization of both single- and multi-label chloroplast proteins. Experimental results on a stringent benchmark dataset and a novel independent dataset suggest that LNP-Chlo performs at least 6% (absolute) better than state-of-the-art predictors. This paper also demonstrates that ensemble LNP significantly outperforms LNP based on individual features. For readers' convenience, the online Web server LNP-Chlo is freely available at http://bioinfo.eie.polyu.edu.hk/LNPChloServer/ .

LocateP: Genome-scale subcellular-location predictor for bacterial proteins

Directory of Open Access Journals (Sweden)

Zhou Miaomiao

2008-03-01

Full Text Available Abstract Background In the past decades, various protein subcellular-location (SCL predictors have been developed. Most of these predictors, like TMHMM 2.0, SignalP 3.0, PrediSi and Phobius, aim at the identification of one or a few SCLs, whereas others such as CELLO and Psortb.v.2.0 aim at a broader classification. Although these tools and pipelines can achieve a high precision in the accurate prediction of signal peptides and transmembrane helices, they have a much lower accuracy when other sequence characteristics are concerned. For instance, it proved notoriously difficult to identify the fate of proteins carrying a putative type I signal peptidase (SPIase cleavage site, as many of those proteins are retained in the cell membrane as N-terminally anchored membrane proteins. Moreover, most of the SCL classifiers are based on the classification of the Swiss-Prot database and consequently inherited the inconsistency of that SCL classification. As accurate and detailed SCL prediction on a genome scale is highly desired by experimental researchers, we decided to construct a new SCL prediction pipeline: LocateP. Results LocateP combines many of the existing high-precision SCL identifiers with our own newly developed identifiers for specific SCLs. The LocateP pipeline was designed such that it mimics protein targeting and secretion processes. It distinguishes 7 different SCLs within Gram-positive bacteria: intracellular, multi-transmembrane, N-terminally membrane anchored, C-terminally membrane anchored, lipid-anchored, LPxTG-type cell-wall anchored, and secreted/released proteins. Moreover, it distinguishes pathways for Sec- or Tat-dependent secretion and alternative secretion of bacteriocin-like proteins. The pipeline was tested on data sets extracted from literature, including experimental proteomics studies. The tests showed that LocateP performs as well as, or even slightly better than other SCL predictors for some locations and outperforms

Shapley value-based multi-objective data envelopment analysis application for assessing academic efficiency of university departments

Science.gov (United States)

Abing, Stephen Lloyd N.; Barton, Mercie Grace L.; Dumdum, Michael Gerard M.; Bongo, Miriam F.; Ocampo, Lanndon A.

2018-02-01

This paper adopts a modified approach of data envelopment analysis (DEA) to measure the academic efficiency of university departments. In real-world case studies, conventional DEA models often identify too many decision-making units (DMUs) as efficient. This occurs when the number of DMUs under evaluation is not large enough compared to the total number of decision variables. To overcome this limitation and reduce the number of decision variables, multi-objective data envelopment analysis (MODEA) approach previously presented in the literature is applied. The MODEA approach applies Shapley value as a cooperative game to determine the appropriate weights and efficiency score of each category of inputs. To illustrate the performance of the adopted approach, a case study is conducted in a university in the Philippines. The input variables are academic staff, non-academic staff, classrooms, laboratories, research grants, and department expenditures, while the output variables are the number of graduates and publications. The results of the case study revealed that all DMUs are inefficient. DMUs with efficiency scores close to the ideal efficiency score may be emulated by other DMUs with least efficiency scores.

Variability in Multi-Tenant Enterprise Software

NARCIS (Netherlands)

Kabbedijk, J.

2014-01-01

Enterprise software applications have changed significantly over the last decades. Increasingly, software is deployed in a central location to be accessed through the internet, instead of installing software at end-users. Having software in a central location enables multi-tenancy, where multiple

Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

Science.gov (United States)

Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

2010-01-01

Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

Cost-effectiveness of an integrated 'fast track' rehabilitation service for multi-trauma patients involving dedicated early rehabilitation intervention programs: design of a prospective, multi-centre, non-randomised clinical trial.

NARCIS (Netherlands)

Kosar, S.; Seelen, H.A.M.; Hemmen, B.; Evers, S.M.; Brink, P.R.

2009-01-01

ABSTRACT: BACKGROUND: In conventional multi-trauma care service (CTCS), patients are admitted to hospital via the accident & emergency room. After surgery they are transferred to the IC-unit followed by the general surgery ward. Ensuing treatment takes place in a hospital's outpatient clinic, a

Source of learning basic clinical skills by medical interns Tehran University of Medical Sciences

Directory of Open Access Journals (Sweden)

Meshkani Z

2004-07-01

Full Text Available Background: Effective clinical teaching is a major objective in general practitioner’s education at medical schools. Purpose: To identify the sources of clinical skills learning that medical student experience Methods: In this cross sectional study, interns of Tehran medical university who spent at least 12 months of their internship answered a questionnaire on the sources of clinical skills training. Chi2 test was used to examine the association of source of learning and students,’ specification such as sex, score of pre –internship exam, and marital status. Results: All 250 interns who were eligible participated. Over all 46.60% interns learned their clinical skills from residents or clinical teachers, 29.61% observed others performing the procedures, 16.25 learned the skills from hospital staff or nurses, 7.54% practiced their knowledge when confronted to an emergency situation Conclusion: Our results warrant a more attentive approach to clinical skills (specially procedural skills training Key words: LEARNING RESOURCES

A multi-method study to determine the effectiveness of, and student attitudes to, online instructional videos for teaching clinical nursing skills.

Science.gov (United States)

Kelly, Mary; Lyng, Colette; McGrath, Mary; Cannon, Gerald

2009-04-01

E-learning is regularly promoted in higher education settings as a way of fostering more flexible approaches to learning. It has been argued however that the 'potential benefits of new information and communication technology instruments in education' have not been subjected to critical scrutiny (Debande, O., 2004. ICTs and the development of e-learning in Europe: the role of the public and private sectors. European Journal of Education 39 (2), 191-208, p. 192). This paper outlines a multi-method evaluation of an e-learning innovation designed to teach clinical skills to student nurses. Responding to the challenges of teaching clinical skills to large class sizes, we developed a set of instructional videos for one undergraduate skills-based module, which are now integral to the module and available online to students on a continuous basis. Evaluation suggests that students' performance outcomes are unchanged. The students view the flexible and self-management aspects of this method of learning positively, with some attitudinal differences between male and female, and mature and non-mature students. However, it is best used to complement rather than replace lecturer demonstration, lending support to a 'blended' model (Collis, B., van der Wende, M., 2002. Models of Technology and Change in Higher Education: An International Comparative Survey on The Current and Future Use of ICT in Higher Education, University of Twente, Center for Higher Education Policy Studies, The Netherlands).

Attitude of clinical faculty members in Shiraz Medical University towards private practice physicians' participation in ambulatory care education

Directory of Open Access Journals (Sweden)

Khatereh Mahori

2002-04-01

Full Text Available Background: Improvement of medical education is necessary for meeting health care demands. Participation of private practice physicians in ambulatory care training is an effective method for enhancing medical students' skills. Purpose This study was undertaken to determine clinical professors' views about participation of physicians with private office in ambulatory care training. Methods: Participants composed of 162 Shiraz Medical University faculty members from 12 disciplines. A questionnaire requesting faculty members' views on different aspects of ambulat01y care teaching and interaction of community-based organizations was distributed. Results: Of 120 (74.1% respondents, 64 (54.2% believed that clinical settings of medical university are appropriate for ambulatory care training. Private practice physicians believed more than academic physicians without private office that private offices have wider range of patients, more common cases, and better follow up chance; and is also a better setting for learning ambulatory care compared with medical university clinical centers. Overall, 32 (29.1% respondent’s found the participation of physicians with private practice on medical education positive. Key words medical education, ambulatory medicine, private practice

GIS Methodology for Location of Biomass Power Plants Via Multi -Criteria Evaluation and Network Analysis. Location-Allocation Models for Forest Biomass Use; Metodologia SIG para la Localizacion de Centrales de Biomasa mediante Evaluacion Multicriterio y Analisis de Redes. Modelos de Localizacion-Asignacion para el Aprovechamiento de Biomasa Forestal

Energy Technology Data Exchange (ETDEWEB)

Paz, C de la; Dominguez, J; Perez, M E

2013-02-01

The main purpose of this study is to find optimal areas for the installation of Biomass Plants for electric generation and grid connected. In order to achieve this goal, a methodology based on Multi-Criteria Evaluation (MCE) and implemented by means a Geographic Information System (GIS) has been developed. Factors and restrictions for biomass resource and power plants location of biomass have been obtained through the dataset. The methodology output includes maps of greater aptitude areas for resource use (forest biomass available), as well as suitable locations for the placement of Forest Biomass facilities. Both cartographic products have been related by means Network Analysis. It generates Location-Allocation Models which allows locating Forest Biomass Facilities according with an optimization of the supply chain from the resource areas. (Author)

Geopolitical location and plot in The Night Manager

DEFF Research Database (Denmark)

Agger, Gunhild

2017-01-01

The Night Manager. Three perspectives are tested in combining the analysis of location with the development of the plot: the general concepts of universal and real geography; the idea of being located inside or outside a given context; and the associated notion of centre-periphery opposition. A geopolitical...

Utilizing patient geographic information system data to plan telemedicine service locations.

Science.gov (United States)

Soares, Neelkamal; Dewalle, Joseph; Marsh, Ben

2017-09-01

To understand potential utilization of clinical services at a rural integrated health care system by generating optimal groups of telemedicine locations from electronic health record (EHR) data using geographic information systems (GISs). This retrospective study extracted nonidentifiable grouped data of patients over a 2-year period from the EHR, including geomasked locations. Spatially optimal groupings were created using available telemedicine sites by calculating patients' average travel distance (ATD) to the closest clinic site. A total of 4027 visits by 2049 unique patients were analyzed. The best travel distances for site groupings of 3, 4, 5, or 6 site locations were ranked based on increasing ATD. Each one-site increase in the number of available telemedicine sites decreased minimum ATD by about 8%. For a given group size, the best groupings were very similar in minimum travel distance. There were significant differences in predicted patient load imbalance between otherwise similar groupings. A majority of the best site groupings used the same small number of sites, and urban sites were heavily used. With EHR geospatial data at an individual patient level, we can model potential telemedicine sites for specialty access in a rural geographic area. Relatively few sites could serve most of the population. Direct access to patient GIS data from an EHR provides direct knowledge of the client base compared to methods that allocate aggregated data. Geospatial data and methods can assist health care location planning, generating data about load, load balance, and spatial accessibility. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Imaging the renal lesion with dual-energy multidetector CT and multi-energy applications in clinical practice: what can it truly do for you?

Energy Technology Data Exchange (ETDEWEB)

Mileto, Achille; Marin, Daniele [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Sofue, Keitaro [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Kobe University School of Medicine, Department of Radiology, Kobe (Japan)

2016-10-15

Many fortuitously detected renal lesions are incompletely characterised at traditional MDCT imaging, thus posing daily challenges to radiologists and referring physicians. There is burgeoning evidence that dual-energy MDCT and multi-energy applications provide an added value over traditional MDCT imaging in renal lesion characterisation and throughput. This special report gives a vendor-neutral outlook on technical essentials, recommended protocols, high-yield clinical opportunities and reviews radiation dose aspects of dual-energy MDCT imaging and multi-energy applications in renal lesions. In addition to a guide on interpretative traps and emerging problems, we provide an update on new, potential imaging horizons. Dual-energy MDCT and multi-energy applications can facilitate the imaging interpretation and throughput of renal lesions. Conjointly with capitalisation on the benefits, familiarity with dual- and multi-energy data sets as well as continuous scrutiny of interpretative traps can be the keys to the successful implementation and enhanced clinical acceptance of this powerful technique in the imaging community. Continuous advances in hardware and computer interfaces are expected to pave the way for the further expansion of the application spectrum. (orig.)

i-Locate - Indoor/Outdoor location and Asset Management through Open Data

Directory of Open Access Journals (Sweden)

Claudio Eccher

2015-02-01

Full Text Available Studi recenti hanno evidenziato che, in media, trascorriamo circa il 90% del nostro tempo in ambienti chiusi e, spesso, non familiari. L’esigenza di localizzare/guidare persone o ogg etti in spazi sia esterni che interni (senza discontinuità tra esterno ed interno darà origine ad una serie di nuovi servizi di tipo LBS (Location-Based Services che potranno avere anche una notevole rilevanza economica. i-locate (Indoor / outdoor location and Asset Management Through open geodata is a project that aims to develop a set of tools and services based on geo location technologies based on open data for the location and management of objects in indoor and outdoor spaces. The tools are intended both to citizens who use their smartphones to access services, aids to navigation from the front door to internal destinations to buildings (public office, clinic, shop, etc.. Obtaining any information available to support (code , unforeseen changes in the path, suggestions, etc., and professionals for specific activities that require the location of people, equipment, etc. i-locate to an intense use of GIS technologies for navigation and tracking "indoor" (indoor GIS, 3D GIS, to locate people (eg. Alzheimer's patients and their movements in areas not suited (geofencing to identify and track objects / portable equipment for their location, management and maintenance.

i-Locate - Indoor/Outdoor location and Asset Management through Open Data

Directory of Open Access Journals (Sweden)

Claudio Eccher

2015-02-01

Full Text Available Studi recenti hanno evidenziato che, in media, trascorriamo circa il 90% del nostro tempo in ambienti chiusi e, spesso, non familiari. L’esigenza di localizzare/guidare persone o ogg etti in spazi sia esterni che interni (senza discontinuità tra esterno ed interno darà origine ad una serie di nuovi servizi di tipo LBS (Location-Based Services che potranno avere anche una notevole rilevanza economica.i-locate (Indoor / outdoor location and Asset Management Through open geodata is a project that aims to develop a set of tools and services based on geo location technologies based on open data for the location and management of objects in indoor and outdoor spaces. The tools are intended both to citizens who use their smartphones to access services, aids to navigation from the front door to internal destinations to buildings (public office, clinic, shop, etc.. Obtaining any information available to support (code , unforeseen changes in the path, suggestions, etc., and professionals for specific activities that require the location of people, equipment, etc. i-locate to an intense use of GIS technologies for navigation and tracking "indoor" (indoor GIS, 3D GIS, to locate people (eg. Alzheimer's patients and their movements in areas not suited (geofencing to identify and track objects / portable equipment for their location, management and maintenance.

Presence of multi-drug resistant pathogenic Escherichia coli in the San Pedro River located in the State of Aguascalientes, Mexico.

Directory of Open Access Journals (Sweden)

Flor Yazmin Ramirez Castillo

2013-06-01

Full Text Available Contamination of surface waters in developing countries is a great concern. Treated and untreated wastewaters have been discharged into rivers and streams, leading to possible waterborne infection outbreaks and may represent a significant dissemination mechanism of antibiotic resistance genes. In this study, the water quality of San Pedro River, the main river and pluvial collector of the Aguascalientes State, Mexico was assessed. Thirty sample locations were tested throughout the River. The main physicochemical parameters of water were evaluated. Results showed high levels of fecal pollution as well as inorganic and organic matter abundant enough to support the heterotrophic growth of microorganisms. These results indicate poor water quality in samples from different locations. One hundred and fifty Escherichia coli were collected and screened by PCR for several virulence genes. Isolates were classified as either pathogenic (n = 91 or commensal (n = 59. The disc diffusion method was used to determine antimicrobial susceptibility to 13 antibiotics. Fifty-two percent of the isolates were resistant to at least one antimicrobial agent and 30.6% were multi-resistant. Eighteen E. coli strains were quinolone resistant of which 16 were multi-resistant. Plasmid-mediated quinolone resistance genes were detected in 12 isolates. Mutations at the Ser-83→Leu and/or Asp-87→Asn in the gyrA gene were detected as well as mutations at the Ser-80→Ile in parC. An E. coli microarray (Maxivirulence V 3.1 was used to characterize the virulence and antimicrobial resistance genes profiles of the fluoroquinolone-resistant isolates. Antimicrobial resistance genes such as blaTEM, sulI, sulII, dhfrIX, aph3 (strA and tet (B as well as integrons were found in fluoroquinolone resistance E. coli strains. The presence of potential pathogenic E. coli and antibiotic resistance in San Pedro River such as fluoroquinolone resistant E. coli could pose a potential threat to human

A multi-state model for the reliability assessment of a distributed generation system via universal generating function

International Nuclear Information System (INIS)

Li, Yan-Fu; Zio, Enrico

2012-01-01

The current and future developments of electric power systems are pushing the boundaries of reliability assessment to consider distribution networks with renewable generators. Given the stochastic features of these elements, most modeling approaches rely on Monte Carlo simulation. The computational costs associated to the simulation approach force to treating mostly small-sized systems, i.e. with a limited number of lumped components of a given renewable technology (e.g. wind or solar, etc.) whose behavior is described by a binary state, working or failed. In this paper, we propose an analytical multi-state modeling approach for the reliability assessment of distributed generation (DG). The approach allows looking to a number of diverse energy generation technologies distributed on the system. Multiple states are used to describe the randomness in the generation units, due to the stochastic nature of the generation sources and of the mechanical degradation/failure behavior of the generation systems. The universal generating function (UGF) technique is used for the individual component multi-state modeling. A multiplication-type composition operator is introduced to combine the UGFs for the mechanical degradation and renewable generation source states into the UGF of the renewable generator power output. The overall multi-state DG system UGF is then constructed and classical reliability indices (e.g. loss of load expectation (LOLE), expected energy not supplied (EENS)) are computed from the DG system generation and load UGFs. An application of the model is shown on a DG system adapted from the IEEE 34 nodes distribution test feeder.

Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial

Science.gov (United States)

Harris, David M.; Nicholson, Dawn M.; McCarthy, Delwin; Yukna, Raymond A.; Reynolds, Mark A.; Greenwell, Henry; Finley, James; McCawley, Thomas K.; Xenoudi, Pinelopi; Gregg, Robert H.

2014-02-01

Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.

Agreement between Cochrane Neonatal Group reviews and clinical guidelines for newborns at a Copenhagen University Hospital - a cross-sectional study

DEFF Research Database (Denmark)

Brok, Jesper; Greisen, Gorm; Jacobsen, Robert Thorkild

2007-01-01

To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development.......To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development....

Clinical trials of CAR-T cells in China

Directory of Open Access Journals (Sweden)

Bingshan Liu

2017-10-01

Full Text Available Abstract Novel immunotherapeutic agents targeting tumor-site microenvironment are revolutionizing cancer therapy. Chimeric antigen receptor (CAR-engineered T cells are widely studied for cancer immunotherapy. CD19-specific CAR-T cells, tisagenlecleucel, have been recently approved for clinical application. Ongoing clinical trials are testing CAR designs directed at novel targets involved in hematological and solid malignancies. In addition to trials of single-target CAR-T cells, simultaneous and sequential CAR-T cells are being studied for clinical applications. Multi-target CAR-engineered T cells are also entering clinical trials. T cell receptor-engineered CAR-T and universal CAR-T cells represent new frontiers in CAR-T cell development. In this study, we analyzed the characteristics of CAR constructs and registered clinical trials of CAR-T cells in China and provided a quick glimpse of the landscape of CAR-T studies in China.

Design and Development of a New Multi-Projection X-Ray System for Chest Imaging

Science.gov (United States)

Chawla, Amarpreet S.; Boyce, Sarah; Washington, Lacey; McAdams, H. Page; Samei, Ehsan

2009-02-01

Overlapping anatomical structures may confound the detection of abnormal pathology, including lung nodules, in conventional single-projection chest radiography. To minimize this fundamental limiting factor, a dedicated digital multi-projection system for chest imaging was recently developed at the Radiology Department of Duke University. We are reporting the design of the multi-projection imaging system and its initial performance in an ongoing clinical trial. The system is capable of acquiring multiple full-field projections of the same patient along both the horizontal and vertical axes at variable speeds and acquisition frame rates. These images acquired in rapid succession from slightly different angles about the posterior-anterior (PA) orientation can be correlated to minimize the influence of overlying anatomy. The developed system has been tested for repeatability and motion blur artifacts to investigate its robustness for clinical trials. Excellent geometrical consistency was found in the tube motion, with positional errors for clinical settings within 1%. The effect of tube-motion on the image quality measured in terms of impact on the modulation transfer function (MTF) was found to be minimal. The system was deemed clinic-ready and a clinical trial was subsequently launched. The flexibility of image acquisition built into the system provides a unique opportunity to easily modify it for different clinical applications, including tomosynthesis, correlation imaging (CI), and stereoscopic imaging.

The Multi-Location Transshipment Problem with Positive Replenishment Lead Times

NARCIS (Netherlands)

Y. Gong (Yeming); E. Yucesan

2006-01-01

textabstractTransshipments, monitored movements of material at the same echelon of a supply chain, represent an effective pooling mechanism. With a single exception, research on transshipments overlooks replenishment lead times. The only approach for two-location inventory systems with

Patient-centered and clinical outcomes of mandibular overdentures retained with the locator system: A prospective observational study.

Science.gov (United States)

Fernandez-Estevan, Lucia; Montero, Javier; Selva Otaolaurruchi, Eduardo J; Sola Ruiz, Fernanda

2017-03-01

Whether clinical or demographic variables affect the perception of treatment in terms of quality of life and satisfaction is unknown. The purpose of this prospective study was to make an evidence-based assessment of the treatment outcomes (patient- and clinically based) of locator-retained mandibular overdentures. This prospective observational study assessed patients with edentulism who had worn mandibular overdentures supported by 2 implants and retained by the locator system for at least 1 year of functional life (N=80). Medical histories were reviewed, and patients underwent oral examinations. Prosthetic clinical outcomes and patient well-being were registered using the Oral Health Impact Profile 20 (OHIP-20) and Oral Satisfaction Scale (OSS). Patient well-being scored an overall OHIP-20 score of 19.0 ±14.0 of 80 (the higher the score, the greater the impact and the worse the oral health-related quality of life); overall oral satisfaction was 8.3 ±1.7 of 10. Women suffered greater social impact (0.8 ±1.0) and disability (0.4 ±0.8) than men (0.4 ±0.7 versus 0.2 ±0.4, respectively). Impact on well-being was inversely proportional to both patient age and the age of the prosthesis (r=-0.25; Poverdentures had been functioning for over 60 months. Relining (46.3%), readjustments (82.5%), and changes of nylon retention (1.5 ±1.8 per patient over 60 months of use) devices negatively influenced well-being. Mandibular overdentures produced good results with regard to quality of life and oral satisfaction, but attention should be paid to factors affecting clinical outcomes and patient well-being. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Compare Clinical Competence and Job Satisfaction Among Nurses Working in Both University and Non-University Hospital in Bushehr 2015

Directory of Open Access Journals (Sweden)

Abdolrasoul Abbasi

2017-04-01

Full Text Available Background: Nurses are the biggest component of the health care system in the world and their job satisfaction and clinical competence affect performance and success of the organization. This study aimed to determine and compare the clinical competence and job satisfaction of nurses in both academic and non-academic hospitals in Bushehr in 2015. Materials & Methods: In this cross-sectional study, 257 nurses were studied in two hospitals of Bushehr city selected by census method. Data was collected by using valid and reliable Nurse Clinical Competence and Job Satisfaction Inventory questionnaires. Data analyzed by using SPSS- 21, and descriptive statistics, t-test, and ANOVA and Pearson correlation coefficient. Statistical significance was set at P< 0.05. Results: Findings showed that there were no significant diffrences between academic hospital nurses' job satisfaction with 126.96±29.34 and non-academic hospital with 128.31±23.26. Also, there were a significant diffrences between total score of nurses' clinical competence in academic hospital 62.18±18.09 and in non-academic hospital 67.78±17.64. There were a significant and direct association between the clinical competence and job satisfaction of nurses in both hospitals (p≤0.05. Conclusion: Although nurses clinical competence and job satisfaction in both hospitals were assessed at desirable level but both criteria were higher in non-university hospital nurses. It is nessessary that Nurse Manager’s of academic hospitals should pay attention to assessment and improvement of nurse clinical competence and job satisfaction

Is correction necessary when clinically determining quantitative cerebral perfusion parameters from multi-slice dynamic susceptibility contrast MR studies?

International Nuclear Information System (INIS)

Salluzzi, M; Frayne, R; Smith, M R

2006-01-01

Several groups have modified the standard singular value decomposition (SVD) algorithm to produce delay-insensitive cerebral blood flow (CBF) estimates from dynamic susceptibility contrast (DSC) perfusion studies. However, new dependences of CBF estimates on bolus arrival times and slice position in multi-slice studies have been recently recognized. These conflicting findings can be reconciled by accounting for several experimental and algorithmic factors. Using simulation and clinical studies, the non-simultaneous measurement of arterial and tissue concentration curves (relative slice position) in a multi-slice study is shown to affect time-related perfusion parameters, e.g. arterial-tissue-delay measurements. However, the current clinical impact of relative slice position on amplitude-related perfusion parameters, e.g. CBF, can be expected to be small unless any of the following conditions are present individually or in combination: (a) high concentration curve signal-to-noise ratios, (b) small tissue mean transit times, (c) narrow arterial input functions or (d) low temporal resolution of the DSC image sequence. Recent improvements in magnetic resonance (MR) technology can easily be expected to lead to scenarios where these effects become increasingly important sources of inaccuracy for all perfusion parameter estimates. We show that using Fourier interpolated (high temporal resolution) residue functions reduces the systematic error of the perfusion parameters obtained from multi-slice studies

Computational modelling of multi-cell migration in a multi-signalling substrate

International Nuclear Information System (INIS)

Mousavi, Seyed Jamaleddin; Doblaré, Manuel; Doweidar, Mohamed Hamdy

2014-01-01

Cell migration is a vital process in many biological phenomena ranging from wound healing to tissue regeneration. Over the past few years, it has been proven that in addition to cell–cell and cell-substrate mechanical interactions (mechanotaxis), cells can be driven by thermal, chemical and/or electrical stimuli. A numerical model was recently presented by the authors to analyse single cell migration in a multi-signalling substrate. That work is here extended to include multi-cell migration due to cell–cell interaction in a multi-signalling substrate under different conditions. This model is based on balancing the forces that act on the cell population in the presence of different guiding cues. Several numerical experiments are presented to illustrate the effect of different stimuli on the trajectory and final location of the cell population within a 3D heterogeneous multi-signalling substrate. Our findings indicate that although multi-cell migration is relatively similar to single cell migration in some aspects, the associated behaviour is very different. For instance, cell–cell interaction may delay single cell migration towards effective cues while increasing the magnitude of the average net cell traction force as well as the local velocity. Besides, the random movement of a cell within a cell population is slightly greater than that of single cell migration. Moreover, higher electrical field strength causes the cell slug to flatten near the cathode. On the other hand, as with single cell migration, the existence of electrotaxis dominates mechanotaxis, moving the cells to the cathode or anode pole located at the free surface. The numerical results here obtained are qualitatively consistent with related experimental works. (paper)

Origin (?) of the Universe

Indian Academy of Sciences (India)

cal models of the universe are based on the idea, which is supported by ... Only the continuous distribution was clearly ... displaced from their natural locations, their observed wave- .... universe? Mathematical Models: Basic Assumptions.

Comparison of Nursing Student and Instructor Preferences for Block and Nonblock Clinical Models.

Science.gov (United States)

Rohatinsky, Noelle; Chachula, Kathryn; Sedgwick, Monique; Press, Madeline M; Compton, Roslyn M; Lane, Brenda

2017-10-05

Clinical experiences are the hallmark of prelicensure nursing programs and assist students with applying nursing theory into practice. The literature is limited with respect to nursing student and instructor preferences for type of clinical model to facilitate student learning. This article explores these perceptions in the nursing programs of 5 universities located in 4 Western Canadian provinces. Findings support the use of both nonblock and block clinical models throughout nursing education programs.

Factors Enhancing Manpower Efficiency from the Viewpoint of Clinical and Non-clinical Faculty Members at Guilan University of Medical Sciences in 2011

Directory of Open Access Journals (Sweden)

Fardin Mehrabian

2012-11-01

Full Text Available Introduction: There are various factors that affect manpower efficiency. Identification of the most important and influential factors on efficiency is quite essential. Analysis of factors affecting manpower efficiency from the viewpoint of clinical and non-clinical faculty members at Guilan University of Medical Sciences in 2011.Methods: This descriptive, analytical, cross-sectional study was performed in October and November in 2011. The study sample consisted of 186 faculty members, including 128 clinical and 58 non-clinical. Instruments used to collect library data were questionnaire and field studies. Exploratory factor analysis with Varimax rotation was utilized to determine the factors influencing manpower efficiency as well as loading level of each of the variables. Results: Among clinical faculty members, 70.66% of changes in manpower efficiency, and among non-clinical faculty members, 79.57% of changes in manpower efficiency were explained by 9 and 8 factors, respectivelyConclusion: Staff empowerment and organizational culture were recognized as the most important factors enhancing manpower efficiency from the viewpoint of clinical and non-clinical faculty members, respectively.

Combined PACS and intranet information system in a University Hospital

International Nuclear Information System (INIS)

Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K.; Koenig, A.; Endres, S.

2000-01-01

Purpose: The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. Methods: As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an intranet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. Results: After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. Conclusion: The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from every where at any time. (orig.) [de

Location of airports - selected quantitative methods

Directory of Open Access Journals (Sweden)

Agnieszka Merkisz-Guranowska

2016-09-01

Full Text Available Background: The role of air transport in  the economic development of a country and its regions cannot be overestimated. The decision concerning an airport's location must be in line with the expectations of all the stakeholders involved. This article deals with the issues related to the choice of  sites where airports should be located. Methods: Two main quantitative approaches related to the issue of airport location are presented in this article, i.e. the question of optimizing such a choice and the issue of selecting the location from a predefined set. The former involves mathematical programming and formulating the problem as an optimization task, the latter, however, involves ranking the possible variations. Due to various methodological backgrounds, the authors present the advantages and disadvantages of both approaches and point to the one which currently has its own practical application. Results: Based on real-life examples, the authors present a multi-stage procedure, which renders it possible to solve the problem of airport location. Conclusions: Based on the overview of literature of the subject, the authors point to three types of approach to the issue of airport location which could enable further development of currently applied methods.

Clinical Trials

Medline Plus

Full Text Available ... questions and clinical trials. Optimizing our Clinical Trials Enterprise NHLBI has a strong tradition of supporting clinical ... multi-pronged approach to Optimize our Clinical Trials Enterprise that will make our clinical trials enterprise even ...

Assessment of the National Research Universal Reactor Proposed New Stack Sampling Probe Location for Compliance with ANSI/HPS N13.1-1999

Energy Technology Data Exchange (ETDEWEB)

Glissmeyer, John A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Antonio, Ernest J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Flaherty, Julia E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-02-29

This document reports on a series of tests conducted to assess the proposed air sampling location for the National Research Universal reactor (NRU) complex exhaust stack, located in Chalk River, Ontario, Canada, with respect to the applicable criteria regarding the placement of an air sampling probe. Due to the age of the equipment in the existing monitoring system, and the increasing difficulty in acquiring replacement parts to maintain this equipment, a more up-to-date system is planned to replace the current effluent monitoring system, and a new monitoring location has been proposed. The new sampling probe should be located within the exhaust stack according to the criteria established by the American National Standards Institute/Health Physics Society (ANSI/HPS) N13.1-1999, Sampling and Monitoring Releases of Airborne Radioactive Substances from the Stack and Ducts of Nuclear Facilities. These criteria address the capability of the sampling probe to extract a sample that represents the effluent stream. The internal Pacific Northwest National Laboratory (PNNL) project for this task was 65167, Atomic Energy Canada Ltd. Chalk River Effluent Duct Flow Qualification. The testing described in this document was guided by the Test Plan: Testing of the NRU Stack Air Sampling Position (TP-STMON-032).

Clinical education stressors in medical trainees in Shahid Sadoughi University of Medical Sciences, Yazd

Directory of Open Access Journals (Sweden)

MAHDIEH MOMAYYEZI

2016-01-01

Full Text Available Introduction: Stress is an important factor in the educational process. Teaching and learning are stressful processes. This stress can affect one’s ability and change his/her performance. The purpose of this study was to investigate stressors of clinical education from the perspective of medical students in Yazd University of Medical Sciences. Methods: This descriptive-analytic study was conducted in Yazd University of Medical Science during year 2014-2015. The sample size was 170 medical students who were selected randomly. The data were collected by a questionnaire including four components: interpersonal relationship, educational environment, clinical experience and the unpleasant emotions. A significance level of 0.05 was considered for analysis. The statistical analyses included descriptive statistics, ANOVA and T-tests, using SPSS software, version 14. Results: The results showed that the highest domain score belonged to interpersonal relationship (3.33±0.3 followed by unpleasant emotions domain (3.3±0.3. The lowest domain score of clinical education stressors was educational environment (3.12±0.1. The results showed that the mean score of interpersonal relationship domain was more in women than in men (p<0.05. Conclusion: The relationship between teachers and students is an effective factor in all dimensions of clinical education stressors. So proper measures such as the promotion of scientific awareness of teachers and educational staff about factors that lead to stress and the best way to communicate with students should be taken to reduce the students’ stress.

[A combined PACS and Internet information system in a university medical center].

Science.gov (United States)

Heiss, D; König, A; Endres, S; Pfluger, T; Pfeifer, K J; Hahn, K

2000-06-01

The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an Internet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from everywhere at any time.

Innovating to enhance clinical data management using non-commercial and open source solutions across a multi-center network supporting inpatient pediatric care and research in Kenya.

Science.gov (United States)

Tuti, Timothy; Bitok, Michael; Paton, Chris; Makone, Boniface; Malla, Lucas; Muinga, Naomi; Gathara, David; English, Mike

2016-01-01

To share approaches and innovations adopted to deliver a relatively inexpensive clinical data management (CDM) framework within a low-income setting that aims to deliver quality pediatric data useful for supporting research, strengthening the information culture and informing improvement efforts in local clinical practice. The authors implemented a CDM framework to support a Clinical Information Network (CIN) using Research Electronic Data Capture (REDCap), a noncommercial software solution designed for rapid development and deployment of electronic data capture tools. It was used for collection of standardized data from case records of multiple hospitals' pediatric wards. R, an open-source statistical language, was used for data quality enhancement, analysis, and report generation for the hospitals. In the first year of CIN, the authors have developed innovative solutions to support the implementation of a secure, rapid pediatric data collection system spanning 14 hospital sites with stringent data quality checks. Data have been collated on over 37 000 admission episodes, with considerable improvement in clinical documentation of admissions observed. Using meta-programming techniques in R, coupled with branching logic, randomization, data lookup, and Application Programming Interface (API) features offered by REDCap, CDM tasks were configured and automated to ensure quality data was delivered for clinical improvement and research use. A low-cost clinically focused but geographically dispersed quality CDM (Clinical Data Management) in a long-term, multi-site, and real world context can be achieved and sustained and challenges can be overcome through thoughtful design and implementation of open-source tools for handling data and supporting research. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Multi-Angle Snowflake Camera Value-Added Product

Energy Technology Data Exchange (ETDEWEB)

Shkurko, Konstantin [Univ. of Utah, Salt Lake City, UT (United States); Garrett, T. [Univ. of Utah, Salt Lake City, UT (United States); Gaustad, K [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-12-01

The Multi-Angle Snowflake Camera (MASC) addresses a need for high-resolution multi-angle imaging of hydrometeors in freefall with simultaneous measurement of fallspeed. As illustrated in Figure 1, the MASC consists of three cameras, separated by 36°, each pointing at an identical focal point approximately 10 cm away. Located immediately above each camera, a light aims directly at the center of depth of field for its corresponding camera. The focal point at which the cameras are aimed lies within a ring through which hydrometeors fall. The ring houses a system of near-infrared emitter-detector pairs, arranged in two arrays separated vertically by 32 mm. When hydrometeors pass through the lower array, they simultaneously trigger all cameras and lights. Fallspeed is calculated from the time it takes to traverse the distance between the upper and lower triggering arrays. The trigger electronics filter out ambient light fluctuations associated with varying sunlight and shadows. The microprocessor onboard the MASC controls the camera system and communicates with the personal computer (PC). The image data is sent via FireWire 800 line, and fallspeed (and camera control) is sent via a Universal Serial Bus (USB) line that relies on RS232-over-USB serial conversion. See Table 1 for specific details on the MASC located at the Oliktok Point Mobile Facility on the North Slope of Alaska. The value-added product (VAP) detailed in this documentation analyzes the raw data (Section 2.0) using Python: images rely on OpenCV image processing library and derived aggregated statistics rely on some clever averaging. See Sections 4.1 and 4.2 for more details on what variables are computed.

Own-Group Face Recognition Bias: The Effects of Location and Reputation

OpenAIRE

Yan, Linlin; Wang, Zhe; Huang, Jianling; Sun, Yu-Hao P.; Judges, Rebecca A.; Xiao, Naiqi G.; Lee, Kang

2017-01-01

In the present study, we examined whether social categorization based on university affiliation can induce an advantage in recognizing faces. Moreover, we investigated how the reputation or location of the university affected face recognition performance using an old/new paradigm. We assigned five different university labels to the faces: participants’ own university and four other universities. Among the four other university labels, we manipulated the academic reputation and geographical lo...

From Physical Campus Space to a Full-view Figure: University Atlas Compiling Based on `Information Design' Concept

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Song, Ge; Tang, Xi; Zhu, Feng

2018-05-01

Traditional university maps, taking campus as the principal body, mainly realize the abilities of space localization and navigation. They don't take full advantage of map, such as multi-scale representations and thematic geo-graphical information visualization. And their inherent propaganda functions have not been entirely developed. Therefore, we tried to take East China Normal University (ECNU) located in Shanghai as an example, and integrated various information related to university propaganda need (like spatial patterns, history and culture, landscape ecology, disciplinary constructions, cooperation, social services, development plans and so on). We adopted the frontier knowledge of `information design' as well as kinds of information graphics and visualization solutions. As a result, we designed and compiled a prototype atlas of `ECNU Impression' to provide a series of views of ECNU, which practiced a new model of `narrative campus map'. This innovative propaganda product serves as a supplement to typical shows with official authority, data maturity, scientificity, dimension diversity, and timing integrity. The university atlas will become a usable media for university overall figure shaping.

Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic.

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Herbert, R; Ashraf, A N; Yates, T A; Spriggs, K; Malinnag, M; Durward-Brown, E; Phillips, D; Mewse, E; Daniel, A; Armstrong, M; Kidd, I M; Waite, J; Wilks, P; Burns, F; Bailey, R; Brown, M

2012-09-01

Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection. © 2012 British HIV Association.

Perceptions of Students and Clinical Instructors of Academic Learning Environments at Yazd University of Medical Sciences

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Hamideh Montazeri

2012-12-01

Full Text Available Introduction: The purpose of this cross sectional study is to gain insight into the students and clinical instructors’ perception of learning environments at Yazd medical University in 2012. Various aspects of environment are compared between courses, gender and age. Students and instructors’ perspectives are reported. Methods: The sample consisted of 158 undergraduate students in their final year of graduation in the nursing, anesthesia, operating room, laboratory, radiology, midwifery courses and their 20 clinical instructors at Yazd University. Data were obtained using the Dundee Ready Education Environment Measure (DREEM. Scores were compared across grouping variables identified via demographic information. Results: Scores were fairly high for both students and clinical instructors (M=110.0; SD=21.2 and M=93.1; SD=10.3 respectively, indicating an overall positive perception of learning environments between both groups. The perception of atmosphere subscale (PA received the highest mean grade by both groups. Total DREEM scores didn’t vary significantly between courses (p>0.05 but the results of ANOVA test showed significant differences only for perception of teaching and perception of atmosphere domains. There was not a significant association between females and males regarding total DREEM score (p>0.05. Conclusions: The more positive than negative perception held by the Yazd University health science students and instructors is hopefully indicative of a favorable teaching-learning environment. Overall; teachers’ attention to principles of educational design and setting a favorable environment to promote better learning is recommended.

Institutional Identity and Organizational Structure in Multi-Campus Universities.

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Dengerink, Harold A.

2001-01-01

Explores the structure of universities with multiple campuses but no independent central administrative system. Discusses the hybrid missions of branch campuses, which are asked to serve both the overall university and local constituent communities. Explains that these multiple missions may conflict and thus require intentional organizational…

Combining a Multi-Agent System and Communication Middleware for Smart Home Control: A Universal Control Platform Architecture.

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Zheng, Song; Zhang, Qi; Zheng, Rong; Huang, Bi-Qin; Song, Yi-Lin; Chen, Xin-Chu

2017-09-16

In recent years, the smart home field has gained wide attention for its broad application prospects. However, families using smart home systems must usually adopt various heterogeneous smart devices, including sensors and devices, which makes it more difficult to manage and control their home system. How to design a unified control platform to deal with the collaborative control problem of heterogeneous smart devices is one of the greatest challenges in the current smart home field. The main contribution of this paper is to propose a universal smart home control platform architecture (IAPhome) based on a multi-agent system and communication middleware, which shows significant adaptability and advantages in many aspects, including heterogeneous devices connectivity, collaborative control, human-computer interaction and user self-management. The communication middleware is an important foundation to design and implement this architecture which makes it possible to integrate heterogeneous smart devices in a flexible way. A concrete method of applying the multi-agent software technique to solve the integrated control problem of the smart home system is also presented. The proposed platform architecture has been tested in a real smart home environment, and the results indicate that the effectiveness of our approach for solving the collaborative control problem of different smart devices.

Combining a Multi-Agent System and Communication Middleware for Smart Home Control: A Universal Control Platform Architecture

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Zheng, Song; Zhang, Qi; Zheng, Rong; Huang, Bi-Qin; Song, Yi-Lin; Chen, Xin-Chu

2017-01-01

In recent years, the smart home field has gained wide attention for its broad application prospects. However, families using smart home systems must usually adopt various heterogeneous smart devices, including sensors and devices, which makes it more difficult to manage and control their home system. How to design a unified control platform to deal with the collaborative control problem of heterogeneous smart devices is one of the greatest challenges in the current smart home field. The main contribution of this paper is to propose a universal smart home control platform architecture (IAPhome) based on a multi-agent system and communication middleware, which shows significant adaptability and advantages in many aspects, including heterogeneous devices connectivity, collaborative control, human-computer interaction and user self-management. The communication middleware is an important foundation to design and implement this architecture which makes it possible to integrate heterogeneous smart devices in a flexible way. A concrete method of applying the multi-agent software technique to solve the integrated control problem of the smart home system is also presented. The proposed platform architecture has been tested in a real smart home environment, and the results indicate that the effectiveness of our approach for solving the collaborative control problem of different smart devices. PMID:28926957

Combining a Multi-Agent System and Communication Middleware for Smart Home Control: A Universal Control Platform Architecture

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Song Zheng

2017-09-01

Full Text Available In recent years, the smart home field has gained wide attention for its broad application prospects. However, families using smart home systems must usually adopt various heterogeneous smart devices, including sensors and devices, which makes it more difficult to manage and control their home system. How to design a unified control platform to deal with the collaborative control problem of heterogeneous smart devices is one of the greatest challenges in the current smart home field. The main contribution of this paper is to propose a universal smart home control platform architecture (IAPhome based on a multi-agent system and communication middleware, which shows significant adaptability and advantages in many aspects, including heterogeneous devices connectivity, collaborative control, human-computer interaction and user self-management. The communication middleware is an important foundation to design and implement this architecture which makes it possible to integrate heterogeneous smart devices in a flexible way. A concrete method of applying the multi-agent software technique to solve the integrated control problem of the smart home system is also presented. The proposed platform architecture has been tested in a real smart home environment, and the results indicate that the effectiveness of our approach for solving the collaborative control problem of different smart devices.

Demographic characteristics and clinical predictors of patients discharged from university hospital-affiliated pain clinic due to breach in narcotic use contract.

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Chakrabortty, Shushovan; Gupta, Deepak; Rustom, David; Berry, Hussein; Rai, Ajit

2014-01-01

The current retrospective study was completed with the aim to identify demographic characteristics and clinical predictors (if any) of the patients discharged from our pain clinic due to breach in narcotic use contract (BNUC). Retrospective patient charts' review and data audit. University hospital-affiliated pain clinic in the United States. All patient charts in our pain clinic for a 2-year period (2011-2012). The patients with BNUC were delineated from the patients who had not been discharged from our pain clinic. Pain characteristics, pain management, and substance abuse status were compared in each patient with BNUC between the time of admission and the time of discharge. The patients with BNUC discharges showed significant variability for the discharging factors among the pain physicians within a single pain clinic model with this variability being dependent on their years of experience and their proactive interventional pain management. The patients with BNUC in our pain clinic setting were primarily middle-aged, obese, unmarried males with nondocumented stable occupational history who were receiving only noninterventional pain management. Substance abuse, doctor shopping, and potential diversion were the top three documented reasons for BNUC discharges. In 2011-2012, our pain clinic discharged 1-in-16 patients due to breach in narcotic use contract.

Validation of Foot Placement Locations from Ankle Data of a Kinect v2 Sensor.

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Geerse, Daphne; Coolen, Bert; Kolijn, Detmar; Roerdink, Melvyn

2017-10-10

The Kinect v2 sensor may be a cheap and easy to use sensor to quantify gait in clinical settings, especially when applied in set-ups integrating multiple Kinect sensors to increase the measurement volume. Reliable estimates of foot placement locations are required to quantify spatial gait parameters. This study aimed to systematically evaluate the effects of distance from the sensor, side and step length on estimates of foot placement locations based on Kinect's ankle body points. Subjects (n = 12) performed stepping trials at imposed foot placement locations distanced 2 m or 3 m from the Kinect sensor (distance), for left and right foot placement locations (side), and for five imposed step lengths. Body points' time series of the lower extremities were recorded with a Kinect v2 sensor, placed frontoparallelly on the left side, and a gold-standard motion-registration system. Foot placement locations, step lengths, and stepping accuracies were compared between systems using repeated-measures ANOVAs, agreement statistics and two one-sided t -tests to test equivalence. For the right side at the 2 m distance from the sensor we found significant between-systems differences in foot placement locations and step lengths, and evidence for nonequivalence. This distance by side effect was likely caused by differences in body orientation relative to the Kinect sensor. It can be reduced by using Kinect's higher-dimensional depth data to estimate foot placement locations directly from the foot's point cloud and/or by using smaller inter-sensor distances in the case of a multi-Kinect v2 set-up to estimate foot placement locations at greater distances from the sensor.

Foot ulcer risk and location in relation to prospective clinical assessment of foot shape and mobility among persons with diabetes.

Science.gov (United States)

Cowley, Matthew S; Boyko, Edward J; Shofer, Jane B; Ahroni, Jessie H; Ledoux, William R

2008-11-01

We assessed baseline clinical foot shape for 2939 feet of diabetic subjects who were monitored prospectively for foot ulceration. Assessments included hammer/claw toes, hallux valgus, hallux limitus, prominent metatarsal heads, bony prominences, Charcot deformity, plantar callus, foot type, muscle atrophy, ankle and hallux mobility, and neuropathy. Risk factors were linked to ulcer occurrence and location via a Cox proportional hazards model. Hammer/claw toes (hazard ratio [HR] (95% confidence interval [CI])=1.43 (1.06, 1.94) p=0.02), marked hammer/claw toes (HR=1.77 (1.18, 2.66) p=0.006), bony prominences (HR=1.38 (1.02, 1.88), p=0.04), and foot type (Charcot or drop foot vs. neutrally aligned) (HR=2.34 (1.33, 4.10), p=0.003) were significant risk factors for ulceration adjusting for age, body mass index, insulin medication, ulcer history and amputation history. With adjustment for neuropathy only hammer/claw toes (HR=1.40 (1.03, 1.90), p=0.03) and foot type (HR=1.76 (1.04, 3.04), p=0.05) were significantly related to ulceration. However, there was no relationship between ulcer location and foot deformity. Certain foot deformities were predictive of ulceration, although there was no relationship between clinical foot deformity and ulcer location.

Centralization Versus Decentralization: A Location Analysis Approach for Librarians.

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Shishko, Robert; Raffel, Jeffrey

One of the questions that seems to perplex many university and special librarians is whether to move in the direction of centralizing or decentralizing the library's collections and facilities. Presented is a theoretical approach, employing location theory, to the library centralization-decentralization question. Location theory allows the analyst…

Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan

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Minamisawa A

2016-09-01

Full Text Available Atsumi Minamisawa,1 Jin Narumoto,1 Isao Yokota,2 Kenji Fukui1 1Department of Psychiatry, 2Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan Background: Patient dropout from treatment can lead to a deterioration in clinical condition, thereby increasing the need for more intensive therapy that incurs substantial social and economic losses. The aim of this study was to identify factors related to psychiatric patient dropout at a university outpatient clinic in Japan.Methods: We retrospectively examined the medical charts of new psychiatric patients who were diagnosed with either a mood disorder (International Classification of Diseases, 10th revision, code: F3 or an anxiety disorder (F4 in the outpatient clinic at Kyoto Prefectural University of Medicine Hospital in Kyoto, Japan, between April 2010 and March 2013. The baseline characteristics of the patients (age, sex, Global Assessment of Functioning score, Clinical Global Impression–Severity of Illness score, education, occupation, marital status, duration of treatment, and prior treatment history, treating psychiatrist experience in years, and sex concordance between the patients and their treating psychiatrists were analyzed using Cox regression models.Results: From among 1,626 eligible new patients during the study period, 532 patients were enrolled in the study (F3: n=176; F4: n=356. The dropout rate was 35.7%, which was similar to that of previous studies. Higher educational level, being married, and lower Global Assessment of Functioning scores were associated with a lower dropout rate. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, patients treated by less experienced psychiatrists had a higher hazard ratio for dropout (1.31; 95% confidence interval: 0.94–1.85.Conclusion: In order to reduce the dropout rate, special focus should be placed on

Location of the internal carotid artery and ophthalmic artery segments for non-invasive intracranial pressure measurement by multi-depth TCD.

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Hamarat, Yasin; Deimantavicius, Mantas; Kalvaitis, Evaldas; Siaudvytyte, Lina; Januleviciene, Ingrida; Zakelis, Rolandas; Bartusis, Laimonas

2017-12-01

The aim of the present study was to locate the ophthalmic artery by using the edge of the internal carotid artery (ICA) as the reference depth to perform a reliable non-invasive intracranial pressure measurement via a multi-depth transcranial Doppler device and to then determine the positions and angles of an ultrasonic transducer (UT) on the closed eyelid in the case of located segments. High tension glaucoma (HTG) patients and healthy volunteers (HVs) undergoing non-invasive intracranial pressure measurement were selected for this prospective study. The depth of the edge of the ICA was identified, followed by a selection of the depths of the IOA and EOA segments. The positions and angles of the UT on the closed eyelid were measured. The mean depth of the identified ICA edge for HTG patients was 64.3 mm and was 63.0 mm for HVs (p = 0.21). The mean depth of the selected IOA segment for HTG patients was 59.2 mm and 59.3 mm for HVs (p = 0.91). The mean depth of the selected EOA segment for HTG patients was 48.5 mm and 49.8 mm for HVs (p = 0.14). The difference in the located depths of the segments between groups was not statistically significant. The results showed a significant difference in the measured UT angles in the case of the identified edge of the ICA and selected ophthalmic artery segments (p = 0.0002). We demonstrated that locating the IOA and EOA segments can be achieved using the edge of the ICA as a reference point. OA: ophthalmic artery; IOA: intracranial segments of the ophthalmic artery; EOA: extracranial segments of the ophthalmic artery; ICA: internal carotid artery; UT: ultrasonic transducer; HTG: high tension glaucoma; SD: standard deviation; ICP: intracranial pressure; TCD: transcranial Doppler.

Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study

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Bateman James

2012-08-01

Full Text Available Abstract Background Virtual Patients (VPs are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent and structured clinical reasoning feedback (present or absent. Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent, and structured clinical reasoning feedback (present or absent.The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for

The Assessment of the Applications to University Hospital Urology Outpatient Clinic

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Adnan Gucuk

2013-04-01

Full Text Available Introduction: Provision of health care services to persons where it is needed required for the production of quality service in the organization of health services. The purpose of this study, determine the reason for admission and factors affecting admission and evaluate the current status for the patients admitted to a tertiary health care center. Materials and methods: The study was planned descriptive. Participants were determined among the patients were admitted to urology clinic between December 2011-March 2012 for any reason on a voluntary basis. Fourteen item questionnaire was completed by the physician. The survey asked the age, educational status, initial complaint, elapsed time from the beginning of complaints, whether was the previous treatment from another institution, reasons for choosing a university hospital polyclinics for participants. Results: A total of 337 participants attended, and their gender were 23.7% female, 76.3% male. 61.7% participants had received earlier medical attention because of complaints, 38.3% of had not received previously medical attention in any health institution and had to apply directly to the tertiary health care center. Apply directly to the university hospital outpatient clinic was significantly higher in men (p:0.11(table 1. Direct applications are increasing significantly in participant has higher education level. Compared to complexity of required investigations for patients had received and had not received earlier medical attention were no significant differences (p:0.134. Conclusion: For more effective use of health resources and results-oriented, training must be relevant to users of health care services to increase health literacy as well as a number of legal arrangements. [TAF Prev Med Bull 2013; 12(2.000: 165-168

Matching Expectations for Successful University Student Volunteering

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Paull, Megan; Omari, Maryam; MacCallum, Judith; Young, Susan; Walker, Gabrielle; Holmes, Kirsten; Haski-Leventha, Debbie; Scott, Rowena

2017-01-01

Purpose: The purpose of this paper is to demonstrate the importance of expectation formation and matching for university student volunteers and their hosts. Design/methodology/approach: This research involved a multi-stage data collection process including interviews with student volunteers, and university and host representatives from six…

A 3-year prospective clinical study of telescopic crown, bar, and locator attachments for removable four implant-supported maxillary overdentures.

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Zou, Duohong; Wu, Yiqun; Huang, Wei; Wang, Feng; Wang, Shen; Zhang, Zhiyong; Zhang, Zhiyuan

2013-01-01

To evaluate telescopic crown (TC), bar, and locator attachments used in removable four implant-supported overdentures for patients with edentulous maxillae. A total of 30 maxillary edentulous patients were enrolled in a 3-year prospective study. Ten patients (group A) were treated with overdentures supported by TCs, 10 patients (group B) with overdentures supported by bar attachments, and 10 patients (group C) with overdentures supported by locator attachments. A total of 120 implants were used to restore oral function. During the 3-year follow-up period, implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance efforts, and patient satisfaction were evaluated. All 30 patients were available for the 3-year follow-up and exhibited 100% implant survival and success rates. Peri-implant marginal bone resorption was not statistically significant for the three groups. There were lower plaque, bleeding, gingiva, and calculus indices in group C compared with groups A and B. The number of prosthodontic maintenance visits revealed eight complications in the TC group, seven complications in the bar group, and four complications in the locator group. However, there were no differences in the clinical effects of the overdentures in the three groups. Within the limits of this prospective study, it was concluded that the locator system produced superior clinical results compared with the TC and bar attachments in terms of peri-implant hygiene parameters, the frequency of prosthodontic maintenance measures, cost, and ease of denture preparation. However, longer-term prospective studies are required to confirm these results.

New mathematical modeling for a location-routing-inventory problem in a multi-period closed-loop supply chain in a car industry

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Forouzanfar, F.; Tavakkoli-Moghaddam, R.; Bashiri, M.; Baboli, A.; Hadji Molana, S. M.

2017-11-01

This paper studies a location-routing-inventory problem in a multi-period closed-loop supply chain with multiple suppliers, producers, distribution centers, customers, collection centers, recovery, and recycling centers. In this supply chain, centers are multiple levels, a price increase factor is considered for operational costs at centers, inventory and shortage (including lost sales and backlog) are allowed at production centers, arrival time of vehicles of each plant to its dedicated distribution centers and also departure from them are considered, in such a way that the sum of system costs and the sum of maximum time at each level should be minimized. The aforementioned problem is formulated in the form of a bi-objective nonlinear integer programming model. Due to the NP-hard nature of the problem, two meta-heuristics, namely, non-dominated sorting genetic algorithm (NSGA-II) and multi-objective particle swarm optimization (MOPSO), are used in large sizes. In addition, a Taguchi method is used to set the parameters of these algorithms to enhance their performance. To evaluate the efficiency of the proposed algorithms, the results for small-sized problems are compared with the results of the ɛ-constraint method. Finally, four measuring metrics, namely, the number of Pareto solutions, mean ideal distance, spacing metric, and quality metric, are used to compare NSGA-II and MOPSO.

Electronic apex locator: A comprehensive literature review — Part II: Effect of different clinical and technical conditions on electronic apex locator′s accuracy

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Hamid Razavian

2014-01-01

Full Text Available Introduction: To investigate the effects of different clinical and technical conditions on the accuracy of electronic apex locators (EALs. Materials and Methods: "Tooth apex," "dental instrument," "odontometry," "electronic medical," and "electronic apex locator" were searched as primary identifiers via Medline/PubMed, Cochrane library, and Scopus data base up to 30 July 2013. Original articles that fulfilled the inclusion criteria were selected and reviewed. Results: Out of 402 relevant studies, 183 were selected based on the inclusion criteria. In this part, 75 studies are presented. Pulp vitality conditions and root resorption, types of files and irrigating materials do not affect an EAL′s accuracy; however, the file size and foramen diameter can affect its accuracy. Conclusions: Various clinical conditions such as the file size and foramen diameter may affect EALs′ accuracy. However, more randomized clinical trials are needed for definitive conclusion.

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

Science.gov (United States)

Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

2016-05-01

Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

Analysis of neurological sequelae from radiosurgery of arteriovenous malformations: how location effects outcome

International Nuclear Information System (INIS)

Flickinger, John C.; Kondziolka, Douglas; Maitz, Ann H.; Lunsford, L. Dade

1997-01-01

Purpose/Objective: To elucidate how the risks of developing temporary and permanent neurological sequelae from radiosurgery for arteriovenous malformations (AVM) relate to AVM location, the addition of stereotactic magnetic resonance (MR) imaging to angiographic targeting, and prior hemorrhage or neurological deficits. Materials and Methods: We evaluated follow-up imaging and clinical data in 332 AVM patients who received gamma knife radiosurgery at the University of Pittsburgh between 1987 and 1994. All patients had regular clinical or imaging follow up for a minimum of two years (range: 24-96 mo., median=45 mo.). 83 patients had MR. planning, and 187 previously bled. Results: Symptomatic post-radiosurgery sequelae (any neurological problem including headache) developed in 30/332 patients (9.0%). Symptoms resolved in 58% of patients within 24 mo. with a significantly greater proportion (p=0.006) resolving in patients with Dmin <20 vs. ≥20 Gy (89 vs. 36%). The 7 yr. actuarial rate for developing persistent symptomatic sequelae was 3.8%. We first evaluated the relative risks for different locations to construct a post-radiosurgery injury expression (PIE) score for AVM location (see Table 1). Multivariate logistic regression analysis of symptomatic post-radiosurgery injury identified independent significant correlations with PIE location score (p=0.0007) and 12 Gy volume (p=0.008) but none of the other factors tested (p≥0.3) including the addition of MR targeting, average radiation dose in 20 cc, prior bleed or neurological deficit. We used these results to construct risk prediction models for any symptomatic post-radiosurgery sequelae and for symptomatic necrosis. Conclusion: The risks of complications from AVM radiosurgery can be predicted according to location with the PIE score and by the 12 Gy treatment volume (Table 2)

Multicentric evaluation of the impact of central tumour location when comparing rates of N1 upstaging in patients undergoing video-assisted and open surgery for clinical Stage I non-small-cell lung cancer.

Science.gov (United States)

Decaluwé, Herbert; Petersen, René Horsleben; Brunelli, Alex; Pompili, Cecilia; Seguin-Givelet, Agathe; Gust, Lucile; Aigner, Clemens; Falcoz, Pierre-Emmanuel; Rinieri, Philippe; Augustin, Florian; Sokolow, Youri; Verhagen, Ad; Depypere, Lieven; Papagiannopoulos, Kostas; Gossot, Dominique; D'Journo, Xavier Benoit; Guerrera, Francesco; Baste, Jean-Marc; Schmid, Thomas; Stanzi, Alessia; Van Raemdonck, Dirk; Bardet, Jeremy; Thomas, Pascal-Alexandre; Massard, Gilbert; Fieuws, Steffen; Moons, Johnny; Dooms, Christophe; De Leyn, Paul; Hansen, Henrik Jessen

2017-09-27

Large retrospective series have indicated lower rates of cN0 to pN1 nodal upstaging after video-assisted thoracic surgery (VATS) compared with open resections for Stage I non-small-cell lung cancer (NSCLC). The objective of our multicentre study was to investigate whether the presumed lower rate of N1 upstaging after VATS disappears after correction for central tumour location in a multivariable analysis. Consecutive patients operated for PET-CT based clinical Stage I NSCLC were selected from prospectively managed surgical databases in 11 European centres. Central tumour location was defined as contact with bronchovascular structures on computer tomography and/or visibility on standard bronchoscopy. Eight hundred and ninety-five patients underwent pulmonary resection by VATS (n = 699, 9% conversions) or an open technique (n = 196) in 2014. Incidence of nodal pN1 and pN2 upstaging was 8% and 7% after VATS and 15% and 6% after open surgery, respectively. pN1 was found in 27% of patients with central tumours. Less central tumours were operated on by VATS compared with the open technique (12% vs 28%, P < 0.001). Logistic regression analysis showed that only tumour location had a significant impact on N1 upstaging (OR 6.2, confidence interval 3.6-10.8; P < 0.001) and that the effect of surgical technique (VATS versus open surgery) was no longer significant when accounting for tumour location. A quarter of patients with central clinical Stage I NSCLC was upstaged to pN1 at resection. Central tumour location was the only independent factor associated with N1 upstaging, undermining the evidence for lower N1 upstaging after VATS resections. Studies investigating N1 upstaging after VATS compared with open surgery should be interpreted with caution due to possible selection bias, i.e. relatively more central tumours in the open group with a higher chance of N1 upstaging. © The Author 2017. Published by Oxford University Press on behalf of the European

Intelligent Multi-Media Integrated Interface Project

Science.gov (United States)

1990-06-01

been devoted to the application of aritificial intelligence technology to the development of human -computer interface technology that integrates speech...RADC-TR-90-128 Final Technical Report June 1090 AD-A225 973 INTELLIGENT MULTI-MEDIA INTEGRATED INTERFACE PROJECT Calspan-University of Buffalo...contractual obligations or notices on a specific document require that it be returned. INTELLIGENT MULTI-MEDIA INTEGRATED INTERFACE PROJECT J. G. Neal J. M

Is it the time to rethink clinical decision-making strategies? From a single clinical outcome evaluation to a Clinical Multi-criteria Decision Assessment (CMDA).

Science.gov (United States)

Migliore, Alberto; Integlia, Davide; Bizzi, Emanuele; Piaggio, Tomaso

2015-10-01

There are plenty of different clinical, organizational and economic parameters to consider in order having a complete assessment of the total impact of a pharmaceutical treatment. In the attempt to follow, a holistic approach aimed to provide an evaluation embracing all clinical parameters in order to choose the best treatments, it is necessary to compare and weight multiple criteria. Therefore, a change is required: we need to move from a decision-making context based on the assessment of one single criteria towards a transparent and systematic framework enabling decision makers to assess all relevant parameters simultaneously in order to choose the best treatment to use. In order to apply the MCDA methodology to clinical decision making the best pharmaceutical treatment (or medical devices) to use to treat a specific pathology, we suggest a specific application of the Multiple Criteria Decision Analysis for the purpose, like a Clinical Multi-criteria Decision Assessment CMDA. In CMDA, results from both meta-analysis and observational studies are used by a clinical consensus after attributing weights to specific domains and related parameters. The decision will result from a related comparison of all consequences (i.e., efficacy, safety, adherence, administration route) existing behind the choice to use a specific pharmacological treatment. The match will yield a score (in absolute value) that link each parameter with a specific intervention, and then a final score for each treatment. The higher is the final score; the most appropriate is the intervention to treat disease considering all criteria (domain an parameters). The results will allow the physician to evaluate the best clinical treatment for his patients considering at the same time all relevant criteria such as clinical effectiveness for all parameters and administration route. The use of CMDA model will yield a clear and complete indication of the best pharmaceutical treatment to use for patients

Authorship issues in multi-centre clinical trials

DEFF Research Database (Denmark)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

2015-01-01

to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference...... to the original source....

Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

Directory of Open Access Journals (Sweden)

Birhanu AM

2016-05-01

Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

Using the Multi-Criteria AHP for the Optimal Selection of Site Location and Wastewater Collection System The Case Study of Varzeghan

Directory of Open Access Journals (Sweden)

Hassan talebi

2015-11-01

Full Text Available This study investigates the use of multi-criteria decision making in waste management and selection of the site location and proper wastewater collection and processing system in Varzeqan Town. Moreover, the effect of the decision-making method employed on ranking the final alternatives will be evaluated. Different factors are involved in the selection of wastewater treatment construction sites. These factors, in turn, not only depend on the special location and time the decision is made but also have their own weights in the final decision. In this study, the environmental conditions in the study area are initially investigated to select one site from among five different alternatives proposed for the construction of the facility using the AHP method. Also, the AHP method is used to evaluate and select the suitable collection and treatment method from among the four non-conventional options including Septic Tank Effluent Gravity, Septic Tank Effluent Pressure, Vacuum Sewerage System, and Simplified Sewerage for this region based on the special geographical and geotechnical conditions. The results indicate that the barren lands between Varzeghan Town and Dizaj Safar Ali Village are the best site for constructing the treatment facility and that the simplified sewarge system is the best collection system for the region.

An inventory location routing model with environmental considerations

Directory of Open Access Journals (Sweden)

Lerhlaly Sanaa

2017-01-01

Full Text Available In this work we consider an integrated Inventory Location Routing problem ILRP. The objective is to select depots to open, the routes to perform distribution from the capacitated depots to the clients by a homogeneous fleet of vehicles and over a multi-period planning horizon. To solve the problem, an exact model is designed in order to minimize the total cost (location, routing and inventory and the routing CO2 emissions, while respecting transport and storage constraints for a hazardous material. We have also studied an industrial real case to illustrate the problem.

Universal Cable Brackets

Science.gov (United States)

Vanvalkenburgh, C.

1985-01-01

Concept allows routing easily changed. No custom hardware required in concept. Instead, standard brackets cut to length and installed at selected locations along cable route. If cable route is changed, brackets simply moved to new locations. Concept for "universal" cable brackets make it easy to route electrical cable around and through virtually any structure.

Real-Time Multi-Directional Equipment Site

Data.gov (United States)

Federal Laboratory Consortium — As part of the George E. Brown, Jr. Network for Earthquake Engineering Simulation (NEES) Program, Lehigh University has established the Real-Time Multi-Directional...

Development of a Patient-Specific Multi-Scale Model to Understand Atherosclerosis and Calcification Locations: Comparison with In vivo Data in an Aortic Dissection

Science.gov (United States)

Alimohammadi, Mona; Pichardo-Almarza, Cesar; Agu, Obiekezie; Díaz-Zuccarini, Vanessa

2016-01-01

Vascular calcification results in stiffening of the aorta and is associated with hypertension and atherosclerosis. Atherogenesis is a complex, multifactorial, and systemic process; the result of a number of factors, each operating simultaneously at several spatial and temporal scales. The ability to predict sites of atherogenesis would be of great use to clinicians in order to improve diagnostic and treatment planning. In this paper, we present a mathematical model as a tool to understand why atherosclerotic plaque and calcifications occur in specific locations. This model is then used to analyze vascular calcification and atherosclerotic areas in an aortic dissection patient using a mechanistic, multi-scale modeling approach, coupling patient-specific, fluid-structure interaction simulations with a model of endothelial mechanotransduction. A number of hemodynamic factors based on state-of-the-art literature are used as inputs to the endothelial permeability model, in order to investigate plaque and calcification distributions, which are compared with clinical imaging data. A significantly improved correlation between elevated hydraulic conductivity or volume flux and the presence of calcification and plaques was achieved by using a shear index comprising both mean and oscillatory shear components (HOLMES) and a non-Newtonian viscosity model as inputs, as compared to widely used hemodynamic indicators. The proposed approach shows promise as a predictive tool. The improvements obtained using the combined biomechanical/biochemical modeling approach highlight the benefits of mechanistic modeling as a powerful tool to understand complex phenomena and provides insight into the relative importance of key hemodynamic parameters. PMID:27445834

Non-localization and localization ROC analyses using clinically based scoring

Science.gov (United States)

Paquerault, Sophie; Samuelson, Frank W.; Myers, Kyle J.; Smith, Robert C.

2009-02-01

We are investigating the potential for differences in study conclusions when assessing the estimated impact of a computer-aided detection (CAD) system on readers' performance. The data utilized in this investigation were derived from a multi-reader multi-case observer study involving one hundred mammographic background images to which fixed-size and fixed-intensity Gaussian signals were added, generating a low- and high-intensity signal sets. The study setting allowed CAD assessment in two situations: when CAD sensitivity was 1) superior or 2) lower than the average reader. Seven readers were asked to review each set in the unaided and CAD-aided reading modes, mark and rate their findings. Using this data, we studied the effect on study conclusion of three clinically-based receiver operating characteristic (ROC) scoring definitions. These scoring definitions included both location-specific and non-location-specific rules. The results showed agreement in the estimated impact of CAD on the overall reader performance. In the study setting where CAD sensitivity is superior to the average reader, the mean difference in AUC between the CAD-aided read and unaided read was 0.049 (95%CIs: -0.027; 0.130) for the image scoring definition that is based on non-location-specific rules, and 0.104 (95%CIs: 0.036; 0.174) and 0.090 (95%CIs: 0.031; 0.155) for image scoring definitions that are based on location-specific rules. The increases in AUC were statistically significant for the location-specific scoring definitions. It was further observed that the variance on these estimates was reduced when using the location-specific scoring definitions compared to that using a non-location-specific scoring definition. In the study setting where CAD sensitivity is equivalent or lower than the average reader, the mean differences in AUC are slightly above 0.01 for all image scoring definitions. These increases in AUC were not statistical significant for any of the image scoring definitions

Multiple-animal MR imaging using a 3T clinical scanner and multi-channel coil for volumetric analysis in a mouse tumor model

International Nuclear Information System (INIS)

Mitsuda, Minoru; Yamaguchi, Masayuki; Furuta, Toshihiro; Fujii, Hirofumi; Nabetani, Akira; Hirayama, Akira; Nozaki, Atsushi; Niitsu, Mamoru

2011-01-01

Multiple small-animal magnetic resonance (MR) imaging to measure tumor volume may increase the throughput of preclinical cancer research assessing tumor response to novel therapies. We used a clinical scanner and multi-channel coil to evaluate the usefulness of this imaging to assess experimental tumor volume in mice. We performed a phantom study to assess 2-dimensional (2D) geometric distortion using 9-cm spherical and 32-cell (8 x 4 one-cm 2 grids) phantoms using a 3-tesla clinical MR scanner and dedicated multi-channel coil composed of 16 5-cm circular coils. Employing the multi-channel coil, we simultaneously scanned 6 or 8 mice bearing sarcoma 180 tumors. We estimated tumor volume from the sum of the product of tumor area and slice thickness on 2D spin-echo images (repetition time/echo time, 3500/16 ms; in-plane resolution, 0.195 x 0.195 x 1 mm 3 ). After MR acquisition, we excised and weighed tumors, calculated reference tumor volumes from actual tumor weight assuming a density of 1.05 g/cm 3 , and assessed the correlation between the estimated and reference volumes using Pearson's test. Two-dimensional geometric distortion was acceptable below 5% in the 9-cm spherical phantom and in every cell in the 32-cell phantom. We scanned up to 8 mice simultaneously using the multi-channel coil and found 11 tumors larger than 0.1 g in 12 mice. Tumor volumes were 1.04±0.73 estimated by MR imaging and 1.04±0.80 cm 3 by reference volume (average±standard deviation) and highly correlated (correlation coefficient, 0.995; P<0.01, Pearson's test). Use of multiple small-animal MR imaging employing a clinical scanner and multi-channel coil enabled accurate assessment of experimental tumor volume in a large number of mice and may facilitate high throughput monitoring of tumor response to therapy in preclinical research. (author)

Size of shell universe in light of Fermi GBM transient associated with GW150914

Directory of Open Access Journals (Sweden)

Merab Gogberashvili

2016-12-01

Full Text Available The possible burst occurred in location and temporal consistence with gravitational wave event GW150914, as reported by Fermi GBM, offers a new way of constraining models with extra dimensions. Using the time delay in arrival of the gamma ray transient observed by Fermi Gamma-ray Burst Monitor (GMB relative to the gravitational waves event triggered by the LIGO detectors we investigate the size of the spherical brane-universe expanding in multi-dimensional space–time. It is shown that a joint observation of gravitational waves in association with gamma ray burst can provide a very stringent bound on the spatial curvature of the brain.

Size of shell universe in light of Fermi GBM transient associated with GW150914

Energy Technology Data Exchange (ETDEWEB)

Gogberashvili, Merab, E-mail: gogber@gmail.com [Department of Exact and Natural Sciences, Javakhishvili Tbilisi State University, Tbilisi 0179, Georgia (United States); Department of High Energy Physics, Andronikashvili Institute of Physics, Tbilisi 0177, Georgia (United States); Sakharov, Alexander S., E-mail: Alexandre.Sakharov@cern.ch [Department of Physics, New York University, 4 Washington Place, New York, NY 10003 (United States); Physics Department, Manhattan College, 4513 Manhattan College Parkway, Riverdale, NY 10471 (United States); Experimental Physics Department, CERN, CH-1211 Genève 23 (Switzerland); Sarkisyan-Grinbaum, Edward K., E-mail: sedward@cern.ch [Experimental Physics Department, CERN, CH-1211 Genève 23 (Switzerland); Department of Physics, The University of Texas at Arlington, 502 Yates Street, Box 19059, Arlington, TX 76019 (United States)

2016-12-10

The possible burst occurred in location and temporal consistence with gravitational wave event GW150914, as reported by Fermi GBM, offers a new way of constraining models with extra dimensions. Using the time delay in arrival of the gamma ray transient observed by Fermi Gamma-ray Burst Monitor (GMB) relative to the gravitational waves event triggered by the LIGO detectors we investigate the size of the spherical brane-universe expanding in multi-dimensional space–time. It is shown that a joint observation of gravitational waves in association with gamma ray burst can provide a very stringent bound on the spatial curvature of the brain.

Clinical nurses' attitudes towards research, management and organisational resources in a university hospital: part 1.

Science.gov (United States)

Akerjordet, Kristin; Lode, Kirsten; Severinsson, Elisabeth

2012-09-01

The aim of this study was to determine clinical nurses' interest in and motivation for research. An additional aim was to identify management and organisational resources in order to improve nurses' research capacity in practice. Clinical nurses find conducting research challenging, which accords with observations of the continuing research-practice gap. This descriptive cross-sectional survey sampled 364 clinical nurses from a university hospital on the west coast of Norway. The response rate was 61%. An increasingly positive attitude towards research emerged (40%), despite the fact that few were engaged in research-based activities. Clinical nurses emphasised that lack of designated time (60%), interest (31%) and knowledge (31%) constituted important research barriers, as did lack of research supervision and support (25%). Research supervision was one of the most significant needs to enhance clinical nurses' research skills, management and organisation of research activities (30%). Conscious efforts strategically built on clinical and academic collaborative networks are required to promote and sustain clinical nurses' research capacity. The findings of this survey should be useful in the building of clinical nurses' research capacity. © 2012 Blackwell Publishing Ltd.

Active Multi-Field Learning for Spam Filtering

OpenAIRE

Wuying Liu; Lin Wang; Mianzhu Yi; Nan Xie

2015-01-01

Ubiquitous spam messages cause a serious waste of time and resources. This paper addresses the practical spam filtering problem, and proposes a universal approach to fight with various spam messages. The proposed active multi-field learning approach is based on: 1) It is cost-sensitive to obtain a label for a real-world spam filter, which suggests an active learning idea; and 2) Different messages often have a similar multi-field text structure, which suggests a multi-field learning idea. The...

Perspectives on Spatial Decision Support Concerning Location of Biogas Production

DEFF Research Database (Denmark)

Bojesen, Mikkel

in biogas production. This ambition requires that more than 20 new large scale centralised biogas plants are built. The location of these plants is associated with a number of externalities and uncertainties and the existing biogas sector struggles to establish itself as a viable energy producing sector....... Meanwhile planners and decision makers struggle to find sustainable locations that comprehensively balance the multiple concerns the location of biogas facilities includes. This PhD project examines how spatial decision support models can be used to ensure sustainable locations of future biogas plants......, understand the industrial economic aspects of such a role. Through the use of spatial multi-criteria evaluation models stakeholder preferences to decision criteria are included in a sustainable biogas facility location analysis. By the use of these models it is demonstrated how overall biogas production...

Fuzzy MCDM framework for locating a nuclear power plant in Turkey

International Nuclear Information System (INIS)

Erol, İsmail; Sencer, Safiye; Özmen, Aslı; Searcy, Cory

2014-01-01

Turkey has recently initiated a project to revise its nuclear policy. The revised nuclear energy policy considers searching for possible alternative locations for future nuclear power plants in Turkey. At the most basic level, the public cannot accurately evaluate whether it is willing to support nuclear energy unless it has an idea about where the power plants are likely to be located. It is argued that the selection of a facility location is a multi-criteria decision-making problem including both quantitative and qualitative criteria. In this research, given the multi-criteria nature of the nuclear facility location selection problem, a new decision tool is proposed to rank the alternative nuclear power plant sites in Turkey. The proposed tool is based on fuzzy Entropy and t norm based fuzzy compromise programming to deal with the vagueness of human judgments. Finally, a discussion and some concluding remarks are provided. - Highlights: • Fuzzy MCDM approach is developed to select nuclear power plant location in Turkey. • The proposed framework employs fuzzy entropy and fuzzy compromise programming. • A criterion set was developed using a map by The Turkish Atomic Energy Authority. • Cilingoz is found to be the best with the index values 0.6584 and 0.0838. • The proposed tool can be considered a tool to evaluate the alternative sites

Effect of caries-affected dentin on one-step universal and multi-step etch-and-rinse adhesives’ bond strength

Directory of Open Access Journals (Sweden)

Clecila MÜLLER

2017-10-01

Full Text Available Abstract Objective To evaluate the influence of caries-affected dentin on bond strength of a universal one-step and a multi-step etch-and-rinse adhesive system. Material and method Enamel of 60 third human molars with and without caries was removed to expose dentin. The teeth were randomly assigned to six groups: Single Bond Universal (3M ESPE, St. Paul, MN, USA in etch-and-rinse and in self-etch mode and Prime & Bond NT (Dentsply Co, Konstanz, Germany, all on sound and caries-affected dentin. Smear layer of the 30 sound dentin specimens was standardized by polishing with 600-grit SiC paper under water cooling. Residual infected dentin of the 30 caries-affected specimens was removed with a number 4 CA carbide bur until no caries smooth tissue was detectable by tactile-visual inspection. Cylinders of a light cured composite resin (Filtek Z350 XT, 3M ESPE were built up using starch tubes and microshear test was performed until failure. The data was analyzed by one-way ANOVA and Tukey’s post hoc test. Result Significant differences in microshear bond strength (μSBS were observed for the caries-affected groups, but not for sound dentin. The μSBS of Single Bond Universal were not influenced by the application protocol on sound dentin, however they were lower in the caries-affected group with both application protocols. The μSBS for Prime & Bond NT was not influenced by the dentin conditions. Conclusion Caries-affected dentin decrease in bond strength of Single Bond Universal in comparison to sound dentin. The bond strength of Prime & Bond NT was not altered by substrate conditions.

Innovating information-delivery for potential clinical trials participants. What do patients want from multi-media resources?

Science.gov (United States)

Shneerson, Catherine; Windle, Richard; Cox, Karen

2013-01-01

To discover whether the provision of clinical trials information via a multi-media platform could better meet the needs, preferences and practices of potential cancer trial participants. A mixed qualitative and quantitative questionnaire was delivered to 72 participants from cancer support groups to elicit views on the provision and design features of multimedia resources in delivering clinical trials information. Perceived lack of information is an expressed barrier to clinical trials participation. Multimedia resources were viewed positively as a way to address this barrier by most potential clinical trials participants; in particular by helping to align information to individual needs, promote active engagement with information, and by allowing more control of the learning experience. Whilst text remained the most valued attribute of any resource, other highly rated attributes included the resource being simple to use, easily accessible, having a clear focus, incorporating examples and visual aids, and being interactive. Provision of support for the learning resource was also rated highly. As in other areas, such as education, multimedia resources may enhance the delivery and acceptance of information regarding clinical trials. Better alignment of information may have a positive impact on recruitment and retention into clinical trials. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A multi-step method with signal quality assessment and fine-tuning procedure to locate maternal and fetal QRS complexes from abdominal ECG recordings

International Nuclear Information System (INIS)

Liu, Chengyu; Li, Peng; Zhao, Lina; Di Maria, Costanzo; Zhang, Henggui; Chen, Zhiqing

2014-01-01

Non-invasive monitoring of fetal electrocardiogram (fECG) plays an important role in detecting and diagnosing fetal diseases. This study aimed to develop a multi-step method for locating both maternal and fetal QRS complexes from abdominal ECG (aECG) recordings. The proposed method included four major steps: abdominal ECG pre-processing, maternal QRS complex locating, maternal ECG cancellation and fetal QRS complex locating. Signal quality assessment (SQA) and fine-tuning for maternal ECG (FTM) were implemented in the first and third steps, respectively. The method was then evaluated using 75 non-invasive 4-channel aECG recordings provided by the PhysioNet/Computing in Cardiology Challenge 2013. The F 1 measure, which is a new index introduced by Behar et al (2013 Proc. Comput. Cardiol. 40 297–300), was used to assess the locating accuracy. The other two indices, mean squared error of heart rate (MSE H R) between the fetal HR signals estimated from the reference and our method (MSE H R in bpm 2 ) and root mean squared difference between the corresponding fetal RR intervals (MSE R R in ms) were also used to assess the locating accuracy. Overall, for the maternal QRS complex, the F 1 measure was 98.4% from the method without the implementation of SQA, and it was improved to 99.8% with SQA. For the fetal QRS complex, the F 1 measure, MSE H R and MSE R R were 84.9%, 185.6 bpm 2 and 19.4 ms for the method without both SQA and FTM procedures. They were improved to 93.9%, 47.5 bpm 2 and 7.6 ms with both SQA and FTM procedures. These improvements were observed from each individual subject. It can be concluded that implementing both SQA and FTM procedures could achieve better performance for locating both maternal and fetal QRS complexes. (paper)

Optimal sizing of a multi-source energy plant for power heat and cooling generation

International Nuclear Information System (INIS)

Barbieri, E.S.; Dai, Y.J.; Morini, M.; Pinelli, M.; Spina, P.R.; Sun, P.; Wang, R.Z.

2014-01-01

Multi-source systems for the fulfilment of electric, thermal and cooling demand of a building can be based on different technologies (e.g. solar photovoltaic, solar heating, cogeneration, heat pump, absorption chiller) which use renewable, partially renewable and fossil energy sources. Therefore, one of the main issues of these kinds of multi-source systems is to find the appropriate size of each technology. Moreover, building energy demands depend on the climate in which the building is located and on the characteristics of the building envelope, which also influence the optimal sizing. This paper presents an analysis of the effect of different climatic scenarios on the multi-source energy plant sizing. For this purpose a model has been developed and has been implemented in the Matlab ® environment. The model takes into consideration the load profiles for electricity, heating and cooling for a whole year. The performance of the energy systems are modelled through a systemic approach. The optimal sizing of the different technologies composing the multi-source energy plant is investigated by using a genetic algorithm, with the goal of minimizing the primary energy consumption only, since the cost of technologies and, in particular, the actual tariff and incentive scenarios depend on the specific country. Moreover economic considerations may lead to inadequate solutions in terms of primary energy consumption. As a case study, the Sino-Italian Green Energy Laboratory of the Shanghai Jiao Tong University has been hypothetically located in five cities in different climatic zones. The load profiles are calculated by means of a TRNSYS ® model. Results show that the optimal load allocation and component sizing are strictly related to climatic data (e.g. external air temperature and solar radiation)

Student travel health and the role of universities and health clinics in New Zealand to prevent imported infections: a cross-sectional study.

Science.gov (United States)

Neave, Penny E; Nair, Balakrishnan; Heywood, Anita E

2017-05-01

Tertiary students are at risk of acquiring infectious diseases during overseas travel as they visit low-income countries, have low perceptions of risk and are unlikely to access travel health advice. Some will visit friends and relatives abroad, a group identified as disproportionately affected by imported infections. There is no national student travel health policy in NZ. This study aimed to explore travel health training of university-based health providers; academics' practices and perceptions of travel health; reasons for travel and countries visited by NZ university students, their travel health uptake and factors affecting decision making about this. A cross-sectional study consisting of surveys sent in 2014 to university clinics, senior academics and students. Surveys were completed by 251 respondents. Three of nine clinicians had only undertaken a short course in travel health. Competing resources and time constraints in health clinics were amongst the barriers to providing optimal services. Of the senior academics, only 14% were able to confirm their university collaborated with health clinics. Sixty seven percent of students were unaware that clinics provided travel health services and 19% had or intended to seek professional travel health advice. A national policy is warranted involving all stakeholders, utilizing innovative technologies to increase uptake of student travel health services. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Public data and open source tools for multi-assay genomic investigation of disease.

Science.gov (United States)

Kannan, Lavanya; Ramos, Marcel; Re, Angela; El-Hachem, Nehme; Safikhani, Zhaleh; Gendoo, Deena M A; Davis, Sean; Gomez-Cabrero, David; Castelo, Robert; Hansen, Kasper D; Carey, Vincent J; Morgan, Martin; Culhane, Aedín C; Haibe-Kains, Benjamin; Waldron, Levi

2016-07-01

Molecular interrogation of a biological sample through DNA sequencing, RNA and microRNA profiling, proteomics and other assays, has the potential to provide a systems level approach to predicting treatment response and disease progression, and to developing precision therapies. Large publicly funded projects have generated extensive and freely available multi-assay data resources; however, bioinformatic and statistical methods for the analysis of such experiments are still nascent. We review multi-assay genomic data resources in the areas of clinical oncology, pharmacogenomics and other perturbation experiments, population genomics and regulatory genomics and other areas, and tools for data acquisition. Finally, we review bioinformatic tools that are explicitly geared toward integrative genomic data visualization and analysis. This review provides starting points for accessing publicly available data and tools to support development of needed integrative methods. © The Author 2015. Published by Oxford University Press.

Embry-Riddle Aeronautical University multispectral sensor and data fusion laboratory: a model for distributed research and education

Science.gov (United States)

McMullen, Sonya A. H.; Henderson, Troy; Ison, David

2017-05-01

The miniaturization of unmanned systems and spacecraft, as well as computing and sensor technologies, has opened new opportunities in the areas of remote sensing and multi-sensor data fusion for a variety of applications. Remote sensing and data fusion historically have been the purview of large government organizations, such as the Department of Defense (DoD), National Aeronautics and Space Administration (NASA), and National Geospatial-Intelligence Agency (NGA) due to the high cost and complexity of developing, fielding, and operating such systems. However, miniaturized computers with high capacity processing capabilities, small and affordable sensors, and emerging, commercially available platforms such as UAS and CubeSats to carry such sensors, have allowed for a vast range of novel applications. In order to leverage these developments, Embry-Riddle Aeronautical University (ERAU) has developed an advanced sensor and data fusion laboratory to research component capabilities and their employment on a wide-range of autonomous, robotic, and transportation systems. This lab is unique in several ways, for example, it provides a traditional campus laboratory for students and faculty to model and test sensors in a range of scenarios, process multi-sensor data sets (both simulated and experimental), and analyze results. Moreover, such allows for "virtual" modeling, testing, and teaching capability reaching beyond the physical confines of the facility for use among ERAU Worldwide students and faculty located around the globe. Although other institutions such as Georgia Institute of Technology, Lockheed Martin, University of Dayton, and University of Central Florida have optical sensor laboratories, the ERAU virtual concept is the first such lab to expand to multispectral sensors and data fusion, while focusing on the data collection and data products and not on the manufacturing aspect. Further, the initiative is a unique effort among Embry-Riddle faculty to develop multi

A Software Module for High-Accuracy Calibration of Rings and Cylinders on CMM using Multi-Orientation Techniques (Multi-Step and Reversal methods)

DEFF Research Database (Denmark)

Tosello, Guido; De Chiffre, Leonardo

. The Centre for Geometrical Metrology (CGM) at the Technical University of Denmark takes care of free form measurements, in collaboration with DIMEG, University of Padova, Italy. The present report describes a software module, ROUNDCAL, to be used for high-accuracy calibration of rings and cylinders....... The purpose of the software is to calculate the form error and the least square circle of rings and cylinders by mean of average of pontwise measuring results becoming from so-called multi-orientation techniques (both reversal and multi-step methods) in order to eliminate systematic errors of CMM ....

Neurosurgery clinical registry data collection utilizing Informatics for Integrating Biology and the Bedside and electronic health records at the University of Rochester.

Science.gov (United States)

Pittman, Christine A; Miranpuri, Amrendra S

2015-12-01

In a population health-driven health care system, data collection through the use of clinical registries is becoming imperative to continue to drive effective and efficient patient care. Clinical registries rely on a department's ability to collect high-quality and accurate data. Currently, however, data are collected manually with a high risk for error. The University of Rochester's Department of Neurosurgery in conjunction with the university's Clinical and Translational Science Institute has implemented the integrated use of the Informatics for Integrating Biology and the Bedside (i2b2) informatics framework with the Research Electronic Data Capture (REDCap) databases.

Enhanced associative memory for colour (but not shape or location) in synaesthesia.

OpenAIRE

Pritchard Jamie; Rothen Nicolas; Coolbear Daniel; Ward Jamie

2013-01-01

People with grapheme colour synaesthesia have been shown to have enhanced memory on a range of tasks using both stimuli that induce synaesthesia (e.g. words) and more surprisingly stimuli that do not (e.g. certain abstract visual stimuli). This study examines the latter by using multi featured stimuli consisting of shape colour and location conjunctions (e.g. shape A+colour A+location A; shape B+colour B+location B) presented in a recognition memory paradigm. This enables distractor items to ...

Job Satisfaction in Basic and Clinical Faculty Members in Shiraz University of Medical Sciences, Iran

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Mehdi Saberi-Firoozi

2009-02-01

Full Text Available Background and Purpose: Shiraz University of Medical Sciences as one of the oldest and largest universities of medicine in Iran with 50 years history has more than 450 faculty members and 5000 students. This study is an attempt to find out the level of job satisfaction among Shiraz University ofMedical Sciences’ faculty members.Methods: In midterm of 2003-2004, data on job satisfaction level among 404 faculty members from all schools of Shiraz University of Medical Sciences were collected. The translation of Spector’s job satisfaction score was used including 34 questions in 9 items of job satisfaction and each one based on Likert’s Scale with score an of 1-5. A question related to overall job satisfaction of faculty members was added.Results: Of all faculties,, 252 responded to the questionnaire and 70.1% expressed satisfaction in response the added question. The mean scores of job satisfaction in items of coworkers, work nature, supervision, management methods, academic relations, promotion, salary and suitable benefits were3.771, 3.265, 2.557, 2.454, 2.395, and 2.376 out of 5 respectively (F=223.8, p=0.0001. In the promotion item, the satisfaction of female faculty was lower than male subjects. The level of job satisfaction was not different between clinical faculty members of Medical School with or without private activity. The results of linear regression analysis between the items of job satisfaction revealed that reimbursement and fringe benefits could predict the overall job satisfaction (r2=0.70, p<0.01.Conclusion: As a whole, the faculty members of the university were satisfied with their jobs, but a correction in reimbursement, benefits and promotion regulations especially in lower academic ranks is needed to improve the level of job satisfaction in this group.Key words: JOB SATISFACTION, FACULTY MEMBER, BASIC AND CLINICAL DEPARTMENTS, FULLTIME, PART-TIME

Robust facility location: Hedging against failures

International Nuclear Information System (INIS)

Hernandez, Ivan; Emmanuel Ramirez-Marquez, Jose; Rainwater, Chase; Pohl, Edward; Medal, Hugh

2014-01-01

While few companies would be willing to sacrifice day-to-day operations to hedge against disruptions, designing for robustness can yield solutions that perform well before and after failures have occurred. Through a multi-objective optimization approach this paper provides decision makers the option to trade-off total weighted distance before and after disruptions in the Facility Location Problem. Additionally, this approach allows decision makers to understand the impact on the opening of facilities on total distance and on system robustness (considering the system as the set of located facilities). This approach differs from previous studies in that hedging against failures is done without having to elicit facility failure probabilities concurrently without requiring the allocation of additional hardening/protections resources. The approach is applied to two datasets from the literature

A comparative study of FDG PET/CT and enhanced multi-detector CT for detecting liver metastasis according to the size and location.

Science.gov (United States)

Park, Jung Mi; Kim, Il Young; Kim, Sang Won; Lee, Sang Mi; Kim, Hyun Gi; Kim, Shin Young; Shin, Hyung Chul

2013-04-01

The aim of this study was to compare the diagnosability between (18)F-fluorodeoxyglucose (FDG) PET/CT and enhanced multi-detector CT (MDCT) for the detection of liver metastasis (LM) according to the size and location in liver and to evaluate standard maximum standardized uptake values (SUVmax) of all liver metastatic lesions. One hundred two consecutive patients with malignancy who underwent both FDG PET/CT and MDCT for LM evaluation were retrospectively reviewed. Among them, 56 patients with LM were enrolled in this study. LM was confirmed by follow-up imaging studies after at least 6 months or by histopathology. FDG PET/CT and MDCT images were visually analyzed using three-point scale by the consensus of two radiologists and two nuclear medicine physicians. The size and location (central vs. sub-capsular) of the all liver lesions were evaluated using MDCT images. Furthermore, SUVmax of all liver lesions on FDG PET/CT images were calculated. A total of 146 liver lesions were detected by FDG PET/CT and MDCT and 142 of the lesions were diagnosed as LM. The detection rates of MDCT and FDG PET/CT for LM by visual analysis were 77 and 78%, respectively. There was no significant difference of detection rate according to the overall location and size of the lesions. However, FDG PET/CT was more sensitive than MDCT for detecting small and sub-capsular LM. The detection rate of FDG PET/CT for LM was 68% by the cutoff SUVmax of 2.7. Although the diagnosabilities of MDCT and FDG PET/CT for detecting LM were comparable, FDG PET/CT is superior to MDCT for detecting small LM located in the sub-capsular portion of liver.

Clinical profile of hypertension at a University Teaching Hospital in Nigeria

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Arthur C Onwuchekwa

2010-07-01

Full Text Available Arthur C Onwuchekwa, Sunday ChinenyeDepartment of Internal Medicine, University of Port Harcourt Teaching Hospital, NigeriaBackground: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications.Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH.Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed.Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all ­medical admissions. Only 424 (15.2% had complete records and were analyzed. Record keeping was poor. There were 173 (41% males and 251 (59% females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9% hypertensive complications. Heart failure occurred in 97 (22% cases while renal failure and encephalopathy accounted for 40 (9.4% and 7 (1.7% hypertensive complications respectively. There were 99 deaths out of which 51 (51.5% were due to stroke, 14 (14.12% were due to heart failure, and 12 (12.1% were due to renal failure.Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant.Keywords: clinical profile, hypertension, University of Port Harcourt Teaching Hospital

3-Dimensional and Interactive Istanbul University Virtual Laboratory Based on Active Learning Methods

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Ince, Elif; Kirbaslar, Fatma Gulay; Yolcu, Ergun; Aslan, Ayse Esra; Kayacan, Zeynep Cigdem; Alkan Olsson, Johanna; Akbasli, Ayse Ceylan; Aytekin, Mesut; Bauer, Thomas; Charalambis, Dimitris; Gunes, Zeliha Ozsoy; Kandemir, Ceyhan; Sari, Umit; Turkoglu, Suleyman; Yaman, Yavuz; Yolcu, Ozgu

2014-01-01

The purpose of this study is to develop a 3-dimensional interactive multi-user and multi-admin IUVIRLAB featuring active learning methods and techniques for university students and to introduce the Virtual Laboratory of Istanbul University and to show effects of IUVIRLAB on students' attitudes on communication skills and IUVIRLAB. Although there…

Revitalization of clinical skills training at the University of the Western Cape

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J.D. Jeggels

2010-09-01

Full Text Available Most educational institutions that offer health related qualifications make use of clinical skills laboratories. These spaces are generally used for the demonstration and assessment of clinical skills. The purpose of this paper is to share our experiences related to the revitalization of skills training by introducing the skills lab method at the School of Nursing (SoN, University of the Western Cape (UWC. To accommodate the contextual changes as a result of the restructuring of the higher education landscape in 2003, the clinical skills training programme at UWC had to be reviewed. With a dramatic increase in the student numbers and a reduction in hospital beds, the skills lab method provided students with an opportunity to develop clinical skills prior to their placement in real service settings. The design phase centred on adopting a skills training methodology that articulates with the case-based approach used by the SoN. Kolb’s, experiential learning cycle provided the theoretical underpinning for the methodology. The planning phase was spent on the development of resources. Eight staff members were trained by our international higher education collaborators who also facilitated the training of clinical supervisors and simulated patients. The physical space had to be redesigned to accommodate audio visual and information technology to support the phases of the skills lab method. The implementation of the skills lab method was phased in from the first-year level. An interactive seminar held after the first year of implementation provided feedback from all the role players and was mostly positive. The results of introducing the skills lab method include: a move by students towards self-directed clinical skills development, clinical supervisors adopting the role of facilitators of learning and experiential clinical learning being based on, amongst others, the students’ engagement with simulated patients. Finally, the recommendations relate

Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study.

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Buddingh, K Tim; Herngreen, Thomas; Haringsma, Jelle; van der Zwet, Wil C; Vleggaar, Frank P; Breumelhof, Ronald; Ter Borg, Frank

2011-06-01

Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor. The objective of this study was to determine whether polyp location is an independent risk factor for delayed post-polypectomy hemorrhage. A retrospective case-control study was conducted in two university hospitals and two community hospitals. Thirty-nine cases and 117 controls were identified. In multivariate analysis, size and location were found to be independent polyp-related risk factors for delayed type hemorrhage. The risk increased by 13% for every 1 mm increase in polyp diameter (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.05-1.20, Plocated in the right hemi-colon had an OR of 4.67 (1.88-11.61, P=0.001) for delayed hemorrhage. Polyps in the cecum seemed to be especially at high risk in univariate analysis (OR 13.82, 95% CI 2.66-71.73), but this could not be assessed in multivariate analysis as the number of cases was too small. Polyp type (sessile or pedunculated) was not a risk factor. Polyp location in the right hemi-colon seems to be an independent and substantial risk factor for delayed post-polypectomy hemorrhage. A low threshold for preventive hemostatic measures is advised when removing polyps from this region.

Building Multi-Agent Systems Using Jason

DEFF Research Database (Denmark)

Boss, Niklas Skamriis; Jensen, Andreas Schmidt; Villadsen, Jørgen

2010-01-01

We provide a detailed description of the Jason-DTU system, including the used methodology, tools as well as team strategy. We also discuss the experience gathered in the contest. In spring 2009 the course “Artificial Intelligence and Multi- Agent Systems” was held for the first time...... on the Technical University of Denmark (DTU). A part of this course was a short introduction to the multi-agent framework Jason, which is an interpreter for AgentSpeak, an agent-oriented programming language. As the final project in this course a solution to the Multi-Agent Programming Contest from 2007, the Gold...

Cancers by Body Location/System

Science.gov (United States)

A list of all cancers, organized by location and/or function in the body. Cancers on the list are linked to information about treatment, supportive care, screening, prevention, clinical trials, and other topics.

The optimal location of piezoelectric actuators and sensors for vibration control of plates

Science.gov (United States)

Kumar, K. Ramesh; Narayanan, S.

2007-12-01

This paper considers the optimal placement of collocated piezoelectric actuator-sensor pairs on a thin plate using a model-based linear quadratic regulator (LQR) controller. LQR performance is taken as objective for finding the optimal location of sensor-actuator pairs. The problem is formulated using the finite element method (FEM) as multi-input-multi-output (MIMO) model control. The discrete optimal sensor and actuator location problem is formulated in the framework of a zero-one optimization problem. A genetic algorithm (GA) is used to solve the zero-one optimization problem. Different classical control strategies like direct proportional feedback, constant-gain negative velocity feedback and the LQR optimal control scheme are applied to study the control effectiveness.

Random Fuzzy Extension of the Universal Generating Function Approach for the Reliability Assessment of Multi-State Systems Under Aleatory and Epistemic Uncertainties

DEFF Research Database (Denmark)

Li, Yan-Fu; Ding, Yi; Zio, Enrico

2014-01-01

. In this work, we extend the traditional universal generating function (UGF) approach for multi-state system (MSS) availability and reliability assessment to account for both aleatory and epistemic uncertainties. First, a theoretical extension, named hybrid UGF (HUGF), is made to introduce the use of random...... fuzzy variables (RFVs) in the approach. Second, the composition operator of HUGF is defined by considering simultaneously the probabilistic convolution and the fuzzy extension principle. Finally, an efficient algorithm is designed to extract probability boxes ($p$ -boxes) from the system HUGF, which...

Analysis of a yearly multi-round, multi-period, multi-product transmission rights auction

International Nuclear Information System (INIS)

Ziogos, N.P.; Bakirtzis, A.G.

2008-01-01

A yearly multi-round, multi-period, multi-product transmission rights (TR) auction issuing both point-to-point Financial Transmission Rights (FTRs) and Flow-Gate Rights (FGRs) is studied in this paper. In each round the TR market participants (buyers or sellers) submit their bid or offer prices based on past energy market performance. A Locational Marginal Pricing (LMP) based energy market is assumed. The TR market participants' bid or offer prices reflect their expectation of the average annual LMP differences between withdrawal and injections points for FTRs and of the transmission link capacity prices for FGRs. The TR auction is performed in four rounds; in each round 25% of the entire system capability is awarded. TRs that are awarded in one round are modeled as fixed injections in subsequent rounds. Market participants that have acquired TRs in one round can sell them in subsequent rounds. A market participant can submit bids or offers for on-peak, off-peak or 24-h TRs. A three-area, nine-bus test system with six TR market participants is used for the analysis of the TR auction. (author)

The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial

DEFF Research Database (Denmark)

Lindholt, J S; Gottschalksen, B; Johannesen, N

2011-01-01

To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study.......To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study....

Composition at Washington State University: Building a Multimodal Bricolage

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Ericsson, Patricia; Hunter, Leeann Downing; Macklin, Tialitha Michelle; Edwards, Elizabeth Sue

2016-01-01

Multimodal pedagogy is increasingly accepted among composition scholars. However, putting such pedagogy into practice presents significant challenges. In this profile of Washington State University's first-year composition program, we suggest a multi-vocal and multi-theoretical approach to addressing the challenges of multimodal pedagogy. Patricia…

Expansion of the consultation-liaison psychiatry paradigm at a university medical center: integration of diversified clinical and funding models.

Science.gov (United States)

Bourgeois, James A; Hilty, Donald M; Klein, Sally C; Koike, Alan K; Servis, Mark E; Hales, Robert E

2003-01-01

The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner. In addition, the department has in recent years expanded the delivery of psychiatry consultation-liaison clinical and educational services to other models of care delivery, broadening the role and influence of the CLS. Several of the initiatives described in this paper parallel an overall evolution of the practice of consultation-liaison psychiatry in response to managed care influences and other systems pressures. This consultation-liaison paradigm expansion with diversified sources of funding support facilitates the development of consultation-liaison psychiatry along additional clinical, administrative, research, and educational dimensions. Other university medical centers may consider adaptation of some of the initiatives described here to their institutions.

International, multi-center standardization of acute graft-versus-host disease clinical data collection: a report from the MAGIC consortium

Science.gov (United States)

Harris, Andrew C.; Young, Rachel; Devine, Steven; Hogan, William J.; Ayuk, Francis; Bunworasate, Udomsak; Chanswangphuwana, Chantiya; Efebera, Yvonne A.; Holler, Ernst; Litzow, Mark; Ordemann, Rainer; Qayed, Muna; Renteria, Anne S.; Reshef, Ran; Wölfl, Matthias; Chen, Yi-Bin; Goldstein, Steven; Jagasia, Madan; Locatelli, Franco; Mielke, Stephan; Porter, David; Schechter, Tal; Shekhovtsova, Zhanna; Ferrara, James L.M.; Levine, John E.

2015-01-01

Acute graft-versus-host disease (GVHD) remains a leading cause of morbidity and non-relapse mortality following allogeneic hematopoietic cell transplantation. The clinical staging of GVHD varies greatly between transplant centers and is frequently not agreed upon by independent reviewers. The lack of standardized approaches to handle common sources of discrepancy in GVHD grading likely contributes to why promising GVHD treatments reported from single centers have failed to show benefit in randomized multi-center clinical trials. We developed guidelines through international expert consensus opinion to standardize the diagnosis and clinical staging of GVHD for use in a large international GVHD research consortium. During the first year of use, the guidance was following discussion of complex clinical phenotypes by experienced transplant physicians and data managers. These guidelines increase the uniformity of GVHD symptom capture which may improve the reproducibility of GVHD clinical trials after further prospective validation. PMID:26386318

A multi-element cosmological model with a complex space-time topology

Science.gov (United States)

Kardashev, N. S.; Lipatova, L. N.; Novikov, I. D.; Shatskiy, A. A.

2015-02-01

Wormhole models with a complex topology having one entrance and two exits into the same space-time of another universe are considered, as well as models with two entrances from the same space-time and one exit to another universe. These models are used to build a model of a multi-sheeted universe (a multi-element model of the "Multiverse") with a complex topology. Spherical symmetry is assumed in all the models. A Reissner-Norström black-hole model having no singularity beyond the horizon is constructed. The strength of the central singularity of the black hole is analyzed.

Research on university culture construction in the view of ecological idea

Directory of Open Access Journals (Sweden)

Wang Xinggang

2016-01-01

Full Text Available With the progress of times, our spiritual pursuit becomes higher and higher, and it is especially true among modern youth. Therefore, establishment of university culture has gradually become the focus of attention. This paper firstly quantized university culture construction into four parts: material culture construction, spiritual culture construction, system culture construction, and behavioral culture construction. It then analogized each part as one population in ecological system; established multi-population ecological model; and analyzed the interactional relations between each part. At last, this paper reached conclusions based on multi-population ecological model and analyzed the correlations among various factors of university culture construction, so as to obtain a comprehensive, scientific and healthy scheme for university culture construction.

Online teaching of inflammatory skin pathology by a French-speaking International University Network.

Science.gov (United States)

Perron, Emilie; Battistella, Maxime; Vergier, Béatrice; Fiche, Maryse; Bertheau, Philippe; Têtu, Bernard

2014-01-01

Developments in technology, web-based teaching and whole slide imaging have broadened the teaching horizon in anatomic pathology. Creating online learning material including many types of media such as radiologic images, whole slides, videos, clinical and macroscopic photographs, is now accessible to most universities. Unfortunately, a major limiting factor to maintain and update the learning material is the amount of resources needed. In this perspective, a French-national university network was initiated in 2011 to build joint online teaching modules consisting of clinical cases and tests. The network has since expanded internationally to Québec, Switzerland and Ivory Coast. One of the first steps of the project was to build a learning module on inflammatory skin pathology for interns and residents in pathology and dermatology. A pathology resident from Québec spent 6 weeks in France and Switzerland to develop the contents and build the module on an e-learning Moodle platform under the supervision of two dermatopathologists. The learning module contains text, interactive clinical cases, tests with feedback, virtual slides, images and clinical photographs. For that module, the virtual slides are decentralized in 2 universities (Bordeaux and Paris 7). Each university is responsible of its own slide scanning, image storage and online display with virtual slide viewers. The module on inflammatory skin pathology includes more than 50 web pages with French original content, tests and clinical cases, links to over 45 virtual images and more than 50 microscopic and clinical photographs. The whole learning module is being revised by four dermatopathologists and two senior pathologists. It will be accessible to interns and residents in the spring of 2014. The experience and knowledge gained from that work will be transferred to the next international resident whose work will be aimed at creating lung and breast pathology learning modules. The challenges of sustaining a

Consolidated clinical microbiology laboratories.

Science.gov (United States)

Sautter, Robert L; Thomson, Richard B

2015-05-01

The manner in which medical care is reimbursed in the United States has resulted in significant consolidation in the U.S. health care system. One of the consequences of this has been the development of centralized clinical microbiology laboratories that provide services to patients receiving care in multiple off-site, often remote, locations. Microbiology specimens are unique among clinical specimens in that optimal analysis may require the maintenance of viable organisms. Centralized laboratories may be located hours from patient care settings, and transport conditions need to be such that organism viability can be maintained under a variety of transport conditions. Further, since the provision of rapid results has been shown to enhance patient care, effective and timely means for generating and then reporting the results of clinical microbiology analyses must be in place. In addition, today, increasing numbers of patients are found to have infection caused by pathogens that were either very uncommon in the past or even completely unrecognized. As a result, infectious disease specialists, in particular, are more dependent than ever on access to high-quality diagnostic information from clinical microbiology laboratories. In this point-counterpoint discussion, Robert Sautter, who directs a Charlotte, NC, clinical microbiology laboratory that provides services for a 40-hospital system spread over 3 states in the southeastern United States explains how an integrated clinical microbiology laboratory service has been established in a multihospital system. Richard (Tom) Thomson of the NorthShore University HealthSystem in Evanston, IL, discusses some of the problems and pitfalls associated with large-scale laboratory consolidation. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

A Web-Based Review of Sexual and Reproductive Health Services Available at Colleges and Universities in Georgia.

Science.gov (United States)

Cushing, Katherine F; Carson, Anna E; Short, Tyiesha D; Kot, Stefanie N; Tschokert, Merete; Sales, Jessica M

2018-04-13

Although two-thirds of graduating high school seniors attend college or university in the U.S., there is a paucity of national or state specific research regarding SRH services available on or near college and university campuses. A review of websites for all colleges and universities in Georgia was conducted to evaluate sexual health services available on campuses and evidence of referral to community providers. Of 96 colleges in Georgia, 44░had campus-located health centers, with only 3 at two-year colleges. Overall SRH service provision was low, with great variation between colleges. Distances between colleges and Title X clinics ranged from 0.33 to 35.45 miles. Many students lack access to campus health centers, and information on college websites regarding SRH service availability and referrals differs dramatically between campuses. In the absence of robust campus-located services, schools should highlight where students can obtain comprehensive SRH care in the community.

Evaluation of infectious diseases and clinical microbiology specialists' preferences for hand hygiene: analysis using the multi-attribute utility theory and the analytic hierarchy process methods.

Science.gov (United States)

Suner, Aslı; Oruc, Ozlem Ege; Buke, Cagri; Ozkaya, Hacer Deniz; Kitapcioglu, Gul

2017-08-31

Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews. Afterwards, these opinions were examined with two widely used multi-criteria decision analysis (MCDA) methods, the Multi-Attribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). A total of 15 IDCM specialist opinions were collected from diverse private and public hospitals located in İzmir, Turkey. The mean age of the participants was 49.73 ± 8.46, and the mean experience year of the participants in their fields was 17.67 ± 11.98. The findings that we obtained through two distinct decision making methods, the MAUT and the AHP, suggest that alcohol-based antiseptic solution (ABAS) has the highest utility (0.86) and priority (0.69) among the experts' choices. In conclusion, the MAUT and the AHP, decision models developed here indicate that rubbing the hands with ABAS is the most favorable choice for IDCM specialists to prevent nosocomial infection.

Multi-stakeholder perspectives in defining health-services quality in cataract care.

Science.gov (United States)

Stolk-Vos, Aline C; van de Klundert, Joris J; Maijers, Niels; Zijlmans, Bart L M; Busschbach, Jan J V

2017-08-01

To develop a method to define a multi-stakeholder perspective on health-service quality that enables the expression of differences in systematically identified stakeholders' perspectives, and to pilot the approach for cataract care. Mixed-method study between 2014 and 2015. Cataract care in the Netherlands. Stakeholder representatives. We first identified and classified stakeholders using stakeholder theory. Participants established a multi-stakeholder perspective on quality of cataract care using concept mapping, this yielded a cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined in a plenary stakeholder session. Stakeholders and multi-stakeholder perspective on health-service quality. Our analysis identified seven definitive stakeholders, as follows: the Dutch Ophthalmology Society, ophthalmologists, general practitioners, optometrists, health insurers, hospitals and private clinics. Patients, as dependent stakeholders, were considered to lack power by other stakeholders; hence, they were not classified as definitive stakeholders. Overall, 18 stakeholders representing ophthalmologists, general practitioners, optometrists, health insurers, hospitals, private clinics, patients, patient federations and the Dutch Healthcare Institute sorted 125 systematically collected indicators into the seven following clusters: patient centeredness and accessibility, interpersonal conduct and expectations, experienced outcome, clinical outcome, process and structure, medical technical acting and safety. Importance scores from stakeholders directly involved in the cataract service delivery process correlated strongly, as did scores from stakeholders not directly involved in this process. Using a case study on cataract care, the proposed methods enable different views among stakeholders concerning quality dimensions to be systematically revealed, and the stakeholders jointly agreed on these dimensions. The methods

Prognostic Significance of Nodal Location and Ratio in Stage IIIC Endometrial Carcinoma Among a Multi-Institutional Academic Collaboration.

Science.gov (United States)

Mayadev, Jyoti; Elshaikh, Mohamed A; Christie, Alana; Nagel, Christa; Kennedy, Vanessa; Khan, Nadia; Lea, Jayanthi; Ghanem, Ahmad; Miller, David; Xie, Xian-Jin; Folkert, Michael; Albuquerque, Kevin

2018-04-20

Stage IIIC endometrial carcinoma (EC) represents pathologically heterogenous patients with single/multiple pelvic (stage IIIC1) or paraaortic (stage IIIC2) lymph nodes (LNs). There is an increasing trend to offer adjuvant chemotherapy (CT) +/- radiation (RT) uniformly to these patients, regardless of substage. We investigate the prognostic significance of positive LN (pLN) number, ratio (%pLN), location (IIC1 vs. IIC2), and adjuvant treatment on patterns of failure and survival in a large collaborative multi-institutional series. Clinical data for stage III EC patients such as patient characteristics, surgery/pathologic details, adjuvant therapies (including CT, RT, and chemotherapy and radiation), and outcomes (including pelvic control [PC], disease-free survival [DFS], distant DFS, and overall survival [OS]) were collected from 3 academic institutions. Log-rank analyses, Cox regression univariate and multivariate analyses were performed. Of the 264 patients queried for stage III disease, 237 (73%) had pLN, and complete LN sampling for analysis. The mean number of pLN in the combined data were 3.9, with 26.1% of all LN sampled positive; 121 patients (51%) staged IIIC1, and 116 patients (49%) staged IIIC2. There was a significant difference in number of pLN (P=0.0006) and total LN sampled by institution (range, 13 to 35; P=0.0004), without a difference in %pLN (P=0.35). Ninety-seven of 220 (44.1%) have ≥20% pLN. While controlling for substage and institution, a decrease in DFS (hazard ratio [HR], 1.1; P=0.007), and OS (HR, 1.1; P=0.01) was observed with every increase of 10% in the pLN ratio. There was a significant difference in DFS (HR, 1.8; P=0.003), PC (HR, 1.9; P=0.004), and distant DFS (HR, 1.6; P=0.03), as well as a trend for decreased OS (HR, 1.6; P=0.08) for substage IIIC2 versus IIIC1 disease; 5 years DFS 40% versus 45%, OS 50% versus 57%. Patients received no adjuvant therapy (10%), CT alone (27%), RT alone (16%), or chemotherapy and radiation (47

Effects of multi-domain interventions in (prefrail elderly on frailty, functional, and cognitive status: a systematic review

Directory of Open Access Journals (Sweden)

Dedeyne L

2017-05-01

Full Text Available Lenore Dedeyne,1 Mieke Deschodt,2–4 Sabine Verschueren,5 Jos Tournoy,1,3 Evelien Gielen1,3 1Department of Clinical and Experimental Medicine, 2Department of Public Health and Primary Care, KU Leuven – University of Leuven, Leuven, Belgium; 3Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; 4Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland; 5Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Heverlee, Belgium Background: Frailty is an aging syndrome caused by exceeding a threshold of decline across multiple organ systems leading to a decreased resistance to stressors. Treatment for frailty focuses on multi-domain interventions to target multiple affected functions in order to decrease the adverse outcomes of frailty. No systematic reviews on the effectiveness of multi-domain interventions exist in a well-defined frail population. Objectives: This systematic review aimed to determine the effect of multi-domain compared to mono-domain interventions on frailty status and score, cognition, muscle mass, strength and power, functional and social outcomes in (prefrail elderly (≥65 years. It included interventions targeting two or more domains (physical exercise, nutritional, pharmacological, psychological, or social interventions in participants defined as (prefrail by an operationalized frailty definition. Methods: The databases PubMed, EMBASE, CINAHL, PEDro, CENTRAL, and the Cochrane Central register of Controlled Trials were searched from inception until September 14, 2016. Additional articles were searched by citation search, author search, and reference lists of relevant articles. The protocol for this review was registered on PROSPERO (CRD42016032905. Results: Twelve studies were included, reporting a large diversity of interventions in terms of content, duration, and follow-up period. Overall, multi-domain interventions tended to be more

Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units

International Nuclear Information System (INIS)

Cohen, Mervyn D.; Alam, Khurshaid

2005-01-01

Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years. (orig.)

Lattice Based Mix Network for Location Privacy in Mobile System

Directory of Open Access Journals (Sweden)

Kunwar Singh

2015-01-01

Full Text Available In 1981, David Chaum proposed a cryptographic primitive for privacy called mix network (Mixnet. A mixnet is cryptographic construction that establishes anonymous communication channel through a set of servers. In 2004, Golle et al. proposed a new cryptographic primitive called universal reencryption which takes the input as encrypted messages under the public key of the recipients not the public key of the universal mixnet. In Eurocrypt 2010, Gentry, Halevi, and Vaikunthanathan presented a cryptosystem which is an additive homomorphic and a multiplicative homomorphic for only one multiplication. In MIST 2013, Singh et al. presented a lattice based universal reencryption scheme under learning with error (LWE assumption. In this paper, we have improved Singh et al.’s scheme using Fairbrother’s idea. LWE is a lattice hard problem for which till now there is no polynomial time quantum algorithm. Wiangsripanawan et al. proposed a protocol for location privacy in mobile system using universal reencryption whose security is reducible to Decision Diffie-Hellman assumption. Once quantum computer becomes a reality, universal reencryption can be broken in polynomial time by Shor’s algorithm. In postquantum cryptography, our scheme can replace universal reencryption scheme used in Wiangsripanawan et al. scheme for location privacy in mobile system.

School-Located Influenza Vaccination Clinics: Local Health Department Perspectives

Science.gov (United States)

Ransom, James

2009-01-01

Universal childhood influenza vaccination presents challenges and opportunities for health care and public health systems to vaccinate the children who fall under the new recommendation. Advisory Committee on Immunization Practices (ACIP) recommendations and guidelines are helpful, but they do not provide strategies on how to deliver immunization…

[Effectiveness and difficulty of education on nosocomial infection control for pre-clinical practice in the clinic, so-called inclusive clinical practice phase I, for students in the Faculty of Dentistry, Tokyo Medical and Dental University].

Science.gov (United States)

Sunakawa, Mitsuhiro; Matsumoto, Hiroyuki

2009-03-01

It has been planned to give pre-clinical practice in the clinic, so-called inclusive clinical practice phase I, for fifth-grade students in the School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University, to give them the clinical training needed to perform dental practice and clinical practicum for comprehensive patient care, namely inclusive clinical practice phase II. This study analyzed the educative efficiency of the class on nosocomial infection control (NIC) by comparing achievements pre- and post-test, and discussed appropriate education planning on the NIC for dental students. Sixty-two fifth-grade students in the 2007 academic year sat the pre- and post-tests; the mean score and standard deviation of these tests were 5.30 +/- 1.26 (n = 56) and 8.59 +/- 1.18 (n = 59), respectively. There was a statistically significant difference between them (paired t-test, p < 0.01). Another finding was that students with high scores in the post-test did not necessarily achieve high ratings in the pre-test. It is suggested that the introduction of pre- and post-tests and the clarification of main points in the class as a theme of NIC could be a useful tool for increasing the comprehension of students on the theme. Since students at lower grades will attend clinical practice in the university hospital, it is thought that students should be given NIC training early in the clinical course, and the current curriculum should be improved to increase the opportunity for students to study this important issue.

Advanced computational workflow for the multi-scale modeling of the bone metabolic processes.

Science.gov (United States)

Dao, Tien Tuan

2017-06-01

Multi-scale modeling of the musculoskeletal system plays an essential role in the deep understanding of complex mechanisms underlying the biological phenomena and processes such as bone metabolic processes. Current multi-scale models suffer from the isolation of sub-models at each anatomical scale. The objective of this present work was to develop a new fully integrated computational workflow for simulating bone metabolic processes at multi-scale levels. Organ-level model employs multi-body dynamics to estimate body boundary and loading conditions from body kinematics. Tissue-level model uses finite element method to estimate the tissue deformation and mechanical loading under body loading conditions. Finally, cell-level model includes bone remodeling mechanism through an agent-based simulation under tissue loading. A case study on the bone remodeling process located on the human jaw was performed and presented. The developed multi-scale model of the human jaw was validated using the literature-based data at each anatomical level. Simulation outcomes fall within the literature-based ranges of values for estimated muscle force, tissue loading and cell dynamics during bone remodeling process. This study opens perspectives for accurately simulating bone metabolic processes using a fully integrated computational workflow leading to a better understanding of the musculoskeletal system function from multiple length scales as well as to provide new informative data for clinical decision support and industrial applications.

A randomized clinical trial of hyperthermia and radiation versus radiation alone for superficially located cancers

International Nuclear Information System (INIS)

Egawa, Sunao; Tsukiyama, Iwao; Watanabe, Shaw

1989-01-01

A randomized clinical trial was performed in order to evaluate the effect of combined hyperthermia and radiation for superficially located tumors. Ten institutions participated in this study and 92 evaluable patients were entered from September 1985 to March 1987 (44 patients for radiation plus hyperthermia and 48 for radiation only). Superficially located tumors, more than 3x3 cm in diameter, regardless of whether they were primary or metastatic, and of their histology, were included in the study. Radiotherapy was performed by the conventional fractionation method (2 Gyx5/week). Hyperthermia was conducted once a week. There was no statistical difference between the two groups regarding age, sex, the distribution of tumors and treatment parameters. The complete response (CR) and partial response (PR) rate for the hyperthermia plus radiation group was 81.8%, while the rate for the radiation alone group was 62.6% (p<0.05). Six factors were selected for analysis of the above effect by a multiple logistic model. Sex contributed the most (p=0.001), then the site of the tumor (p=0.016) and the method of treatment (p=0.023). Sex and the site influenced the results. Age, irradiation dose and frequency and duration of heating were not significant factors for response to treatment. (author)

Adaptive decision making in multi-stakeholder retail planning

NARCIS (Netherlands)

Janssen, I.I.

2011-01-01

The decision where to locate new retail facilities is increasingly more a multi-stakeholder decision instead of a single-actor decision. In the past, the Dutch Government had a strong hand in determining the program and location for new shopping centres. Since the introduction of the newest national

Plaque Index in Multi-Bracket Fixed Appliances

International Nuclear Information System (INIS)

Rahim, Z.H.; Shaikh, S.; Razak, F.A.

2014-01-01

To compare the plaque index in patients receiving multi-bracket fixed orthodontic treatment for various factors like age, gender, socio-economic status, brushing practices, meal habits, types of brackets, types of ligations, use of mouthwash and duration of treatment. Study Design: Cross-sectional analytical study. Place and Duration of Study: Orthodontics Clinic, The Aga Khan University Hospital, from September to November 2011. Methodology: Socio-demographic and clinical modalities were defined and recorded for 131 patients having multi-bracket fixed appliances. The plaque index of subjects were recorded according to the Silness and Loe plaque index method. Independent sample t-test was used to see difference in plaque index in factors having two variables. One way ANOVA and Post-Hoc Tukey tests were used to see difference in plaque index in factors having three variables. Kappa statistics was used to assess inter examiner reliability. P-value 0.05 was taken to be significant. Results: The sample comprised of 37% males (n = 48) and 63% females (n = 83). The plaque index had statistically significant association with practice of brushing i.e., timing of brushing (p=0.001), method of brushing (p=0.08), type of ligatures (p=0.05) and frequency of visits (p=0.01). Conclusion: The plaque accumulation is significantly decreased in subjects who brush the teeth twice or more than twice a day and those who brush their teeth after breakfast. The use of interdental brush and stainless steel ligatures had significantly low plaque. Subjects presenting with more frequent appointments of short-period had significantly less plaque. (author)

MCNP6 model of the University of Washington clinical neutron therapy system (CNTS).

Science.gov (United States)

Moffitt, Gregory B; Stewart, Robert D; Sandison, George A; Goorley, John T; Argento, David C; Jevremovic, Tatjana

2016-01-21

A MCNP6 dosimetry model is presented for the Clinical Neutron Therapy System (CNTS) at the University of Washington. In the CNTS, fast neutrons are generated by a 50.5 MeV proton beam incident on a 10.5 mm thick Be target. The production, scattering and absorption of neutrons, photons, and other particles are explicitly tracked throughout the key components of the CNTS, including the target, primary collimator, flattening filter, monitor unit ionization chamber, and multi-leaf collimator. Simulations of the open field tissue maximum ratio (TMR), percentage depth dose profiles, and lateral dose profiles in a 40 cm × 40 cm × 40 cm water phantom are in good agreement with ionization chamber measurements. For a nominal 10 × 10 field, the measured and calculated TMR values for depths of 1.5 cm, 5 cm, 10 cm, and 20 cm (compared to the dose at 1.7 cm) are within 0.22%, 2.23%, 4.30%, and 6.27%, respectively. For the three field sizes studied, 2.8 cm × 2.8 cm, 10.4 cm × 10.3 cm, and 28.8 cm × 28.8 cm, a gamma test comparing the measured and simulated percent depth dose curves have pass rates of 96.4%, 100.0%, and 78.6% (depth from 1.5 to 15 cm), respectively, using a 3% or 3 mm agreement criterion. At a representative depth of 10 cm, simulated lateral dose profiles have in-field (⩾ 10% of central axis dose) pass rates of 89.7% (2.8 cm × 2.8 cm), 89.6% (10.4 cm × 10.3 cm), and 100.0% (28.8 cm × 28.8 cm) using a 3% and 3 mm criterion. The MCNP6 model of the CNTS meets the minimum requirements for use as a quality assurance tool for treatment planning and provides useful insights and information to aid in the advancement of fast neutron therapy.

Police Spatial Big Data Location Code and Its Application Prospect

Directory of Open Access Journals (Sweden)

HU Xiaoguang

2016-12-01

Full Text Available The rich decision-making basis are provided for police work by police spatial big data. But some challenges are also brought by it, such as:large data integration complex, multi scale information related difficulties, the location identification is not unique. Thus, how to make the data better service to the police work reform and development is a problem need to be study. In this paper, we propose location identification method to solve the existing problems. Based on subdivision grid, we design the location encoding method of police spatial big data, and choose domicile location identification as a case. Finally, the prospect of its application is presented. So, a new idea is proposed to solve the problem existing in the police spatial data organization and application.

Location, location, location: Extracting location value from house prices

OpenAIRE

Kolbe, Jens; Schulz, Rainer; Wersing, Martin; Werwatz, Axel

2012-01-01

The price for a single-family house depends both on the characteristics of the building and on its location. We propose a novel semiparametric method to extract location values from house prices. After splitting house prices into building and land components, location values are estimated with adaptive weight smoothing. The adaptive estimator requires neither strong smoothness assumptions nor local symmetry. We apply the method to house transactions from Berlin, Germany. The estimated surface...

Driving the Energy Transition at Maastricht University? Analysing the Transformative Potential of the Student-Driven and Staff-Supported Maastricht University Green Office

NARCIS (Netherlands)

Spira, Felix; Baker-Shelley, Alex

2014-01-01

Strategies on how to improve energy efficiency at universities as part of the global energy transition are barely understood. This study aims to contribute to this body of knowledge, by investigating the energy efficiency transition at Maastricht University. Using the Multi-Level Perspective of

Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

Directory of Open Access Journals (Sweden)

Moore Ainsley E

2010-12-01

Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

Assessing location attractiveness for manufacturing automobiles

Energy Technology Data Exchange (ETDEWEB)

Hanawalt, Edward; Rouse, William

2017-07-01

Evaluating country manufacturing location attractiveness on various performance measures deepens the analysis and provides a more informed basis for manufacturing site selection versus reliance on labor rates alone. A short list of countries can be used to drive regional considerations for site-specific selection within a country. Design/methodology/approach: The two-step multi attribute decision model contains an initial filter layer to require minimum values for low weighted attributes and provides a rank order utility score for twenty three countries studied. The model contains 11 key explanatory variables with Labor Rate, Material Cost, and Logistics making up the top 3 attributes and representing 54% percent of the model weights. Findings: We propose a multi attribute decision framework for strategically assessing the attractiveness of a country as a location for manufacturing automobiles. Research limitations/implications: Consideration of country level wage variation, specific tariffs, and other economic incentives provides a secondary analysis after the initial list of candidate countries is defined. Practical implications: The results of our modeling shows China, India, and Mexico are currently the top ranked countries for manufacturing attractiveness. These three markets hold the highest utility scores throughout sensitivity analysis on the labor rate attribute weight rating, highlighting the strength and potential of manufacturing in China, India, and Mexico. Originality/value: Combining MAUT with regression analysis to simplify model to core factors then using a “must have” layer to handle extreme impacts of low weight factors and allowing for ease of repeatability.

Assessing location attractiveness for manufacturing automobiles

International Nuclear Information System (INIS)

Hanawalt, Edward; Rouse, William

2017-01-01

Evaluating country manufacturing location attractiveness on various performance measures deepens the analysis and provides a more informed basis for manufacturing site selection versus reliance on labor rates alone. A short list of countries can be used to drive regional considerations for site-specific selection within a country. Design/methodology/approach: The two-step multi attribute decision model contains an initial filter layer to require minimum values for low weighted attributes and provides a rank order utility score for twenty three countries studied. The model contains 11 key explanatory variables with Labor Rate, Material Cost, and Logistics making up the top 3 attributes and representing 54% percent of the model weights. Findings: We propose a multi attribute decision framework for strategically assessing the attractiveness of a country as a location for manufacturing automobiles. Research limitations/implications: Consideration of country level wage variation, specific tariffs, and other economic incentives provides a secondary analysis after the initial list of candidate countries is defined. Practical implications: The results of our modeling shows China, India, and Mexico are currently the top ranked countries for manufacturing attractiveness. These three markets hold the highest utility scores throughout sensitivity analysis on the labor rate attribute weight rating, highlighting the strength and potential of manufacturing in China, India, and Mexico. Originality/value: Combining MAUT with regression analysis to simplify model to core factors then using a “must have” layer to handle extreme impacts of low weight factors and allowing for ease of repeatability.

Does clinical experience affect knowledge regarding hepatitis-B among male medical students at a private university

International Nuclear Information System (INIS)

Nisar, N.

2009-01-01

To assess the knowledge of male medical students about Hepatitis-B in their preclinical and clinical years and to investigate the self reported vaccination status of these students. In the year of 2007, 187 male students of Isra University Hyderabad Sindh Pakistan were selected by convenient sampling and surveyed with a self reported questionnaire comprising of questions regarding knowledge about hepatitis B. Data gathered was analyzed by SPSS V. 16. Knowledge between preclinical and clinical students were compared by Pearson's coefficient chi square test, p value < 0.005 was considered significant. Out of 187 students interviewed, 73 (39%) and 114 (61%) were from preclinical and clinical years respectively. Significant difference was found in clinical and preclinical students regarding basic knowledge about hepatitis B. and mode of transmission of disease (P= 0.004) and (P=< 0.001) respectively. Significant difference was found in the knowledge of both preclinical and clinical male medical students. (JPMA 59:808; 2009). (author)

Construction and simulation of a multi-reflection time-of-flight mass spectrometer at the University of Notre Dame

Energy Technology Data Exchange (ETDEWEB)

Schultz, B.E., E-mail: bschult4@nd.edu; Kelly, J.M.; Nicoloff, C.; Long, J.; Ryan, S.; Brodeur, M.

2016-06-01

One of the most significant problems in the production of rare isotopes is the simultaneous production of contaminants, often time isobaric. Thus, a high-resolution beam purification method is required which needs to be compatible with both the low yield and short half-life of the desired radionuclide. A multi-reflection time-of-flight mass spectrometer meets all these criteria, in addition to boasting a smaller footprint relative to traditional separator dipole magnets. Such a device is currently under construction at the University of Notre Dame and is intended to be coupled to the IG-ISOL source of the planned cyclotron facility. The motivation and conceptual design are presented, as well as the status of simulations to determine the feasibility of using a Bradbury–Nielsen gate for bunching ion beams during initial system testing.

Business analysis for a sustainable, multi-stakeholder ecosystem for leveraging the Electronic Health Records for Clinical Research (EHR4CR) platform in Europe.

Science.gov (United States)

Dupont, Danielle; Beresniak, Ariel; Sundgren, Mats; Schmidt, Andreas; Ainsworth, John; Coorevits, Pascal; Kalra, Dipak; Dewispelaere, Marc; De Moor, Georges

2017-01-01

The Electronic Health Records for Clinical Research (EHR4CR) technological platform has been developed to enable the trustworthy reuse of hospital electronic health records data for clinical research. The EHR4CR platform can enhance and speed up clinical research scenarios: protocol feasibility assessment, patient identification for recruitment in clinical trials, and clinical data exchange, including for reporting serious adverse events. Our objective was to seed a multi-stakeholder ecosystem to enable the scalable exploitation of the EHR4CR platform in Europe, and to assess its economic sustainability. Market analyses were conducted by a multidisciplinary task force to define an EHR4CR emerging ecosystem and multi-stakeholder value chain. This involved mapping stakeholder groups and defining their unmet needs, incentives, potential barriers for adopting innovative solutions, roles and interdependencies. A comprehensive business model, value propositions, and sustainability strategies were developed accordingly. Using simulation modelling (including Monte Carlo simulations) and a 5-year horizon, the potential financial outcomes of the business model were forecasted from the perspective of an EHR4CR service provider. A business ecosystem was defined to leverage the EHR4CR multi-stakeholder value chain. Value propositions were developed describing the expected benefits of EHR4CR solutions for all stakeholders. From an EHR4CR service provider's viewpoint, the business model simulation estimated that a profitability ratio of up to 1.8 could be achieved at year 1, with potential for growth in subsequent years depending on projected market uptake. By enhancing and speeding up existing processes, EHR4CR solutions promise to transform the clinical research landscape. The ecosystem defined provides the organisational framework for optimising the value and benefits for all stakeholders involved, in a sustainable manner. Our study suggests that the exploitation of EHR4CR

Promoting fundamental clinical skills: a competency-based college approach at the University of Washington.

Science.gov (United States)

Goldstein, Erika A; Maclaren, Carol F; Smith, Sherilyn; Mengert, Terry J; Maestas, Ramoncita R; Foy, Hugh M; Wenrich, Marjorie D; Ramsey, Paul G

2005-05-01

The focus on fundamental clinical skills in undergraduate medical education has declined over the last several decades. Dramatic growth in the number of faculty involved in teaching and increasing clinical and research commitments have contributed to depersonalization and declining individual attention to students. In contrast to the close teaching and mentoring relationship between faculty and students 50 years ago, today's medical students may interact with hundreds of faculty members without the benefit of a focused program of teaching and evaluating clinical skills to form the core of their four-year curriculum. Bedside teaching has also declined, which may negatively affect clinical skills development. In response to these and other concerns, the University of Washington School of Medicine has created an integrated developmental curriculum that emphasizes bedside teaching and role modeling, focuses on enhancing fundamental clinical skills and professionalism, and implements these goals via a new administrative structure, the College system, which consists of a core of clinical teachers who spend substantial time teaching and mentoring medical students. Each medical student is assigned a faculty mentor within a College for the duration of his or her medical school career. Mentors continuously teach and reflect with students on clinical skills development and professionalism and, during the second year, work intensively with them at the bedside. They also provide an ongoing personal faculty contact. Competency domains and benchmarks define skill areas in which deepening, progressive attention is focused throughout medical school. This educational model places primary focus on the student.

[Qilin Pills for idiopathic oligoasthenospermia: A multi-centered randomized double-blind controlled clinical trial].

Science.gov (United States)

Mao, Jia-Ming; Jiang, Hui; Wang, Chuan-Hang; Ning, Ke-Qin; Liu, Ji-Hong; Yang, Shu-Wen; Li, Hai-Song; Zhou, Shao-Hu; Zhang, Zhi-Chao; Xu, Ji-Xiu; Huang, Yong-Han

2017-03-01

To evaluate the clinical efficacy and safety of Qilin Pills in the treatment of oligoasthenospermia in infertile men. This multi-centered randomized double-blind controlled clinical trial included 216 infertile males with oligoasthenospermia, 108 in the trial group and the other 108 in the control, the former treated with Qilin Pills at the dose of 6 g tid while the latter with Wuziyanzong Pills at 6 g bid, both for 12 weeks. We examined the total sperm count, sperm motility and the count of progressively motile sperm of the patients before and at 4, 8 and 12 weeks after medication and evaluated the safety of the drug based on the adverse events and the laboratory results of blood and urine routine examinations and liver and kidney function tests. Compared with the baseline, the patients in the trial group showed a significant time-dependent improvement after 4, 8 and 12 weeks of medication in sperm motility (21.75% vs 27.54%, 29.04% and 32.95%, P Pills can evidently improve the semen quality of oligoasthenospermia patients with no obvious adverse events.

Dynamic activity-travel assignment in multi-state supernetworks with road and location capacity constraints

NARCIS (Netherlands)

Liu, P.; Liao, F.; Huang, H.; Timmermans, H.J.P.

2016-01-01

A unified framework coupling activity-based modelling and dynamic traffic assignment has recently been proposed. It formulates dynamic activity-travel assignment (DATA) in multi-state supernetworks as a dynamic user equilibrium. Choices of departure time, route, mode, activity sequence, and

The Fuzzy WOD Model with application to biogas plant location