A New Approach for Quality Management in Pervasive Computing Environments

This paper provides an extension of MDA called Context-aware Quality Model Driven Architecture (CQ-MDA) which can be used for quality control in pervasive computing environments. The proposed CQ-MDA approach based on ContextualArchRQMM (Contextual ARCHitecture Quality Requirement MetaModel), being an extension to the MDA, allows for considering quality and resources-awareness while conducting the design process. The contributions of this paper are a meta-model for architecture quality control of context-aware applications and a model driven approach to separate architecture concerns from context and quality concerns and to configure reconfigurable software architectures of distributed systems. To demonstrate the utility of our approach, we use a videoconference system.Comment: 10 pages, 10 Figures, Oral Presentation in ECSA 201

Automating allocation of development assurance levels: An extension to HiP-HOPS

Controlling the allocation of safety requirements across a system's architecture from the early stages of development is an aspiration embodied in numerous major safety standards. Manual approaches of applying this process in practice are ineffective due to the scale and complexity of modern electronic systems. In the work presented here, we aim to address this issue by presenting an extension to the dependability analysis and optimisation tool, HiP-HOPS, which allows automatic allocation of such requirements. We focus on aerospace requirements expressed as Development Assurance Levels (DALs); however, the proposed process and algorithms can be applied to other common forms of expression of safety requirements such as Safety Integrity Levels. We illustrate application to a model of an aircraft wheel braking system

Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

BACKGROUND: Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. OBJECTIVES: The purpose of this study was to translate research findings into a real world setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a proof of concept model for future programing. METHODS: Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. RESULTS: Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s (p = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 (p = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s (p \u3c 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care. CONCLUSION: Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention

The problem of evaluating automated large-scale evidence aggregators

In the biomedical context, policy makers face a large amount of potentially discordant evidence from different sources. This prompts the question of how this evidence should be aggregated in the interests of best-informed policy recommendations. The starting point of our discussion is Hunter and Williams’ recent work on an automated aggregation method for medical evidence. Our negative claim is that it is far from clear what the relevant criteria for evaluating an evidence aggregator of this sort are. What is the appropriate balance between explicitly coded algorithms and implicit reasoning involved, for instance, in the packaging of input evidence? In short: What is the optimal degree of ‘automation’? On the positive side: We propose the ability to perform an adequate robustness analysis as the focal criterion, primarily because it directs efforts to what is most important, namely, the structure of the algorithm and the appropriate extent of automation. Moreover, where there are resource constraints on the aggregation process, one must also consider what balance between volume of evidence and accuracy in the treatment of individual evidence best facilitates inference. There is no prerogative to aggregate the total evidence available if this would in fact reduce overall accuracy

Iterative criteria-based approach to engineering the requirements of software development methodologies

Software engineering endeavours are typically based on and governed by the requirements of the target software; requirements identification is therefore an integral part of software development methodologies. Similarly, engineering a software development methodology (SDM) involves the identification of the requirements of the target methodology. Methodology engineering approaches pay special attention to this issue; however, they make little use of existing methodologies as sources of insight into methodology requirements. The authors propose an iterative method for eliciting and specifying the requirements of a SDM using existing methodologies as supplementary resources. The method is performed as the analysis phase of a methodology engineering process aimed at the ultimate design and implementation of a target methodology. An initial set of requirements is first identified through analysing the characteristics of the development situation at hand and/or via delineating the general features desirable in the target methodology. These initial requirements are used as evaluation criteria; refined through iterative application to a select set of relevant methodologies. The finalised criteria highlight the qualities that the target methodology is expected to possess, and are therefore used as a basis for de. ning the final set of requirements. In an example, the authors demonstrate how the proposed elicitation process can be used for identifying the requirements of a general object-oriented SDM. Owing to its basis in knowledge gained from existing methodologies and practices, the proposed method can help methodology engineers produce a set of requirements that is not only more complete in span, but also more concrete and rigorous

Effects of vildagliptin on ventricular function in patients with type 2 diabetes mellitus and heart failure: a randomized placebo-controlled trial

Objectives: This study sought to examine the safety of the dipeptidyl peptidase-4 inhibitor, vildagliptin, in patients with heart failure and reduced ejection fraction. Background: Many patients with type 2 diabetes mellitus have heart failure and it is important to know about the safety of new treatments for diabetes in these individuals. Methods: Patients 18 to 85 years of age with type 2 diabetes and heart failure (New York Heart Association functional class I to III and left ventricular ejection fraction [LVEF] <0.40) were randomized to 52 weeks treatment with vildagliptin 50 mg twice daily (50 mg once daily if treated with a sulfonylurea) or matching placebo. The primary endpoint was between-treatment change from baseline in echocardiographic LVEF using a noninferiority margin of −3.5%. Results: A total of 254 patients were randomly assigned to vildagliptin (n = 128) or placebo (n = 126). Baseline LVEF was 30.6 ± 6.8% in the vildagliptin group and 29.6 ± 7.7% in the placebo group. The adjusted mean change in LVEF was 4.95 ± 1.25% in vildagliptin treated patients and 4.33 ± 1.23% in placebo treated patients, a difference of 0.62 (95% confidence interval [CI]: −2.21 to 3.44; p = 0.667). This difference met the predefined noninferiority margin of −3.5%. Left ventricular end-diastolic and end-systolic volumes increased more in the vildagliptin group by 17.1 ml (95% CI: 4.6 to 29.5 ml; p = 0.007) and 9.4 ml (95% CI: −0.49 to 19.4 ml; p = 0.062), respectively. Decrease in hemoglobin A1c from baseline to 16 weeks, the main secondary endpoint, was greater in the vildagliptin group: −0.62% (95% CI: −0.93 to −0.30%; p < 0.001; −6.8 mmol/mol; 95% CI: −10.2 to −3.3 mmol/mol). Conclusions: Compared with placebo, vildagliptin had no major effect on LVEF but did lead to an increase in left ventricular volumes, the cause and clinical significance of which is unknown. More evidence is needed regarding the safety of dipeptidyl peptidase-4 inhibitors in patients with heart failure and left ventricular systolic dysfunction. (Effect of Vildagliptin on Left Ventricular Function in Patients With Type 2 Diabetes and Congestive Heart Failure; NCT00894868

Diagnosis of the significance of inconsistencies in software designs: a framework and its experimental evaluation

This paper presents: (a) a framework for assessing the significance of inconsistencies which arise in object-oriented design models that describe software systems from multiple perspectives, and (b) the findings of a series of experiments conducted to evaluate it. The framework allows the definition of significance criteria and measures the significance of inconsistencies as beliefs for the satisfiability of these criteria. The experiments conducted to evaluate it indicate that criteria definable in the framework have the power to create elaborate rankings of inconsistencies in models