1,240 research outputs found
Southern Adventist University Undergraduate Catalog 2023-2024
Southern Adventist University\u27s undergraduate catalog for the academic year 2023-2024.https://knowledge.e.southern.edu/undergrad_catalog/1123/thumbnail.jp
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Pattern recognition in the nucleation kinetics of non-equilibrium self-assembly
Inspired by biology’s most sophisticated computer, the brain, neural networks constitute a profound reformulation of computational principles. Analogous high-dimensional, highly interconnected computational architectures also arise within information-processing molecular systems inside living cells, such as signal transduction cascades and genetic regulatory networks. Might collective modes analogous to neural computation be found more broadly in other physical and chemical processes, even those that ostensibly play non-information-processing roles? Here we examine nucleation during self-assembly of multicomponent structures, showing that high-dimensional patterns of concentrations can be discriminated and classified in a manner similar to neural network computation. Specifically, we design a set of 917 DNA tiles that can self-assemble in three alternative ways such that competitive nucleation depends sensitively on the extent of colocalization of high-concentration tiles within the three structures. The system was trained in silico to classify a set of 18 grayscale 30 × 30 pixel images into three categories. Experimentally, fluorescence and atomic force microscopy measurements during and after a 150 hour anneal established that all trained images were correctly classified, whereas a test set of image variations probed the robustness of the results. Although slow compared to previous biochemical neural networks, our approach is compact, robust and scalable. Our findings suggest that ubiquitous physical phenomena, such as nucleation, may hold powerful information-processing capabilities when they occur within high-dimensional multicomponent systems
LIPIcs, Volume 251, ITCS 2023, Complete Volume
LIPIcs, Volume 251, ITCS 2023, Complete Volum
Improving patient safety by learning from near misses – insights from safety-critical industries
Background
Patients are at risk of being harmed by the very processes meant to help them. To improve patient safety, healthcare organisations attempt to identify the factors that contribute to incidents and take action to optimise conditions to minimise repeats. However, improvements in patient safety have not matched those observed in other safety-critical industries.
One difference between healthcare and other safety-critical industries may be how they learn from near misses when seeking to make safety improvements. Near misses are incidents that almost happened, but for an interruption in the sequence of events. Management of near misses includes their identification, reporting and investigation, and the learning that results. Safety theory suggests that acting on near misses will lead to actions to help prevent incidents. However, evidence also suggests that healthcare has yet to embrace the learning potential that patient safety near misses offer.
The aims of this research, in support of this thesis, were to explore how best healthcare can learn from patient safety near misses to improve patient safety, and to identify what guidance non-healthcare safety-critical industries, which have implemented effective near-miss management systems, can offer healthcare. As this research progressed the aims were updated to include consideration of whether healthcare should seek to learn from patient safety near misses.
Methods
This research took a mixed-methods approach augmented by scoping reviews of the healthcare (study 1) and non-healthcare safety-critical industry (study 3) literature. A qualitative case study (study 2) was undertaken to explore the management of patient safety near misses in the English National Health Service. Seventeen interviews were undertaken with patient safety leads across acute hospitals, ambulance trusts, mental health trusts, primary care, and national bodies. A questionnaire was also used to help access the views of frontline staff.
A grounded theory (study 4) was used to develop a set of principles, based on learning from non-healthcare safety-critical industries, around how best near misses can be managed. Thirty-five interviews were undertaken across aviation, maritime, and rail, with nuclear later added as per the theoretical sampling.
Results
The scoping reviews contributed 125 healthcare and 108 non-healthcare safety-critical industry academic articles, published internationally between 2000 and 2022, to the evidence gained from the qualitative case study and grounded theory. Safety cultures and maturity with safety management processes were found to vary in and across the different industries, and there was a reluctance for healthcare to learn about safety and near misses from other industries.
Healthcare has yet to establish effective processes to manage patient safety near misses. There is an absence of evidence that learning has led to improvements in patient safety. The definition of a patient safety near miss varies, and organisations focus their efforts on reporting and investigating incidents, with limited attention to patient safety near misses. In non-healthcare safety-critical industries, near-miss management is more established, but process maturity varies in and across industries. Near misses are often defined specifically for an industry, but there is limited evidence that learning from them has improved safety. Information about near misses are commonly aggregated and may contribute to company and industry safety management systems.
Exploration of the definition of a patient safety near miss led to the identification of the features of a near miss. The features have not been previously defined in the manner presented in this thesis. A patient safety near miss is context-specific and complex, involves interruptions, highlights system vulnerabilities, and is delineated from an incident by whether events reach a patient.
Across healthcare and non-healthcare safety-critical industries the impact of learning from near misses is often assumed or extrapolated based on the common cause hypothesis. The hypothesis is regularly cited in safety literature and is used as the basis for justifying a focus on patient safety near misses. However, the validity of the hypothesis has been questioned and has not been validated for different patient safety near miss and incident types.
Conclusions
The research findings challenge long-held beliefs that learning from patient safety near misses will lead to improvements in patient safety. These beliefs are based on traditional safety theory that is unlikely to now be valid in the complexity of modern-day systems where incidents are the result of multiple factors and can emerge without apparent warning. Further research is required to understand the relationship between learning from patient safety near misses and patient safety, and whether the common cause hypothesis is valid for different types of healthcare safety event.
While there are questions about the value of learning directly from patient safety near misses, the contribution of near misses to safety management systems in non-healthcare safety-critical industries looks to be beneficial for safety improvement. Safety management systems have yet to be implemented in the National Health Service and future research should look to understand how best this may be achieved and their value. In the meantime, patient safety near misses may help healthcare’s understanding of systems and their optimisation to create barriers to incidents and build resilience. This research offers an evidence-based definition of a patient safety near miss and describes principles to support identification, reporting, prioritisation, investigation, aggregation, learning, and action to help improve patient safety
Towards A Practical High-Assurance Systems Programming Language
Writing correct and performant low-level systems code is a notoriously demanding job, even for experienced developers. To make the matter worse, formally reasoning about their correctness properties introduces yet another level of complexity to the task. It requires considerable expertise in both systems programming and formal verification. The development can be extremely costly due to the sheer complexity of the systems and the nuances in them, if not assisted with appropriate tools that provide abstraction and automation.
Cogent is designed to alleviate the burden on developers when writing and verifying systems code. It is a high-level functional language with a certifying compiler, which automatically proves the correctness of the compiled code and also provides a purely functional abstraction of the low-level program to the developer. Equational reasoning techniques can then be used to prove functional correctness properties of the program on top of this abstract semantics, which is notably less laborious than directly verifying the C code.
To make Cogent a more approachable and effective tool for developing real-world systems, we further strengthen the framework by extending the core language and its ecosystem. Specifically, we enrich the language to allow users to control the memory representation of algebraic data types, while retaining the automatic proof with a data layout refinement calculus. We repurpose existing tools in a novel way and develop an intuitive foreign function interface, which provides users a seamless experience when using Cogent in conjunction with native C. We augment the Cogent ecosystem with a property-based testing framework, which helps developers better understand the impact formal verification has on their programs and enables a progressive approach to producing high-assurance systems. Finally we explore refinement type systems, which we plan to incorporate into Cogent for more expressiveness and better integration of systems programmers with the verification process
Southern Adventist University Undergraduate Catalog 2022-2023
Southern Adventist University\u27s undergraduate catalog for the academic year 2022-2023.https://knowledge.e.southern.edu/undergrad_catalog/1121/thumbnail.jp
Measuring the impact of COVID-19 on hospital care pathways
Care pathways in hospitals around the world reported significant disruption during the recent COVID-19 pandemic but measuring the actual impact is more problematic. Process mining can be useful for hospital management to measure the conformance of real-life care to what might be considered normal operations. In this study, we aim to demonstrate that process mining can be used to investigate process changes associated with complex disruptive events. We studied perturbations to accident and emergency (A &E) and maternity pathways in a UK public hospital during the COVID-19 pandemic. Co-incidentally the hospital had implemented a Command Centre approach for patient-flow management affording an opportunity to study both the planned improvement and the disruption due to the pandemic. Our study proposes and demonstrates a method for measuring and investigating the impact of such planned and unplanned disruptions affecting hospital care pathways. We found that during the pandemic, both A &E and maternity pathways had measurable reductions in the mean length of stay and a measurable drop in the percentage of pathways conforming to normative models. There were no distinctive patterns of monthly mean values of length of stay nor conformance throughout the phases of the installation of the hospital’s new Command Centre approach. Due to a deficit in the available A &E data, the findings for A &E pathways could not be interpreted
Security and Privacy for Modern Wireless Communication Systems
The aim of this reprint focuses on the latest protocol research, software/hardware development and implementation, and system architecture design in addressing emerging security and privacy issues for modern wireless communication networks. Relevant topics include, but are not limited to, the following: deep-learning-based security and privacy design; covert communications; information-theoretical foundations for advanced security and privacy techniques; lightweight cryptography for power constrained networks; physical layer key generation; prototypes and testbeds for security and privacy solutions; encryption and decryption algorithm for low-latency constrained networks; security protocols for modern wireless communication networks; network intrusion detection; physical layer design with security consideration; anonymity in data transmission; vulnerabilities in security and privacy in modern wireless communication networks; challenges of security and privacy in node–edge–cloud computation; security and privacy design for low-power wide-area IoT networks; security and privacy design for vehicle networks; security and privacy design for underwater communications networks
Pre-hospital trauma assessment and management of older patients and their association with patient outcomes: challenges and barriers
BACKGROUND: Saudi Arabia faces an increasing prehospital healthcare burden from older people with injuries, but little is known about their characteristics and current treatment.
METHODS: This was a sequential explanatory mixed-methods design, preceded by a scoping review on the prehospital geriatric trauma care. A retrospective quantitative study was conducted using registry data from older patients (≥55 years) admitted by ambulances from 01/08/2017 to 31/10/2021 at a major trauma centre in Saudi Arabia. A qualitative study was conducted using a purposive sample of Saudi paramedics and ambulance technicians from Riyadh and Makkah using online semi-structured interviews and analysed using the framework method. The quantitative and qualitative findings were integrated.
RESULTS: The quantitative study recruited 452 eligible cases and found most of them were admitted with low falls (53.7%), normal physiology, and extremities injuries (53.1%). The study identified no significant predictors of in-hospital death (p>0.05 for all predictors), although statistical power was limited. The qualitative study recruited twenty participants and identified that they reported age-related challenges including physiological changes, polypharmacy, and communication difficulties. They all wanted training and guidelines to improve their knowledge. They reported struggling with communication difficulties, inaccurate adverse outcomes predictions, difficult intravenous cannulations, and cultural restrictions affecting care provision for female patients. I identified organisational barriers (e.g. lack of shared patient records and lack of guidelines) and cultural barriers (e.g. barriers to assessing women, attitudes towards older people, and attitudes towards paramedics) that influenced implementation of knowledge. This study also found that the participants' perceptions aligned with the retrospective study’s cohort, and they acknowledged the difficulty of predicting death in older trauma patients.
CONCLUSION: Ambulance clinicians in Saudi Arabia want guidelines and training in managing older trauma patients but these need to take into account the characteristics of older trauma patients and the cultural barriers that I identified
Domes and Crosses: Exploiting synergies in two methodologies for biaxial tensile testing of membrane tissues
Biaxial tensile testing is the preferred method for mechanically testing membranous tissue as it can capture the tissue load response more holistically than uniaxial methods. There are two dominant approaches within the field of biaxial tensile testing: planar and bulge. Both methods can induce a state of biaxial tension within a specimen and both have their advantages and disadvantages. Bulge testing has the benefit of imposing a simple boundary condition on the tissue, making it quick and easy to set up. Planar Biaxial Tensile (PBT) testing is very sensitive to specimen preparation and requires non-trivial gripping systems. Some knowledge of the direction of maximum stiffness, prior to specimen mounting, is necessary for PBT to yield useful data. However, literature suggests that PBT is the more rigorous of the methods when it comes to collecting data to fully characterise a material model for membrane tissues. This study used the ease of bulge testing to determine the mean fibre axis of the tissue which informed the angle of PBT specimen excision. This was a rapid, non-destructive and creative method to avoid otherwise highly expensive imaging approaches to determine mean fibre direction. Further work was also done to develop a method of accurately determining specimen thickness for very thin tissues using a creative histological technique. By using a block of cutting medium to shape the membrane during processing steps, all four of the loaded edges of the tissue could be sectioned simultaneously for thickness measurement. Finally, the study served to develop a membrane tissue test protocol for further research using the in-house built biaxial tensile machines
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