Automated Measurement of Adherence to Traumatic Brain Injury (TBI) Guidelines using Neurological ICU Data

Using a combination of physiological and treatment information from neurological ICU data-sets, adherence to traumatic brain injury (TBI) guidelines on hypotension, intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is calculated automatically. The ICU output is evaluated to capture pressure events and actions taken by clinical staff for patient management, and are then re-expressed as simplified process models. The official TBI guidelines from the Brain Trauma Foundation are similarly evaluated, so the two structures can be compared and a quantifiable distance between the two calculated (the measure of adherence). The methods used include: the compilation of physiological and treatment information into event logs and subsequently process models; the expression of the BTF guidelines in process models within the real-time context of the ICU; a calculation of distance between the two processes using two algorithms (“Direct” and “Weighted”) building on work conducted in th e business process domain. Results are presented across two categories each with clinical utility (minute-by-minute and single patient stays) using a real ICU data-set. Results of two sample patients using a weighted algorithm show a non-adherence level of 6.25% for 42 mins and 56.25% for 708 mins and non-adherence of 18.75% for 17 minutes and 56.25% for 483 minutes. Expressed as two combinatorial metrics (duration/non-adherence (A) and duration * non-adherence (B)), which together indicate the clinical importance of the non-adherence, one has a mean of A=4.63 and B=10014.16 and the other a mean of A=0.43 and B=500.0

Help or hindrance ? the impact of harmonized standards on african exports

The authors test the hypothesis that product standards harmonized to de facto international standards are less trade restrictive than ones that are not. To do this, the authors construct a new database of European Union (EU) product standards. The authors identify standards that are aligned with ISO standards (as a proxy for de facto international norms). The authors use a sample-selection gravity model to examine the impact of EU standards on African textiles and clothing exports, a sector of particular development interest. The authors find robust evidence that non-harmonized standards reduce African exports of these products. EU standards which are harmonized to ISO standards are less trade restricting. Our results suggest that efforts to promote African exports of manufactures may need to be complemented by measures to reduce the cost impacts of product standards, including international harmonization. In addition, efforts to harmonize national standards with international norms, including through the World Trade Organization Technical Barriers to Trade Agreement, promise concrete benefits through trade expansion.Information Security&Privacy,Standards and Technical Regulations,Science Education,Scientific Research&Science Parks,Information and Records Management

Towards new knowledge : The corpus of Late Modern English Medical Texts

Peer reviewe

Trends and concerns in digital cartography

CISRG discussion paper ;

Connectionist Inference Models

The performance of symbolic inference tasks has long been a challenge to connectionists. In this paper, we present an extended survey of this area. Existing connectionist inference systems are reviewed, with particular reference to how they perform variable binding and rule-based reasoning, and whether they involve distributed or localist representations. The benefits and disadvantages of different representations and systems are outlined, and conclusions drawn regarding the capabilities of connectionist inference systems when compared with symbolic inference systems or when used for cognitive modeling

Thinking out of the box? A content analysis of the response to published research on the effects of remote, retroactive intercessory prayer

A content analysis of the rapid email responses to a potentially controversial article published in the British Medical Journal (BMJ) on the effect of remote, retroactive intercessory prayer on a group of patients with bloodstream infection at a university hospital in Israel was performed. The content analysis revealed 12 main themes, of which the most predominant were negative and relating to methodological concerns or comments, and/or were religious in nature, often with direct reference to God. Further responses were of a satirical nature, mocking the study. It is concluded that perhaps the real strength of the paper lies not in the results of the study itself, but in the challenge to what constitutes conventional wisdom and the encouragement to readers of the BMJ to Think out of the box

The Prescription Opioid Epidemic: an Evidence-Based Approach

A group of experts, led by researchers at the Johns Hopkins Bloomberg School of Public Health, issued this report aimed at stemming the prescription opioid epidemic, a crisis that kills an average of 44 people a day in the U.S. The report calls for changes to the way medical students and physicians are trained, prescriptions are dispensed and monitored, first responders are equipped to treat overdoses, and those with addiction are identified and treated. The report grew out of discussions that began last year at a town hall co-hosted by the Bloomberg School and the Clinton Health Matters Initiative, an initiative of the Clinton Foundation. The recommendations were developed by professionals from medicine, pharmacy, injury prevention and law. Patient representatives, insurers and drug manufacturers also participated in developing the recommendations. The report breaks its recommendations into seven categories:Prescribing GuidelinesPrescription Drug Monitoring Programs (PDMPs)Pharmacy Benefit Managers (PBMs) and PharmaciesEngineering Strategies (i.e., packaging)Overdose Education and Naloxone Distribution ProgramsAddiction TreatmentCommunity-Based Prevention Strategie