41,670 research outputs found

    Introducing First Year Medical Students to Personalized Medicine Concepts in a Small Group Activity

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    Presented as a Poster Presentation at 2020 IUSM Education Day.An individuals’ genetic profile is becomingly an increasingly important parameter in healthcare decisions. This small group activity was developed to introduce first year medical students in the Molecules to Cells and Tissues course to the concept and significance of Pharmacogenomics and personalized medicine. Additionally, this activity provided students with an opportunity to work with a large dataset and use the information to impact clinical decision making. This activity has two cases, takes student groups approximately 2 hours to complete, and requires internet access. Case materials are available through the learning management system Canvas, and include open-ended questions to guide students through the cases. In these cases students explore the functional significance of different alleles of a panel of cytochrome P450 genes. The group activity has the students examine a large data set of cytochrome P450 genes and cognate alleles to determine their prevalence in the local population and calculate the individuals’ gene scores. The students are then asked to explain the impact of the genotype (or gene score) on the resulting patient phenotype (i.e. the functional significance of the genotype). The first case involves a breast cancer survivor support group in which patients taking Taxol discuss lack of adequate pain relief from opioids and the potential impact of concomitant use of natural compounds/supplements on drug metabolism. The second case involves a patient presenting with recurrent stroke-like symptoms despite being on the anticoagulant medication clopidogrel. The patient is initially suspected to be non-compliant, but is later determined to be a poor metabolizer of the anticoagulant clopidogrelto its active form thus decreasing its efficacy. The expertise of the IUSM Medical Genetics research faculty was leveraged to provide a large data set of cytochrome P450 genes and cognate alleles. The selection of cytochrome P450 was based upon delivering content focused on the biochemistry of the enzyme system and provided an opportunity to highlight the drug interaction database available through IUSM Clinical Pharmacology (The FlockhartTable™ ; https://drug-interactions.medicine.iu.edu/). The addition of natural compounds was to draw students’ attention to the Natural Medicines database, which is the recommended source for evidence-based data on complementary and alternative medicine. Natural Medicines is available through the Ruth Lilly Medical Library and can be searched by substance or condition. It provides both a summary of the literature available on substances as well as the level of evidence or quality of studies done on the substance

    Mergers and the changing landscape of commercial banking (Part II)

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    Bank mergers ; Financial institutions

    Fog-enabled Edge Learning for Cognitive Content-Centric Networking in 5G

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    By caching content at network edges close to the users, the content-centric networking (CCN) has been considered to enforce efficient content retrieval and distribution in the fifth generation (5G) networks. Due to the volume, velocity, and variety of data generated by various 5G users, an urgent and strategic issue is how to elevate the cognitive ability of the CCN to realize context-awareness, timely response, and traffic offloading for 5G applications. In this article, we envision that the fundamental work of designing a cognitive CCN (C-CCN) for the upcoming 5G is exploiting the fog computing to associatively learn and control the states of edge devices (such as phones, vehicles, and base stations) and in-network resources (computing, networking, and caching). Moreover, we propose a fog-enabled edge learning (FEL) framework for C-CCN in 5G, which can aggregate the idle computing resources of the neighbouring edge devices into virtual fogs to afford the heavy delay-sensitive learning tasks. By leveraging artificial intelligence (AI) to jointly processing sensed environmental data, dealing with the massive content statistics, and enforcing the mobility control at network edges, the FEL makes it possible for mobile users to cognitively share their data over the C-CCN in 5G. To validate the feasibility of proposed framework, we design two FEL-advanced cognitive services for C-CCN in 5G: 1) personalized network acceleration, 2) enhanced mobility management. Simultaneously, we present the simulations to show the FEL's efficiency on serving for the mobile users' delay-sensitive content retrieval and distribution in 5G.Comment: Submitted to IEEE Communications Magzine, under review, Feb. 09, 201

    Population Health Matters, Spring 2013, Vol. 26, No. 2. Download Full PDF

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    Technology and Service Quality in the Banking Industry: An Empirical Study of Various Factors in Electronic Banking Services

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    Technology-based self service has greatly changed the way that service Firms and consumers interact and are raising a host of research and practice issues relating to the delivery of e-service which has become increasingly important not only in determining the success or failure of electronic commerce but also in providing consumers with a superior experience with respect to the interactive flow of information. The purpose of this research study was to establish the relationship between technology and service quality in the banking industry in Nigeria. The research was carried out through a cross sectional smvey design which questioned respondents one e-banking services. The population of study mainly constituted of customers of Oceanic bank within Lagos metropolis and its environs. The respondents of the study were customers of banks using e-banking services (internet banking, mobile banking and AIM). The sample in this study consisted of 120 respondents who are users of thee-banking services. The data collected was analyzed by use of frequency, percentage, means and correlation analysis. The findings revealed that secure services as the most important dimension, followed by convenient location of AIM, efficiency (not need to wait, ability to set up accounts so that the customer can perform transactions immediately, accurately of records, user friendly, ease of user, complaint satisfaction, accurate transactions and operation in 24 h)

    Prescriptions for Excellence in Health Care Summer 2012 Download Full PDF

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    Deregulation, the Internet, and the competitive viability of large banks and community banks

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    Deregulation, technological change, and increased competitive rivalry are transforming U.S. commercial banking from an industry dominated by thousands of small, locally focused banks into an industry where a handful of large banks could potentially span the nation and control the majority of its bank deposits. This paper examines the comparative strengths and weaknesses of large and small banks in this new environment, and outlines the strategic opportunities and threats that new technology - especially the Internet - pose for U.S. banks. We begin by documenting recent trends in bank size, industry structure, competitive conditions, and bank product mix. We argue that these trends are consistent with a simple competitive strategy framework in which commercial banks choose between two profitable business strategies: (a) a community bank business model in which banks have a local focus, a high cost structure, and sell low volumes of personalized service at high margins, and (b) a global bank business model in which banks have a national or international focus, a low cost structure, and sell high volumes of standardized financial products at low margins. Finally, we discuss how Internet banking is likely to affect this strategic equilibrium. In particular, we analyze how a shift away from brick and mortar branches and toward the Internet delivery channel will reduce the switching costs that currently dissuade retail deposit customers from changing banks. Based on the foregoing analysis, we conclude that the number of small banks will continue to decline in the future - not because the community bank business model is flawed, but because most of the small banks that use this model are poorly run. In the long-run, our analysis suggests that well-run community banks should be able to adapt their business practices to technological change and profitably co-exist with large, globally focussed banks.Banks and banking ; Financial institutions

    The appeal of the Functional Fitness MOT to older adults and health professionals in an outpatient setting: a mixed-method feasibility study

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    Purpose: To understand the views and perceptions regarding the Functional Fitness MOT (FFMOT), a battery of functional tests followed by a brief motivational interview, of both the older people undergoing it and the health professionals delivering it. Patients and methods: Physically inactive older adults (n=29) underwent the FFMOT and subsequently attended focus groups to share their perceptions of it and to discuss the barriers, motivators, health behavior change, and scope to improve physical activity (PA) levels. PA levels were recorded at baseline and again at 12 weeks together with a post-intervention questionnaire concerning behavior change. Participating physiotherapists and technical instructors were interviewed. Results: Most participants felt they had learned about their abilities and comparisons with their peers, had a change in perception about the importance of good balance and strength, and felt the FFMOT helped raise their awareness of local and self-directed physical activity opportunities. Most felt their awareness of the need for PA had not changed, but 25% of participants started a new organized PA opportunity. The health professionals perceived the FFMOT as being easy to administer, educating, and motivating for participants to increase their PA. Space, time, finances, and insecurity about having the necessary skills to conduct the FFMOTs were seen as barriers in implementing the FFMOT in daily practice. Conclusion: Over half of those offered the FFMOT accepted it, suggesting it is appealing. However, most participants felt they were already active enough and that their awareness of the need for PA had not changed. There were positive perceptions of the FFMOT from both professionals and older people, but both felt the FFMOT could be held in a community venue. The overall findings suggest that the FFMOT is feasible in the clinical setting, but its effectiveness has yet to be determined

    The 3DMA Middleware for Mobile Applications

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    Mobile devices have received much research interest in re- cent years. Mobility raises new issues such as more dynamic context, limited computing resources, and frequent disconnections. To handle these issues, we propose a middleware, called 3DMA, which introduces three requirements, 1) distribution, 2) decoupling and 3) decomposition. 3DMA uses a space based middleware approach combined with a set of workers which are able to act on the users behalf either to reduce load on the mobile device, or to support disconnected behavior. In order to demonstrate aspects of the middleware architecture we consider the development of a commonly used mobile application
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