Factored Reasoning for Monitoring Dynamic Team and Goal Formation

Engineering and Applied Science

Building successful and sustainable academic health science partnerships: exploring perspectives of hospital leaders

Background: Clinical work-based internships form a key component of health professions education. Integral to these internships, academic health science partnerships (AHSPs) exist between universities and teaching hospitals. Our qualitative descriptive study explored the perspectives of hospital leadership on AHSPs: what they are composed of, and the facilitators and barriers to establishing and sustaining these partnerships.     Methods: Fifteen individuals in a variety of hospital leadership positions were purposively sampled to participate in face-to-face interviews, after which a thematic analysis was conducted.Results: Participants reported that healthcare and hospital infrastructure shapes and constrains the implementation of clinical education. The strength of the hospitals’ relationship with the medical profession facilitated the partnership, however other health professions’ partnerships were viewed less favourably. Participants emphasized the value of hospital leaders prioritizing education. Further, our findings highlighted that communication, collaboration, and involvement are considered as both facilitators and barriers to active engagement. Lastly, opportunities stemming from the partnership were identified as research, current best practice, improved patient care, and career development.Conclusion: Our study found that AHSPs involve the drive of the university and hospitals to gain valued capital, or opportunities. Reciprocal communication, collaboration, and involvement are modifiable components that are integral to optimizing AHSPs

Detect, Retrieve, Comprehend: A Flexible Framework for Zero-Shot Document-Level Question Answering

Researchers produce thousands of scholarly documents containing valuable technical knowledge. The community faces the laborious task of reading these documents to identify, extract, and synthesize information. To automate information gathering, document-level question answering (QA) offers a flexible framework where human-posed questions can be adapted to extract diverse knowledge. Finetuning QA systems requires access to labeled data (tuples of context, question and answer). However, data curation for document QA is uniquely challenging because the context (i.e. answer evidence passage) needs to be retrieved from potentially long, ill-formatted documents. Existing QA datasets sidestep this challenge by providing short, well-defined contexts that are unrealistic in real-world applications. We present a three-stage document QA approach: (1) text extraction from PDF; (2) evidence retrieval from extracted texts to form well-posed contexts; (3) QA to extract knowledge from contexts to return high-quality answers -- extractive, abstractive, or Boolean. Using QASPER for evaluation, our detect-retrieve-comprehend (DRC) system achieves a +7.19 improvement in Answer-F1 over existing baselines while delivering superior context selection. Our results demonstrate that DRC holds tremendous promise as a flexible framework for practical scientific document QA

A Framework for Optimization and Quantification of Uncertainty and Sensitivity for Developing Carbon Capture Systems

AbstractUnder the auspices of the U.S. Department of Energy's Carbon Capture Simulation Initiative (CCSI), a Framework for Optimization and Quantification of Uncertainty and Sensitivity (FOQUS) has been developed. This tool enables carbon capture systems to be rapidly synthesized and rigorously optimized, in an environment that accounts for and propagates uncertainties in parameters and models. FOQUS currently enables (1) the development of surrogate algebraic models utilizing the ALAMO algorithm, which can be used for superstructure optimization to identify optimal process configurations, (2) simulation-based optimization utilizing derivative free optimization (DFO) algorithms with detailed black-box process models, and (3) rigorous uncertainty quantification through PSUADE. FOQUS utilizes another CCSI technology, the Turbine Science Gateway, to manage the thousands of simulated runs necessary for optimization and UQ. This computational framework has been demonstrated for the design and analysis of a solid sorbent based carbon capture system

Methylome-wide Analysis of Chronic HIV Infection Reveals Five-Year Increase in Biological Age and Epigenetic Targeting of HLA

HIV-infected individuals are living longer on antiretro-viral therapy, but many patients display signs that in some ways resemble premature aging. To investigate and quantify the impact of chronic HIV infection on aging, we report a global analysis of the whole-blood DNA methylomes of 137 HIV+ individuals under sustained therapy along with 44 matched HIV- individuals. First,we develop and validate epigenetic models of aging that are independent of blood cell composition. Using these models, we find that both chronic and recent HIV infection lead to an average aging advancement of 4.9 years, increasing expected mortality risk by 19%. In addition, sustained infection results in global deregulation of the methylome across \u3e80,000 CpGs and specific hypomethylation of the region encoding the human leukocyte antigen locus (HLA).We find that decreased HLA methylation is predictive of lower CD4/CD8T cell ratio, linking molecular aging, epigenetic regulation, and disease progression

The final transformation of Étaín

Abstract Background Although serotonin (5-HT3) receptor antagonists are effective in reducing nausea and vomiting, they may be associated with increased cardiac risk. Our objective was to examine the comparative safety and effectiveness of 5-HT3 receptor antagonists (e.g., dolasetron, granisetron, ondansetron, palonosetron, tropisetron) alone or combined with steroids for patients undergoing chemotherapy. Methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception until December 2015 for studies comparing 5-HT3 receptor antagonists with each other or placebo in chemotherapy patients. The search results were screened, data were abstracted, and risk of bias was appraised by pairs of reviewers, independently. Random-effects meta-analyses and network meta-analyses (NMAs) were conducted. Results After screening 9226 citations and 970 full-text articles, we included 299 studies (n = 58,412 patients). None of the included studies reported harms for active treatment versus placebo. For NMAs on the risk of arrhythmia (primary outcome; three randomized controlled trials [RCTs], 627 adults) and mortality (secondary outcome; eight RCTs, 4823 adults), no statistically significant differences were observed between agents. A NMA on the risk of QTc prolongation showed a significantly greater risk for dolasetron + dexamethasone versus ondansetron + dexamethasone (four RCTs, 3358 children and adults, odds ratio 2.94, 95% confidence interval 2.13–4.17). For NMAs on the number of patients without nausea (44 RCTs, 11,664 adults, 12 treatments), number of patients without vomiting (63 RCTs, 15,460 adults, 12 treatments), and number of patients without chemotherapy-induced nausea or vomiting (27 RCTs, 10,924 adults, nine treatments), all agents were significantly superior to placebo. For a NMA on severe vomiting (10 RCTs, 917 adults), all treatments decreased the risk, but only ondansetron and ramosetron were significantly superior to placebo. According to a rank-heat plot with the surface under the cumulative ranking curve results, palonosetron + steroid was ranked the safest and most effective agent overall. Conclusions Most 5-HT3 receptor antagonists were relatively safe when compared with each other, yet none of the studies compared active treatment with placebo for harms. However, dolasetron + dexamethasone may prolong the QTc compared to ondansetron + dexamethasone. All agents were effective for reducing risk of nausea, vomiting, and chemotherapy-induced nausea or vomiting. Trial registration This study was registered at PROSPERO: ( CRD42013003564 )

Effects of poor communication in the construction industry in Klang Valley, Malaysia

The construction industry is a risky and complex industry involving various parties characterized with different objectives, skills, cultures, and values. This requires effective communication management to facilitate interaction between them and ensure delivery of successful projects. The poor performance of the Malaysian construction sector has its root in poor communication. Poor communication may result in project failure. Therefore, this paper is essential to investigate the effects of communication issues in the construction industry. This research study was conducted and analysed using SPSS Software. The five-point Likert type scale has been adopted for the questions which is distributed to over 121 respondents who are working in the construction industry around Petaling Jaya, Klang Valley, Malaysia. A total of 8 effects of poor communication in the construction industry were identified. The most dominant effect is time overrun while other effects include project failure, cost overrun, fatal and non-fatal accidents, waste generation, increase carbon footprint and contribute to greenhouse effect. However, questionnaire surveys may result in dishonest answers. Hence, the study recommends conducting physical interviews to better understand respondents view on the negative impacts of poor communication and at the same time, raise awareness as a strategic approach to achieve successful construction projects