A Bayesian-Decision Analysis Framework for the Financial Evaluation of Automatic Incident Detection Devices

We propose a Bayesian decision analysis framework for the evaluation of automatic incident detection (AID) tools in intelligent transportation systems. The proposed framework can be used by decision makers for financial analysis of AID devices, identify appropriate AID device locations and develop an AID device replacement schedule

A Case Study of the Military Utility of Telemedicine

This paper is designed to relate the rationale used by the Department of Defense to determine the military utility of the Joint Medical Operations – Telemedicine Advanced Concept Technology Demonstration (JMO-T ACTD). The paper also develops Critical Operational Issues (COI) and Measures of Effectiveness (MOE) as methodologies for investigating the military utility of telemedicine. In order to meet increasing global crises, the U.S. military must find ways to more effectively manage manpower and time. Joint Medical Operations – Telemedicine (JMO-T) has been developed by the Department of Defense (DOD) to collect and transmit near-real-time, far-forward medical data and to assess how this improved capability enhances medical management of the battlespace. JMO-T has been successful in resolving uncertain organizational and technological military deficiencies and in improving medical communications and information management. The deployable, mobile Telemedicine Teams are the centerpieces of JMO-T. These teams have the capability of inserting essential networking and communications capabilities into austere theaters and establishing an immediate means for enhancing health protection, collaborative planning, situational awareness, and strategic decision-making

Homocystinuria with Cerebral Venous Sinus Thrombosis: Excellent Recovery with Intravenous Recombinant Tissue Plasminogen Activator

How to Cite This Article: Gowda VK, Nanjundappa RC, Pendharkar H, Benakappa N. Homocystinuria with Cerebral Venous Sinus Thrombosis: Excellent Recovery with Intravenous Recombinant Tissue Plasminogen Activator. Iran J Child Neurol. Summer 2017; 11(3):48-52. AbstractHyperhomocysteinemia can cause cerebral venous thrombosis. Recombinant tissue plasminogen activator is one of the treatment options for cerebral venous thrombosis in selected cases. We present here a 7-year-old boy with homocysteinuria with stroke. MRI of brain showed cerebral venous sinus thrombosis. We successfully treated with intravenous recombinant tissue plasminogen activator. He recovered completely without any complications.Recombinant tissue plasminogen activator can be considered one of the treatment options in cerebral venous thrombosis in homocystinura.References1. Fernando D. Testai, MD, PhD; Philip B. Gorelick, MD,MPH. Inherited Metabolic disorders and stroke part 2-Homocystinuria, organic acidurias, and urea cycle disorders. Arch Neurol 2010; 67 (2):148-153.2. Herrmann E, Lorenzl S, Obeid R. Review of the role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric disorders-current evidence and preliminary recommendations. Fortschr Neurol Psychiatr 2007; 75: 515-527.3. Online Mendelian Inheritance in Man. Homocystinuria. http://www.ncbi.nlm.nih.gov/entrez/dispomim. cgi?id=236200. Accessed March 27, 2009.4. udd SH, Skovby F, Levy HL, Pettigrew KD, Wilcken B, Pyeritz RE, et al. The natural history of homocysteinuria due to cystathionine beta synthase deficiency. Am J Hum Genet 1985; 37: 1-31.5. Hacke W, Doonnan G, Fieschi C, Kaste M, von Kummer R, Broderick JP, et al. Association of outcome with early stroke treatment: Pooled analysis of ATLANTIS, ECASS, and NINDS rt –PA stroke trials. Lancet 2004; 363: 768-774.,6. Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G. et al. Management of stroke in infants and children: a scientific statement from a special writing group of the American Heart Association Stroke Council and the Council on cardiovascular disease in young. Stroke 2008; 39:2644-2691.7. Soleau SW, Schmidt R, Stevens S, Osborn A, MacDonald JD. Extensive experience with dural sinus thrombosis. Neurosurgery 2003; 52: 534-544; discussion 542-544.8. Janjua N, Nasar A, Lynch JK, Qureshi AI. Thrombolysis for ischemic stroke in children: data from the nationwide inpatient sample. Stroke 2007; 38:1850-1854.9. Amlie-Lefond C, deVeber G, Chan AK, Benedict S, Bernard T, Carpenter J et al. Use of alteplase in childhood arterial ischaemic stroke: a multicentre, observational, cohort study. Lancet Neurol 2008; 8:530-536

The Wisconsin division of narcotics enforcement uses multi-agent information systems to investigate drug crimes

We built a multi-agent information system (MAIS) called Sherpa using distributed artificial intelligence architecture. The system integrates distributed knowledge sources and information to help the Wisconsin Division of Narcotics Enforcement (WDNE) make decisions about the level of charges against a drug crime suspect. Sherpa outperforms the existing system in the identification of criminals. B efore drug investigators can arrest suspected criminals, they must identify suspects, collect data about them, and analyze the data. They gather information from different sources external to the drug enforcement agency, such as the Internal Revenue Service and the Division of Criminal Investigation, combining the data with that from internal sources, removing redundancies, and identifying patterns in the data. Drug enforcement agencies face conditions that hinder the use of information systems and the diffusion of information. The issues they need to address in using information systems arise from both external and internal factors. The external factors include a dependency on other agencies for funding projects, the beliefs of politicians, and the assumption that they can work during regular business hours against an enemy that works round the clock. The internal factors include agents poorly trained in use of information technology We designed and implemented a distributed problem-solving multi-agent in

Supercurrent through a single transverse mode in nanowire Josephson junctions

Hybrid superconductor-semiconductor materials are fueling research in mesoscopic physics and quantum technology. Recently demonstrated smooth $\beta$-Sn superconductor shells, due to the increased induced gap, are expanding the available parameter space to new regimes. Fabricated on quasiballistic InSb nanowires, with careful control over the hybrid interface, Sn shells yield critical current-normal resistance products exceeding temperature by at least an order of magnitude even when nanowire resistance is of order 10k$\Omega$. In this regime Cooper pairs travel through a purely 1D quantum wire for at least part of their trajectory. Here, we focus on the evolution of supercurrent in magnetic field parallel to the nanowire. Long decay up to fields of 1T is observed. At the same time, the decay for higher occupied subbands is notably faster in some devices but not in others. We analyze this using a tight-binding numerical model that includes the Zeeman, orbital and spin-orbit effects. When the first subband is spin polarized, we observe a dramatic suppression of supercurrent, which is also confirmed by the model and suggests an absence of significant triplet supercurrent generation

On the limits to mobility in InAs quantum wells with nearly lattice-matched barriers

The growth and the density dependence of the low temperature mobility of a series of two-dimensional electron systems confined to un-intentionally doped, low extended defect density InAs quantum wells with Al$_{1-x}$Ga$_{x}$Sb barriers are reported. The electron mobility limiting scattering mechanisms were determined by utilizing dual-gated devices to study the dependence of mobility on carrier density and electric field independently. Analysis of the possible scattering mechanisms indicate the mobility was limited primarily by rough interfaces in narrow quantum wells and a combination of alloy disorder and interface roughness in wide wells at high carrier density within the first occupied electronic sub-band. At low carrier density the functional dependence of the mobility on carrier density provided evidence of coulombic scattering from charged defects. A gate-tuned electron mobility exceeding 750,000 cm$^{2}$/Vs was achieved at a sample temperature of 2 K.Comment: 23 pages, 7 figures, 1 tabl

Exposure to Weight Management Counseling Among Students at 8 U.S. Medical Schools

INTRODUCTION: Clinical guidelines support physician intervention consistent with the Ask, Advise, Assess, Assist, Arrange framework for adults who have obesity. However, weight management counseling curricula vary across medical schools. It is unknown how frequently students receive experiences in weight management counseling, such as instruction, observation, and direct experience. METHODS: A cross-sectional survey, conducted in 2017, of 730 third-year medical students in 8 U.S. medical schools assessed the frequency of direct patient, observational, and instructional weight management counseling experiences that were reported as summed scores with a range of 018. Analysis was completed in 2017. RESULTS: Students reported the least experience with receiving instruction (6.5, SD=3.9), followed by direct patient experience (8.6, SD=4.8) and observational experiences (10.3, SD=5.0). During the preclinical years, 79% of students reported a total of \u3c /=3 hours of combined weight management counseling instruction in the classroom, clinic, doctor\u27s office, or hospital. The majority of the students (59%-76%) reported never receiving skills-based instruction for weight management counseling. Of the Ask, Advise, Assess, Assist, Arrange framework, scores were lowest for assisting the patient to achieve their agreed-upon goals (31%) and arranging follow-up contact (22%). CONCLUSIONS: Overall exposure to weight management counseling was less than optimal. Medical school educators can work toward developing a more coordinated approach to weight management counseling. Inc

Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial

BACKGROUND: Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts. OBJECTIVE: To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change. DESIGN: A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U.S. medical schools randomized to receive either multi-modal weight management education (MME) or traditional weight management education (TE). SETTING/PARTICIPANTS: Students from the class of 2020 (N=1305) were asked to participate in an objective structured clinical examination (OSCE) focused on weight management counseling and complete pre and post surveys. A total of 70.1% of eligible students (N=915) completed the OSCE and 69.3% (N=904) completed both surveys. INTERVENTIONS: The MME implemented over three years included a web-based course, a role-play classroom exercise, a web-patient encounter with feedback, and an enhanced clerkship experience with preceptors trained in weight management counseling (WMC). Counseling focused on the 5As (Ask, Advise, Assess, Assist, Arrange) and patient-centeredness. MEASUREMENTS: The outcome was student 5As WMC skills assessed using an objective measure, an OSCE, scored using a behavior checklist, and a subjective measure, student self-reported skills for performing the 5As. RESULTS: Among MME students who completed two of three WMC components compared to those who completed none, exposure was significantly associated with higher OSCE scores and self-reported 5A skills. LIMITATIONS: Variability in medical schools requiring participation in the WMC curriculum. CONCLUSIONS: This trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management. NIH TRIAL REGISTRY NUMBER: R01-194787