1,221 research outputs found

    Developing and Applying a User-friendly Web-based GIS for Participative Environmental Assessment

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    The strong spatial and temporal dimensions of development plans necessitate certain requirements in relation to the analytical tools applied to support Strategic Environmental Assessment (SEA) processes. The nature of plans and, subsequently, spatial data requires presenting them in graphic format. Similarly, temporal variation can often be represented in visual form by spatially illustrating changes over-time. Furthermore, it is estimated that up to 85% of all data have a spatial component and, therefore, can be mapped using Geographic Information Systems (GIS) (Chan and Easa, 2000). In this context, the graphic display and analytical potential of GIS can significantly contribute to SEA of development plans by facilitating and enhancing the various stages of the process

    'Working away in that Grey Area...' A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia

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    Background: general practitioners (GPs) have identified the management of behavioural and psychological symptoms of dementia (BPSD) as a particularly challenging aspect of dementia care. However, there is a paucity of research on why GPs find BPSD challenging and how this influences the care they offer to their patients with dementia. Objectives: to establish the challenges GPs experience when managing BPSD; to explore how these challenges influence GPs’ management decisions; and to identify strategies for overcoming these challenges. Design: qualitative study of GPs experiences of managing BPSD. Methods: semi-structured interviews were conducted with 16 GPs in the Republic of Ireland. GPs were purposively recruited to include participants with differing levels of experience caring for people with BPSD in nursing homes and in community settings to provide maximum diversity of views. Interviews were analysed thematically. Results: three main challenges of managing BPSD were identified; lack of clinical guidance, stretched resources and difficulties managing expectations. The lack of relevant clinical guidance available affected GPs’ confidence when managing BPSD. In the absence of appropriate resources GPs felt reliant upon sedative medications. GPs believed their advocacy role was further compromised by the difficulties they experienced managing expectations of family caregivers and nursing home staff. Conclusions: this study helps to explain the apparent discrepancy between best practice recommendations in BPSD and real-life practice. It will be used to inform the design of an intervention to support the management of BPSD in general practice

    ASSESSING RISK INTRODUCED THROUGH A CODE CHANGE

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    Techniques are presented herein that shift the risk assessment focus during a software development process, away from the traditional end-of-process review (when a new feature is delivered, or an application is deployed) to earlier in the process when developers are actively at work. Such an approach allows a developer to assess the risk that a candidate software change is about to introduce prior to the developer committing that change, providing the developer with time (during the early portion of the process) to revisit the software and eliminate the identified risk. Aspects of the presented techniques leverage elements of a continuous integration (CI) and continuous deployment (CD) facility, the results that are available from existing unit and end-to-end tests, and the collection and analysis of OpenTelemetry (OTEL)-based metrics, events, logs, and traces (MELT) data to deliver security insights

    IDENTIFYING ENTERPRISE RISK BASED ON BUSINESS CONTEXT WITH THREAT INTELLIGENCE

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    Presented herein are techniques that facilitate prioritizing risk mitigation efforts for business-critical services and transactions through the incorporation of a business context into threat intelligence scoring. Under aspects of the presented techniques, traditional threat intelligence tools may be employed to evaluate the risk that is associated with an enterprise asset; the results of such an evaluation may then be augmented with an enterprise-assigned business value for the asset to derive the asset’s business risk; and such a business risk may be leveraged to prioritize risk mitigation efforts, may be combined with other business risks, etc. The above-described process may be referred to herein as Business Risk Management (BRM)

    Corticosteroids Are Essential for Maintaining Cardiovascular Function in Male Mice

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    Activation of the hypothalamic-pituitary-adrenal axis results in the release of hormones from the adrenal glands, including glucocorticoids and mineralocorticoids. The physiological association between corticosteroids and cardiac disease is becoming increasingly recognized; however, the mechanisms underlying this association are not well understood. To determine the biological effects of corticosteroids on the heart, we investigated the impact of adrenalectomy in C57BL/6 male mice. Animals were adrenalectomized (ADX) at 1 month of age and maintained for 3–6 months after surgery to evaluate the effects of long-term adrenalectomy on cardiac function. Morphological evaluation suggested that ADX mice showed significantly enlarged hearts compared with age-matched intact controls. These changes in morphology correlated with deficits in left ventricular (LV) function and electrocardiogram (ECG) abnormalities in ADX mice. Correlating with these functional defects, gene expression analysis of ADX hearts revealed aberrant expression of a large cohort of genes associated with cardiac hypertrophy and arrhythmia. Combined corticosterone and aldosterone replacement treatment prevented the emergence of cardiac abnormalities in ADX mice, whereas corticosterone replacement prevented the effects of adrenalectomy on LV function but did not block the emergence of ECG alterations. Aldosterone replacement did not preserve the LV function but prevented ECG abnormalities. Together, the data indicate that adrenal glucocorticoids and mineralocorticoids either directly or indirectly have selective effects in the heart and their signaling pathways are essential in maintaining normal cardiac function

    Alzheimer\u27s Disease Microbiome Is Associated with Dysregulation of the Anti-Inflammatory P-Glycoprotein Pathway

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    The microbiota-gut-brain axis is a bidirectional communication system that is poorly understood. Alzheimer\u27s disease (AD), the most common cause of dementia, has long been associated with bacterial infections and inflammation-causing immunosenescence. Recent studies examining the intestinal microbiota of AD patients revealed that their microbiome differs from that of subjects without dementia. In this work, we prospectively enrolled 108 nursing home elders and followed each for up to 5 months, collecting longitudinal stool samples from which we performed metagenomic sequencing and in vitro T84 intestinal epithelial cell functional assays for P-glycoprotein (P-gp) expression, a critical mediator of intestinal homeostasis. Our analysis identified clinical parameters as well as numerous microbial taxa and functional genes that act as predictors of AD dementia in comparison to elders without dementia or with other dementia types. We further demonstrate that stool samples from elders with AD can induce lower P-gp expression levels in vitro those samples from elders without dementia or with other dementia types. We also paired functional studies with machine learning approaches to identify bacterial species differentiating the microbiome of AD elders from that of elders without dementia, which in turn are accurate predictors of the loss of dysregulation of the P-gp pathway. We observed that the microbiome of AD elders shows a lower proportion and prevalence of bacteria with the potential to synthesize butyrate, as well as higher abundances of taxa that are known to cause proinflammatory states. Therefore, a potential nexus between the intestinal microbiome and AD is the modulation of intestinal homeostasis by increases in inflammatory, and decreases in anti-inflammatory, microbial metabolism.IMPORTANCE Studies of the intestinal microbiome and AD have demonstrated associations with microbiome composition at the genus level among matched cohorts. We move this body of literature forward by more deeply investigating microbiome composition via metagenomics and by comparing AD patients against those without dementia and with other dementia types. We also exploit machine learning approaches that combine both metagenomic and clinical data. Finally, our functional studies using stool samples from elders demonstrate how the c microbiome of AD elders can affect intestinal health via dysregulation of the P-glycoprotein pathway. P-glycoprotein dysregulation contributes directly to inflammatory disorders of the intestine. Since AD has been long thought to be linked to chronic bacterial infections as a possible etiology, our findings therefore fill a gap in knowledge in the field of AD research by identifying a nexus between the microbiome, loss of intestinal homeostasis, and inflammation that may underlie this neurodegenerative disorder

    906-61 Acoustic Quantification in the Infarcted Ventricle: Comparison with Electron Beam Computed Tomography

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    Assessment of LV size and function by acoustic quantification (AQ) correlates well with other techniques in patients with normally contracting ventricles. This prospective study examined the correlation between AQ and electron beam computed tomography (EBCT) volume measurements in patients with first anterior Q-wave MI and abnormally contracting ventricles. End-diastolic (EDV) and end-systolic (ESV) volumes by AQ were determined from standard four-chamber (4ch) and two-chamber (2ch) apical windows. The AQ tracings were transformed to volumetric measurements using the area-length (AL) and the modified Simpson's (mod.S) methods. EDV and ESV by EBCT were obtained conventionally by summation of manually traced LV areas on each short axis tomograms using Simpson's rule. Thirteen patients were imaged by both EBCT and echocardiography within 24 hours. EBCT-EDV ranged from 129–234ml (mean 173±34 ml and ESV from 58–109ml (mean 82±19 ml). The EDV and ESV by AQ, their correlation to EBCT and the accompanying pvalues are shown below:EDV-2chEDV-4chESV-2chESV-4chVol (ml)88±3097±3043±2050±22ALr0.760.560.580.34p0.0060.0490.0610.258Vol (ml)80±3390±3140±2145±20mod.Sr0.760.700.720.58p0.0060.0080.0120.037Conclusions[1] AQ underestimates absolute EDV and ESV measured by EBCT. [2] AQ-EDV correlates well with EBCT, particularly using the mod.S method. [3] AQ-ESV correlation to EBCT drops due to the asymmetric contraction pattern of infarcted ventricles. [4] The AL method's accuracy is particularly susceptible to asymmetric contraction in distorted ventricles. [5] Correction factors can be applied to account for the offset of EDV and ESV measurements by AQ
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