268 research outputs found
Registered report protocol:A scoping review to identify potential predictors as features for developing automated estimation of the probability of being frail in secondary care
INTRODUCTION: The impact of frailty surges, as the prevalence increases with age and the population age is rising. Frailty is associated with adverse health outcomes and increased healthcare costs. Many validated instruments to detect frailty have been developed. Using these in clinical practice takes time. Automated estimation of the probability of being frail using routinely collected data from hospital electronic health records (EHRs) would circumvent that. We aim to identify potential predictors that could be used as features for modeling algorithms on the basis of routine hospital EHR data to incorporate in an automated tool for estimating the probability of being frail. METHODS: PubMed (MEDLINE), CINAHL Plus, Embase, and Web of Science will be searched. The studied population consists of older people (≥65 years). The first step is searching articles published ≥2018. Second, we add two published literature reviews (and the articles included therein) [Bery 2020; Bouillon, 2013] to our search results. In these reviews, articles on potential predictor variables in frailty screening tools were included from inception until March 2018. The goal is to identify and extract all potential predictors of being frail. Domain experts will be consulted to evaluate the results. DISCUSSION: The results of the intended study will increase the quality of the developed algorithms to be used for automated estimation of the probability of being frail in secondary care. This is a promising perspective, being less labor-intensive compared to screening each individual patient by hand. Also, such an automated tool may raise awareness of frailty, especially in those patients who would not be screened for frailty by hand because they seem robust. CONCLUSION: The identified potential predictors of being frail can be used as evidence-based input for machine learning based automated estimation of the probability of being frail using routine EHR data in the near future
Concepts of health in different contexts:A scoping review
The rationale of our study was that the World Health Organization’s (WHO) definition of health from 1947 which includes “… complete physical, mental and social wellbeing…” does not fit the current societal viewpoints anymore. The WHO’s definition of health implies that many people with chronic illnesses or disabilities would be considered unhealthy and complete wellbeing would be utopian and unfeasible for them. This is no longer uniformly accepted. Many alternative concepts of health have been discussed in the last decades such as ‘positive health’, which focusses on someone’s capability rather than incapability,. However, the question remains whether a general health concept can guide all healthcare practices. More likely, health concepts need to be specified for professions or settings. The objective of our study was to create a structured overview of published concepts of health from different perspectives by conducting a scoping review using the PRISMA-ScR guideline. A literature search was conducted in Pubmed and Cinahl. Articles eligible for inclusion focussed on the discussion or the conceptualisation of health or health-related concepts in different contexts (such as the perspective of care workers’ or patients’) published since 2009 (the Dutch Health Council raised the discussion about moving towards a more dynamic perspective on health in that year). Seventy-five articles could be included for thematic analyses. The results showed that most articles described a concept of health consisting of multiple subthemes; no consensus was found on one overall concept of health. This implies that healthcare consumers act based on different health concepts when seeking care than care workers when providing care. Having different understandings of the concepts of health can lead to misunderstandings in practice. In conclusion, from every perspective, and even for every individual, health may mean something different. This finding stresses the importance that care workers’ and healthcare consumers’ meaning of ‘health’ has to be clear to all actors involved. Our review supports a more uniform tuning of healthcare between healthcare providers (the organisations), care workers (the professionals) and healthcare consumers (the patients), by creating more awareness of the differences among these actors, which can be a guide in their communication. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07702-2
Controlling passively-quenched single photon detectors by bright light
Single photon detectors based on passively-quenched avalanche photodiodes can
be temporarily blinded by relatively bright light, of intensity less than a
nanowatt. I describe a bright-light regime suitable for attacking a quantum key
distribution system containing such detectors. In this regime, all single
photon detectors in the receiver Bob are uniformly blinded by continuous
illumination coming from the eavesdropper Eve. When Eve needs a certain
detector in Bob to produce a click, she modifies polarization (or other
parameter used to encode quantum states) of the light she sends to Bob such
that the target detector stops receiving light while the other detector(s)
continue to be illuminated. The target detector regains single photon
sensitivity and, when Eve modifies the polarization again, produces a single
click. Thus, Eve has full control of Bob and can do a successful
intercept-resend attack. To check the feasibility of the attack, 3 different
models of passively-quenched detectors have been tested. In the experiment, I
have simulated the intensity diagrams the detectors would receive in a real
quantum key distribution system under attack. Control parameters and side
effects are considered. It appears that the attack could be practically
possible.Comment: Experimental results from a third detector model added. Minor
corrections and edits made. 11 pages, 10 figure
Human factors and missed solutions to Enigma design weaknesses
The German World War II Enigma suffered from design weaknesses that facilitated its large-scale decryption by the British throughout the war. The author shows that the main technical weaknesses (self-coding and reciprocal coding) could have been avoided using simple contemporary technology, and therefore the true cause of the weaknesses is not technological but must be sought elsewhere. Specifically, human factors issues resulted in the persistent failure to seek out more effective designs. Similar limitations seem to beset the literature on the period, which misunderstands the Enigma weaknesses and therefore inhibits broader thinking about design or realising the critical role of human factors engineering in cryptography
Framework to Support the Process of Decision-Making on Life-Sustaining Treatments in the ICU: Results of a Delphi Study
Objectives: To develop a consensus framework that can guide the process of decision-making on continuing or limiting life-sustaining treatments in ICU patients, using evidence-based items, supported by caregivers, patients, and surrogate decision makers from multiple countries. Design: A three-round web-based international Delphi consensus study with a priori consensus definition was conducted with experts from 13 countries. Participants reviewed items of the decision-making process on a seven-point Likert scale or with open-ended questions. Questions concerned terminology, content, and timing of decision-making steps. The summarized results (including mean scores) and expert suggestions were presented in the subsequent round for review. Setting: Web-based surveys of international participants representing ICU physicians, nurses, former ICU patients, and surrogate decision makers. Patients: Not applicable. Interventions: Not applicable. Measurements and Main Results: In three rounds, respectively, 28, 28, and 27 (of 33 invited) physicians together with 12, 10, and seven (of 19 invited) nurses participated. Patients and surrogates were involved in round one and 12 of 27 responded. Caregivers were mostly working in university affiliated hospitals in Northern Europe. During the Delphi process, most items were modified in order to reach consensus. Seven items lacked consensus after three rounds. The final consensus framework comprises the content and timing of four elements; three elements focused on caregiver-surrogate communication (admission meeting, follow-up meeting, goals-of-care meeting); and one element (weekly time-out meeting) focused on assessing preferences, prognosis, and proportionality of ICU treatment among professionals. Conclusions: Physicians, nurses, patients, and surrogates generated a consensus-based framework to guide the process of decision-making on continuing or limiting life-sustaining treatments in the ICU. Early, frequent, and scheduled family meetings combined with a repeated multidisciplinary time-out meeting may support decisions in relation to patient preferences, prognosis, and proportionality
Fully-Coupled Electromechanical Simulations of the LV Dog Anatomy Using HPC: Model Testing and Verification
Verification of electro-mechanic models of the heart require a good amount of reliable, high resolution, thorough in-vivo measurements. The detail of the mathematical models used to create simulations of the heart beat vary greatly. Generally, the objective of the simulation determines the modeling approach. However, it is important to exactly quantify the amount of error between the various approaches that can be used to simulate a heart beat by comparing them to ground truth data. The more detailed the model is, the more computing power it requires, we therefore employ a high-performance computing solver throughout this study. We aim to compare models to data measured experimentally to identify the effect of using a mathematical model of fibre orientation versus the measured fibre orientations using DT-MRI. We also use simultaneous endocardial stimuli vs an instantaneous myocardial stimulation to trigger the mechanic contraction. Our results show that synchronisation of the electrical and mechanical events in the heart beat are necessary to create a physiological timing of hemodynamic events. Synchronous activation of all of the myocardium provides an unrealistic timing of hemodynamic events in the cardiac cycle. Results also show the need of establishing a protocol to quantify the zero-pressure configuration of the left ventricular geometry to initiate the simulation protocol; however, the predicted zero-pressure configuration of the same geometry was different, depending on the origin of the fibre field employed.This work has been done with the support of the grant SEV-2011-00067 of Severo Ochoa Program, awarded by the Spanish Government to the Barcelona Supercomputing Center. Part of the research leading to these results has received funding from the Seventh Framework Programme (FP7/2007-2013) under grant agreement n 611823. It has also been partially funded from the by the Spanish
Ministry of Economy and Competitiveness (TIN2011-28067).Peer ReviewedPostprint (author's final draft
Wheat-barley hybridization – the last forty years
Abstract Several useful alien gene transfers have
been reported from related species into wheat (Triticum
aestivum), but very few publications have dealt
with the development of wheat/barley (Hordeum
vulgare) introgression lines. An overview is given
here of wheat 9 barley hybridization over the last
forty years, including the development of
wheat 9 barley hybrids, and of addition and translocation
lines with various barley cultivars. A short
summary is also given of the wheat 9 barley hybrids
produced with other Hordeum species. The meiotic
pairing behaviour of wheat 9 barley hybrids is presented,
with special regard to the detection of wheat–
barley homoeologous pairing using the molecular
cytogenetic technique GISH. The effect of in vitro
multiplication on the genome composition of intergeneric
hybrids is discussed, and the production and
characterization of the latest wheat/barley translocation
lines are presented. An overview of the agronomical
traits (b-glucan content, earliness, salt tolerance,
sprouting resistance, etc.) of the newly developed
introgression lines is given. The exploitation and
possible use of wheat/barley introgression lines for
the most up-to-date molecular genetic studies
(transcriptome analysis, sequencing of flow-sorted
chromosomes) are also discussed
The Effect of Bifidobacterium on Reducing Symptomatic Abdominal Pain in Patients with Irritable Bowel Syndrome: A Systematic Review
Probiotics, specifically Bifidobacteria, may improve abdominal pain in patients with irritable bowel syndrome (IBS); however, results from randomised controlled trials (RCTs) are conflicting. Here, we systematically reviewed the efficacy of Bifidobacteria on abdominal pain in IBS. We searched MEDLINE, EMBASE and the Cochrane Controlled Trials Register from inception to 20 May 2019, without language or date restrictions. The search strategy comprised of the combination of three concepts: supplementation, abdominal pain, and IBS. Inclusion criteria included double-blind placebo-controlled RCTs featuring Bifidobacteria supplementation in Rome-diagnosed IBS patients. A total of 8 RCTs involving a total of 1045 patients with Rome diagnosed IBS were included. The dose of total Bifidobacteria ranged from 106 to > 1011 cfu (colony-forming unit) and duration of supplementation ranged between 2 and 8 weeks. Bifidobacteria was delivered through either intake of fermented milk products, encapsulation or via a malted milk beverage, with all studies assessing abdominal pain via a visual analogue Likert scale. From the studies included, 50% (n = 4) of studies found a statistically significant improvement in abdominal pain following Bifidobacteria supplementation compared to placebo, 38% (n = 3) of studies found non-significant improvements and 12% (n = 1) showed a statistically significant dose-response effect of improvement. The evidence shows a heterogeneity of effect for Bifidobacteria dependent upon strain, dosage and delivery method. While not all studies demonstrate significant improvements in abdominal pain, none of the selected studies reported an increase in pain or other adverse effects
Recommended from our members
How do things become strategic? ‘Strategifying’ corporate social responsibility
How do things become ‘strategic’? Despite the development of strategy-as-practice studies and the recognized institutional importance of strategy as a social practice, little is known about how strategy boundaries change within organizations. This article focuses on this gap by conceptualizing ‘strategifying’ – or making something strategic – as a type of institutional work that builds on the institution of strategy to change the boundaries of what is regarded as strategy within organizations. We empirically investigate how corporate social responsibility has been turned into strategy at a UK electricity company, EnergyCorp. Our findings reveal the practices that constitute three types of strategifying work – cognitive coupling, relational coupling and material coupling – and show how, together and over time, these types of work changed the boundaries of strategy so that corporate social responsibility became included in EnergyCorp’s official strategy, became explicitly attended to by strategists and corporate executives and became inscribed within strategy devices. By disambiguating the notions of strategifying and strategizing, our study introduces new perspectives for analysing the institutional implications of the practice of strategy
On the Regression and Assimilation for Air Quality Mapping Using Dense Low-Cost WSN
International audienceThe use of low-cost Wireless Sensor Networks (WSNs) for air quality monitoring has recently attracted a great deal of interest. Indeed, the cost-effectiveness of emerging sensors and their small size allow for dense deployments and hence improve the spatial granularity. However, these sensors offer a low accuracy and their measurement errors may be significant due to the underlying sensing technologies. The main aim of this work is to reconsider and compare some regression approaches to assimilation ones while taking into account the intrinsic characteristics of dense deployment of low cost WSN for air quality monitoring (high density, numerical model errors and sensing errors). For that, we propose a general framework that allows the comparison of different strategies based on numerical simulations and an adequate estimation of the simulation error covariances as well as the sensing errors covariances. While considering the case of Lyon city and a widely used numerical model, we characterize the simulation errors, conduct extensive simulations and compare several regression and assimilation approaches. The results show that from a given sensing error threshold, regression methods present an optimal sensor density from which the mapping quality decreases. Results also show that the Random Forest method is often the best regression approach but still less efficient than the BLUE assimilation approach when using adequate correction parameters
- …