IoMT-Driven eHealth: A Technological Innovation Proposal Based on Smart Speakers

Internet of Medical Things (IoMT) is a technological concept applied in healthcare contexts to achieve the digital interconnection of everyday objects with the Internet in order to make life easier for people. IoMT can help monitor, inform and notify not only caregivers, but provide healthcare providers with actual data to identify issues before they become critical or to allow for earlier invention. In this sense, this paper is contextualized in Assisted Repro duction Treatment (ART) processes to reduce the number of hospital visits, reduce healthcare costs and improve patientcare, as well as the productivity of the healthcare professional. So, we present an IoMT-based technological pro posal to manage and control the prescription of pharmacological treatments to patients who are carried out ART processes. In this context, we propose the integration of iMEDEA (modular system specialized in the management of electronic clinical records for ART unit) and smart speaker devices (specifically, Amazon’s Alexa), as well as the validation of our proposal in the real envi ronment offered by Inebir clinicMinisterio de Economía y Competitividad TIN2016-76956-C3-2-R (POLOLAS)Junta de Andalucía AT17-5904-US

improving mockup based requirement specification with end user annotations

Agile approaches, one of the key methodologies used in today's software projects, often rely on user interface mockups for capturing the goals that the system must satisfy. Mockups, as any other requirement artifact, may suffer from ambiguity and contradiction issues when several points of view are surveyed/elicited by different analysts. This article introduces a novel approach that enhances mockups with friendly end-user annotations that helps formalizing the requirements and reducing or identifying conflicts. We present an evaluation of the approach in order to measure how the use of annotations improves requirements quality

Epidemiology of Streptococcus pneumoniae and Staphylococcus aureus colonization in healthy Venezuelan children

Streptococcus pneumoniae and Staphylococcus aureus cause significant morbidity and mortality worldwide. We investigated both the colonization and co-colonization characteristics for these pathogens among 250 healthy children from 2 to 5 years of age in Merida, Venezuela, in 2007. The prevalence of S. pneumoniae colonization, S. aureus colonization, and S. pneumoniae–S. aureus co-colonization was 28%, 56%, and 16%, respectively. Pneumococcal serotypes 6B (14%), 19F (12%), 23F (12%), 15 (9%), 6A (8%), 11 (8%), 23A (6%), and 34 (6%) were the most prevalent. Non-respiratory atopy was a risk factor for S. aureus colonization (p = 0.017). Vaccine serotypes were negatively associated with preceding respiratory infection (p = 0.02) and with S. aureus colonization (p = 0.03). We observed a high prevalence of pneumococcal resistance against trimethoprim–sulfamethoxazole (40%), erythromycin (38%), and penicillin (14%). Semi-quantitative measurement of pneumococcal colonization density showed that children with young siblings and low socioeconomic status were more densely colonized (p = 0.02 and p = 0.02, respectively). In contrast, trimethoprim–sulfamethoxazole- and multidrug-resistant-pneumococci colonized children sparsely (p = 0.03 and p = 0.01, respectively). Our data form an important basis to monitor the future impact of pneumococcal vaccination on bacterial colonization, as well as to recommend a rationalized and restrictive antimicrobial use in our community

Cdh11 Acts as a Tumor Suppressor in a Murine Retinoblastoma Model by Facilitating Tumor Cell Death

CDH11 gene copy number and expression are frequently lost in human retinoblastomas and in retinoblastomas arising in TAg-RB mice. To determine the effect of Cdh11 loss in tumorigenesis, we crossed Cdh11 null mice with TAg-RB mice. Loss of Cdh11 had no gross morphological effect on the developing retina of Cdh11 knockout mice, but led to larger retinal volumes in mice crossed with TAg-RB mice (p = 0.01). Mice null for Cdh11 presented with fewer TAg-positive cells at postnatal day 8 (PND8) (p = 0.01) and had fewer multifocal tumors at PND28 (p = 0.016), compared to mice with normal Cdh11 alleles. However, tumor growth was faster in Cdh11-null mice between PND8 and PND84 (p = 0.003). In tumors of Cdh11-null mice, cell death was decreased 5- to 10-fold (p<0.03 for all markers), while proliferation in vivo remained unaffected (p = 0.121). Activated caspase-3 was significantly decreased and β-catenin expression increased in Cdh11 knockdown experiments in vitro. These data suggest that Cdh11 displays tumor suppressor properties in vivo and in vitro in murine retinoblastoma through promotion of cell death

Considerations about quality in model-driven engineering

The final publication is available at Springer via http://dx.doi.org/10.1007/s11219-016-9350-6The virtue of quality is not itself a subject; it depends on a subject. In the software engineering field, quality means good software products that meet customer expectations, constraints, and requirements. Despite the numerous approaches, methods, descriptive models, and tools, that have been developed, a level of consensus has been reached by software practitioners. However, in the model-driven engineering (MDE) field, which has emerged from software engineering paradigms, quality continues to be a great challenge since the subject is not fully defined. The use of models alone is not enough to manage all of the quality issues at the modeling language level. In this work, we present the current state and some relevant considerations regarding quality in MDE, by identifying current categories in quality conception and by highlighting quality issues in real applications of the model-driven initiatives. We identified 16 categories in the definition of quality in MDE. From this identification, by applying an adaptive sampling approach, we discovered the five most influential authors for the works that propose definitions of quality. These include (in order): the OMG standards (e.g., MDA, UML, MOF, OCL, SysML), the ISO standards for software quality models (e.g., 9126 and 25,000), Krogstie, Lindland, and Moody. We also discovered families of works about quality, i.e., works that belong to the same author or topic. Seventy-three works were found with evidence of the mismatch between the academic/research field of quality evaluation of modeling languages and actual MDE practice in industry. We demonstrate that this field does not currently solve quality issues reported in industrial scenarios. The evidence of the mismatch was grouped in eight categories, four for academic/research evidence and four for industrial reports. These categories were detected based on the scope proposed in each one of the academic/research works and from the questions and issues raised by real practitioners. We then proposed a scenario to illustrate quality issues in a real information system project in which multiple modeling languages were used. For the evaluation of the quality of this MDE scenario, we chose one of the most cited and influential quality frameworks; it was detected from the information obtained in the identification of the categories about quality definition for MDE. We demonstrated that the selected framework falls short in addressing the quality issues. Finally, based on the findings, we derive eight challenges for quality evaluation in MDE projects that current quality initiatives do not address sufficiently.F.G, would like to thank COLCIENCIAS (Colombia) for funding this work through the Colciencias Grant call 512-2010. This work has been supported by the Gene-ralitat Valenciana Project IDEO (PROMETEOII/2014/039), the European Commission FP7 Project CaaS (611351), and ERDF structural funds.Giraldo-Velásquez, FD.; España Cubillo, S.; Pastor López, O.; Giraldo, WJ. (2016). Considerations about quality in model-driven engineering. Software Quality Journal. 1-66. https://doi.org/10.1007/s11219-016-9350-6S166(1985). Iso information processing—documentation symbols and conventions for data, program and system flowcharts, program network charts and system resources charts. ISO 5807:1985(E) (pp. 1–25).(2011). Iso/iec/ieee systems and software engineering – architecture description. ISO/IEC/IEEE 42010:2011(E) (Revision of ISO/IEC 42010:2007 and IEEE Std 1471-2000) (pp. 1–46).Abran, A., Moore, J.W., Bourque, P., Dupuis, R., & Tripp, L.L. (2013). Guide to the Software Engineering Body of Knowledge (SWEBOK) version 3 public review. IEEE. ISO Technical Report ISO/IEC TR 19759.Agner, L.T.W., Soares, I.W., Stadzisz, P.C., & Simão, J.M. (2013). A brazilian survey on {UML} and model-driven practices for embedded software development. Journal of Systems and Software, 86(4), 997–1005. {SI} : Software Engineering in Brazil: Retrospective and Prospective Views.Amstel, M.F.V. (2010). The right tool for the right job: assessing model transformation quality. pages 69–74. Affiliation: Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, Netherlands. Cited By (since 1996):1.Aranda, J., Damian, D., & Borici, A. (2012). Transition to model-driven engineering: what is revolutionary, what remains the same?. In Proceedings of the 15th international conference on model driven engineering languages and systems, MODELS’12 (pp. 692–708). Berlin, Heidelberg: Springer.Arendt, T., & Taentzer, G. (2013). A tool environment for quality assurance based on the eclipse modeling framework. Automated Software Engineering, 20(2), 141–184.Atkinson, C., Bunse, C., & Wüst, J. (2003). Driving component-based software development through quality modelling, volume 2693. Cited By (since 1996):3.Baker, P., Loh, S., & Weil, F. (2005). Model-driven engineering in a large industrial context—motorola case study. In Briand, L., & Williams, C. (Eds.) Model Driven Engineering Languages and Systems, volume 3713 of Lecture Notes in Computer Science (pp. 476–491). Berlin, Heidelberg: Springer.Barišić, A., Amaral, V., Goulão, M., & Barroca, B. (2011). Quality in use of domain-specific languages: a case study. In Proceedings of the 3rd ACM SIGPLAN workshop on evaluation and usability of programming languages and tools, PLATEAU ’11 (pp. 65–72). New York: ACM.Becker, J., Bergener, P., Breuker, D., & Rackers, M. (2010). Evaluating the expressiveness of domain specific modeling languages using the bunge-wand-weber ontology. In 2010 43rd Hawaii international conference on system sciences (HICSS) (pp. 1–10).Bertrand Portier, L.A. (2009). Model driven development misperceptions and challenges.Bézivin, J., & Kurtev, I. (2005). Model-based technology integration with the technical space concept. In Proceedings of the Metainformatics Symposium: Springer.Brambilla, M. (2016). How mature is of model-driven engineering as an engineering discipline @ONLINE.Brambilla, M., & Fraternali, P. (2014). Large-scale model-driven engineering of web user interaction: The webml and webratio experience. Science of Computer Programming, 89 Part B(0), 71 – 87. Special issue on Success Stories in Model Driven Engineering.Brown, A. (2009). Simple and practical model driven architecture (mda) @ONLINE.Bruel, J.-M., Combemale, B., Ober, I., & Raynal, H. (2015). Mde in practice for computational science. Procedia Computer Science, 51, 660–669.Budgen, D., Burn, A.J., Brereton, O.P., Kitchenham, B.A., & Pretorius, R. (2011). Empirical evidence about the uml: a systematic literature review. Software: Practice and Experience, 41(4), 363–392.Burden, H., Heldal, R., & Whittle, J. (2014). Comparing and contrasting model-driven engineering at three large companies. In Proceedings of the 8th ACM/IEEE International Symposium on Empirical Software Engineering and Measurement, ESEM ’14 (pp. 14:1–14:10). New York: ACM.Cabot, J. Has mda been abandoned (by the omg)?Cabot, J. (2009). Modeling will be commonplace in three years time @ONLINE.Cachero, C., Poels, G., Calero, C., & Marhuenda, Y. (2007). Towards a Quality-Aware Engineering Process for the Development of Web Applications. Working Papers of Faculty of Economics and Business Administration, Ghent University, Belgium 07/462, Ghent University, Faculty of Economics and Business Administration.Challenger, M., Kardas, G., & Tekinerdogan, B. (2015). A systematic approach to evaluating domain-specific modeling language environments for multi-agent systems. Software Quality Journal, 1–41.Chaudron, M.V., Heijstek, W., & Nugroho, A. (2012). How effective is uml modeling? Software & Systems Modeling, 11(4), 571–580. J2: Softw Syst Model.Chenouard, R., Granvilliers, L., & Soto, R. (2008). Model-driven constraint programming. pages 236–246. Affiliation: CNRS, LINA, Universit de Nantes, France; Affiliation: Pontificia Universidad Catlica de, Valparaiso, Chile. Cited By (since 1996):8.Clark, T., & Muller, P.-A. (2012). Exploiting model driven technology: a tale of two startups. Software and Systems Modeling, 11(4), 481–493.Corneliussen, L. (2008). What do you think of model-driven software development?Costal, D., Gómez, C., & Guizzardi, G. (2011). Formal semantics and ontological analysis for understanding subsetting, specialization and redefinition of associations in uml. In Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 6998 LNCS:189–203. cited By (since 1996)3.Cruz-Lemus, J.A., Maes, A., Género, M., Poels, G., & Piattini, M. (2010). The impact of structural complexity on the understandability of uml statechart diagrams. Information Sciences, 180(11), 2209–2220. Cited By (since 1996):14.Cuadrado, J.S., Izquierdo, J.L.C., & Molina, J.G. (2014). Applying model-driven engineering in small software enterprises. Science of Computer Programming, 89 Part B(0), 176 – 198. Special issue on Success Stories in Model Driven Engineering.Da Silva, A.R. (2015). Model-driven engineering: a survey supported by the unified conceptual model. Computer Languages Systems and Structures, 43, 139–155.Da Silva Teixeira, D.G.M., Quirino, G.K., Gailly, F., De Almeida Falbo, R., Guizzardi, G., & Perini Barcellos, M. (2016). PoN-S: a Systematic Approach for Applying the Physics of Notation (PoN), (pp. 432–447). Cham: Springer International Publishing.Davies, I., Green, P., Rosemann, M., Indulska, M., & Gallo, S. (2006). How do practitioners use conceptual modeling in practice? Data and Knowledge Engineering, 58(3), 358 – 380. Including the special issue : {ER} 2004ER 2004.Davies, J., Milward, D., Wang, C.-W., & Welch, J. (2015). Formal model-driven engineering of critical information systems. Science of Computer Programming, 103(0), 88 – 113. Selected papers from the First International Workshop on Formal Techniques for Safety-Critical Systems (FTSCS 2012).De Oca, I.M.-M., Snoeck, M., Reijers, H.A., & Rodríguez-Morffi, A. (2015). A systematic literature review of studies on business process modeling quality. Information and Software Technology, 58, 187–205.DenHaan, J. (2009). 8 reasons why model driven development is dangerous @ONLINE.DenHaan, J. (2010). Model driven engineering vs the commando pattern @ONLINE.DenHaan, J. (2011a). Why aren’t we all doing model driven development yet @ONLINE.DenHaan, J. (2011b). Why there is no future model driven development @ONLINE.Di Ruscio, D., Iovino, L., & Pierantonio, A. (2013). Managing the coupled evolution of metamodels and textual concrete syntax specifications. cited By (since 1996)0.Dijkman, R.M., Dumas, M., & Ouyang, C. (2008). Semantics and analysis of business process models in {BPMN}. Information and Software Technology, 50(12), 1281–1294.Domínguez-Mayo, F.J., Escalona, M.J., Mejías, M., Ramos, I., & Fernández, L. (2011). A framework for the quality evaluation of mdwe methodologies and information technology infrastructures. International Journal of Human Capital and Information Technology Professionals, 2(4), 11–22.Domínguez-Mayo, F.J., Escalona, M.J., Mejías, M., & Torres, A.H. (2010). A quality model in a quality evaluation framework for mdwe methodologies. pages 495–506. Affiliation: Departamento de Lenguajes y Sistemas Informíticos, University of Seville, Seville, Spain., Cited By (since 1996):1.Dubray, J.-J. (2011). Why did mde miss the boat?.Escalona, M.J., Gutiérrez, J.J., Pérez-Pérez, M., Molina, A., Domínguez-Mayo, E., & Domínguez-Mayo, F.J. (2011). Measuring the Quality of Model-Driven Projects with NDT-Quality, (pp. 307–317). New York: Springer.Espinilla, M., Domínguez-Mayo, F.J., Escalona, M.J., Mejías, M., Ross, M., & Staples, G. (2011). A Method Based on AHP to Define the Quality Model of QuEF (Vol. 123, pp. 685–694). Berlin, Heidelberg: Springer.Fabra, J., Castro, V.D., Álvarez, P., & Marcos, E. (2012). Automatic execution of business process models: exploiting the benefits of model-driven engineering approaches. Journal of Systems and Software, 85(3), 607–625. Novel approaches in the design and implementation of systems/software architecture.Falkenberg, E.D., Hesse, W., Lindgreen, P., Nilsson, B.E., Oei, J.L.H., Rolland, C., Stamper, R.K., Assche, F.J.M.V., Verrijn-Stuart, A.A., & Voss, K. (1996). Frisco: a framework of information system concepts. Technical report, The IFIP WG 8. 1 Task Group FRISCO.Fettke, P., Houy, C., Vella, A.-L., & Loos, P. (2012). Towards the Reconstruction and Evaluation of Conceptual Model Quality Discourses – Methodical Framework and Application in the Context of Model Understandability, volume 113 of Lecture Notes in Business Information Processing, chapter 28, pages 406–421, Springer, Berlin, Heidelberg.Finnie, S. (2015). Modeling community: Are we missing something?Fournier, C. (2008). Is uml [email protected], R., & Rumpe, B. (2007). Model-driven development of complex software: a research roadmap. In Future of Software Engineering, 2007, FOSE ’07 (pp. 37–54).Gallego, M., Giraldo, F.D., & Hitpass, B. (2015). Adapting the pbec-otss software selection approach for bpm suites: an application case. In 2015 34th International Conference of the Chilean Computer Science Society (SCCC) (pp. 1–10).Galvão, I., & Goknil, A. (2007). Survey of traceability approaches in model-driven engineering. cited By (since 1996)22.Giraldo, F., España, S., Giraldo, W., & Pastor, O. (2015). Modelling language quality evaluation in model-driven information systems engineering: a roadmap. In 2015 IEEE 9th International Conference on Research Challenges in Information Science (RCIS) (pp. 64–69).Giraldo, F., España, S., & Pastor, O. (2014). Analysing the concept of quality in model-driven engineering literature: a systematic review. In 2014 IEEE Eighth International Conference on Research Challenges in Information Science (RCIS) (pp. 1–12).Giraldo, F.D., España, S., & Pastor, O. (2016). Evidences of the mismatch between industry and academy on modelling language quality evaluation. arXiv: 1606.02025 .González, C., & Cabot, J. (2014). Formal verification of static software models in mde: a systematic review. Information and Software Technology, 56(8), 821–838. cited By (since 1996)0.González, C.A., Büttner, F., Clarisó, R., & Cabot, J. (2012). Emftocsp: a tool for the lightweight verification of emf models. pages 44–50. Affiliation: cole des Mines de Nantes, INRIA, LINA, Nantes, France; Affiliation: Universitat Oberta de Catalunya, Barcelona, Spain. Cited By (since 1996):1.Gorschek, T., Tempero, E., & Angelis, L. (2014). On the use of software design models in software development practice: an empirical investigation. Journal of Systems and Software, 95(0), 176– 193.Goulão, M., Amaral, V., & Mernik, M. (2016). Quality in model-driven engineering: a tertiary study. Software Quality Journal, 1–33.Grobshtein, Y., & Dori, D. (2011). Generating sysml views from an opm model: design and evaluation. Systems Engineering, 14(3), 327–340.Haan, J.d. (2008). 8 reasons why model-driven approaches (will) fail.Harel, D., & Rumpe, B. (2000). Modeling languages: Syntax, semantics and all that stuff, part i: The basic stuff, Israel. Technical report Jerusalem Israel.Harel, D., & Rumpe, B. (2004). Meaningful modeling: what’s the semantics of semantics? Computer, 37(10), 64–72.Hebig, R., & Bendraou, R. (2014). On the need to study the impact of model driven engineering on software processes. In Proceedings of the 2014 International Conference on Software and System Process, ICSSP 2014 (pp. 164–168). New York: ACM.Heidari, F., & Loucopoulos, P. (2014). Quality evaluation framework (qef): modeling and evaluating quality of business processes. International Journal of Accounting Information Systems, 15(3), 193–223. Business Process Modeling.Heymans, P., Schobbens, P.Y., Trigaux, J.C., Bontemps, Y., Matulevicius, R., & Classen, A. (2008). Evaluating formal properties of feature diagram languages. Software, IET, 2(3), 281–302. ID 2.Hindawi, M., Morel, L., Aubry, R., & Sourrouille, J.-L. (2009). Description and Implementation of a UML Style Guide (Vol. 5421, pp. 291–302). Berlin: Springer.Hoang, D. (2012). Current limitations of mdd and its implications @ONLINE.Hodges, W. (2013). Model theory Zalta, E.N. (Ed.) The Stanford Encyclopedia of Philosophy. Fall 2013 edition.Hutchinson, J., Rouncefield, M., & Whittle, J. (2011a). Model-driven engineering practices in industry. In Proceedings of the 33rd International Conference on Software Engineering, ICSE’11 (pp. 633–642). New York: ACM.Hutchinson, J., Whittle, J., & Rouncefield, M. (2014). Model-driven engineering practices in industry: social, organizational and managerial factors that lead to success or failure. Science of Computer Programming, 89 Part B(0), 144–161. Special issue on Success Stories in Model Driven Engineering.Hutchinson, J., Whittle, J., Rouncefield, M., & Kristoffersen, S. (2011b). Empirical assessment of mde in industry. In Proceedings of the 33rd International Conference on Software Engineering, ICSE’11 (pp. 471–480). New York: ACM.Igarza, I.M.H., Boada, D.H.G., & Valdés, A.P. (2012). Una introducción al desarrollo de software dirigido por modelos. Serie Científica, 5(3).ISO/IEC (2001). ISO/IEC 9126. Software engineering—Product quality. ISO/IEC.Izurieta, C., Rojas, G., & Griffith, I. (2015). Preemptive management of model driven technical debt for improving software quality. In Proceedings of the 11th International ACM SIGSOFT Conference on Quality of Software Architectures, QoSA’15 (pp. 31–36). New York: ACM.Jalali, S., & Wohlin, C. (2012). Systematic literature studies: Database searches vs. backward snowballing. In Proceedings of the ACM-IEEE International Symposium on Empirical Software Engineering and Measurement, ESEM’12 (pp. 29–38). New York: ACM.Kahraman, G., & Bilgen, S. (2013). A framework for qualitative assessment of domain-specific languages. Software & Systems Modeling, 1–22.Kessentini, M., Langer, P., & Wimmer, M. (2013). Searching models, modeling search: On the synergies of sbse and mde (pp. 51–54).Kitchenham, B., & Charters, S. (2007). Guidelines for performing Systematic Literature Reviews in Software Engineering. Technical Report EBSE 2007-001, Keele University and Durham University Joint Report.Kitchenham, B., Pfleeger, S., Pickard, L., Jones, P., Hoaglin, D., El Emam, K., & Rosenberg, J. (2002). Preliminary guidelines for empirical research in software engineering. IEEE Transactions on Software Engineering, 28(8), 721–734.Klinke, M. (2008). Do you use mda/mdd/mdsd, any kind of model-driven approach? Will it be the future?Köhnlein, J. (2013). Eclipse diagram editors from a user’s perspective.Kolovos, D.S., Paige, R.F., & Polack, F.A. (2008). The grand challenge of scalability for model driven engineering. In Models in Software Engineering (pp. 48–53): Springer.Kolovos, D.S., Rose, L.M., Matragkas, N., Paige, R.F., Guerra, E., Cuadrado, J.S., De Lara, J., Ráth, I., Varró, D., Tisi, M., & Cabot, J. (2013). A research roadmap towards achieving scalability in model driven engineering. In Proceedings of the Workshop on Scalability in Model Driven Engineering, BigMDE’13 (pp. 2:1–2:10). New York: ACM.Krill, P. (2016). Uml to be ejected from microsoft visual studio (infoworld).Krogstie, J. (2012a). Model-based development and evolution of information systems: a quality approach, Springer Publishing Company, Incorporated.Krogstie, J. (2012b). Quality of modelling languages, (pp. 249–280). London: Springer.Krogstie, J. (2012c). Quality of models, (pp. 205–247). London: Springer.Krogstie, J. (2012d). Specialisations of SEQUAL, (pp. 281–326). London: Springer.Krogstie, J., Lindland, O.I., & Sindre, G. (1995). Defining quality aspects for conceptual models. In Proceedings of the IFIP International Working Conference on Information System Concepts: Towards a Consolidation of Views (pp. 216–231). London: Chapman & Hall, Ltd.Kruchten, P. (2000). The rational unified process: an introduction, 2nd edn. Boston: Addison-Wesley Longman Publishing Co., Inc.Kruchten, P., Nord, R., & Ozkaya, I. (2012). Technical debt: from metaphor to theory and practice. Software, IEEE, 29(6), 18–21.Kulkarni, V., Reddy, S., & Rajbhoj, A. (2010). Scaling up model driven engineering – experience and lessons learnt. In Petriu, D., Rouquette, N., & Haugen, y. (Eds.) Model Driven Engineering Languages and Systems, volume 6395 of Lecture Notes in Computer Science (pp. 331–345). Berlin, Heidelberg: Springer.Laguna, M.A., & Marqués, J.M. (2010). Uml support for designing software product lines: the package merge mechanism, 16(17), 2313–2332.Lange, C. (2007a). Model size matters. Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 4364 LNCS:211–216. cited By (since 1996)1.Lange, C., & Chaudron, M. (2005). Managing Model Quality in UML-Based Software Development. In 13th IEEE International Workshop on Technology and Engineering Practice, 2005 (pp. 7–16).Lange, C., Chaudron, M.R.V., Muskens, J., Somers, L.J., & Dortmans, H.M. (2003). An empirical investigation in quantifying inconsistency and incompleteness of uml designs. In Incompleteness of UML Designs, Proceedings Workshop on Consistency Problems in UML-based Software Development, 6th International Conference on Unified Modeling Language, UML, 2003.Lange, C., DuBois, B., Chaudron, M., & Demeyer, S. (2006). An experimental investigation of uml modeling conventions. In Nierstrasz, O., Whittle, J., Harel, D., & Reggio, G. (Eds.) Model Driven Engineering Languages and Systems, volume 4199 of Lecture Notes in Computer Science (pp. 27–41). Berlin, Heidelberg: Springer.Lange, C.F.J., & Chaudron, M.R.V. (2006). Effe

Can medical therapy mimic the clinical efficacy or physiological effects of bariatric surgery?

The number of bariatric surgical procedures performed has increased dramatically. This review discusses the clinical and physiological changes, and in particular, the mechanisms behind weight loss and glycaemic improvements, observed following the gastric bypass, sleeve gastrectomy and gastric banding bariatric procedures. The review then examines how close we are to mimicking the clinical or physiological effects of surgery through less invasive and safer modern interventions that are currently available for clinical use. These include dietary interventions, orlistat, lorcaserin, phentermine/topiramate, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, pramlintide, dapagliflozin, the duodenal–jejunal bypass liner, gastric pacemakers and gastric balloons. We conclude that, based on the most recent trials, we cannot fully mimic the clinical or physiological effects of surgery; however, we are getting closer. A ‘medical bypass' may not be as far in the future as we previously thought, as the physician's armamentarium against obesity and type 2 diabetes has recently got stronger through the use of specific dietary modifications, novel medical devices and pharmacotherapy. Novel therapeutic targets include not only appetite but also taste/food preferences, energy expenditure, gut microbiota, bile acid signalling, inflammation, preservation of β-cell function and hepatic glucose output, among others. Although there are no magic bullets, an integrated multimodal approach may yield success. Non-surgical interventions that mimic the metabolic benefits of bariatric surgery, with a reduced morbidity and mortality burden, remain tenable alternatives for patients and health-care professionals

Epidemic of hypertension in Ghana: a systematic review

Background Hypertension is a major risk factor for many cardiovascular diseases in developing countries. A comprehensive review of the prevalence of hypertension provides crucial information for the evaluation and implementation of appropriate programmes. Methods The PubMed and Google Scholar databases were searched for published articles on the population-based prevalence of adult hypertension in Ghana between 1970 and August 2009, supplemented by a manual search of retrieved references. Fifteen unique population-based articles in non-pregnant humans were obtained. In addition, two relevant unpublished graduate student theses from one university department were identified after a search of its 1996-2008 theses. Results The age and sex composition of study populations, sampling strategy, measurement of blood pressure, definition of hypertension varied between studies. The prevalence of hypertension (BP ≥ 140/90 mmHg ± antihypertensive treatment) ranged from 19% to 48% between studies. Sex differences were generally minimal whereas urban populations tended to have higher prevalence than rural population in studies with mixed population types. Factors independently associated with hypertension included older age group, over-nutrition and alcohol consumption. Whereas there was a trend towards improved awareness, treatment and control between 1972 and 2005, less than one-third of hypertensive subjects were aware they had hypertension and less than one-tenth had their blood pressures controlled in most studies. Conclusion Hypertension is clearly an important public health problem in Ghana, even in the poorest rural communities. Emerging opportunities such as the national health insurance scheme, a new health policy emphasising health promotion and healthier lifestyles and effective treatment should help prevent and control hypertension

Behavioural and Developmental Interventions for Autism Spectrum Disorder: A Clinical Systematic Review

Background: Much controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD). We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD. Methods and Findings: Comprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlle