TESTING xUML: A STUDY OF IMPLEMENTING AND TESTING MODEL DRIVEN ARCHITECTURE

Model Driven Architecture (MDA) is a relatively new and completely different approach to developing software in which diagrams and formal specifications are written and then translated into executable programs. Development using this approach takes longer than using traditional software engineering approaches, but results in products that more correctly meet user requirements and take less maintenance effort. While there is considerable information available regarding development using MDA, the implications for testing have not been fully explored or measured. In order to investigate this facet of MDA, a traditional C++ program which had previously been tested was rebuilt as an MDA model. Metrics for unit, integration, and system testing on the two systems were then gathered and compared. The MDA model proved to be moderately easier to test than a traditional system; tools are provided to assist testers, allowing testing to potentially be accomplished earlier in the life cycle of a project. Additionally, the MDA approach may make it possible to create a reusable model which could be used for testing many widely different applications with minimal effort required to adapt the model between programs. Results indicated that developers could expect unit and integration testing of iUML systems to take slightly less time than testing traditional systems. System testing of the MDA model is likely to be more expensive in the short term, but payoff over time. While developing in MDA necessitates overcoming several hurdles and may prove to be too expensive to be practical, ease of testing is not one of MDA’s shortcomings

Effect of Soil Chemistry on Microbial Biodiversity and Functionality in Grassland and Tilled Soils

Microorganisms are excellent indicators of soil health, because of their rapid response to environmental change. Traditional microbiology is ineffective for the study of soil, as \u3c 1% of microorganisms are currently culturable (Torsvik et al., 1996). Nucleic acid based methods, however, allow rapid detection of organisms, or particular genes, directly from soil samples. This work investigated, using polymerase chain reaction (PCR)-based approaches, the relationship between key chemical properties and bacterial biodiversity in grassland and tilled soils, with particular emphasis on the abundance and diversity of ammonium oxidisers

Practice patterns for acute ischemic stroke workup: A longitudinal population‐based study

Background We examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence. Methods and Results We identified stroke cases and related diagnostic testing from four 1‐year study periods (July 1993 to June 1994, 1999, 2005, and 2010) of the Greater Cincinnati/Northern Kentucky Stroke Study. Patients aged ≥18 years were included. We focused on evaluation of extracranial arteries for carotid stenosis and assessment of atrial fibrillation because randomized controlled trials supported treatment of these conditions for stroke prevention across all 4 study periods. In each study period, we also recorded stroke etiology, as determined by diagnostic testing and physician adjudication. An increasing proportion of stroke patients received assessment of both extracranial arteries and the heart over time (50%, 58%, 74%, and 78% in the 1993–1994, 1999, 2005, and 2010 periods, respectively; P &lt;0.0001 for trend), with the most dramatic individual increases in echocardiography (57%, 63%, 77%, and 83%, respectively). Concurrently, we observed a decrease in strokes of unknown etiology (47%, 48%, 41%, and 38%, respectively; P &lt;0.0001 for trend). We also found a significant increase in strokes of other known causes (32%, 25%, 45% and 59%, respectively; P &lt;0.0001 for trend). Conclusions Stroke workup for treatable causes of stroke are being used more frequently over time, and this is associated with a decrease in cryptogenic strokes. Future study of whether better determination of treatable stroke etiologies translates to a decrease in stroke recurrence at the population level will be essential. </jats:sec

Prehospital neurological deterioration in stroke

BACKGROUND AND PURPOSE: Patients with stroke can experience neurological deterioration in the prehospital setting. We evaluated patients with stroke to determine factors associated with prehospital neurological deterioration (PND). METHODS: Among the Greater Cincinnati/Northern Kentucky region (population ~1.3 million), we screened all 15 local hospitals' admissions from 2010 for acute stroke and included patients aged ≥20. The GCS was compared between emergency medical services (EMS) arrival and hospital arrival, with decrease ≥2 points considered PND. Data obtained retrospectively included demographics, medical history and medication use, stroke subtype (eg, ischaemic stroke (IS), intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH)) and IS subtype (eg, small vessel, large vessel, cardioembolic), seizure at onset, time intervals between symptom onset, EMS arrival and hospital arrival, EMS level of training, and blood pressure and serum glucose on EMS arrival. RESULTS: Of 2708 total patients who had a stroke, 1092 patients (median (IQR) age 74 (61-83) years; 56% women; 21% black) were analysed. PND occurred in 129 cases (12%), including 9% of IS, 24% of ICH and 16% of SAH. In multivariable analysis, black race, atrial fibrillation, haemorrhagic subtype and ALS level of transport were associated with PND. CONCLUSION: Haemorrhage and atrial fibrillation is associated with PND in stroke, and further investigation is needed to establish whether PND can be predicted. Further studies are also needed to assess whether preferential transport of patients with deterioration to hospitals equipped with higher levels of care is beneficial, identify why race is associated with deterioration and to test therapies targeting PND

NCI-MATCH Arms N & P: Phase II study of PI3K beta inhibitor GSK2636771 in patients (pts) with cancers (ca) with PTEN mutation/deletion (mut/del) or PTEN protein loss

Background: The NCI-MATCH trial is the largest national study (1173 sites) for ptswith relapsed/ refractory solid tumors, lymphomas and myeloma, which assigns tar-geted therapies based on individual tumor molecular alterations detected using theadapted Oncomine AmpliSeq panel (143 genes) and immunohistochemistry (IHC).We hypothesized that patients with PTEN-deficient cancers enrolled to Arms N and Pmay benefit from treatment with the PI3K beta-selective inhibitor GSK2636771. Methods: Eligibility: relapsed/refractory ca, good end-organ function, and ECOG PS ≤ 1. Pts were screened for molecular alterations by centralized testing on fresh tumor biopsy and had deleterious PTEN mut/del without loss of expression (Arm N) or complete loss of cytoplasmic and nuclear PTEN staining on IHC (Arm P), and no other aberrations activating the PI3K/MTOR and MAPK pathways (mut in PIK3CA, PIK3R1, BRAF, KRAS, AKT1, TSC1/2, mTOR, RHEB, NF2, NRAS, HRAS). Pts received GSK2636771 400mg/day (28-days cycles). RECIST 1.1 overall response rate (ORR) was the primary endpoint. Results: Of 59 enrolled pts, 56 were eligible and received treatment. Of 22 pts with PTEN mut/del (Arm N: 6 uterine, 2 breast, 2 prostate, 2 head/neck ca, 10 other), all are off treatment as of analysis (14 disease progression, 4 for adverse events [AEs], 4 other). One pt (4.5%) with prostate ca (PTEN deletion, MPRSS2-ERG fusion) attained a partial response (-42%). Of 7 (32%) pts with stable disease (SD), 2 had SD \u3e 6 months (uterine leiomyosarcoma; endometrial carcinoma). Of 34 pts with loss of PTEN protein by IHC (Arm P: 7 prostate, 6 breast, 3 squamous anal ca, 2 cholangiocarcinoma, 16 other), all are off treatment as of analysis (26 disease progression, 4 for AE, 4 other). Of 9 (37.5%) pts with SD, 3 had SD \u3e 6 months (prostate cancer; squamous bladder cancer, squamous anal cancer). Median progression-free survival was 1.8 months for both arms. Gr ≥ 3 treatment-related (tr) reversible toxicities were experienced by 30% (7) and 20% (7) of pts in arms N and P, respectively. No tr Gr 5 toxicities were observed in either arm. Conclusions: Single agent GSK2636771 has very modest activity in ca with PTEN gene mutation/deletion and/or PTEN protein loss

Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

Objective: This study was designed to compare the initial efficacy of Motivational Interviewing (MI), Online Transtheoretical Model (TTM)-tailored communications and a brief Health Risk Intervention (HRI) on four health risk factors (inactivity, BMI, stress and smoking) in a worksite sample. Method: A randomized clinical trial assigned employees to one of three recruitment strategies and one of the three treatments. The treatment protocol included an HRI session for everyone and in addition either a recommended three TTM online sessions or three MI in person or telephone sessions over 6 months. At the initial post-treatment assessment at 6 months, groups were compared on the percentage who had progressed from at risk to taking effective action on each of the four risks. Results: Compared to the HRI only group, the MI and TTM groups had significantly more participants in the Action stage for exercise and effective stress management and significantly fewer risk behaviors at 6 months. MI and TTM group outcomes were not different. Conclusion: This was the first study to demonstrate that MI and online TTM could produce significant multiple behavior changes. Future research will examine the long-term impacts of each treatment, their cost effectiveness, effects on productivity and quality of life and process variables mediating outcomes

Stereotyping starlings are more 'pessimistic'.

Negative affect in humans and animals is known to cause individuals to interpret ambiguous stimuli pessimistically, a phenomenon termed 'cognitive bias'. Here, we used captive European starlings (Sturnus vulgaris) to test the hypothesis that a reduction in environmental conditions, from enriched to non-enriched cages, would engender negative affect, and hence 'pessimistic' biases. We also explored whether individual differences in stereotypic behaviour (repetitive somersaulting) predicted 'pessimism'. Eight birds were trained on a novel conditional discrimination task with differential rewards, in which background shade (light or dark) determined which of two covered dishes contained a food reward. The reward was small when the background was light, but large when the background was dark. We then presented background shades intermediate between those trained to assess the birds' bias to choose the dish associated with the smaller food reward (a 'pessimistic' judgement) when the discriminative stimulus was ambiguous. Contrary to predictions, changes in the level of cage enrichment had no effect on 'pessimism'. However, changes in the latency to choose and probability of expressing a choice suggested that birds learnt rapidly that trials with ambiguous stimuli were unreinforced. Individual differences in performance of stereotypies did predict 'pessimism'. Specifically, birds that somersaulted were more likely to choose the dish associated with the smaller food reward in the presence of the most ambiguous discriminative stimulus. We propose that somersaulting is part of a wider suite of behavioural traits indicative of a stress response to captive conditions that is symptomatic of a negative affective state

Probing the centre of the large circumstellar disc in M17

We investigated the nature of the hitherto unresolved elliptical infrared emission in the centre of the ~20000 AU disc silhouette in M 17. We combined high-resolution JHKsL'M' band imaging carried out with NAOS/CONICA at the VLT with [Fe II] narrow band imaging using SOFI at the NTT. The analysis is supported by Spitzer/GLIMPSE archival data and by already published SINFONI/VLT Integral Field Spectroscopy data. For the first time, we resolve the elongated central infrared emission into a point-source and a jet-like feature that extends to the northeast in the opposite direction of the recently discovered collimated H2 jet. They are both orientated almost perpendicular to the disc plane. In addition, our images reveal a curved southwestern emission nebula whose morphology resembles that of the previously detected northeastern one. Both nebulae are located at a distance of 1500 AU from the disc centre. We describe the infrared point-source in terms of a protostar that is embedded in circumstellar material producing a visual extinction of 60 <= Av <= 82. The observed Ks band magnitude is equivalent to a stellar mass range of 2.8 Msun <= Mstar <= 8 Msun adopting conversions for a main-sequence star. Altogether, we suggest that the large M 17 accretion disc is forming an intermediate to high-mass protostar. Part of the accreted material is expelled through a symmetric bipolar jet/outflow.Comment: 6 pages, 3 figures, accepted by MNRAS (16 May 2008

Effect of a Multidisciplinary Team Approach to Eradicate Central Line Associated Blood-Stream Infections (CLABSI)

Introduction: CLABSI remains a significant problem in the intensive care unit. Hypothesis: A multimodal approach for the insertion and care of CVC will prevent CLABSI. Methods: A Critical Care Operations Committee was formed to transform care in 8 intensive care units (ICU) in an academic medical center in 9/2004. One goal was to reduce CLABSI. Using evidence based medicine, a clinical practice guideline was developed that incorporated the use of maximum barrier precautions, chlorhexidine skin preparation, avoidance of the femoral insertion site, dedicated catheter cart, a check list, the tracking of high risk CVC, anti-septic or antimicrobial impregnated catheters, a recommendation to use ultrasound guidance when inserting CVC in the internal jugular vein, daily determination of the need for the CVC and treatment of CLABSI as a critical event.CLABSI were adjudicated by the hospital epidemiologist and CVC days were tracked. Rates of CLABSI were followed from 9/2004 through 7/2011. The Spearman correlation coefficient was used for statistical evaluation. A p Results: CLABSI rates (per 1000 catheter-days) declined dramatically from 2004 to 2011 (p Conclusions: A multimodal approach to CVC insertion and care reduces CLABSI by over 90%. Our ultimate goal is the complete eradication of CRBSI in our institution