152 research outputs found

    Knowledge Audit Model for Requirement Elicitation Process

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    Knowledge plays an important role to the success of any organization. Software development organizations are highly knowledge-intensive organizations especially in their Requirement Elicitation Process (REP). There are several problems regarding communicating and using the knowledge in REP such as misunderstanding, being out of scope, conflicting information and changes of requirements. All of these problems occurred in transmitting the requirements knowledge during REP. Several researches have been done in REP in order to solve the problem towards requirements. Knowledge Audit (KA) approaches were proposed in order to solve managing knowledge in human resources, financial, and manufacturing. There is lack of study applying the KA in requirements elicitation process. Therefore, this paper proposes a KA model for REP in supporting to acquire good requirements

    A knowledge audit model for requirement elicitation: a case study to assess knowledge in requirement elicitation

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    This paper aims to develop a knowledge audit (KA) model with the focus on knowledge assessment in the requirements elicitation process (REP) to allay the problems of REP regarding knowledge communication. The principal problems with REP are knowledge conflict and the failure to mention a variety of knowledge and requirements changes. Despite of many existing studies relating to KA, inadequate effort has been directed towards investigating the full part played by the KA process in REP. The purpose of this paper is to bridge this gap using a software prototype that uses the KA model in the REP. This study proposes a KA model using an iterative triangulation method. The proposed model is validated through a case study by using a software prototype developed based on the proposed KA model to see if this KA model is effective for software developers in REP by improving the completeness, correctness, and understandability of the elicited requirements knowledge. Research findings are based on responses of 40 respondents from software development organizations. The results of case study confirmed the effectiveness of KA model for REP with respect to completeness, correctness, and understandability. This research answers the call to assess knowledge in REP by developing a KA model and prototype to fill the existing gap in this area. Overall, a KA model for REP is introduced and validated to identify and assess knowledge that supports knowledge communication in REP

    A knowledge audit model to assess the knowledge in requirement elicitation process

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    There is a great deal of knowledge in requirement elicitation process (REP), because there are different stakeholders with various knowledge backgrounds. Different backgrounds of knowledge lead to different ways of knowledge expression that negatively affect knowledge understandability and cause ambiguity. Knowledge ambiguity results in incorrect interpretation of knowledge and requirements. On the other hand, different stakeholders have different needs and expectations from the software to be developed. This problem causes conflicting information and also negatively affects the correctness of knowledge. Furthermore, stakeholders may ignore mentioning some knowledge because they think it is obvious or their requirements change over time, this negatively affects completeness of knowledge in REP. To mitigate these problems, it is necessary to identify and assess the knowledge in REP. Knowledge Audit (KA) is the process of knowledge analysis and assessment. Therefore, this research introduces a KA model to support knowledge communication among stakeholders through objectively assessing the knowledge in REP

    Early readmission and length of hospitalization practices in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

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    Background:  Rising hospital care costs have created pressure to shorten hospital stays and emphasize outpatient care. This study tests the hypothesis that shorter median length of stay (LOS) as a dialysis facility practice is associated with higher rates of early readmission. Methods:  Readmission within 30 days of each hospitalization was evaluated for participants in the Dialysis Outcomes and Practice Patterns Study, an observational study of randomly selected hemodialysis patients in the United States (142 facilities, 5095 patients with hospitalizations), five European countries (101 facilities, 2281 patients with hospitalizations), and Japan (58 facilities, 883 patients with hospitalizations). Associations between median facility LOS (estimated from all hospitalizations at the facility and interpreted as a dialysis facility practice pattern) and odds of readmission were assessed using logistic regression, adjusted for patient characteristics and the LOS of each index hospitalization. Results:  Risk of readmission was directly and significantly associated with LOS of the index hospitalization (adjusted odds ratio [AOR] 1.005 per day in median facility LOS, p = 0.007) and inversely associated with median facility LOS (AOR = 0.974 per day, p = 0.016). This latter association was strongest for US hemodialysis centers (AOR = 0.954 per day, p = 0.015). Conclusions:  Dialysis facilities with shorter median hospital LOS for their patients have higher odds of readmission, particularly in the United States, where there is greater pressure to shorten LOS. The determinants and consequences of practices related to hospital LOS for hemodialysis patients should be further studied.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73641/1/j.1492-7535.2004.01107.x.pd

    Recombinant Lysyl Oxidase Propeptide Protein Inhibits Growth and Promotes Apoptosis of Pre-Existing Murine Breast Cancer Xenografts

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    Lysyl oxidase propeptide (LOX-PP) ectopic overexpression inhibits the growth of cancer xenografts. Here the ability and mode of action of purified recombinant LOX-PP (rLOX-PP) protein to inhibit the growth of pre-existing xenografts was determined. Experimental approaches employed were direct intratumoral injection (i.t.) of rLOX-PP protein into murine breast cancer NF639 xenografts, and application of a slow release formulation of rLOX-PP implanted adjacent to tumors in NCR nu/nu mice (n = 10). Tumors were monitored for growth, and after sacrifice were subjected to immunohistochemical and Western blot analyses for several markers of proliferation, apoptosis, and for rLOX-PP itself. Direct i.t. injection of rLOX-PP significantly reduced tumor volume on days 20, 22 and 25 and tumor weight at harvest on day 25 by 30% compared to control. Implantation of beads preloaded with 35 micrograms rLOX-PP (n = 10) in vivo reduced tumor volume and weight at sacrifice when compared to empty beads (p<0.05). A 30% reduction of tumor volume on days 22 and 25 (p<0.05) and final tumor weight on day 25 (p<0.05) were observed with a reduced tumor growth rate of 60% after implantation. rLOX-PP significantly reduced the expression of proliferation markers and Erk1/2 MAP kinase activation, while prominent increases in apoptosis markers were observed. rLOX-PP was detected by immunohistochemistry in harvested rLOX-PP tumors, but not in controls. Data provide pre-clinical findings that support proof of principle for the therapeutic anti-cancer potential of rLOX-PP protein formulations

    A Markov computer simulation model of the economics of neuromuscular blockade in patients with acute respiratory distress syndrome

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    BACKGROUND: Management of acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU) is clinically challenging and costly. Neuromuscular blocking agents may facilitate mechanical ventilation and improve oxygenation, but may result in prolonged recovery of neuromuscular function and acute quadriplegic myopathy syndrome (AQMS). The goal of this study was to address a hypothetical question via computer modeling: Would a reduction in intubation time of 6 hours and/or a reduction in the incidence of AQMS from 25% to 21%, provide enough benefit to justify a drug with an additional expenditure of 267(thedifferenceinacquisitioncostbetweenagenericandbrandnameneuromuscularblocker)?METHODS:Thebasecasewasa55yearoldmanintheICUwithARDSwhoreceivesneuromuscularblockadefor3.5days.AMarkovmodelwasdesignedwithhypotheticalpatientsin1of6mutuallyexclusivehealthstates:ICUintubated,ICUextubated,hospitalward,longtermcare,home,ordeath,overaperiodof6months.Thenetmonetarybenefitwascomputed.RESULTS:OurcomputersimulationmodelingpredictedthemeancostforARDSpatientsreceivingstandardcarefor6monthstobe267 (the difference in acquisition cost between a generic and brand name neuromuscular blocker)? METHODS: The base case was a 55 year-old man in the ICU with ARDS who receives neuromuscular blockade for 3.5 days. A Markov model was designed with hypothetical patients in 1 of 6 mutually exclusive health states: ICU-intubated, ICU-extubated, hospital ward, long-term care, home, or death, over a period of 6 months. The net monetary benefit was computed. RESULTS: Our computer simulation modeling predicted the mean cost for ARDS patients receiving standard care for 6 months to be 62,238 (5% – 95% percentiles 42,25942,259 – 83,766), with an overall 6-month mortality of 39%. Assuming a ceiling ratio of 35,000,evenifadrug(thatcost35,000, even if a drug (that cost 267 more) hypothetically reduced AQMS from 25% to 21% and decreased intubation time by 6 hours, the net monetary benefit would only equal $137. CONCLUSION: ARDS patients receiving a neuromuscular blocker have a high mortality, and unpredictable outcome, which results in large variability in costs per case. If a patient dies, there is no benefit to any drug that reduces ventilation time or AQMS incidence. A prospective, randomized pharmacoeconomic study of neuromuscular blockers in the ICU to asses AQMS or intubation times is impractical because of the highly variable clinical course of patients with ARDS

    The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

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    The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

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    Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe
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