255 research outputs found

    Intrusiveness, Trust and Argumentation: Using Automated Negotiation to Inhibit the Transmission of Disruptive Information

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    The question of how to promote the growth and diffusion of information has been extensively addressed by a wide research community. A common assumption underpinning most studies is that the information to be transmitted is useful and of high quality. In this paper, we endorse a complementary perspective. We investigate how the growth and diffusion of high quality information can be managed and maximized by preventing, dampening and minimizing the diffusion of low quality, unwanted information. To this end, we focus on the conflict between pervasive computing environments and the joint activities undertaken in parallel local social contexts. When technologies for distributed activities (e.g. mobile technology) develop, both artifacts and services that enable people to participate in non-local contexts are likely to intrude on local situations. As a mechanism for minimizing the intrusion of the technology, we develop a computational model of argumentation-based negotiation among autonomous agents. A key component in the model is played by trust: what arguments are used and how they are evaluated depend on how trustworthy the agents judge one another. To gain an insight into the implications of the model, we conduct a number of virtual experiments. Results enable us to explore how intrusiveness is affected by trust, the negotiation network and the agents' abilities of conducting argumentation

    Crafting positive/negative patterns and nanopillars of polymer brushes by photocatalytic lithography

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    We demonstrate a convenient and versatile approach based on the photocatalytic lithography to obtain micro- and nanostructures of polymer brushes. Micro-patterns of polymer brushes are obtained through two ways: by the selective photocatalytic degradation of an initiator, self-assembled on the surface (\u201cpositive\u201d pattern), or by a \u201cnegative\u201d pattern obtained, first, degrading an alkylsiloxane monolayer and, then, refilling it with the initiator. In both cases, the patterned initiator monolayer is eventually amplified into polymer brushes with a controlled radical polymerization protocol (ARGET ATRP). The approach described here mimics the conventional photolithography but is free from the disadvantages associated to this technique (i.e. highly energetic light sources, polymeric resists and on purpose-made photomasks). Moreover, the ability to generate nanometer-sized pillars of polymer brushes using remote photocatalysis coupled with nanosphere lithography is demonstrated. Highly monodisperse silica particles with spherical shape (diameter 3c600\ua0nm) are assembled on the surface to be patterned and used as a mask for remote photocatalysis. Our results confirm the great potentialities of TiO2-photocatalytic lithography for patterning of polymer brushes

    Evidence-based careflow management systems: the case of post-stroke rehabilitation

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    AbstractThe activities of a care providers’ team need to be coordinated within a process properly designed on the basis of available best practice medical knowledge. It requires a rethinking of the management of care processes within health care organizations. The current workflow technology seems to offer the most convenient solution to build such cooperative systems. However, some of its present weaknesses still require an intense research effort to find solutions allowing its exploitation in real medical practice. This paper presents an approach to design and build evidence-based careflow management systems, which can be viewed as components of a knowledge management infrastructure each health care organization should be provided with to increase its performance in delivering high quality care by efficiently exploiting the available knowledge resources. The post-stroke rehabilitation process has been taken as a challenging care problem to assess our methodology for designing and developing careflow management systems. Then a system was co-developed with a team of rehabilitation professionals who will be committed to use it in their daily work. The system’s main goal is to deliver a full array of rehabilitation services provided by an interdisciplinary team. They are related to identify which patients are most likely to benefit from rehabilitation, manage a rehabilitation treatment plan, and monitor progress both during rehabilitation and after return to a community residence. A model of the rehabilitation process was derived from an international guideline and adapted to the local organization of work. It involves different organizational units, such as wards, rehabilitation units, clinical laboratories, and imaging services. Several organizational agents work within them and play one or more roles. Each role is defined by the goals’ set that she/he must fulfill. Special effort has been given to the design and development of a knowledge-based system for managing exceptions, which may occur in daily medical work as any deviation from the normal flow of activities. It allows either avoiding or recovering automatically from expected exceptions. When they are not expected, organizational agents, with enough power to do that, are allowed to modify the scheduled flow of activities for an individual patient under the only constraint of justifying their decision. After an intensive testing in a research laboratory, the system is now in the process of being transferred in a real working setting with the full support of its future users

    Predicting success in the worldwide start-up network

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    By drawing on large-scale online data we construct and analyze the time-varying worldwide network of professional relationships among start-ups. The nodes of this network represent companies, while the links model the flow of employees and the associated transfer of know-how across companies. We use network centrality measures to assess, at an early stage, the likelihood of the long-term positive performance of a start-up, showing that the start-up network has predictive power and provides valuable recommendations doubling the current state of the art performance of venture funds. Our network-based approach not only offers an effective alternative to the labour-intensive screening processes of venture capital firms, but can also enable entrepreneurs and policy-makers to conduct a more objective assessment of the long-term potentials of innovation ecosystems and to target interventions accordingly

    Towards the interoperability of computerised guidelines and electronic health records: an experiment with openEHR archetypes and a chronic heart failure guideline

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    Clinical guidelines contain recommendations based on the best empirical evidence available at the moment. There is a wide consensus about the benefits of guidelines and about the fact that they should be deployed through clinical information systems, making them available during clinical consultations. However, one of the main obstacles to this integration is the interaction with the electronic healthrecord system. With the aim of solving the interoperability problems of guideline systems, we have investigated the utilisation of the openEHR standardisation proposal in the context of one of the existing guideline representation languages. Concretely, we have designed a collection of archetypes to be used within a chronic heart failure guideline. The main contribution of our work is the utilisation of openEHR archetypes in the framework of guideline representation languages. Other contributions include both the concrete set of archetypes that we have selected and the methodological approach that we have followed to obtain itThis work has been supported by Fundaci´o Caixa Castell´o-Bancaixa, through the research project P11B2009-3

    Patterning of polymer brushes made easy using titanium dioxide: direct and remote photocatalytic lithography

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    Photocatalytic lithography is proved for the realization of micropatterned polymer brushes. Initiator-functionalized titanium dioxide or silicon surfaces are respectively exposed directly to near-UV light through a photomask (direct approach) or through a transparent photoactive TiO2 film (remote approach). Initiator patterns are then amplified as polymer brushes with SI-ATRP. Features down to 10 \u3bcm could be obtained using simple equipment. The process is intrinsically parallel, has high throughput and scalable to wafer size, making it powerful for microfabrication purposes

    An archetype-based solution for the interoperability of computerised guidelines and electronic health records

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    Clinical guidelines contain recommendations based on the best empirical evidence available at the moment. There is a wide con- sensus about the benefits of guidelines and about the fact that they should be deployed through clinical information systems, making them available during consultation time. However, one of the main obstacles to this integration is still the interaction with the electronic health record. In this paper we present an archetype-based approach to solve the inter- operability problems of guideline systems, as well as to enable guideline sharing. We also describe the knowledge requirements for the develop- ment of archetype-enabled guideline systems, and then focus on the de- velopment of appropriate guideline archetypes and on the connection of these archetypes to the target electronic health record

    How Online Communities of People With Long-Term Conditions Function and Evolve: Network Analysis of the Structure and Dynamics of the Asthma UK and British Lung Foundation Online Communities.

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    BACKGROUND: Self-management support can improve health and reduce health care utilization by people with long-term conditions. Online communities for people with long-term conditions have the potential to influence health, usage of health care resources, and facilitate illness self-management. Only recently, however, has evidence been reported on how such communities function and evolve, and how they support self-management of long-term conditions in practice. OBJECTIVE: The aim of this study is to gain a better understanding of the mechanisms underlying online self-management support systems by analyzing the structure and dynamics of the networks connecting users who write posts over time. METHODS: We conducted a longitudinal network analysis of anonymized data from 2 patients' online communities from the United Kingdom: the Asthma UK and the British Lung Foundation (BLF) communities in 2006-2016 and 2012-2016, respectively. RESULTS: The number of users and activity grew steadily over time, reaching 3345 users and 32,780 posts in the Asthma UK community, and 19,837 users and 875,151 posts in the BLF community. People who wrote posts in the Asthma UK forum tended to write at an interval of 1-20 days and six months, while those in the BLF community wrote at an interval of two days. In both communities, most pairs of users could reach one another either directly or indirectly through other users. Those who wrote a disproportionally large number of posts (the superusers) represented 1% of the overall population of both Asthma UK and BLF communities and accounted for 32% and 49% of the posts, respectively. Sensitivity analysis showed that the removal of superusers would cause the communities to collapse. Thus, interactions were held together by very few superusers, who posted frequently and regularly, 65% of them at least every 1.7 days in the BLF community and 70% every 3.1 days in the Asthma UK community. Their posting activity indirectly facilitated tie formation between other users. Superusers were a constantly available resource, with a mean of 80 and 20 superusers active at any one time in the BLF and Asthma UK communities, respectively. Over time, the more active users became, the more likely they were to reply to other users' posts rather than to write new ones, shifting from a help-seeking to a help-giving role. This might suggest that superusers were more likely to provide than to seek advice. CONCLUSIONS: In this study, we uncover key structural properties related to the way users interact and sustain online health communities. Superusers' engagement plays a fundamental sustaining role and deserves research attention. Further studies are needed to explore network determinants of the effectiveness of online engagement concerning health-related outcomes. In resource-constrained health care systems, scaling up online communities may offer a potentially accessible, wide-reaching and cost-effective intervention facilitating greater levels of self-management

    Hospital admissions for hypertensive crisis in the Emergency Departments: a large multicenter Italian study

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    Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001). Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001). Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs
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