Association of Health Departments’ Completion of A Community Health Assessment, Community Health Improvement Plan, and Strategic Plan With Better Population Health Outcomes

Promoting health and well-being requires a strong public health infrastructure. This study examined the association of engagement of local health departments (LHDs) in accreditation and its pre-requisites with health outcomes in LHD jurisdictions such as the prevalence of premature death and tobacco use in the counties they serve. Two data sets, The 2016 National Profile of Local Health Departments and 2018 Community Health Rankings were linked using deterministic linkage approach, based on county FIPS codes as a unique identifier. Descriptive and multinomial logistic regression analyses were performed using SPSS Version 25. The results showed that having recently completed a community health improvement plan, a strategic plan, PHAB accreditation engagement, governance structure, and jurisdiction size are all significantly associated with high levels of premature death and tobacco use outcomes

Machine-Checked Proofs For Realizability Checking Algorithms

Virtual integration techniques focus on building architectural models of systems that can be analyzed early in the design cycle to try to lower cost, reduce risk, and improve quality of complex embedded systems. Given appropriate architectural descriptions, assume/guarantee contracts, and compositional reasoning rules, these techniques can be used to prove important safety properties about the architecture prior to system construction. For these proofs to be meaningful, each leaf-level component contract must be realizable; i.e., it is possible to construct a component such that for any input allowed by the contract assumptions, there is some output value that the component can produce that satisfies the contract guarantees. We have recently proposed (in [1]) a contract-based realizability checking algorithm for assume/guarantee contracts over infinite theories supported by SMT solvers such as linear integer/real arithmetic and uninterpreted functions. In that work, we used an SMT solver and an algorithm similar to k-induction to establish the realizability of a contract, and justified our approach via a hand proof. Given the central importance of realizability to our virtual integration approach, we wanted additional confidence that our approach was sound. This paper describes a complete formalization of the approach in the Coq proof and specification language. During formalization, we found several small mistakes and missing assumptions in our reasoning. Although these did not compromise the correctness of the algorithm used in the checking tools, they point to the value of machine-checked formalization. In addition, we believe this is the first machine-checked formalization for a realizability algorithm.Comment: 14 pages, 1 figur

The JKind Model Checker

JKind is an open-source industrial model checker developed by Rockwell Collins and the University of Minnesota. JKind uses multiple parallel engines to prove or falsify safety properties of infinite state models. It is portable, easy to install, performance competitive with other state-of-the-art model checkers, and has features designed to improve the results presented to users: inductive validity cores for proofs and counterexample smoothing for test-case generation. It serves as the back-end for various industrial applications.Comment: CAV 201

Verifying the Safety of a Flight-Critical System

This paper describes our work on demonstrating verification technologies on a flight-critical system of realistic functionality, size, and complexity. Our work targeted a commercial aircraft control system named Transport Class Model (TCM), and involved several stages: formalizing and disambiguating requirements in collaboration with do- main experts; processing models for their use by formal verification tools; applying compositional techniques at the architectural and component level to scale verification. Performed in the context of a major NASA milestone, this study of formal verification in practice is one of the most challenging that our group has performed, and it took several person months to complete it. This paper describes the methodology that we followed and the lessons that we learned.Comment: 17 pages, 5 figure

Application of Dynamic System Identification to Timber Beams - part I

In this first part of a two-part paper, development of a method of dynamic system identification for timber beams is presented with an analytical verification of the method using a finite-element model. A method of global nondestructive evaluation for identifying local damage and decay in timber beams is investigated in this paper. Experimental modal analysis is used in conjunction with a previously developed damage localization algorithm. The damage localization algorithm utilizes changes in modal strain energy between the mode shapes of a calibrated model, representing the undamaged state of the beam of interest, and the experimentally obtained mode shapes for a timber beam. Analytical evaluations were performed to demonstrate and verify the use of this method of global nondestructive evaluation for the localization of damage or decay in timber beams. In a companion paper, experimental laboratory tests are presented that verify the use of dynamic system identification to locate damage within timber beams

Boundaries of Semantic Distraction: Dominance and Lexicality Act at Retrieval

Three experiments investigated memory for semantic information with the goal of determining boundary conditions for the manifestation of semantic auditory distraction. Irrelevant speech disrupted the free recall of semantic category-exemplars to an equal degree regardless of whether the speech coincided with presentation or test phases of the task (Experiment 1) and occurred regardless of whether it comprised random words or coherent sentences (Experiment 2). The effects of background speech were greater when the irrelevant speech was semantically related to the to-be-remembered material, but only when the irrelevant words were high in output dominance (Experiment 3). The implications of these findings in relation to the processing of task material and the processing of background speech is discussed

Research of working area development parameters in conditions of deep steep deposit finalizing

Отримано формули розрахунку об’єму запасів корисних копалин в приконтурній та глибинній зоні. Встановлено характер впливу параметрів доробки глибоких крутоспадних родовищ відкритим способом на доцільне положення поточних та проектних контурів кар’єру. Встановлено, що найменший середній коефіцієнт розкриву досягається при мінімальному значенні суми обсягів корисної копалини приконтурної зони лежачого і висячого боків покладу в проектному положенні. Найменший поточний коефіцієнт розкриву досягається при мінімальному значенні суми обсягів корисної копалини приконтурної зони лежачого і висячого боків покладу, а також робочого борту кар'єру в поточному положенні

Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement

Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients

Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis

Introduction: The ability to preserve organs prior to transplant is essential to the organ allocation process. Objective: The purpose of this study is to describe the functional relationship between cold-ischemia time (CIT) and primary nonfunction (PNF), patient and graft survival in liver transplant. Methods: To identify relevant articles Medline, EMBASE and the Cochrane database, including the non-English literature identified in these databases, was searched from 1966 to April 2008. Two independent reviewers screened and extracted the data. CIT was analyzed both as a continuous variable and stratified by clinically relevant intervals. Nondichotomous variables were weighted by sample size. Percent variables were weighted by the inverse of the binomial variance. Results: Twenty-six studies met criteria. Functionally, PNF%=-6.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean-9.89535) 2 - 0.0067663*(CIT Mean-9.89535) 3, r2=.625, p<.0001. Mean patient survival: 93 % (1 month), 88 % (3 months), 83 % (6 months) and 83 % (12 months). Mean graft survival: 85.9 % (1 month), 80.5 % (3 months), 78.1 % (6 months) and 76.8 % (12 months). Maximum patient and graft survival occurred with CITs between 7.5-12.5 hrs at each survival interval. PNF was also significantly correlated with ICU time, % first time grafts and % immunologic mismatches. Conclusion: The results of this work imply that CIT may be the most important pre-transplant information needed in the decision to accept an organ. © 2008 Stahl et al

MR histology reveals tissue features beneath heterogeneous MRI signal in genetically engineered mouse models of sarcoma

PurposeTo identify significant relationships between quantitative cytometric tissue features and quantitative MR (qMRI) intratumorally in preclinical undifferentiated pleomorphic sarcomas (UPS).Materials and methodsIn a prospective study of genetically engineered mouse models of UPS, we registered imaging libraries consisting of matched multi-contrast in vivo MRI, three-dimensional (3D) multi-contrast high-resolution ex vivo MR histology (MRH), and two-dimensional (2D) tissue slides. From digitized histology we generated quantitative cytometric feature maps from whole-slide automated nuclear segmentation. We automatically segmented intratumoral regions of distinct qMRI values and measured corresponding cytometric features. Linear regression analysis was performed to compare intratumoral qMRI and tissue cytometric features, and results were corrected for multiple comparisons. Linear correlations between qMRI and cytometric features with p values of &lt;0.05 after correction for multiple comparisons were considered significant.ResultsThree features correlated with ex vivo apparent diffusion coefficient (ADC), and no features correlated with in vivo ADC. Six features demonstrated significant linear relationships with ex vivo T2*, and fifteen features correlated significantly with in vivo T2*. In both cases, nuclear Haralick texture features were the most prevalent type of feature correlated with T2*. A small group of nuclear topology features also correlated with one or both T2* contrasts, and positive trends were seen between T2* and nuclear size metrics.ConclusionRegistered multi-parametric imaging datasets can identify quantitative tissue features which contribute to UPS MR signal. T2* may provide quantitative information about nuclear morphology and pleomorphism, adding histological insights to radiological interpretation of UPS