Change Support in Process-Aware Information Systems - A Pattern-Based Analysis

In today's dynamic business world the economic success of an enterprise increasingly depends on its ability to react to changes in its environment in a quick and flexible way. Process-aware information systems (PAIS) offer promising perspectives in this respect and are increasingly employed for operationally supporting business processes. To provide effective business process support, flexible PAIS are needed which do not freeze existing business processes, but allow for loosely specified processes, which can be detailed during run-time. In addition, PAIS should enable authorized users to flexibly deviate from the predefined processes if required (e.g., by allowing them to dynamically add, delete, or move process activities) and to evolve business processes over time. At the same time PAIS must ensure consistency and robustness. The emergence of different process support paradigms and the lack of methods for comparing existing change approaches have made it difficult for PAIS engineers to choose the adequate technology. In this paper we suggest a set of changes patterns and change support features to foster the systematic comparison of existing process management technology with respect to process change support. Based on these change patterns and features, we provide a detailed analysis and evaluation of selected systems from both academia and industry. The identified change patterns and change support features facilitate the comparison of change support frameworks, and consequently will support PAIS engineers in selecting the right technology for realizing flexible PAIS. In addition, this work can be used as a reference for implementing more flexible PAIS

Identifying and Evaluating Change Patterns and Change Support Features in Process-Aware Information Systems.

In order to provide effective support, the introduction of process-aware information systems (PAIS) must not freeze existing business processes. Instead PAIS should allow authorized users to flexibly deviate from the predefined processes if required and to evolve business processes in a controlled manner over time. Many software vendors promise flexible system solutions for realizing such adaptive PAIS, but are often unable to cope with fundamental issues elated to process change (e.g., correctness and robustness). The existence of different process support paradigms and the lack of methods for comparing existing change approaches makes it difficult for PAIS engineers to choose the adequate technology. In this paper we suggest a set of changes patterns and change support features to foster systematic comparison of existing process management technology with respect to change support. Based on these change patterns and features, we provide a detailed analysis and evaluation of selected systems from both academia and industry

Acute Bacterial Meningitis in Adults – A Review of 493 Episodes

To characterize acute bacterial meningitis in adults, we reviewed the charts of all persons 16 years of age or older in whom acute bacterial meningitis was diagnosed at Massachusetts General Hospital from 1962 through 1988. We included patients who were admitted after initial treatment at other hospitals. During the 27-year period, 445 adults were treated for 493 episodes of acute bacterial meningitis, of which 197 (40 percent) were nosocomial. Gram-negative bacilli (other than Haemophilus influenzae) caused 33 percent of the nosocomial episodes but only 3 percent of the community-acquired episodes. In the 296 episodes of community-acquired meningitis, the most common pathogens were Streptococcus pneumoniae (37 percent), Neisseria meningitidis (13 percent), and Listeria monocytogenes (10 percent); these organisms accounted for only 8 percent of the nosocomial episodes. Only 19 of the 493 episodes of meningitis (4 percent) were due to H. influenzae. Nine percent of all patients had recurrent meningitis; many had a cerebrospinal fluid leak. Seizures occurred in 23 percent of patients with community-acquired meningitis, and 28 percent had focal central nervous system findings. Risk factors for death among those with single episodes of community-acquired meningitis included older age ( ≥ 60 years), obtunded mental state on admission, and seizures within the first 24 hours. Among those with single episodes, the in-hospital mortality rate was 25 percent for community-acquired and 35 percent for nosocomial meningitis. The overall case fatality rate was 25 percent and did not vary significantly over the 27 years. In our large urban hospital, a major proportion of cases of acute bacterial meningitis in adults were nosocomial. Recurrent episodes of meningitis were frequent. The overall mortality rate remained high., Few studies of bacterial meningitis have focused on the clinical and pathologic features of the illness in adults1–5. Most large series have included both children and adults, with children accounting for 45 to 87 percent of cases6–16. Results have rarely been reported according to age group in these studies. To characterize acute bacterial meningitis in adults, we reviewed our experience at Massachusetts General Hospital over a 27-year period, from 1962 through 1988

Spatio-temporal processes drive fine-scale genetic structure in an otherwise panmictic seabird population

When and where animals breed can shape the genetic structure and diversity of animal populations. The importance of drivers of genetic diversity is amplified in island populations that tend to have more delineated gene pools compared to continental populations. Studies of relatedness as a function of the spatial distribution of individuals have demonstrated the importance of spatial organisation for individual fitness with outcomes that are conditional on the overall genetic diversity of the population. However, few studies have investigated the impact of breeding timing on genetic structure. We characterise the fine-scale genetic structure of a geographically-isolated population of seabirds. Microsatellite markers provide evidence for largely transient within-breeding season temporal processes and limited spatial processes, affecting genetic structure in an otherwise panmictic population of sooty terns Onychoprion fuscatus. Earliest breeders had significantly different genetic structure from the latest breeders. Limited evidence was found for localised spatial structure, with a small number of individuals being more related to their nearest neighbours than the rest of the population. Therefore, population genetic structure is shaped by heterogeneities in collective movement in time and to a lesser extent space, that result in low levels of spatio-temporal genetic structure and the maintenance of genetic diversity

Isotopic and spin selectivity of H_2 adsorbed in bundles of carbon nanotubes

Due to its large surface area and strongly attractive potential, a bundle of carbon nanotubes is an ideal substrate material for gas storage. In addition, adsorption in nanotubes can be exploited in order to separate the components of a mixture. In this paper, we investigate the preferential adsorption of D_2 versus H_2(isotope selectivity) and of ortho versus para(spin selectivity) molecules confined in the one-dimensional grooves and interstitial channels of carbon nanotube bundles. We perform selectivity calculations in the low coverage regime, neglecting interactions between adsorbate molecules. We find substantial spin selectivity for a range of temperatures up to 100 K, and even greater isotope selectivity for an extended range of temperatures,up to 300 K. This isotope selectivity is consistent with recent experimental data, which exhibit a large difference between the isosteric heats of D_2 and H_2 adsorbed in these bundles.Comment: Paper submitted to Phys.Rev. B; 17 pages, 2 tables, 6 figure

The Efficacy, Safety, and Immunogenicity of Switching Between Reference Biopharmaceuticals and Biosimilars: A Systematic Review

To date, no consensus exists among stakeholders about the safety of switching between reference biological products (RPs) and biosimilars, which may have been curbing the implementation of biosimilars in clinical practice. This study synthesizes the available data on switching and assesses whether switching patients from a RP to its biosimilar or vice versa affects efficacy, safety, or immunogenicity outcomes. A total of 178 studies, in which switch outcomes from a RP to a biosimilar were reported, was identified. Data were derived from both randomized controlled trials and real-world evidence. Despite the limitations stemming from a lack of a robust design for most of the studies, the available switching data do not indicate that switching from a RP to a biosimilar is associated with any major efficacy, safety, or immunogenicity issues. Some open-label and observational studies reported increased discontinuation rates after switching, which were mainly attributed to nocebo effects. Involvement of the prescriber in any decision to switch should remain and attention should be paid to the mitigation of a potential nocebo effect

The Perplexing Problem of Persistently PCR-Positive Personnel

Early in the coronavirus disease 2019 (COVID-19) pandemic, the Centers for Disease Control and Prevention (CDC) published return-to-work criteria for healthcare personnel who had recovered from severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection. These criteria were most recently updated on April 3, 2020.1 The CDC has endorsed 2 different approaches to allow staff to return to work: a symptom or time-based strategy and a test-based strategy. Many institutions initially adopted the test-based strategy, in part because CDC initially recommended it as the preferred option (but no longer does so) and, in part, because it seemed the more definitive or conservative of the 2 CDC options

Measurement of νˉμ\bar{\nu}_{\mu} and νμ\nu_{\mu} charged current inclusive cross sections and their ratio with the T2K off-axis near detector

We report a measurement of cross section $\sigma(\nu_{\mu}+{\rm nucleus}\rightarrow\mu^{-}+X)$ and the first measurements of the cross section $\sigma(\bar{\nu}_{\mu}+{\rm nucleus}\rightarrow\mu^{+}+X)$ and their ratio $R(\frac{\sigma(\bar \nu)}{\sigma(\nu)})$ at (anti-)neutrino energies below 1.5 GeV. We determine the single momentum bin cross section measurements, averaged over the T2K $\bar{\nu}/\nu$-flux, for the detector target material (mainly Carbon, Oxygen, Hydrogen and Copper) with phase space restricted laboratory frame kinematics of $\theta_{\mu}$500 MeV/c. The results are $\sigma(\bar{\nu})=\left( 0.900\pm0.029{\rm (stat.)}\pm0.088{\rm (syst.)}\right)\times10^{-39}$ and $\sigma(\nu)=\left( 2.41\ \pm0.022{\rm{(stat.)}}\pm0.231{\rm (syst.)}\ \right)\times10^{-39}$in units of cm$^{2}$/nucleon and$R\left(\frac{\sigma(\bar{\nu})}{\sigma(\nu)}\right)= 0.373\pm0.012{\rm (stat.)}\pm0.015{\rm (syst.)}$.Comment: 18 pages, 8 figure