A Task-based Support Architecture for Developing Point-of-care Clinical Decision Support Systems for the Emergency Department

Objectives: The purpose of this study was to create a task-based support architecture for developing clinical decision support systems (CDSSs) that assist physicians in making decisions at the point-of-care in the emergency department (ED). The backbone of the proposed architecture was established by a task-based emergency workflow model for a patient-physician encounter. Methods: The architecture was designed according to an agent-oriented paradigm. Specifically, we used the O-MaSE (Organization-based Multi-agent System Engineering) method that allows for iterative translation of functional requirements into architectural components (e.g., agents). The agent-oriented paradigm was extended with ontology-driven design to implement ontological models representing knowledge required by specific agents to operate. Results: The task-based architecture allows for the creation of a CDSS that is aligned with the task-based emergency workflow model. It facilitates decoupling of executable components (agents) from embedded domain knowledge (ontological models), thus supporting their interoperability, sharing, and reuse. The generic architecture was implemented as a pilot system, MET3-AE – a CDSS to help with the management of pediatric asthma exacerbation in the ED. The system was evaluated in a hospital ED. Conclusions: The architecture allows for the creation of a CDSS that integrates support for all tasks from the task-based emergency workflow model, and interacts with hospital information systems. Proposed architecture also allows for reusing and sharing system components and knowledge across disease-specific CDSSs

Community Reaction to Bioterrorism: Prospective Study of Simulated Outbreak

To assess community needs for public information during a bioterrorism-related crisis, we simulated an intentional Rift Valley fever outbreak in a community in the southern part of the United States. We videotaped a series of simulated print and television “news reports” over a fictional 9-day crisis period and invited various groups (e.g., first-responders and their spouses or partners, journalists) within the selected community to view the videotape and respond to questions about their reactions. All responses were given anonymously. First-responders and their spouses or partners varied in their reactions about how the crisis affected family harmony and job performance. Local journalists exhibited considerable personal fear and confusion. All groups demanded, and put more trust in, information from local sources. These findings may have implications for risk communication during bioterrorism-related outbreaks

Modeling of Surface Damage at the Si/SiO2_2-interface of Irradiated MOS-capacitors

Surface damage caused by ionizing radiation in SiO$_2$ passivated silicon particle detectors consists mainly of the accumulation of a positively charged layer along with trapped-oxide-charge and interface traps inside the oxide and close to the Si/SiO$_2$-interface. High density positive interface net charge can be detrimental to the operation of a multi-channel $n$-on-$p$ sensor since the inversion layer generated under the Si/SiO$_2$-interface can cause loss of position resolution by creating a conduction channel between the electrodes. In the investigation of the radiation-induced accumulation of oxide charge and interface traps, a capacitance-voltage characterization study of n/$\gamma$- and $\gamma$-irradiated Metal-Oxide-Semiconductor (MOS) capacitors showed that close agreement between measurement and simulation were possible when oxide charge density was complemented by both acceptor- and donor-type deep interface traps with densities comparable to the oxide charges. Corresponding inter-strip resistance simulations of a $n$-on-$p$ sensor with the tuned oxide charge density and interface traps show close agreement with experimental results. The beneficial impact of radiation-induced accumulation of deep interface traps on inter-electrode isolation may be considered in the optimization of the processing parameters of isolation implants on $n$-on-$p$ sensors for the extreme radiation environments.Comment: Corresponding author: T. Peltola. 24 pages, 17 figures, 6 table

Low-temperature gas from marine shales: wet gas to dry gas over experimental time

Marine shales exhibit unusual behavior at low temperatures under anoxic gas flow. They generate catalytic gas 300° below thermal cracking temperatures, discontinuously in aperiodic episodes, and lose these properties on exposure to trace amounts of oxygen. Here we report a surprising reversal in hydrocarbon generation. Heavy hydrocarbons are formed before light hydrocarbons resulting in wet gas at the onset of generation grading to dryer gas over time. The effect is moderate under gas flow and substantial in closed reactions. In sequential closed reactions at 100°C, gas from a Cretaceous Mowry shale progresses from predominately heavy hydrocarbons (66% C5, 2% C1) to predominantly light hydrocarbons (56% C1, 8% C5), the opposite of that expected from desorption of preexisting hydrocarbons. Differences in catalyst substrate composition explain these dynamics. Gas flow should carry heavier hydrocarbons to catalytic sites, in contrast to static conditions where catalytic sites are limited to in-place hydrocarbons. In-place hydrocarbons and their products should become lighter with conversion thus generating lighter hydrocarbon over time, consistent with our experimental results

Lymphocytes of Type 2 Diabetic Women Carry a High Load of Stable Chromosomal Aberrations : A Novel Risk Factor for Disease-Related Early Death

OBJECTIVE—Diabetes is associated with an increased risk of death in women. Oxidative stress due to chronic hyperglycemia leads to the generation of reactive oxygen species and loss of chromosomal integrity. To clarify whether diabetes is a premature aging syndrome, we determined telomere erosion dynamics and occurrence of structural chromosomal aberrations in women of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

Charge Collection and Electrical Characterization of Neutron Irradiated Silicon Pad Detectors for the CMS High Granularity Calorimeter

The replacement of the existing endcap calorimeter in the Compact Muon Solenoid (CMS) detector for the high-luminosity LHC (HL-LHC), scheduled for 2027, will be a high granularity calorimeter. It will provide detailed position, energy, and timing information on electromagnetic and hadronic showers in the immense pileup of the HL-LHC. The High Granularity Calorimeter (HGCAL) will use 120-, 200-, and 300-$\mu\textrm{m}$ thick silicon (Si) pad sensors as the main active material and will sustain 1-MeV neutron equivalent fluences up to about $10^{16}~\textrm{n}_\textrm{eq}\textrm{cm}^{-2}$. In order to address the performance degradation of the Si detectors caused by the intense radiation environment, irradiation campaigns of test diode samples from 8-inch and 6-inch wafers were performed in two reactors. Characterization of the electrical and charge collection properties after irradiation involved both bulk polarities for the three sensor thicknesses. Since the Si sensors will be operated at -30 $^\circ$C to reduce increasing bulk leakage current with fluence, the charge collection investigation of 30 irradiated samples was carried out with the infrared-TCT setup at -30 $^\circ$C. TCAD simulation results at the lower fluences are in close agreement with the experimental results and provide predictions of sensor performance for the lower fluence regions not covered by the experimental study. All investigated sensors display 60$\%$ or higher charge collection efficiency at their respective highest lifetime fluences when operated at 800 V, and display above 90$\%$ at the lowest fluence, at 600 V. The collected charge close to the fluence of $10^{16}~\textrm{n}_\textrm{eq}\textrm{cm}^{-2}$ exceeds 1 fC at voltages beyond 800 V.Comment: 36 pages, 34 figure

Association between fat-soluble vitamins and self-reported health status: A cross-sectional analysis of the MARK-AGE cohort

Self-rated health (SRH) is associated with higher risk of death. Since low plasma levels of fat-soluble vitamins are related to mortality, we aimed to assess whether plasma concentrations of vitamins A, D and E were associated with SRH in the MARK-AGE study. We included 3158 participants (52% female) aged between 35-75 years. Cross-sectional data were collected via questionnaires. An enzyme immunoassay quantified 25-hydroxyvitamin D and HPLC determined α-tocopherol and retinol plasma concentrations. The median 25-hydroxyvitamin D and retinol concentrations differed significantly (P<0.001) between SRH categories, and were lower in the combined fair/poor category versus the excellent, very good, good categories (25-hydroxvitamin D: 40.8 vs. 51.9, 49.3, 46.7 nmol/l, respectively; retinol: 1.67 vs. 1.75, 1.74, 1.70 μmol/l, respectively). Both vitamin D and retinol status were independently associated with fair/poor SRH in multiple regression analyses: adjusted ORs (95% CI) for the vitamin D insufficiency, deficiency, severe deficiency categories were 1.33 (1.06-1.68), 1.50 (1.17-1.93), and 1.83 (1.34-2.50) respectively; P=0.015, P=0.001, P<0.001, and for the second/third/fourth retinol quartiles: 1.44 (1.18-1.75), 1.57 (1.28-1.93), 1.49 (1.20-1.84); all P<0.001. No significant associations were reported for α-tocopherol quartiles. Lower vitamin A and D status emerged as independent markers for fair/poor SRH. Further insights into the long-term implications of these modifiable nutrients on health status are warranted

Siderite micro-modification for enhanced corrosion protection

Production of oil and gas results in the creation of carbon dioxide (CO₂) which when wet is extremely corrosive owing to the speciation of carbonic acid. Severe production losses and safety incidents occur when carbon steel (CS) is used as a pipeline material if corrosion is not properly managed. Currently corrosion inhibitor (CI) chemicals are used to ensure that the material degradation rates are properly controlled; this imposes operational constraints, costs of deployment and environmental issues. In specific conditions, a naturally growing corrosion product known as siderite or iron carbonate (FeCO₃) precipitates onto the internal pipe wall providing protection from electrochemical degradation. Many parameters influence the thermodynamics of FeCO₃ precipitation which is generally favoured at high values of temperatures, pressure and pH. In this paper, a new approach for corrosion management is presented; micro-modifying the corrosion product. This novel mitigation approach relies on enhancing the crystallisation of FeCO₃ and improving its density, protectiveness and mechanical properties. The addition of a silicon-rich nanofiller is shown to augment the growth of FeCO₃ at lower pH and temperature without affecting the bulk pH. The hybrid FeCO₃ exhibits superior general and localised corrosion properties. The findings herein indicate that it is possible to locally alter the environment in the vicinity of the corroding steel in order to grow a dense and therefore protective FeCO₃ film via the incorporation of hybrid organic-inorganic silsesquioxane moieties. The durability and mechanical integrity of the film is also significantly improved