Evaluating Technology-Mediated Collaborative Workflows for Telehealth

Goals: This paper discusses the need for a predictable method to evaluate gains and gaps of collaborative technology-mediated workflows and introduces an evaluation framework to address this need. Methods: The Collaborative Space Analysis Framework (CS-AF), introduced in this research, is a cross-disciplinary evaluation method designed to evaluate technology-mediated collaborative workflows. The 5-step CS-AF approach includes: (1) current-state workflow definition, (2) current-state (baseline) workflow assessment, (3) technology-mediated workflow development and deployment, (4) technology-mediated workflow assessment, (5) analysis, and conclusions. For this research, a comprehensive, empirical study of hypertension exam workflow for telehealth was conducted using the CS-AF approach. Results: The CS-AF systemized approach reveals critical cross-disciplinary evaluation data concerning gains and gaps of collaborative workflows when technology-mediated enhancements are characterized and compared with a baseline workflow for the goal of continuous workflow improvement. Conclusion: The CS-AF is an effective approach that can be adapted for use in multiple domains

Retrospective Chart Review of Metastatic Solid Tumor Discharges to Subacute Rehab

Introduction: Regaining strength through rehabilitation as a mechanism to return cancer patients to therapy is poorly understood and therefore realistic advice cannot be given to patients when cancer-directed therapy must be stopped. This research examines what cancer patients are able to accomplish following referral to subacute rehabilitation (SAR). It was hypothesized that the majority of patients would not return to cancer-directed therapy following SAR and that a high functional status at discharge would be the best predictor of this return. Methods: A retrospective chart review was completed for 112 metastatic solid tumor patients discharged to SAR (2018-2020). The primary outcome was patient return to anti-cancer therapy and a physical therapist assigned functional status score (AMPAC) was the main proposed predictor. The association between the AMPAC score and return to cancer-directed therapy was evaluated using logistic regression. Results: Only 31 of the 112 patients (28%) returned to cancer-directed therapy within 60 days of discharge to SAR. Functional status score was positively associated with return to cancer-directed therapy. The average survival for patients was 36 days from original discharge and 40% of patients were readmitted to the hospital within 30 days. Conclusion: The majority of patients who were discharged to SAR were unable to return to cancer-directed therapy. While SAR may have other benefits, it is important to be realistic with cancer patients when cancer-directed therapy must be stopped. Functional status before discharge to SAR is a useful tool for guiding patients about their likelihood of return to therapy

Data-Centric Multiobjective QoS-Aware Routing Protocol for Body Sensor Networks

In this paper, we address Quality-of-Service (QoS)-aware routing issue for Body Sensor Networks (BSNs) in delay and reliability domains. We propose a data-centric multiobjective QoS-Aware routing protocol, called DMQoS, which facilitates the system to achieve customized QoS services for each traffic category differentiated according to the generated data types. It uses modular design architecture wherein different units operate in coordination to provide multiple QoS services. Their operation exploits geographic locations and QoS performance of the neighbor nodes and implements a localized hop-by-hop routing. Moreover, the protocol ensures (almost) a homogeneous energy dissipation rate for all routing nodes in the network through a multiobjective Lexicographic Optimization-based geographic forwarding. We have performed extensive simulations of the proposed protocol, and the results show that DMQoS has significant performance improvements over several state-of-the-art approaches

Circuit Quantum Electrodynamics with a Spin Qubit

Circuit quantum electrodynamics allows spatially separated superconducting qubits to interact via a "quantum bus", enabling two-qubit entanglement and the implementation of simple quantum algorithms. We combine the circuit quantum electrodynamics architecture with spin qubits by coupling an InAs nanowire double quantum dot to a superconducting cavity. We drive single spin rotations using electric dipole spin resonance and demonstrate that photons trapped in the cavity are sensitive to single spin dynamics. The hybrid quantum system allows measurements of the spin lifetime and the observation of coherent spin rotations. Our results demonstrate that a spin-cavity coupling strength of 1 MHz is feasible.Comment: Related papers at http://pettagroup.princeton.edu

ATLAS: A Traffic Load Aware Sensor MAC Design for Collaborative Body Area Sensor Networks

In collaborative body sensor networks, namely wireless body area networks (WBANs), each of the physical sensor applications is used to collaboratively monitor the health status of the human body. The applications of WBANs comprise diverse and dynamic traffic loads such as very low-rate periodic monitoring (i.e., observation) data and high-rate traffic including event-triggered bursts. Therefore, in designing a medium access control (MAC) protocol for WBANs, energy conservation should be the primary concern during low-traffic periods, whereas a balance between satisfying high-throughput demand and efficient energy usage is necessary during high-traffic times. In this paper, we design a traffic load-aware innovative MAC solution for WBANs, called ATLAS. The design exploits the superframe structure of the IEEE 802.15.4 standard, and it adaptively uses the contention access period (CAP), contention free period (CFP) and inactive period (IP) of the superframe based on estimated traffic load, by applying a dynamic “wh” (whenever which is required) approach. Unlike earlier work, the proposed MAC design includes load estimation for network load-status awareness and a multi-hop communication pattern in order to prevent energy loss associated with long range transmission. Finally, ATLAS is evaluated through extensive simulations in ns-2 and the results demonstrate the effectiveness of the protocol

Geo-electrical characterization of landslide materials: The case study of slopes at Kundasang

The Electrical resistivity imaging (ERI) and Induced polarization imaging (IPI) were carried out at two slopes; slope A and B within Kundasang, Sabah to investigates the geoelectrical characteristic of the landslide subsurface. ERI and IPI data at slope A indicates three apparent zones within the subsurface with correlation with in-situ data and interpreted into three materials characterization. Two survey line of ERI and IPI were conducted at slope B which focusing on the head and foot of the landslide. For the head region of landslide (survey 2), ERI & IPI indicate there are three distinct values observed. Survey 3 were carried out at the foot region of landslides and the ERI-IPI results indicates slightly different pattern compare to survey 2. The results also indicates three apparent zone but totally different range resistivity and chargeability values compare to the results from the head of landslides (survey 2). Overall, the head region (Survey 1 and survey 2) gives higher range of resistivity value compare to resistivity that acquire from the foot region (survey 3)

Denitrification and nitrous oxide emissions from riparian forests soils exposed to prolonged nitrogen runoff

Compared to upland forests, riparian forest soils have greater potential to remove nitrate (NO3) from agricultural run-off through denitrification. It is unclear, however, whether prolonged exposure of riparian soils to nitrogen (N) loading will affect the rate of denitrification and its end products. This research assesses the rate of denitrification and nitrous oxide (N2O) emissions from riparian forest soils exposed to prolonged nutrient run-off from plant nurseries and compares these to similar forest soils not exposed to nutrient run-off. Nursery run-off also contains high levels of phosphate (PO4). Since there are conflicting reports on the impact of PO4 on the activity of denitrifying microbes, the impact of PO4 on such activity was also investigated. Bulk and intact soil cores were collected from N-exposed and non-exposed forests to determine denitrification and N2O emission rates, whereas denitrification potential was determined using soil slurries. Compared to the non-amended treatment, denitrification rate increased 2.7- and 3.4-fold when soil cores collected from both N-exposed and non-exposed sites were amended with 30 and 60 μg NO3-N g-1 soil, respectively. Net N2O emissions were 1.5 and 1.7 times higher from the N-exposed sites compared to the non-exposed sites at 30 and 60 μg NO3-N g-1 soil amendment rates, respectively. Similarly, denitrification potential increased 17 times in response to addition of 15 μg NO3-N g-1 in soil slurries. The addition of PO4 (5 μg PO4–P g-1) to soil slurries and intact cores did not affect denitrification rates. These observations suggest that prolonged N loading did not affect the denitrification potential of the riparian forest soils; however, it did result in higher N2O emissions compared to emission rates from non-exposed forests

Transient peak-strain matching partially recovers the age-impaired mechanoadaptive cortical bone response

Mechanoadaptation maintains bone mass and architecture; its failure underlies age-related decline in bone strength. It is unclear whether this is due to failure of osteocytes to sense strain, osteoblasts to form bone or insufficient mechanical stimulus. Mechanoadaptation can be restored to aged bone by surgical neurectomy, suggesting that changes in loading history can rescue mechanoadaptation. We use non-biased, whole-bone tibial analyses, along with characterisation of surface strains and ensuing mechanoadaptive responses in mice at a range of ages, to explore whether sufficient load magnitude can activate mechanoadaptation in aged bone. We find that younger mice adapt when imposed strains are lower than in mature and aged bone. Intriguingly, imposition of short-term, high magnitude loading effectively primes cortical but not trabecular bone of aged mice to respond. This response was regionally-matched to highest strains measured by digital image correlation and to osteocytic mechanoactivation. These data indicate that aged bone’s loading response can be partially recovered, non-invasively by transient, focal high strain regions. Our results indicate that old murine bone does respond to load when the loading is of sufficient magnitude, and bones’ age-related adaptation failure may be due to insufficient mechanical stimulus to trigger mechanoadaptation

Proximity to Sports Facilities and Sports Participation for Adolescents in Germany

Objectives - To assess the relationship between proximity to specific sports facilities and participation in the corresponding sports activities for adolescents in Germany. Methods - A sample of 1,768 adolescents aged 11–17 years old and living in 161 German communities was examined. Distances to the nearest sports facilities were calculated as an indicator of proximity to sports facilities using Geographic Information Systems (GIS). Participation in specific leisure-time sports activities in sports clubs was assessed using a self-report questionnaire and individual-level socio-demographic variables were derived from a parent questionnaire. Community-level socio-demographics as covariates were selected from the INKAR database, in particular from indicators and maps on land development. Logistic regression analyses were conducted to examine associations between proximity to the nearest sports facilities and participation in the corresponding sports activities. Results - The logisitic regression analyses showed that girls residing longer distances from the nearest gym were less likely to engage in indoor sports activities; a significant interaction between distances to gyms and level of urbanization was identified. Decomposition of the interaction term showed that for adolescent girls living in rural areas participation in indoor sports activities was positively associated with gym proximity. Proximity to tennis courts and indoor pools was not associated with participation in tennis or water sports, respectively. Conclusions - Improved proximity to gyms is likely to be more important for female adolescents living in rural areas

Learning from the process evaluation of a complex, pre-conception randomised controlled trial in Malaysia:The Jom Mama project

Background: Seen from a life-course perspective, pre-conception interventions are essential to reduce transmission to the next generation of obesity as a risk factor for later non-communicable diseases. The Malaysian Jom Mama project investigated the effectiveness of a combined behaviour change communication and e-health intervention in young married couples prior to first pregnancy. This paper reports on the extensive process evaluation (PE) that accompanied the Jom Mama trial.Methods: In accordance with the realistic evaluation approach, a programme theory was developed for the Jom Mama project, based on key functions selected for six PE sub-studies, namely: Recruitment; attrition; behaviour change communication (BCC); e-health (the Jom app); peer-support for community health promoters (CHPs); and contextual factors. The results of the first four sub-studies are reported here. Three cycles of data collection were conducted based on triangulation and a mixed-methods approach.Results: The findings permitted distinguishing between theory and implementation challenges in interpreting the outcome of the Jom Mama trial.1 Recruitment and attrition proved to be challenges, and although the PE allowed Jom Mama investigators to improve procedures in order to achieve a sufficient sample size, it also has implications for engaging this age group in future pre-conception interventions. PE sub-studies showed that there were challenges in applying the BCC, and that the uptake of the Jom app varied. In one way this can be seen as an indication of limited fidelity, but it also leads to questions about how best to change the communication culture within the Malaysian health care system.Conclusions: The Jom Mama PE highlighted the challenges of recruiting newly-wed couples for a pre-conception intervention. Despite thorough intervention development preparations, the PE revealed the difficulty of lifestyle behaviour change through Malaysian community health wokers who were trained on new communication strategies combined with e-health solutions, and that six intervention sessions of eight months do not constitute a sufficient dose to affect change.</p