MobiGuide: a personalized and patient-centric decision-support system and its evaluation in the atrial fibrillation and gestational diabetes domains

MobiGuide is a ubiquitous, distributed and personalized evidence-based decision-support system (DSS) used by patients and their care providers. Its central DSS applies computer-interpretable clinical guidelines (CIGs) to provide real-time patient-specific and personalized recommendations by matching CIG knowledge with a highly-adaptive patient model, the parameters of which are stored in a personal health record (PHR). The PHR integrates data from hospital medical records, mobile biosensors, data entered by patients, and recommendations and abstractions output by the DSS. CIGs are customized to consider the patients’ psycho-social context and their preferences; shared decision making is supported via decision trees instantiated with patient utilities. The central DSS “projects” personalized CIG-knowledge to a mobile DSS operating on the patients’ smart phones that applies that knowledge locally. In this paper we explain the knowledge elicitation and specification methodologies that we have developed for making CIGs patient-centered and enabling their personalization. We then demonstrate feasibility, in two very different clinical domains, and two different geographic sites, as part of a multi-national feasibility study, of the full architecture that we have designed and implemented. We analyze usage patterns and opinions collected via questionnaires of the 10 atrial fibrillation (AF) and 20 gestational diabetes mellitus (GDM) patients and their care providers. The analysis is guided by three hypotheses concerning the effect of the personal patient model on patients and clinicians’ behavior and on patients’ satisfaction. The results demonstrate the sustainable usage of the system by patients and their care providers and patients’ satisfaction, which stems mostly from their increased sense of safety. The system has affected the behavior of clinicians, which have inspected the patients’ models between scheduled visits, resulting in change of diagnosis for two of the ten AF patients and anticipated change in therapy for eleven of the twenty GDM patients.     

Geometrically nonlinear analysis of shell structures using a flat triangular shell finite element

Summary This paper presents a state of the art review on geometrically nonlinear analysis of shell structures that is limited to the co-rotational approach and to flat triangular shell finite elements. These shell elements are built up from flat triangular membranes and plates. We propose an element comprised of the constant strain triangle (CST) membrane element and the discrete Kirchhoff (DKT) plate element and describe its formulation while stressing two main issues: the derivation of the geometric stiffness matrix and the isolation of the rigid body motion from the total deformations. We further use it to solve a broad class of problems from the literature to validate its use.     

The nature and dimensionality of organizational citizenship behavior: A critical review and meta-analysis.

This article reviews the literature on organizational citizenship behavior (OCB) and its dimensions as proposed by D. W. Organ (1988) and other scholars. Although it is assumed that the behavioral dimensions of OCB are distinct from one another, past research has not assessed this assumption beyond factor analysis. Using meta-analysis, the authors demonstrate that there are strong relationships among most of the dimensions and that the dimensions have equivalent relationships with the predictors (job satisfaction, organizational commitment, fairness, trait conscientiousness, and leader support) most often considered by OCB scholars. Implications of these results are discussed with respect to how the OCB construct should be conceptualized and measured in the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Carbon Copying Onto Dirty Paper

A generalization of the problem of writing on dirty paper is considered in which one transmitter sends a common message to multiple receivers. Each receiver experiences on its link an additive interference (in addition to the additive noise), which is known noncausally to the transmitter but not to any of the receivers. Applications range from wireless multiple-antenna multicasting to robust dirty paper coding. We develop results for memoryless channels in Gaussian and binary special cases. In most cases, we observe that the availability of side information at the transmitter increases capacity relative to systems without such side information, and that the lack of side information at the receivers decreases capacity relative to systems with such side information. For the noiseless binary case, we establish the capacity when there are two receivers. When there are many receivers, we show that the transmitter side information provides a vanishingly small benefit. When the interference is large and independent across the users, we show that time sharing is optimal. For the Gaussian case, we present a coding scheme and establish its optimality in the high signal-to-interference-plus-noise limit when there are two receivers. When the interference power is large and independent across all the receivers, we show that time-sharing is again optimal. Connections to the problem of robust dirty paper coding are also discussed     

"Selfobject" Needs in Kohut's Self Psychology: Links With Attachment, Self-Cohesion, Affect Regulation, and Adjustment.

Seven studies examined the validity and usefulness of central constructs in Kohut's self psychology: selfobject needs for mirroring, idealization, and twinship and avoidance of acknowledging these needs. These constructs were assessed with a new self-report measure that was found to be reliable, valid, and empirically linked with a variety of constructs in contemporary personality and social psychology. The findings supported and refined Kohut's ideas about the independence of the 3 selfobject needs, the orthogonality between these needs and defensive attempts to avoid acknowledging them, the motivational bases of narcissism, and the contribution of selfobject needs to problems in interpersonal functioning, mental health, self-cohesion, and affect regulation. The findings reveal mutually beneficial conceptual links between Kohut's self psychology and attachment theory and suggest ways in which Kohut's theory can be studied empirically. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Applications of Horizontal Characterization Techniques in Trenchless Construction

Horizontal site characterization technologies present a rapidly evolving alternative to traditional vertical site investigation methods for subsurface investigations of large diameter trenchless construction projects. A state-of-the-art review of horizontal site characterization tools, both currently available and under development, is presented. Additionally, a rational methodology for the selection and deployment of horizontal site investigation techniques in trenchless construction projects is also presented. The methodology enables the user to define and quantify the risks involved in a particular project, as well as to evaluate the degree to which these risks can be mitigated using various site characterization techniques. The proposed model is demonstrated using a working example. The paper concludes with a discussion of future trends in this exciting new field. The main conclusions drawn from this work are (1) adequate subsurface information is invaluable for underground construction; (2) site investigation programs of linear construction projects can be enhanced by horizontal characterization techniques; and (3) the availability of continuous and near-continuous subsurface information enables the utilization of new approaches for the analysis and representation of subsurface data.     

The Light-Wall: tangible user interfaces for learning systems thinking

This paper presents the design of the Light-Wall, a tangible user interface aimed at teaching children the core principles of systems thinking. This document presents the design problem, process and solution.     

Numerical modeling and experimental evaluation of a time domain UWB technique for soil void detection

A growing percentage of waste and storm water conveyance systems are approaching or exceeded their design life, suffering from accelerated deterioration and subsequently increased rates of failure. Discontinuities in the pipe wall may lead to the formation of voids in the soil embedment surrounding it via the transportation of fine soil particles by infiltrating ground water. This paper describes a method that utilizes ultra wideband (UWB) time domain principles to detect the presence and location of soil voids in early stages of formation, thus preventing a catastrophic collapse of the pipe and/or a structure above it (e.g., road surface). A three dimensional numerical model simulating the propagation of UWB pulses within a buried pipeline was developed. The results from the numerical model were validated using experimental measurements performed utilizing a full scale test bed. It is shown that a UWB based sensory system is capable of detecting even minor voids around non-ferrous buried pipes.     

Dynamic optogalvanic effect in rare gases and uranium

We present time resolved observations of the optogalvanic signal from a rare-gas buffered, uranium hollow-cathode tube irradiated by pulsed dye lasers. The design of the measurement circuit is also discussed.     

InterAspect: aspect-oriented instrumentation with GCC

We present the InterAspect instrumentation framework for GCC, a widely used compiler infrastructure. The addition of plug-in support in the latest release of GCC makes it an attractive platform for runtime instrumentation, as GCC plug-ins can directly add instrumentation by transforming the compiler??s intermediate representation. Such transformations, however, require expert knowledge of GCC internals. InterAspect addresses this situation by allowing instrumentation plug-ins to be developed using the familiar vocabulary of Aspect-Oriented Programming: pointcuts, join points, and advice functions. Moreover, InterAspect uses specific information about each join point in a pointcut, possibly including results of static analysis, to support powerful customized instrumentation. We describe the InterAspect API and present several examples that illustrate its practical utility as a runtime-verification platform. We also introduce a tracecut system that uses InterAspect to construct program monitors that are formally specified as regular expressions.