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Hume, Stacey, Tanya N. Nelson, Marsha Speevak, Elizabeth McCready, Ron Agatep, Harriet Feilotter, Jillian Parboosingh, Dimitri J. Stavropoulos, Sherryl Taylor und Tracy L. Stockley. „CCMG practice guideline: laboratory guidelines for next-generation sequencing“. Journal of Medical Genetics 56, Nr. 12 (12.07.2019): 792–800. http://dx.doi.org/10.1136/jmedgenet-2019-106152.
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PurposeThe purpose of this document is to provide guidance for the use of next-generation sequencing (NGS, also known as massively parallel sequencing or MPS) in Canadian clinical genetic laboratories for detection of genetic variants in genomic DNA and mitochondrial DNA for inherited disorders, as well as somatic variants in tumour DNA for acquired cancers. They are intended for Canadian clinical laboratories engaged in developing, validating and using NGS methods.Methods of statement developmentThe document was drafted by the Canadian College of Medical Geneticists (CCMG) Ad Hoc Working Group on NGS Guidelines to make recommendations relevant to NGS. The statement was circulated for comment to the CCMG Laboratory Practice and Clinical Practice committees, and to the CCMG membership. Following incorporation of feedback, the document was approved by the CCMG Board of Directors.DisclaimerThe CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. The current CCMG Practice Guidelines were developed as a resource for clinical laboratories in Canada and should not be considered to be inclusive of all information laboratories should consider in the validation and use of NGS for a clinical laboratory service.
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Heo, Jun-Ho, und Seon-Bong Lee. „A Study on Parking Guideline Generation Algorithm“. Journal of the Korea Academia-Industrial cooperation Society 16, Nr. 5 (31.05.2015): 3060–70. http://dx.doi.org/10.5762/kais.2015.16.5.3060.
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Mühlhauser, I., und G. Meyer. „Evidence base in guideline generation in diabetes“. Diabetologia 56, Nr. 6 (09.03.2013): 1201–9. http://dx.doi.org/10.1007/s00125-013-2872-6.
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&NA;. „Closing the Gap Between Guideline Generation and Clinical Practice“. Disease Management & Health Outcomes 2, Nr. 5 (November 1997): 261–62. http://dx.doi.org/10.2165/00115677-199702050-00006.
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Riley, Shannon, und Barbara S. Chaparro. „User Password Generation Practices and Strong Password Guideline Compliance“. Proceedings of the Human Factors and Ergonomics Society Annual Meeting 50, Nr. 17 (Oktober 2006): 1812–16. http://dx.doi.org/10.1177/154193120605001720.
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Smit, Marjon A., Caroline M. J. van Kinschot, Joke van der Linden, Charlotte van Noord und Snježana Kos. „Clinical Guidelines and PTH Measurement: Does Assay Generation Matter?“ Endocrine Reviews 40, Nr. 6 (13.05.2019): 1468–80. http://dx.doi.org/10.1210/er.2018-00220.
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AbstractPTH is an important regulator of calcium and phosphate homeostasis and bone remodeling. It is metabolized into PTH fragments, which are measured to a different extent by PTH assays of different generations because of differences in fragments recognized and lack of assay standardization. PTH is measured in the workup of several conditions, and clinical guidelines provide recommendations concerning these measurements. This review provides an overview of the impact of differences between PTH assays, applying distinct clinical guidelines for primary and secondary hyperparathyroidism and perioperative use of PTH measurements. Guidelines deal with PTH measurement in different ways, recommending either trend monitoring, the use of a fold increase of the upper reference limit, or an absolute PTH cutoff value. For classic primary hyperparathyroidism (PHPT), the type of PTH assay used will not affect diagnosis or management because the precise concentration of PTH is less relevant. In chronic kidney disease, the guideline recommends treating secondary hyperparathyroidism above a twofold to ninefold PTH increase, which will result in different clinical decisions depending on the assay used. For patients after bariatric surgery, guidelines state absolute cutoff values for PTH, but the impact of different generation assays is unknown because direct comparison of PTH assays has never been performed. During parathyroid surgery, PTH measurements with a third-generation assay reflect treatment success more rapidly than second-generation assays. Increased awareness among clinicians regarding the complexity of PTH measurements is warranted because it can affect clinical decisions.
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Baw, Bandar, Teresa Chan und Suneel Upadhye. „Clinical education guideline creation by residents for junior learners in emergency medicine: a novel educational experience“. CJEM 16, Nr. 06 (November 2014): 490–93. http://dx.doi.org/10.1017/s1481803500003511.
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Abstract Clinical practice guidelines are an important vehicle for knowledge translation and improving patient care. For most learners, these documents can be daunting and confusing. We describe a novel educational experience that clarified the guideline generation process for learners while at the same time creating clinical educational guidelines (simplified learning aids) for junior learners in the emergency department (ED). We devised a system using near-peer mentors to generate a series of clinical education guideline learning materials created by residents and junior learners for the evaluation of undifferentiated chest pain in the ED. This process assisted in teaching residents and junior learners and generated an endurable educational product.
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Kietzmann, Peter, Thomas C. Schmidt und Matthias Wählisch. „A Guideline on Pseudorandom Number Generation (PRNG) in the IoT“. ACM Computing Surveys 54, Nr. 6 (Juli 2021): 1–38. http://dx.doi.org/10.1145/3453159.
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Random numbers are an essential input to many functions on the Internet of Things (IoT). Common use cases of randomness range from low-level packet transmission to advanced algorithms of artificial intelligence as well as security and trust, which heavily rely on unpredictable random sources. In the constrained IoT, though, unpredictable random sources are a challenging desire due to limited resources, deterministic real-time operations, and frequent lack of a user interface. In this article, we revisit the generation of randomness from the perspective of an IoT operating system (OS) that needs to support general purpose or crypto-secure random numbers. We analyze the potential attack surface, derive common requirements, and discuss the potentials and shortcomings of current IoT OSs. A systematic evaluation of current IoT hardware components and popular software generators based on well-established test suits and on experiments for measuring performance give rise to a set of clear recommendations on how to build such a random subsystem and which generators to use.
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Hakami, Tahir. „Efficacy and tolerability of antiseizure drugs“. Therapeutic Advances in Neurological Disorders 14 (Januar 2021): 175628642110374. http://dx.doi.org/10.1177/17562864211037430.
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Drug-resistant epilepsy occurs in 25–30% of patients. Furthermore, treatment with a first-generation antiseizure drug (ASD) fails in 30–40% of individuals because of their intolerable adverse effects. Over the past three decades, 20 newer- (second- and third-)generation ASDs with unique mechanisms of action and pharmacokinetic profiles have been introduced into clinical practice. This advent has expanded the therapeutic armamentarium of epilepsy and broadens the choices of ASDs to match the individual patient’s characteristics. In recent years, research has been focused on defining the ASD of choice for different seizure types. In 2017, the International League Against Epilepsy published a new classification for seizure types and epilepsy syndrome. This classification has been of paramount importance to accurately classify the patient’s seizure type(s) and prescribe the ASD that is appropriate. A year later, the American Academy of Neurology published a new guideline for ASD selection in adult and pediatric patients with new-onset and treatment-resistant epilepsy. The guideline primarily relied on studies that compare the first-generation and second-generation ASDs, with limited data for the efficacy of third-generation drugs. While researchers have been called for investigating those drugs in future research, epilepsy specialists may wish to share their personal experiences to support the treatment guidelines. Given the rapid advances in the development of ASDs in recent years and the continuous updates in definitions, classifications, and treatment guidelines for seizure types and epilepsy syndromes, this review aims to present a complete overview of the current state of the literature about the efficacy and tolerability of ASDs and provide guidance to clinicians about selecting appropriate ASDs for initial treatment of epilepsy according to different seizure types and epilepsy syndromes based on the current literature and recent US and UK practical guidelines.
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McGorry, Patrick, Eoin Killackey, Kathryn Elkins, Martin Lambert und Tim Lambert. „Summary Australian and New Zealand Clinical Practice Guideline for the Treatment of Schizophrenia 2003“. Australasian Psychiatry 11, Nr. 2 (Juni 2003): 136–47. http://dx.doi.org/10.1046/j.1039-8562.2003.00535.x.
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Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the Management of Schizophrenia. Conclusions: Schizophrenia is a complex and misunderstood illness with a poor public image, but it is more treatable than ever before. A new generation of medication and psychosocial therapies, combined with a first generation of service reform, have created an evidence-based climate of realistic optimism. However, the potential for better outcomes and quality of life for people with schizophrenia has not been translated into reality. The gap between efficacy and effectiveness is wider for schizophrenia than for any other serious medical disorder. These guidelines distil the current evidence and make recommendations based on the best available knowledge. They are based on systematic meta-analyses and comprehensive reviews of the evidence, and their validity is supported by their congruence with several recent rigorous and independent guideline statements from the UK and North America.
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Marsh, Sophia, und Ilse Truter. „VP33 Pharmacoeconomic Submission Requirements: Africa Compared With England“. International Journal of Technology Assessment in Health Care 35, S1 (2019): 84. http://dx.doi.org/10.1017/s0266462319003076.
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IntroductionThe South African Pharmacoeconomic Submissions Guideline (SAPG) is currently voluntary for medicines in the private health sector but may become mandatory and more widely used under the proposed National Health Insurance system. To make recommendations on evidence generation and areas where the SAPG could be strengthened, the study compared the SAPG requirements with other African pharmacoeconomic guidelines and the National Institute for Health and Care Excellence Methods Guide (NICE MG).MethodsThe World Health Organisation, International Network of Agencies for Health Technology Assessment (INAHTA), HTA International, and the International Society for Pharmacoeconomics and Outcomes Research websites were consulted, and email requests sent to named individuals from retrieved source material. The European Network for HTA Core Model® (version 3.0) (the Model®) provided the evaluation and comparison framework, using three criteria: completely, partly or not completely requiring the same or similar information as the Model®.ResultsOf the forty-five countries identified, only Egypt had a publicly available pharmacoeconomic guideline (Egyptian Pharmacoeconomic Guideline (EPG)). The guidelines varied considerably in their intended audience, size and content. All three guidelines’ primary focus was the cost and economic evaluation, and health problem and current use domains. Safety, organisational, ethical and legal aspects were poorly covered by the SAPG and EPG guidelines (less than thirty percent of issues in each domain completely / partly covered). The SAPG completely or partly required the same or similar information in the Model® for thirty-nine percent of total issues, the EPG thirty-three percent and the NICE MG sixty-six percentConclusionsThe SAPG was not as comprehensive as the NICE MG and poorly covered some key aspects of HTAs, suggesting that the SAPG could be developed to be more informative for decision-makers. Evidence generation should focus on describing the health problem the technology is targeting and on evidence that can be synthesized into cost-effectiveness analyses.
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Kane, John M., und Carlos Garcia-Ribera. „Clinical guideline recommendations for antipsychotic long-acting injections“. British Journal of Psychiatry 195, S52 (November 2009): s63—s67. http://dx.doi.org/10.1192/bjp.195.52.s63.
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BackgroundLong-acting injections (LAIs) of antipsychotic drugs were developed over 40 years ago in an attempt to improve the long-term treatment of schizophrenia.AimsTo review existing guidelines concerning antipsychotic use generally, and LAIs in particular, and how patients might be identified as potential candidates for LAI treatment.MethodLiterature review.ResultsCurrently several first-generation and one second-generation antipsychotic LAIs are available, with others under development. Although the use of LAIs is widespread around the world, patterns of use vary widely. Important considerations regarding the use of LAIs include the indications for long-term pharmacotherapy in schizophrenia in general, the indications for LAIs, the risks associated with LAIs, the need to update guidelines and the issue of cost.ConclusionsThe use of these injections in first-episode psychosis and treatment-refractory schizophrenia is not currently a focus of recommendations, but should be considered. Long-acting injections remain an underutilised option in many countries despite frequent non-adherence with oral medication and subsequent relapse.
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Yonts, Alexandra B., Michael Jason Bozzella, Matthew Magyar, Laura O’Neill und Nada Harik. „1139. Multidisciplinary Initiative to Increase Guideline-Concordant Antibiotic Prescriptions at Discharge for Hospitalized Children with Uncomplicated Community-Acquired Pneumonia“. Open Forum Infectious Diseases 6, Supplement_2 (Oktober 2019): S405—S406. http://dx.doi.org/10.1093/ofid/ofz360.1003.
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Abstract Background Community-acquired pneumonia (CAP) is the most common diagnosis in hospitalized children. The Pediatric Infectious Diseases Society and the Infectious Diseases Society of America published evidenced-based clinical practice guidelines for the management of CAP in children 3 months of age or older in 2011. These guidelines are not consistently followed. Our objective was to evaluate if quality improvement (QI) methods could improve guideline-concordant antibiotic prescribing, specifically addressing the use of oral third-generation cephalosporins, at hospital discharge for children with uncomplicated CAP. Methods QI interventions, implemented at a single tertiary care children’s hospital in Washington, D.C., focused on key drivers targeting hospital medicine resident teams. Multiple plan-do-study-act (PDSA) cycles were performed. Initial interventions included educational sessions (in small group and lecture formats) aimed at pediatric resident physicians, as well as visual job aids (Figure 1) and guideline summaries posted in resident physician work areas. Interventions were implemented in series to allow for statistical analysis via run chart. Medical records of eligible patients were reviewed monthly after each intervention to determine the impact on appropriate discharge antibiotic prescribing. Results At baseline, the median percentage of children with a diagnosis of uncomplicated CAP discharged with guideline-concordant antibiotics was 50%. Median rates of guideline-concordant antibiotic prescribing improved to 87.5% after initial interventions (Figure 2). Conclusion A fellow-led multidisciplinary QI initiative was successful in decreasing rates of non-guideline-concordant antibiotic prescribing at discharge. These interventions can be tailored for use at other institutions and for other infectious processes with established treatment guidelines. To ensure sustained improvement in guideline-concordant prescribing, future planned interventions include additional educational sessions with residents, faculty, and pharmacists, EMR order set modification and physician benchmarking. These tactics are intended to address the anticipated challenge of resident/faculty turnover and automate antibiotic choice for uncomplicated CAP. Disclosures All authors: No reported disclosures.
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Heo, Jun-Ho, und Seon-Bong Lee. „A Study on Generation of Reverse Parking Guideline Reflecting Position of Camera“. Journal of the Korea Academia-Industrial cooperation Society 17, Nr. 3 (31.03.2016): 591–98. http://dx.doi.org/10.5762/kais.2016.17.3.591.
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Jeon, In-Kyu, und Jean-Hun Chung. „Study of GUI design convergence guideline for the users of aged generation“. Journal of Digital Convergence 13, Nr. 7 (28.07.2015): 323–31. http://dx.doi.org/10.14400/jdc.2015.13.7.323.
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Mikami, Koichi, und Yoshimitsu Itoh. „Metal enolates ofα-CF3 ketones: theoretical guideline, direct generation, and synthetic use“. Chemical Record 6, Nr. 1 (2006): 1–11. http://dx.doi.org/10.1002/tcr.20066.
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Brennan, Sue E., und Zachary Munn. „PRISMA 2020: a reporting guideline for the next generation of systematic reviews“. JBI Evidence Synthesis 19, Nr. 5 (Mai 2021): 906–8. http://dx.doi.org/10.11124/jbies-21-00112.
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Miller, Tyler E., Michael Yang, David Bajor, Judah D. Friedman, Richard Y. C. Chang, Afshin Dowlati, Joseph E. Willis und Navid Sadri. „Clinical utility of reflex testing using focused next-generation sequencing for management of patients with advanced lung adenocarcinoma“. Journal of Clinical Pathology 71, Nr. 12 (18.09.2018): 1108–15. http://dx.doi.org/10.1136/jclinpath-2018-205396.
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AimsThe growing number of genomically targeted therapies has made genomic testing an important part of the care for patients with non-small cell lung cancer. However, limited tissue availability, cost and long turnaround times can create barriers to efficient genomic testing and subsequent treatment. Effective approaches to reduce these barriers are needed.Methods302 advanced lung adenocarcinomas from consecutive patients seen at University Hospitals Cleveland Medical Center (UHCMC) were tested inhouse using a hybrid DNA/RNA next-generation sequencing (NGS) panel. Sample testing was reflexed from pathology for all stage III or IV tumours. Genomic alterations were tiered according to their clinical relevance and reported with guideline-recommended therapies. Clinical implications of genomic testing results were assessed by manual chart review.ResultsWith a sample cohort consisting of 64% biopsies, 16% excisions/resections and 20% fine needle aspirations, the assay was reliable with a 95% success rate. The average turnaround time from receipt of unstained formalin-fixed paraffin embedded slides to reporting was 4.8±2.1 days, half of the recommended 10 days and similar to single-gene testing. Alterations with Food and Drug Administration-approved or the National Cancer Center Network guideline-recommended targeted therapies were found in 18% of cases. Within this group, 60% of patients went on genomically driven therapies.ConclusionsWe found our reflexed inhouse NGS assay to be reliable, cost-effective and efficient. Incorporation of reflex testing with our NGS assay led to an expansion of successful genomic profiling for all guideline-recommended alterations, and by including an expanded number of alterations within our panel we obtained clinically useful information outside the guidelines without changing cost or efficiency. This approach has enabled UHCMC clinicians to efficiently initiate genomically driven therapies for patients with lung adenocarcinoma.
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de Leon, Jose. „A Critical Commentary on the 2017 AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology“. Pharmacopsychiatry 51, Nr. 01/02 (18.09.2017): 63–68. http://dx.doi.org/10.1055/s-0043-117891.
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AbstractIn 2004, 2011, and 2017, the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), a group of German-speaking psychiatric researchers and psychiatrists, published successive versions of therapeutic drug monitoring (TDM) expert group consensus guidelines. The 2017 version has as a major strength its encyclopedic nature, including 1358 references. The guideline has 3 major sections: 1) theoretical aspects of TDM, 2) drug concentration levels in blood to guide neuropsychopharmacotherapy, and 3) practical aspects of TDM in psychiatry and neurology. The writer hopes the time is right for a TDM guideline in psychiatry, which is indicated for: 1) psychiatric researchers ready to value how TDM can contribute to moving psychopharmacology forward, 2) flexible clinicians ready to improve their patient care by personalizing dosing, and 3) today’s psychiatry residents prepared as a new generation ready to be trained in TDM and willing to continue incorporating TDM as new psychiatric drugs are marketed.
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Marwaha, Steven, Andrew Thompson, Rachel Upthegrove und Matthew R. Broome. „Fifteen years on – early intervention for a new generation“. British Journal of Psychiatry 209, Nr. 3 (September 2016): 186–88. http://dx.doi.org/10.1192/bjp.bp.115.170035.
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SummaryEarly intervention for psychosis (EIP) is a model of service delivery that aims to support young people with first-episode psychosis by providing the best available treatments, supporting recovery and preventing relapse. In this editorial, we review the evidence for EIP, how the model has developed since its inclusion in the NHS policy implementation guideline for mental health in 2001, challenges and areas of ongoing debate, and future development.
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Chul Kim, Hee. „A study on problem diagnosis and maintenance guideline of small scale PV system“. International Journal of Engineering & Technology 7, Nr. 2.12 (03.04.2018): 105. http://dx.doi.org/10.14419/ijet.v7i2.12.11102.
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Background/Objectives: Research and development of low-cost, high-efficiency devices that can be installed without replacing existing power generation equipment is promoted early. It is aimed to prevent the damage of property and human life by detecting the fire of PV system. Therefore, it is possible to easily install the device without replacing the solar module The aim is to minimize the damage to people.Methods/Statistical analysis: In order to prepare for the safety accidents of the photovoltaic power generation facilities due to fire and blast, the monitoring system should have the following functions as essential. Measures and analyzes the voltage and current of power generated in each string in the connection board in real time. An alarm is triggered when an abnormality of a specific string is detected or when an abnormal temperature change is detected in the connection panel internal temperature sensor.If the smoke sensor inside the connection panel detects smoke generation and an abnormality such as a fire is caught, the monitoring system immediately generates an alarm.Findings: It provides services such as checking the status of customer power plants, improving power generation efficiency, and recovering quickly in case of a disaster through a monitoring system that supports stable operation of the PV plant and profit generation. By using the existing connection box function as it is, the company minimized the additional cost, and promoted and promoted a low-cost, high-efficiency system.Improvements/Applications: H/W module using temperature and smoke sensor is interlocked with existing connection semi-control system to develop efficient connection monitoring device. In order to link the sensor value with the monitoring system, messages are added and supplemented. For the application of the fail-safe solution, we developed a monitoring device to prevent the escape of the solar module and developed the H / W module using the vibration and loosening sensor. We will develop the solar monitoring system based on cloud type IoT platform by linking the fault recognition and alarm generation function by adding / supplementing the sensor value to link with the monitoring system.As a power station management for cloud type (ASP) service, adoption of oneM2M standard based IoT platform can expand acceptance by monitoring web and mobile based monitoring as well as real time monitoring and fault monitoring of solar power plant.
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Гогунська, І., Д. Заболотна, С. Зайков, И. Кайдашев, Т. Уманець, В. Чоп’як, Л. Яшина et al. „ПРОЕКТ “ARIA”: ШЛЯХИ НАДАННЯ МЕДИЧНОЇ ДОПОМОГИ ПРИ АЛЕРГІЧНОМУ РИНІТІ (2019 РІК) – УКРАЇНА“. Medical and Ecological Problems 23, Nr. 5-6 (16.12.2019): 3–14. http://dx.doi.org/10.31718/mep.2019.23.5-6.01.
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In all societies, the burden and cost of allergic diseases are increasing rapidly, and change management strategies are needed to support the transformation of the health care system for integrated care. A meeting was held in Paris, December 3, 2018 for chronic disease care. It was organised by MASK (Mobile Airways Sentinel NetworK) and POLLAR (Impact of Air Pollution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases. The evaluation of real-life Integrated Care Pathways (ICPs) was recommended fordigitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity embedding environmental exposure. ICPs are structured multi-disciplinary care plans detailing key steps of patient care. They promote the translation of guideline recommendations into local protocols and their application to clinical practice. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology explicitly considers all types of study designs but guideline developers often prefer to restrict guidelines to RCTs. GRADE also considers evidence about values and preferences, acceptability and feasibility or directness of findings. There is an increasing trend to use real-world evidence (RWE) to inform clinical practice. AIRWAYS ICPs (Integrated care pathways for airway diseases) were the first steps towards the development of ICPs for rhinitis and asthma multimorbidity. During the Paris meeting, next-generation guidelines for the pharmacologic treatment of AR were developed using existing GRADE-based guidelines for AR tested using RWE provided by mobile technology and chamber studies. These recommendations were used to refine the MASK algorithm for AR treatment proposed by a consensus group. In allergic rhinitis (AR), there is an urgent need to develop next-generation guidelines for pharmacotherapy and ICPs for allergen immunotherapy (AIT). Two separate documents were produced following the Paris meeting. This paper clarifies the ways of implementing this direction in Ukraine.
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Hawryluk, Gregory W. J., Andres M. Rubiano, Annette M. Totten, Cindy O’Reilly, Jamie S. Ullman, Susan L. Bratton, Randall Chesnut et al. „Guidelines for the Management of Severe Traumatic Brain Injury: 2020 Update of the Decompressive Craniectomy Recommendations“. Neurosurgery 87, Nr. 3 (06.08.2020): 427–34. http://dx.doi.org/10.1093/neuros/nyaa278.
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Abstract When the fourth edition of the Brain Trauma Foundation's Guidelines for the Management of Severe Traumatic Brain Injury were finalized in late 2016, it was known that the results of the RESCUEicp (Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension) randomized controlled trial of decompressive craniectomy would be public after the guidelines were released. The guideline authors decided to proceed with publication but to update the decompressive craniectomy recommendations later in the spirit of “living guidelines,” whereby topics are updated more frequently, and between new editions, when important new evidence is published. The update to the decompressive craniectomy chapter presented here integrates the findings of the RESCUEicp study as well as the recently published 12-mo outcome data from the DECRA (Decompressive Craniectomy in Patients With Severe Traumatic Brain Injury) trial. Incorporation of these publications into the body of evidence led to the generation of 3 new level-IIA recommendations; a fourth previously presented level-IIA recommendation remains valid and has been restated. To increase the utility of the recommendations, we added a new section entitled Incorporating the Evidence into Practice. This summary of expert opinion provides important context and addresses key issues for practitioners, which are intended to help the clinician utilize the available evidence and these recommendations. The full guideline can be found at: https://braintrauma.org/guidelines/guidelines-for-the-management-of-severe-tbi-4th-ed#/.
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Vargas, Persephone. „Dietary Intake and Obesity among Filipino Americans in New Jersey“. Journal of Environmental and Public Health 2018 (16.09.2018): 1–6. http://dx.doi.org/10.1155/2018/6719861.
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The prevalence of obesity is a public concern and is linked to chronic diseases. Filipino Americans have a high prevalence rate of hypertension and diabetes. This study investigated the dietary intake of first-generation Filipino Americans (n=210). In addition, it provides a comparison of the obesity rates using the International guideline and the WHO Asian recommendation. The dietary intake included caloric, carbohydrate, and fat intake and was determined using the Block Brief Food Frequency Questionnaire. The anthropometric measurements included actual height, weight, and waist measurements. The body mass index (BMI) and waist circumference were categorized using the International guideline and the WHO Asian recommendation to determine obesity. The caloric and carbohydrate intake were normal; however, fat intake was increased. The BMI and waist circumference showed substantial difference when using the International and Asian guidelines to determine obesity. The results highlight the increased health risks of Filipino American immigrants including a high dietary fat intake and an increased obesity rate.
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Cagle, Philip T., Timothy Craig Allen und Randall J. Olsen. „Lung Cancer Biomarkers: Present Status and Future Developments“. Archives of Pathology & Laboratory Medicine 137, Nr. 9 (01.09.2013): 1191–98. http://dx.doi.org/10.5858/arpa.2013-0319-cr.
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The publication of the “Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitors: Guideline From the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology” has now provided a guideline for biomarker testing for first-generation lung cancer tyrosine kinase inhibitors. Biomarker testing has forever altered the role of pathologists in the management of patients with lung cancer. Current, unresolved issues in the precision medicine of lung cancer will be addressed by the development of new biomarker tests, new drugs, and new test technologies and by improvement in the cost to benefit ratio of biomarker testing.
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Iheme, Gideon, Chinwe Uzokwe, Happiness Ezenwa, Chinaza Nwamadi und Elizabeth Okonkwo. „Application of the WHO (2007) Growth Reference in Assessing the Anthropometric Status of Nigerian Adolescents; a Systematic Review and Meta Analysis“. Current Developments in Nutrition 5, Supplement_2 (Juni 2021): 875. http://dx.doi.org/10.1093/cdn/nzab048_010.
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Abstract Objectives The study was designed to assess the application of WHO 2007 growth reference by local studies published from 2008 to 2020 in data generation of Nigerian adolescents’ anthropometric status. Methods Meta-analysis of literatures on anthropometric status of adolescents in Nigeria by articles published from 2009–2020 was conducted. A bibliographic survey was carried out in several databases –Google Scholar, PubMed and African Journal Online. Review of abstracts and full texts followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodology for anthropometric assessment of these eligible studies were compared to WHO 2007 growth reference. Data was analysed using IBM SPSS version 25. Results A total of 24 articles which captured 12,482 adolescents met the inclusion criteria. More than one fifth (20.8%) of the studies adopted the WHO 2007 growth references in their data generation. A weak positive correlation was observed between year of publication and application of WHO 2007 reference in data generation (r = .0.28; p = 0.04). Conclusions The low application of an age long guideline by local researchers is of concern. Hence, the need to ensure quick adoption of standard indicators/guidelines in local studies will not only promote the generation of pooled evidence to reveal cross-cutting gaps but also ensure that the public health situation is not under/over estimated. Funding Sources This research work received no funding.
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Shimazaki, Kiwamu, Mao Adachi und Minoru Nakayama. „Effectiveness of Instruction for Summarising Handouts and Academic Writings“. International Journal of Emerging Technologies in Learning (iJET) 13, Nr. 08 (30.08.2018): 51. http://dx.doi.org/10.3991/ijet.v13i08.8333.
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Academic writing skills are expected to acquire logical thinking and to lead to effective learning. The summarised handout is an academic writing activi-ty. To promote the creation of suitable handouts for learners, a guideline of the preparation procedure was developed in a previous study. In this study. The validity of the procedure is evaluated experimentally. First, the factors useful for assessing handouts were confirmed through a handout generation and evaluation experiment. When the guideline instructions were given be-fore handout creation session, factor scores increased in comparison to the condition when instruction was not given. The effectiveness of instruction was investigated by assessing the handouts generated using the guideline items. In the results, two factors were extracted: "Format" and "Content". The instructions promoted the contribution of the "Content" factor regard-ing the degree of usefulness of the handout. The contributions of handout content instructions were then evaluated lexically using morphological analysis. The instructions encouraged taking concise notes from handouts, and the total number of morphemes and nouns subjects wrote down de-creased, though the number of adjectives increased slightly. Accordingly, the effectiveness of instructions for generating handouts was evaluated.
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Danilycheva, I. V. „New European urticaria guideline. What’s new?“ Russian Journal of Allergy 15, Nr. 4 (15.12.2018): 54–61. http://dx.doi.org/10.36691/rja136.
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Urticaria is a disease which symptoms are caused by the activation and degranulation of the mast cells (MC). Urticaria and angioedema persisting for more than 6 weeks is concerning to be the chronic form of the disease (CU). Chronic spontaneous urticaria (CSU) is the most common subtype of CU and has a great negative impact on all aspects of the patient’s life, causing a decreasing a quality of life, as a burden for a health system and society as a whole. In the present version of the conciliatory document diagnostic approaches in CSU have three goals: to make a differential diagnosis; to evaluate an activity of the disease, its control and the impact on the patient’s life; to identify the triggers of exacerbation or, if possible, the causes of a disease. A basic assessment of disease activity (UAS, AAS), quality of life (CU-Q2oL, AE-QoL) and disease activity control (UCT) are necessary for decisionmaking in the treatment of patients with CSU, better understanding of the disease burden, and documentation improvement and standardization. The aim of a treatment of patients with CSU is the complete control of the symptoms. A therapy should be performed by steps. On the first step a 2nd generation of Hj-antihistamines in standard doses has to be applied. In case of unresponsiveness a dose step-up up to 4 times is recommended, at the third step omalizumab is advised, at the fourth step (inefficiency of omalizumab) - cyclosporine. At any step, it is possible to use a short term course of glucocorticosteroids to set back an exacerbation.
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Min, Young-Kyu, und Kyung-Sun Park. „The Application of Control Materials for Ongoing Quality Management of Next-Generation Sequencing in a Clinical Genetic Laboratory“. Medicina 57, Nr. 6 (28.05.2021): 543. http://dx.doi.org/10.3390/medicina57060543.
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Next-generation sequencing (NGS) has played an important role in detecting genetic variants with pathologic and therapeutic potential. The advantages of NGS, such as high-throughput sequencing capacity and massively parallel sequencing, have a significant impact on realization of genetic profiling in clinical genetic laboratories. These changes have enabled clinicians to execute precision medicine in diagnosis, prognosis, and treatment for patients. However, to adapt targeted gene panels in diagnostic use, analytical validation and ongoing quality control should be implemented and applied with both practical guidelines and appropriate control materials. Several guidelines for NGS quality control recommend usage of control materials such as HapMap cell lines, synthetic DNA fragments, and genetically characterized cell lines; however, specifications or applications of such usage are insufficient to guideline method development. This review focuses on what factors should be considered before control material selection for NGS assay and practical methods of how they could be developed in clinical genetic laboratories. This review also provides the detailed sources of critical information related to control materials.
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Piersma, Aldert, und Andre Muller. „The Extended One Generation Reproduction Toxicity Study: Expectations for the new guideline, opportunities, threats“. Toxicology Letters 258 (September 2016): S52. http://dx.doi.org/10.1016/j.toxlet.2016.06.1284.
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Bousquet, J., H. J. Schunemann, J. Fonseca, B. Samolinski, C. Bachert, G. W. Canonica, T. Casale et al. „MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation“. Allergy 70, Nr. 11 (13.09.2015): 1372–92. http://dx.doi.org/10.1111/all.12686.
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Skouteris, Helen, Angela Melder, Cate Bailey, Heather Morris, Rhonda Garad, Helena Teede und Tracy Robinson. „Application of Monash Centre for Health Research and Implementation Framework to the Development of Polycycstic Ovary Syndrome Guideline: A Case Study on Implementation“. Seminars in Reproductive Medicine 36, Nr. 01 (Januar 2018): 013–18. http://dx.doi.org/10.1055/s-0038-1667311.
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AbstractImplementation of healthcare guidelines, a set of recommendations aiming to optimize patient care, can be a complex process which is at risk of poor translation into practice. Failure to adopt new evidence-based healthcare findings can contribute to a large variation in care, potentially affecting outcomes for service users. Designed to avoid this issue, the Monash Centre for Health Research and Implementation (MCHRI) knowledge translation framework was created to support the development and future implementation of clinical practice guidelines. The framework is distinguished by a focus on methodological rigor, stakeholder engagement, and partnership, leading to the coproduction of a guideline and research projects. In this article, we use the development of the International Evidence-based Guideline on the Assessment and Management of Polycystic Ovarian Syndrome (2018) as a case study to articulate the MCHRI knowledge translation framework. Specifically, this article discusses stakeholder engagement; development and codesign of evidence-based recommendations; implementation and knowledge generation; dissemination, translation, and scale up; and refinement/learning from evaluation. This case study demonstrates how hybrid frameworks, models, and theories for implementation, such as the MCHRI implementation framework, have their place in healthcare. The underlying principle that informs the framework is stakeholder engagement, including codesign, empowerment, and partnership.
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Ramadhani, Farah, Mohd Azlan Hussain und Hazlie Mokhlis. „A Comprehensive Review and Technical Guideline for Optimal Design and Operations of Fuel Cell-Based Cogeneration Systems“. Processes 7, Nr. 12 (12.12.2019): 950. http://dx.doi.org/10.3390/pr7120950.
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The need for energy is increasing from year to year and has to be fulfilled by developing innovations in energy generation systems. Cogeneration is one of the matured technologies in energy generation, which has been implemented since the last decade. Cogeneration is defined as energy generation unit that simultaneously produced electricity and heat from a single primary fuel source. Currently, the implementation of this system has been spread over the world for stationary and mobile power generation in residential, industrial and transportation uses. On the other hand, fuel cells as an emerging energy conversion device are potential prime movers for this cogeneration system due to its high heat production and flexibility in its fuel usage. Even though the fuel cell-based cogeneration system has been popularly implemented in research and commercialization sectors, the review regarding this technology is still limited. Focusing on the optimal design of the fuel cell-based cogeneration system, this study attempts to provide a comprehensive review, guideline and future prospects of this technology. With an up-to-date literature list, this review study becomes an important source for researchers who are interested in developing this system for future implementation.
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Kendall, T. „Nice, schizophrenia and the evidence behind the treatments“. European Psychiatry 26, S2 (März 2011): 2188. http://dx.doi.org/10.1016/s0924-9338(11)73891-3.
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This talk will describe the methodology used for the development of the new NICE guideline on the treatment of schizophrenia for the UK, paying particular attention to meta-analytic and, where possible, economic methods or considerations used to develop recommendations on the use of Family therapy, CBT and the arts therapies. Some time will also be given to examining the evidence behind the first formal meta-analytic review of early intervention services for people with early schizophrenia, and a suggestion that these services may be beneficial as a result of them including evidence-based treatments rather than such services having a particular approach or service ideology. If time allows, we will also examine the evidence behind the choice of antipsychotic in the schizophrenia guideline, and speculate on the continuing usefulness, if any, of using terms such as ‘typical’, ‘atypical’, ‘first generation’ or ‘second generation’.
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Gandhi, S., G. G. Fletcher, A. Eisen, M. Mates, O. C. Freedman, S. F. Dent und M. E. Trudeau. „Adjuvant chemotherapy for early female breast cancer: A systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline“. Current Oncology 22 (18.12.2014): 82. http://dx.doi.org/10.3747/co.22.2321.
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BackgroundThe Program in Evidence-Based Care (PEBC) of Cancer Care Ontario (CCO) has recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer. The evidence for this guideline was compiled using a systematic review to answer the question: “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?” This question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and human epidermal growth factor receptor 2 (HER2) directed therapy.MethodsA systematic review was performed using the MEDLINE and EMBASE databases for the period January 2008 to May 2014. The SAGE Directory of Cancer Guidelines and websites of major oncology guideline organizations were also searched. The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and was limited to randomized controlled trials (RCTs), guidelines, systematic reviews, and meta-analyses. ResultsSeveral hundred documents were retrieved that met the inclusion criteria; the Early Breast Cancer Trialists Collaborative Group (EBCTCG) meta-analyses encompassed many of the RCTs found. Several additional studies which met the inclusion criteria were included, as well as other guidelines and systematic reviews. Chemotherapy was largely reviewed as three classes of agents: anti-metabolite based regimens (e.g., CMF), anthracyclines, and taxane-based regimens. Single-agent chemotherapy in general is not recommended for the adjuvant treatment of breast cancer in any patient population. Anthracycline and taxane-based polychemotherapy regimens are overall considered superior to earlier generation regimens, with the most significant impact on patient survival outcomes. Various regimens with disparate anthracycline and taxane doses and schedules are options; in general, paclitaxel given every 3 weeks is inferior. Evidence does not support the use of bevacizumab in the adjuvant setting; other systemic therapy agents such as metformin and vaccines remain under investigation. Adjuvant bisphosphonates for menopausal women will be discussed in later work. ConclusionThe results of this systematic review represent a comprehensive compilation of high-level evidence which was the basis for the 2014 PEBC CCO guideline on systemic therapy for early breast cancer. The use of cytotoxic chemotherapy is presented here; the results addressing endocrine therapy and HER-2 targeted treatment, as well as the final clinical practice recommendations, are published separately in this issue.
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Zimmerman, Mark. „The Influence of Comorbid Anxiety Disorders on the Selection of Antidepressant Medication in Depressed Patients“. CNS Spectrums 11, S1 (Januar 2006): 4–6. http://dx.doi.org/10.1017/s1092852900028194.
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Although there is a wide array of choices of antidepressants, there is little empirical evidence to guide clinicians in their selection. Most reviews of the antidepressant literature, including the American Psychiatric Association's (APA) Practice Guideline for the Treatment of Major Depressive Disorder, conclude that these medications are generally equally effective. Consistent with this, a recent metaanalysis of studies comparing two or more new-generation antidepressants found little evidence that any medication was superior to the others. Although the APA guideline suggests that the choice of antidepressant be based principally on side effects, tolerability, patient preference, and cost, it also reviewed evidence of differential treatment response related to patients' clinical profiles. For patients with nonpsychotic, nonbipolar major depressive disorder (MDD), the guideline indicated that the presence of anxiety symptoms, atypical features, melancholic subtype, symptom severity, and borderline personality disorder may be associated with differential response to antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are recommended for high anxiety, SSRIs and clomipramine for obsessive-compulsive disorder (OCD) symptoms, tricyclic antidepressants (TCAs) for severe depression and melancholia, and SSRIs and monoamine oxidase inhibitors (MAOIs) for atypical depression.What is most striking in the guideline's review is how limited in scope and utility are the data to guide the outpatient psychiatrist in selecting an antidepressant. Melancholia and severe depression are relatively infrequently encountered in the outpatient setting. The most common comorbidities in depressed outpatients are anxiety disorders, but the guideline simply says that bupropion may be anxiogenic and should be avoided, and that although MAOIs may work well in depressed patients with anxiety, other medications are preferred. It does not discuss the possible influence of specific comorbidities on antidepressant selection.
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Saghir, Shakil A., und Michael A. Dorato. „Reproductive and developmental toxicity testing: Examination of the extended one-generation reproductive toxicity study guideline“. Regulatory Toxicology and Pharmacology 79 (August 2016): 110–17. http://dx.doi.org/10.1016/j.yrtph.2016.03.023.
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Ficker, Mario, Valentina Paolucci und Jørn B. Christensen. „Improved large-scale synthesis and characterization of small and medium generation PAMAM dendrimers“. Canadian Journal of Chemistry 95, Nr. 9 (September 2017): 954–64. http://dx.doi.org/10.1139/cjc-2017-0108.
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Dendrimers are promising polymers for biomedical applications; however, most dendrimer formulations have failed to move from laboratory science to upscaled products for preclinical testing or GMP production. This publications reports on an improved large-scale PAMAM dendrimer synthesis that is suitable to manufacture large amounts of highly pure and monodisperse dendrimers of generations G0–G5. Furthermore, an extended analytical guideline how to characterize PAMAM dendrimers with NMR, HPLC, SEC-MALS, ESI, MALDI, UV–vis, fluorescence, and IR spectroscopy is provided.
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Lee, Byung Uk. „Cryogenic Aerosol Generation: Airborne Mist Particles Surrounding Liquid Nitrogen“. International Journal of Environmental Research and Public Health 17, Nr. 3 (07.02.2020): 1071. http://dx.doi.org/10.3390/ijerph17031071.
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Aerosol mist particles generated near the surface of a liquid nitrogen container were measured and analyzed. The particles present at various distances from the boiling surface of liquid nitrogen were detected using an optical particle counter. In this experiment, 3 micrometer particles exhibited a more than 100-fold increase in concentration due to the liquid nitrogen surface. However, 0.3 micrometer and 10 micrometer particles showed smaller variations (2% to 79%) in their concentrations in the vicinity of liquid nitrogen. The distance from the boiling surface of the liquid nitrogen strongly affected the variations in particle concentration. The variations in aerosol concentrations were significant within 20 cm of the liquid nitrogen surface. These results can be considered as a useful quantitative environmental guideline in cryogenic studies that use liquid nitrogen, and this concept can be applied to cryogenic aerosol mist generation mechanisms.
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Singhal, Sorabh, Casey Kloosterman, Joseph Billian, Teresa Bailey und Neelkamal Soares. „Most Second-Generation Antipsychotic Prescriptions in Community Practice Are Neither FDA-Approved nor Within Prescribing Guideline Recommendations“. Journal of Pediatric Pharmacology and Therapeutics 26, Nr. 5 (28.06.2021): 460–66. http://dx.doi.org/10.5863/1551-6776-26.5.460.
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OBJECTIVE Second-generation antipsychotic (SGA) prescription use has become increasingly prevalent in the pediatric population, despite metabolic adverse effects. A significant number of SGA medications are prescribed for indications that are not approved by the FDA. This study aimed to quantify clinician adherence to the FDA and professional society indication, age, and dosing guidelines when prescribing SGA medications for pediatric patients. METHODS We used electronic health record data from 3 health care systems. We analyzed outpatient encounters where a pediatric patient was prescribed an SGA during an 18-month time frame. Clinician prescribing patterns were compared to a therapeutic regimen table created using professional society guidelines and FDA medication labels. RESULTS Most of the encounters listed an indication that was not documented as a recommended use (84.3%). Most prescriptions aligned with the generalized dose guidelines (93.8%) and age guidelines (94.9%). Clinicians were more likely to follow indication guidelines when prescribing risperidone, the highest adherence medication, compared with quetiapine, the lowest adherence medication (odds ratio [OR], 2.5; 95% CI, 1.1–6.0). Compared with prescriptions for younger children, clinicians were more likely to follow indication guidelines for children aged 13 to 15 years (OR, 2.8; 95% CI, 1.1–7.2) and 16 to 18 years (OR, 3.1; 95% CI, 1.2–8.1). CONCLUSION Community clinicians overall demonstrated a low level of adherence to indication guidelines when prescribing SGA medications to pediatric populations, while maintaining higher adherence to age and dosing guidelines. Older children were more likely to receive an SGA prescription for recommended indications compared with younger children.
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HANAKAWA, NORIKO, HAJIMU IIDA, KEN-ICHI MATSUMOTO und KOJI TORII. „GENERATION OF OBJECT-ORIENTED SOFTWARE PROCESS USING MILESTONES“. International Journal of Software Engineering and Knowledge Engineering 09, Nr. 04 (August 1999): 445–66. http://dx.doi.org/10.1142/s0218194099000255.
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One of the major problems in object-oriented software projects is the lack of management's ability to comprehend and control the development progress of a project. This is because traditional phases of software development are not appropriate for object-oriented development. The project manager's "road map" is likely to be different with different phases, different milestones, and different checkpoints. This paper proposes a new framework which gives us a guideline for generating software process with relevant milestones for object-oriented development methods. The framework provides algorithms for identifying development phases and baseline products based on relationships among activities and products of the development method. In addition, the framework defines a software process model to manage a development progress in which milestones are established at the end of each phase in order to check the baseline product and establish goals for the following phase. Results of the application of the proposed framework show that the framework can generate a software process customized for well-known object-oriented development methods in a systematic way.
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Boano, Fulvio, Silvia Fiore und Roberto Revelli. „Chlorate formation in water distribution systems: a modeling study“. Journal of Hydroinformatics 18, Nr. 1 (21.01.2015): 115–25. http://dx.doi.org/10.2166/hydro.2015.079.
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Chlorine-based disinfection agents are known to favor the production of disinfection by-products (DBPs), whose concentrations are restricted by international guidelines to ensure a safe consumption of drinking water. Hence, it is important to understand the behavior of DBPs within water distribution networks (WDNs) to avoid users' exposure to concentrations higher than guideline values. The build-up in chlorate concentration resulting from chlorinated disinfectants is here simulated with the EPANET 2.0 software for one benchmark WDN serving about 130,000 inhabitants. Chlorate generation was accounted by means of an empirical model, considering different boundary conditions (physicochemical features of raw water, disinfectant dose). The gathered results indicate that increases in chlorate concentration within the considered WDN are narrow. Chlorate neo-formation in the WDN is, however, strictly related to the initial amount of chlorate released by the water treatment plant, i.e., to the input value in the WDN. If chlorate concentration in treatment plants is kept below 700 μg/L (i.e., World Health Organization guideline), depending on the mixing conditions in tanks, the simulation results referred to the considered WDN show that the DBP build-up within the network is limited (in any case lower than 5–7% of the threshold value).
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Carpintero-Rentería, Miguel, David Santos-Martín, Mónica Chinchilla und David Rebollal. „Microgrid Infrastructure Compendium Analysis with a Model Creation Tool and Guideline Based on Machine Learning Techniques“. Energies 12, Nr. 23 (27.11.2019): 4509. http://dx.doi.org/10.3390/en12234509.
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A microgrid (MG) is an electric power distribution system that may provide a suitable ecosystem for distributed generation. Detailed information about the infrastructure layer in MG projects is available, so this study aimed to propose a compendium and a model creation guideline for MGs. The aggregated information based on 1618 MGs was summarized into different tables and analyzed based on various parameters. Two MG infrastructure model creation tools were developed. First, a simple guideline was created based on the information in the tables, and then a machine learning tool based on decision trees was proposed that generates more accurate MG models using two main inputs: latitude and the segment in which they operate.
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Liu, Chengyang. „Research on age-friendly garden design in China based on the case study of WANSHOU Park“. E3S Web of Conferences 283 (2021): 02007. http://dx.doi.org/10.1051/e3sconf/202128302007.
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The rate of population aging has reached a high level in China that age-friendly design should be concerned when designing gardens in urban place. Although the generation-skipping guardianship phenomenon always exists in present situation of elderly people in China that grandchildren are taken with the elderly and are involved in their daily activities in most family, the needs of children are neglected in urban garden design. The paper generalized guidelines of age-friendly garden design according to LEED, Chinese garden design standard, and the guideline of global age-friendly cities in Europe. Childrenfriendliness have also been included based on the above-mentioned new guidelines. 29 reports have been collected in the case study of WANSHOU Park which can be characterized as an age-friendly garden involving basic information and scoring records on its environment and facilities. Through the increasement of children-friendly features and installments in the park, the design will have great potential to deal with aging problems.
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Arinto, Fransiscus Xaverius Eddy. „Preservation in Architecture Based on Architectural Archetypes Through the Graphic Methods“. ARTEKS : Jurnal Teknik Arsitektur 3, Nr. 1 (01.12.2018): 37–44. http://dx.doi.org/10.30822/arteks.v3i1.52.
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Preservation of cultural heritage is an obligation so that future generations can still enjoy the cultural riches that their predecessor generation has made. In reality, changes occur over time. These changes are sometimes uncontrollable and cause damage to artifacts. They ultimately eliminate the source of discourse and even its characteristics. To maintain cultural sustainability, preservation must be based on the characteristics of the cultural heritage itself. The problem is how to explore and obtain these cultural characteristics so that they can become a foothold in developing further designs. The graphic method for artifacts is one method that helps to explore archetypes, basic characters contained in artifacts in an easier way. This basic character will later become a guideline for the development of a sustainable design.
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Ghoddousi, Saeed, Behnaz Rezaie und Samane Ghandehariun. „Guideline for electricity generation from hot springs (natural energy storage systems): A techno-enviro-economic assessment“. Sustainable Energy Technologies and Assessments 47 (Oktober 2021): 101407. http://dx.doi.org/10.1016/j.seta.2021.101407.
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Wang, Hsin-Erh, und I.-Chi Chan. „Numerical Investigation of Wave Generation Characteristics of Bottom-Tilting Flume Wavemaker“. Journal of Marine Science and Engineering 8, Nr. 10 (30.09.2020): 769. http://dx.doi.org/10.3390/jmse8100769.
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Motivated by the recently developed bottom-tilting wavemaker specially designed for tsunami research, we propose to investigate numerically the wave generation mechanism of this new wave generator. A series of numerical experiments is carried out using a RANS-based computer model to evaluate the effects of wavemaker length, bottom displacement, motion duration, and water depth on the wavelength, wave amplitude, phase speed, and waveform of the leading waves produced by the bottom-motion wave generator. Numerical results fit well with the existing laboratory data. Explicit equations for the wavelength and wave amplitude are developed and can serve as the guideline for wave generation. Encouraging results suggest that bottom-tilting wavemaker is a good alternative to the traditional piston-type wavemaker for tsunami research.
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Wu, Janet, Kaitlyn R. Rivard, Elizabeth A. Neuner, Vasilios Athans, Camille Sabella, Robert Estridge, Robert Curtis und Thomas G. Fraser. „1958. Assessment of Guideline-Concordant Antimicrobial Prescribing in Urgent Care Centers“. Open Forum Infectious Diseases 6, Supplement_2 (Oktober 2019): S62. http://dx.doi.org/10.1093/ofid/ofz359.135.
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Abstract Background In the United States in 2014, 266 million outpatient antibiotic prescriptions were dispensed. The Center for Disease Control and Prevention estimates that 30% of outpatient antibiotic prescriptions are inappropriate. These inappropriate prescriptions contribute to increased resistance, adverse events, and healthcare costs. Methods This was a retrospective study of patients presenting to 22 urgent care centers within a large healthcare system between September 1, 2018 and February 28, 2019. Data were collected from a dashboard designed to track antimicrobial prescribing data by indication, location, and provider. ICD-9 and -10 codes associated with otitis media, pharyngitis, sinusitis, cystitis, and upper respiratory infections (URI) were included. Guideline-concordant antimicrobial prescribing was determined based on compliance with national guideline recommendations, after taking patient allergies into account. The URI category includes disease states in which antimicrobials are rarely appropriate (e.g., acute rhinitis, nasopharyngitis, and acute bronchitis). Results A total of 57,799 encounters were included in this analysis (19,242 pediatric and 38,557 adult) and 60% of patients received an antibiotic prescription. Overall antimicrobial guideline concordance was higher in pediatrics (84%) than adults (62%). Rates of guideline-concordant antimicrobial selection are shown in Table 1. The most common guideline-discordant prescriptions were tetracyclines (39%), amoxicillin/clavulanate (26%), and macrolides (17%) in adult patients with sinusitis, pharyngitis, or otitis media. In pediatric patients, the most common discordant prescriptions were macrolides (32%), third-generation cephalosporins (30%), and amoxicillin/clavulanate (19%). Unnecessary antimicrobial prescribing for URI occurred in 23% of pediatric patients and 36% of adult patients. Conclusion Guideline-discordant antimicrobial prescribing is common in urgent care centers, particularly in adult patients. In addition to encouraging utilization of order sets, emphasis on education and feedback may be important to improve and sustain guideline-concordant prescribing rates and reduce prescribing for URI. Disclosures All Authors: No reported Disclosures.
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Trudeau, Maureen, Esther Green, Roxanne Cosby, Flay Charbonneau, Tony Easty, Yooj Ko, Patti Marchand, U. David, Nadia Berger und Sherrie Hertz. „Key components of intravenous chemotherapy labeling: A systematic review and practice guideline“. Journal of Oncology Pharmacy Practice 17, Nr. 4 (27.09.2010): 409–24. http://dx.doi.org/10.1177/1078155210385160.
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Objective. To determine the necessary components and formatting of an intravenous chemotherapy label to maximize safe delivery and minimize errors. Date sources. The MEDLINE and EMBASE databases (up to April 2009) were searched for relevant evidence. Reference lists from retained studies were then searched for additional trials. An environmental scan was also conducted to locate other published and unpublished sources of information. Study selection. Relevant articles were selected and reviewed by one methodologist. Articles were selected for inclusion if they were published English language reports of Phases II or III randomized controlled trials, other comparative studies, single-arm studies, practice guidelines, or systematic reviews with or without meta-analyses, which related to the study question. MEDLINE and EMBASE searches yielded 685 potential studies of which 17 met the inclusion criteria. The environmental scan located one guideline. Three additional relevant studies were identified during the external review process. In total, 21 documents met the inclusion criteria. Data extraction. Data were extracted by one methodologist. Quality of systematic reviews was assessed using the AMSTAR tool. All other studies were evaluated based on study characteristics applicable to the particular study design. Data synthesis. The evidence collected and the consensus of expert opinion of Cancer Care Ontario’s Chemotherapy Labeling Panel form the basis of a series of recommendations for the generation of intravenous chemotherapy labels including formatting, required information, and order of information. These guidelines inform the efficient, effective, and safe administration of intravenous chemotherapy. Illustrative examples are provided.
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Skok, Srđan, Ahmed Mutapčić, Renata Rubesa und Mario Bazina. „Transmission Power System Modeling by Using Aggregated Distributed Generation Model Based on a TSO—DSO Data Exchange Scheme“. Energies 13, Nr. 15 (01.08.2020): 3949. http://dx.doi.org/10.3390/en13153949.
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By integrating distributed energy resources (DER, mostly renewable energy sources) in the depth of the distribution network transmission system operators (TSOs), planning and control of transmission systems has been greatly hindered due to the lack of knowledge about the circumstances at the transmission and distribution network’s interface and the lack of coordination with the distribution system operator (DSO). By adopting the Commission Regulation (EU) 2017/1485 (System Operational Guideline—SOGL) establishing a guideline on electricity transmission system operation, harmonized rules on system operation for TSOs, DSOs and significant grid users (SGUs) are set out, inter alia, in order to provide a clear legal framework for the exchange of necessary data and information between the aforementioned subjects. In this paper, the methodology of DER representation at the interface of the transmission and distributed system is presented, with the indicated interactive data exchange between TSO and DSO, for running and analyzing the operation of the entire power system (PS) in real and extended real time. The proposed methodology was tested on a real model of the Croatian transmission PS and with representative DER in the depth of the distribution network.