The general equilibrium model is approximated as a piecewise linear convex model and solved from the point of view of welfare economics using linear programming and fixed point methods.
The general equilibrium model is approximated as a piecewise linear convex model and solved from the point of view of welfare economics using linear programming and fixed point methods.
This article describes how cloud computing has become a significant IT infrastructure in business, government, education, research, and service industry domains. Security of cloud-based applications, especially for th...
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This article describes how cloud computing has become a significant IT infrastructure in business, government, education, research, and service industry domains. Security of cloud-based applications, especially for those applications with constant inbound and outbound user traffic is important. It becomes of the utmost importance to secure the data flowing between the cloud application and user systems against cyber criminals who launch Denial of Service (DoS) attacks. Existing research related to cloud security focuses on securing the flow of information on servers or between networks but there is a lack of research to mitigate Distributed Denial of Service attacks on cloud environments as presented by Buyya et al. and Fachkha, et al. In this article, the authors propose an algorithm and a Hybrid Cloud-based Secure Architecture to mitigate DDoS attacks. By proposing a three-tier cloud infrastructure with a two-tier defense system for separate Network and Application layers, the authors show that DDoS attacks can be detected and blocked before reaching the infrastructure hosting the Cloud applications.
AimFrail older people typically suffer several chronic diseases, receive multiple medications and are more likely to be institutionalized in residential aged care facilities. In such patients, optimizing prescribing a...
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AimFrail older people typically suffer several chronic diseases, receive multiple medications and are more likely to be institutionalized in residential aged care facilities. In such patients, optimizing prescribing and avoiding use of high-risk medications might prevent adverse events. The present study aimed to develop a pragmatic, easily applied algorithm for medication review to help clinicians identify and discontinue potentially inappropriate high-risk medications. MethodsThe literature was searched for robust evidence of the association of adverse effects related to potentially inappropriate medications in older patients to identify high-risk medications. Prior research into the cessation of potentially inappropriate medications in older patients in different settings was synthesized into a four-step algorithm for incorporation into clinical assessment protocols for patients, particularly those in residential aged care facilities. ResultsThe algorithm comprises several steps leading to individualized prescribing recommendations: (i) identify a high-risk medication;(ii) ascertain the current indications for the medication and assess their validity;(iii) assess if the drug is providing ongoing symptomatic benefit;and (iv) consider withdrawing, altering or continuing medications. Decision support resources were developed to complement the algorithm in ensuring a systematic and patient-centered approach to medication discontinuation. These include a comprehensive list of high-risk medications and the reasons for inappropriateness, lists of alternative treatments, and suggested medication withdrawal protocols. ConclusionsThe algorithm captures a range of different clinical scenarios in relation to potentially inappropriate medications, and offers an evidence-based approach to identifying and, if appropriate, discontinuing such medications. Studies are required to evaluate algorithm effects on prescribing decisions and patient outcomes. Geriatr Gerontol Int 2016;16
Autosomal recessive polycystic kidney disease (ARPKD) is an important cause of childhood renal- and liver. related morbidity and mortality with variable disease expression. While most cases manifest peri-/neonatally w...
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Autosomal recessive polycystic kidney disease (ARPKD) is an important cause of childhood renal- and liver. related morbidity and mortality with variable disease expression. While most cases manifest peri-/neonatally with a high mortality rate in the first month of life, others survive to adulthood. ARPKD is caused by mutations in the Polycystic Kidney and Hepatic Disease 1 (PKHD1) gene on chromosome 6p12. PKHD1 is an exceptionally large gene (470 kb) with a longest open reading frame transcript of 67 exons predicted to encode a 4,074-amino acid (aa) (447 kDa) multidomain integral membrane protein (fibrocystin/polyductin) of unknown function. Recent DHPLC-based mutational studies have reported detection rates of about 80% and a minimum of one PKHD1 mutation in more than 95% of families. Thus far, a total of 263 different PKHD1 mutations (639 mutated alleles) are included in the locus,specific database (***). Except for a few populations specific founder alleles and the common c.107C > T (***36Met) missense change, PKHD1 is characterized by significant allelic diversity, making mutation screening time,consuming and labor-intensive. Mutations are distributed throughout the gene's coding sequence;however, they are not equally scattered. Thus, we aimed to set up an algorithm for efficient molecular genetic diagnostics in ARPKD. A total of 80% of known PKHD1 mutations can be identified if a subset of 27 out of 77 DHPLC fragments is screened. The current study provides an essential platform for PKHD1 mutation screening in a routine setting that will largely alleviate molecular genetic diagnostics in patients suspected to have ARPKD. (C) 2005 Wiley-Liss, Inc.
Background. In emergency rescue organizations, pretriage systems (e.g., mSTaRT) are often used in case of mass casualty incidents. Due to call overflow, people are faced with waiting times before their emergency call ...
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Background. In emergency rescue organizations, pretriage systems (e.g., mSTaRT) are often used in case of mass casualty incidents. Due to call overflow, people are faced with waiting times before their emergency call can be accepted. Therefore, our aim was to develop a pretriage algorithm for integrated control centers to accelerate the identification of patients requiring critical care. Materials and methods. The empirical work is based on a qualitative research design and the theory following the resource concept of Wernefeldt (1984). For derivation and justification of questions concerning pretriage, existing triage systems were interpreted qualitatively by means of document analysis. In order to gain further insights, problem-oriented expert interviews and a group discussion were conducted and a standardized questionnaire was used. Results. The Eisenhower principle could be adapted for prioritization in integrated control centers and to develop a pretriage algorithm. The algorithm was specially designed for call overflow situations: callers with lower priority are recalled later, while higher priority emergency calls are immediately alerted. As the pretriage does not result in an explicit allocation, the dispatcher performs the usual emergency call handling. Conclusion. Through slight modifications, it is also possible to use the developed algorithm in other public safety answering points in case of call overflow. In addition, the technological progress, for example applications for smartphones, enables new pathways of emergency call handling. In the future, it will therefore be more important to reconsider new methods and to implement them after scientific evaluation.
Assessing individual reports of adverse events following immunizations (AEFI) can be challenging. Most published reviews are based on expert opinions, but the methods and logic used to arrive at these opinions are nei...
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Assessing individual reports of adverse events following immunizations (AEFI) can be challenging. Most published reviews are based on expert opinions, but the methods and logic used to arrive at these opinions are neither well described nor understood by many health care providers and scientists. We developed a standardized algorithm to assist in collecting and interpreting data, and to help assess causality after individual AEFI. Key questions that should be asked during the assessment of AEFI include: Is the diagnosis of the AEFI correct? Does clinical or laboratory evidence exist that supports possible causes for the AEFI other than the vaccine in the affected individual? Is there a known causal association between the AEFI and the vaccine? Is there strong evidence against a causal association? Is there a specific laboratory test implicating the vaccine in the pathogenesis? An algorithm can assist with addressing these questions in a standardized, transparent manner which can be tracked and reassessed if additional information becomes available. Examples in this document illustrate the process of using the algorithm to determine causality. As new epidemiologic and clinical data become available, the algorithm and guidelines will need to be modified. Feedback from users of the algorithm will be invaluable in this process. We hope that this algorithm approach can assist with educational efforts to improve the collection of key information on AEFI and provide a platform for teaching about causality assessment. (C) 2012 Elsevier Ltd. All rights reserved.
Objective: The goal of this work is to determine whether improved performance (compared to patient independent algorithms) can be achieved by an algorithm, developed on the fly, that requires no user input beyond the ...
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Objective: The goal of this work is to determine whether improved performance (compared to patient independent algorithms) can be achieved by an algorithm, developed on the fly, that requires no user input beyond the identification of the first one or two seizures in the record. Methods: The previously developed AutoLearn (TM) algorithm, which employs the probabilistic neural network (PNN), is tested on 209 seizures obtained from the epilepsy monitoring unit (EMU) or ambulatory recordings. A construction algorithm is used to compare a variety of algorithm architectures and factors. The Taguchi design of experiments (DoE) method is employed find the significant factors without resorting to a full factorial design. Results: Architectures that train a single PNN per channel and use segmentation to identify ranges of similar activity are preferred. The two best architectures are insensitive to the levels of any of the other factors tested. The training time for the algorithm is less than 1 s, and approximately 2 min are required to find the seizures in an 8 h record. Conclusions: The final algorithm, which requires no input from the user other than the marking of the first seizure in a record, performs as well or better than the 3 seizure detectors on EMU and ambulatory records. The algorithm performs nearly as well as human experts on the EMU records. Significance: The described method can be used to identify unusual seizures (or other patterns) that will be missed by the current generation of seizure detectors. We expect that the methods developed here will also aid the development of patient independent seizure detectors that can improve their performance over time by incorporating new examples. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Ocean color remote sensing has provided the scientific community with unprecedented global coverage of chlorophyll a, an indicator of phytoplankton biomass. Together, satellite-derived chlorophyll a and knowledge of P...
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Ocean color remote sensing has provided the scientific community with unprecedented global coverage of chlorophyll a, an indicator of phytoplankton biomass. Together, satellite-derived chlorophyll a and knowledge of Phytoplankton Functional Types (PFTs) will improve our limited understanding of marine ecosystem responses to physiochemical climate drivers involved in carbon cycle dynamics and linkages. Using cruise data from the Gulf of Maine and the Middle Atlantic Bight (N = 269 pairs of HPLC and phytoplankton absorption samples), two modeling approaches were utilized to predict phytoplankton absorption and pigments. algorithm I predicts the chlorophyll-specific absorption coefficient (a*(ph) (m(2) mg chl a(-1))) using inputs of temperature, light, and chlorophyll a. Modeled r(2) values (400-700 nm) ranged from 0.79 to 0.99 when compared to in situ observations with similar to 25% lower r(2) values in the UV region. algorithm II-a utilizes matrix inversion analysis to predict a(ph)(m(-1), 400-700 nm) and r(2) values ranged from 0.89 to 0.99. The prediction of phytoplankton pigments with algorithm II-b produced r(2) values that ranged from 0.40 to 0.93. When used in combination, algorithm I, and algorithm II-a are able to use satellite products of SST, PAR, and chlorophyll a (algorithm I) to predict pigment concentrations and ratios to describe the phytoplankton community. The results of this study demonstrate that the spatial variation in modeled pigment ratios differ significantly from the 10-year SeaWiFS average chlorophyll a data set. Contiguous observations of chlorophyll a and phytoplankton biodiversity will elucidate ecosystem responses with unprecedented complexity. Published by Elsevier Ltd.
Alveolar-pleural fistulas (APF) are a clinical entity that represents a diagnostic and therapeutic challenge. Objective: The objective of this work is to design a diagnostic algorithm for the anatomical detection of A...
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Alveolar-pleural fistulas (APF) are a clinical entity that represents a diagnostic and therapeutic challenge. Objective: The objective of this work is to design a diagnostic algorithm for the anatomical detection of APF in patients who are not candidates for surgical treatment. Method: Prospective non-randomized study of 47 patients. Diagnostic procedures were performed: (a) prior to bronchoscopy: computed axial tomography (CT) and implantation of electronic pleural drainage system (EPD) and (b) endoscopic: endobronchial occlusion (EO) by balloon, selective endobronchial oxygen insufflation (OI) (2 l) and selective bronchography (BS) (instillation of iodinated radiological contrast using continuous fluoroscopy). Results: The sample was predominantly male (81%). The diagnostic methods revealed: (a) Determination of the anatomical location of APF by CT in 15/46 patients (31.9% of sample), and variations in the pattern (intermittent or continuous air leak) and quantification after drug administration sedatives using EPD, (b) endoscopic: anatomical determination of APF was achieved in 57.1, 81 and 63.4% respectively using EO, OI and BS. The combination of the diagnostic tests allowed us to determine the anatomical location of the APF in 91.5% of the sample. No complications were recorded in 85.1% of cases. Conclusions: The diagnosis of APF by flexible bronchoscopy is a useful method, with an adequate safety and efficacy profile. The proposed diagnostic algorithm includes the use of EPD and performing a CT scan. Regarding endoscopic diagnosis: in case of continuous air leak, the first option is OE;and if the leak is intermittent, we recommend endobronchial OI, with BS as a secondary option (respective sensitivity 81% vs 63.4% and complications 8.1% vs 7.3%). (c) 2024 SEPAR. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
This article presented a new approach for the research of virtual individualized 3D mannequin. First, the author summarized and analyzed the current research methods and pointed out the shortage of these methods. Seco...
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