A global model for effective use and evaluation of e-learning in health.

Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

Prediction of FRP debonding using the global-energy-balance approach

A major research program was carried out to analyze the mechanism of FRP debonding from concrete beams using global-energy-balance approach (GEBA). The key findings are that the fracture process zone is small so there is no R-curve to consider, failure is dominated by Mode I behavior, and the theory agrees well with tests. The analyses developed in the study provide an essential tool that will enable fracture mechanics to be used to determine the load at which FRP plates will debond from concrete beams. This obviates the need for finite element (FE) analyses in situations where reliable details of the interface geometry and crack-tip stress fields are not attainable for an accurate analysis. This paper presents an overview of the GEBA analyses that is described in detail elsewhere, and explains the slightly unconventional assumptions made in the analyses, such as the revised moment-curvature model, the location of an effective centroid, the separate consideration of the FRP and the RC beam for the purposes of the analysis, the use of Mode I fracture energies and the absence of an R-curve in the fracture mechanics analysis.

Global analysis of dynamical decision-making models through local computation around the hidden saddle

Bistable dynamical switches are frequently encountered in mathematical modeling of biological systems because binary decisions are at the core of many cellular processes. Bistable switches present two stable steady-states, each of them corresponding to a distinct decision. In response to a transient signal, the system can flip back and forth between these two stable steady-states, switching between both decisions. Understanding which parameters and states affect this switch between stable states may shed light on the mechanisms underlying the decision-making process. Yet, answering such a question involves analyzing the global dynamical (i.e., transient) behavior of a nonlinear, possibly high dimensional model. In this paper, we show how a local analysis at a particular equilibrium point of bistable systems is highly relevant to understand the global properties of the switching system. The local analysis is performed at the saddle point, an often disregarded equilibrium point of bistable models but which is shown to be a key ruler of the decision-making process. Results are illustrated on three previously published models of biological switches: two models of apoptosis, the programmed cell death and one model of long-term potentiation, a phenomenon underlying synaptic plasticity. © 2012 Trotta et al.

Feedback mechanisms for global oscillations in Lure systems

The paper presents two mechanisms for global oscillations in feedback systems, based on bifurcations in absolutely stable systems. The external characterization of the oscillators provides the basis for a (energy-based) dissipativity theory for oscillators, thereby opening new possibilities for rigorous stability analysis of high-dimensional systems and interconnected oscillators. © 2004 Elsevier B.V. All rights reserved.

Trading the stability of finite zeros for global stabilization of nonlinear cascade systems

This note analyzes the stabilizability properties of nonlinear cascades in which a nonminimum phase linear system is interconnected through its output to a Stable nonlinear system. It is shown that the instability of the zeros of the linear System can be traded with the stability of the nonlinear system up to a limit fixed by the growth properties of the cascade interconnection term. Below this limit, global stabilization is achieved by smooth static-state feedback. Beyond this limit, various examples illustrate that controllability of the cascade may be lost, making it impossible to achieve large regions of attractions.

Trading the stability of finite zeros for global stabilization of nonlinear cascade systems

This paper analyzes the stabilizability properties of nonlinear cascades in which a nonminimum phase linear system is interconnected through its output to a stable nonlinear system. It is shown that the instability of the zeros of the linear system can be traded with the stability of the nonlinear system up to a limit fixed by the growth properties of the cascade interconnection term. Below this limit, global stabilization is achieved by smooth static state feedback. Beyond this limit, various examples illustrate that controllability of the cascade may be lost, making it impossible to achieve large regions of attractions.

Slow peaking and low-gain designs for global stabilization of nonlinear systems

This paper presents an analysis of the slow-peaking phenomenon, a pitfall of low-gain designs that imposes basic limitations to large regions of attraction in nonlinear control systems. The phenomenon is best understood on a chain of integrators perturbed by a vector field up(x, u) that satisfies p(x, 0) = 0. Because small controls (or low-gain designs) are sufficient to stabilize the unperturbed chain of integrators, it may seem that smaller controls, which attenuate the perturbation up(x, u) in a large compact set, can be employed to achieve larger regions of attraction. This intuition is false, however, and peaking may cause a loss of global controllability unless severe growth restrictions are imposed on p(x, u). These growth restrictions are expressed as a higher order condition with respect to a particular weighted dilation related to the peaking exponents of the nominal system. When this higher order condition is satisfied, an explicit control law is derived that achieves global asymptotic stability of x = 0. This stabilization result is extended to more general cascade nonlinear systems in which the perturbation p(x, v) v, v = (ξ, u) T, contains the state ξ and the control u of a stabilizable subsystem ξ = a(ξ, u). As an illustration, a control law is derived that achieves global stabilization of the frictionless ball-and-beam model.

Global stabilization of feedforward systems with exponentially unstable Jacobian linearization

The global stabilization of a class of feedforward systems having an exponentially unstable Jacobian linearization is achieved by a high-gain feedback saturated at a low level. The control law forces the derivatives of the state variables to small values along the closed-loop trajectories. This "slow control" design is illustrated with a benchmark example and its limitations are emphasized. © 1999 Elsevier Science B.V. All rights reserved.

Lyapunov functions for stable cascades and applications to global stabilization

This paper generalizes recent Lyapunov constructions for a cascade of two nonlinear systems, one of which is stable rather than asymptotically stable. A new cross-term construction in the Lyapunov function allows us to replace earlier growth conditions by a necessary boundedness condition. This method is instrumental in the global stabilization of feedforward systems, and new stabilization results are derived from the generalized construction.