Corneal confocal microscopy : a novel noninvasive means to diagnose neuropathy in patients with Fabry disease

ABSTRACT: Neuropathy is a cause of significant disability in patients with Fabry disease, yet its diagnosis is difficult. In this study we compared the novel noninvasive techniques of corneal confocal microscopy (CCM) to quantify small-fiber pathology, and non-contact corneal esthesiometry (NCCA) to quantify loss of corneal sensation, with established tests of neuropathy in patients with Fabry disease. Ten heterozygous females with Fabry disease not on enzyme replacement therapy (ERT), 6 heterozygous females, 6 hemizygous males on ERT, and 14 age-matched, healthy volunteers underwent detailed quantification of neuropathic symptoms, neurological deficits, neurophysiology, quantitative sensory testing (QST), NCCA, and CCM. All patients with Fabry disease had significant neuropathic symptoms and an elevated Mainz score. Peroneal nerve amplitude was reduced in all patients and vibration perception threshold was elevated in both male and female patients on ERT. Cold sensation (CS) threshold was significantly reduced in both male and female patients on ERT (P < 0.02), but warm sensation (WS)and heat-induced pain (HIP) were only significantly increased in males onERT (P<0.01). However, corneal sensation assessed withNCCAwas significantly reduced in female (P < 0.02) and male (P < 0.04) patients on ERT compared with control subjects. According to CCM, corneal nerve fiber and branch density was significantly reduced in female (P < 0.03) and male (P < 0.02) patients on ERT compared with control subjects. Furthermore, the severity of neuropathic symptoms and the neurological component of the Mainz Severity Score Index correlated significantly with QSTand CCM. This study shows that CCM and NCCA provide a novel means to detect early nerve fiber damage and dysfunction, respectively, in patients with Fabry disease.

YAWL : power through patterns

Workflow Management Systems (WfMSs) enable the development and maintenance of workflow specifications at design time and their execution and monitoring at runtime. The open source WfMS YAWL supports the YAWL language – a formally defined language based on Petri nets which offers comprehensive support for control-flow and resource patterns. In addition, the YAWL system provides extensive support for process flexibility, in particular for process configuration, exception handling, dynamic workflow and declarative workflow. Due to its formal foundation, sophisticated verification support can also be achieved. This paper presents the YAWL system and its main applications.

Decision-support for service bundling

Offering service bundles to the market is a promising option for service providers to strengthen their competitive advantages, cope with dynamic market conditions and deal with heterogeneous consumer demand. Although the expected positive effects of bundling strategies and pricing considerations for bundles are covered well by the available literature, limited guidance can be found regarding the identification of potential bundle candidates and the actual process of bundling. The proposed research aims at filling this gap by offering a service bundling method complemented by a proof-of-concept prototype, which extends the existing knowledge base in the multidisciplinary research area of Information Systems and Service Science as well as providing an organisation with a structured approach for bundling services.

A geographical analysis of the role of water supply and sanitation in the risk of helminth infections of children in West Africa

Background We investigated the geographical variation of water supply and sanitation indicators (WS&S) and their role to the risk of schistosomiasis and hookworm infection in school age children in West Africa. The aim was to predict large-scale geographical variation in WS&S, quantify the attributable risk of S. haematobium, S. mansoni and hookworm infections due to WS&S and identify communities where sustainable transmission control could be targeted across the region. Methods National cross-sectional household-based demographic health surveys were conducted in 24,542 households in Burkina Faso, Ghana and Mali, in 2003–2006. We generated spatially-explicit predictions of areas without piped water, toilet facilities and finished floors in West Africa, adjusting for household covariates. Using recently published helminth prevalence data we developed Bayesian geostatistical models (MGB) of S. haematobium, S. mansoni and hookworm infection in West Africa including environmental and the mapped outputs for WS&S. Using these models we estimated the effect of WS&S on parasite risk, quantified their attributable fraction of infection, and mapped the risk of infection in West Africa. Findings Our maps show that most areas in West Africa are very poorly served by water supply except in major urban centers. There is a better geographical coverage for toilet availability and improved household flooring. We estimated smaller attributable risks for water supply in S. mansoni (47%) compared to S. haematobium (71%), and 5% of hookworm cases could be averted by improving sanitation. Greater levels of inadequate sanitation increased the risk of schistosomiasis, and increased levels of unsafe water supply increased the risk of hookworm. The role of floor type for S. haematobium infection (21%) was comparable to that of S. mansoni (16%), but was significantly higher for hookworm infection (86%). S. haematobium and hookworm maps accounting for WS&S show small clusters of maximal prevalence areas in areas bordering Burkina Faso and Mali smaller. The map of S. mansoni shows that this parasite is much more wide spread across the north of the Niger River basin than previously predicted. Interpretation Our maps identify areas where the Millennium Development Goal for water and sanitation is lagging behind. Our results show that WS&S are important contributors to the burden of major helminth infections of children in West Africa. Including information about WS&S as well as the “traditional” environmental risk factors in spatial models of helminth risk yielded a substantial gain both in model fit and at explaining the proportion of spatial variance in helminth risk. Mapping the distribution of infection risk adjusted for WS&S allowed the identification of communities in West Africa where integrative preventive chemotherapy and engineering interventions will yield the greatest public health benefits.

The effect of various pH, ionic strength and temperature on papain hydrolysis of salivary film

Stimulated human whole saliva (WS) was used to study the dynamics of papain hydrolysis at defined pH, ionic strength and temperature with the view of reducing an acquired pellicle. A quartz crystal microbalance with dissipation (QCM-D) was used to monitor the changes in frequency due to enzyme hydrolysis of WS films and the hydrolytic parameters were calculated using an empirical model. The morphological and conformational changes of the salivary films before and after enzymatic hydrolysis were characterized by atomic force microscopy (AFM) imaging and grazing angle infrared spectroscopy (GA-FTIR) spectra, respectively. The characteristics of papain hydrolysis of WS films were pH-, ionic strength- and temperature-dependent. The WS films were partially removed by the action of enzyme, resulting thinner and smoother surfaces. The IR data suggested that hydrolysis-induced deformation did not occur onto the remnants salivary films. The processes of papain hydrolysis of WS films can be controlled by properly regulating pH, ionic strength and temperature.

Introduction to the First International Workshop on Empirical Research in Business Process Management (ER-BPM 2009)

Providing effective IT support for business processes has become crucial for enterprises to stay competitive. In response to this need numerous process support paradigms (e.g., workflow management, service flow management, case handling), process specification standards (e.g., WS-BPEL, BPML, BPMN), process tools (e.g., ARIS Toolset, Tibco Staffware, FLOWer), and supporting methods have emerged in recent years. Summarized under the term “Business Process Management” (BPM), these paradigms, standards, tools, and methods have become a success-critical instrument for improving process performance.

An introduction to service choreographies (Servicechoreographien – eine Einführung)

Service oriented architecture (SOA) is an architectural style for building software systems based on services. Especially in those scenarios where services implement business processes, complex conversations between the services occur. Service choreographies are a means to capture all interaction obligations and constraints from a global perspective. This article introduces choreographies as an important artifact for SOA, compares them to service orchestrations and surveys existing languages for modeling them.

A software framework for risk-aware business process management

With the large diffusion of Business Process Managemen (BPM) automation suites, the possibility of managing process-related risks arises. This paper introduces an innovative framework for process-related risk management and describes a working implementation realized by extending the YAWL system. The framework covers three aspects of risk management: risk monitoring, risk prevention, and risk mitigation. Risk monitoring functionality is provided using a sensor-based architecture, where sensors are defined at design time and used at run-time for monitoring purposes. Risk prevention functionality is provided in the form of suggestions about what should be executed, by who, and how, through the use of decision trees. Finally, risk mitigation functionality is provided as a sequence of remedial actions (e.g. reallocating, skipping, rolling back of a work item) that should be executed to restore the process to a normal situation.

Knowledge-Intensive Business Processes: Proceedings of the 1st International Workshop on Knowledge-intensive Business Processes [CEUR Workshop Proceedings, Volume 861]

Nowadays, Workflow Management Systems (WfMSs) and, more generally, Process Management Systems (PMPs) are process-aware Information Systems (PAISs), are widely used to support many human organizational activities, ranging from well-understood, relatively stable and structures processes (supply chain management, postal delivery tracking, etc.) to processes that are more complicated, less structured and may exhibit a high degree of variation (health-care, emergency management, etc.). Every aspect of a business process involves a certain amount of knowledge which may be complex depending on the domain of interest. The adequate representation of this knowledge is determined by the modeling language used. Some processes behave in a way that is well understood, predictable and repeatable: the tasks are clearly delineated and the control flow is straightforward. Recent discussions, however, illustrate the increasing demand for solutions for knowledge-intensive processes, where these characteristics are less applicable. The actors involved in the conduct of a knowledge-intensive process have to deal with a high degree of uncertainty. Tasks may be hard to perform and the order in which they need to be performed may be highly variable. Modeling knowledge-intensive processes can be complex as it may be hard to capture at design-time what knowledge is available at run-time. In realistic environments, for example, actors lack important knowledge at execution time or this knowledge can become obsolete as the process progresses. Even if each actor (at some point) has perfect knowledge of the world, it may not be certain of its beliefs at later points in time, since tasks by other actors may change the world without those changes being perceived. Typically, a knowledge-intensive process cannot be adequately modeled by classical, state of the art process/workflow modeling approaches. In some respect there is a lack of maturity when it comes to capturing the semantic aspects involved, both in terms of reasoning about them. The main focus of the 1st International Workshop on Knowledge-intensive Business processes (KiBP 2012) was investigating how techniques from different fields, such as Artificial Intelligence (AI), Knowledge Representation (KR), Business Process Management (BPM), Service Oriented Computing (SOC), etc., can be combined with the aim of improving the modeling and the enactment phases of a knowledge-intensive process. The 1st International Workshop on Knowledge-intensive Business process (KiBP 2012) was held as part of the program of the 2012 Knowledge Representation & Reasoning International Conference (KR 2012) in Rome, Italy, in June 2012. The workshop was hosted by the Dipartimento di Ingegneria Informatica, Automatica e Gestionale Antonio Ruberti of Sapienza Universita di Roma, with financial support of the University, through grant 2010-C26A107CN9 TESTMED, and the EU Commission through the projects FP7-25888 Greener Buildings and FP7-257899 Smart Vortex. This volume contains the 5 papers accepted and presented at the workshop. Each paper was reviewed by three members of the internationally renowned Program Committee. In addition, a further paper was invted for inclusion in the workshop proceedings and for presentation at the workshop. There were two keynote talks, one by Marlon Dumas (Institute of Computer Science, University of Tartu, Estonia) on "Integrated Data and Process Management: Finally?" and the other by Yves Lesperance (Department of Computer Science and Engineering, York University, Canada) on "A Logic-Based Approach to Business Processes Customization" completed the scientific program. We would like to thank all the Program Committee members for the valuable work in selecting the papers, Andrea Marrella for his valuable work as publication and publicity chair of the workshop, and Carola Aiello and the consulting agency Consulta Umbria for the organization of this successful event.

Words and Silences : The journal of the International Oral History Association

Words and Silences is the official on-line journal of the International Oral History Association. It is an internationally peer reviewed, high quality forum for oral historians from a wide range of disciplines and a means for the professional community to share projects and current trends of oral history from around the world. We are extremely pleased to release the first online issue of Word &Silences. This e-journal is the result of long standing discussion and debate about the best way to publish a quality bilingual oral history journal (including a blind peer reviewed section) as a viable solution to mounting difficulties associated with publishing in print. We have discovered that an online version is also not without its challenges and requires tremendous labor intensive dedication. We strongly encourage members to assist us with small review process tasks in the future, so that we can ensure the sustainability of an annual W&S publication for our members and beyond.