Knowledge-based clinical pathway for medical quality improvement

Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis of clinical pathways is a promising strategy to improve medical quality effectively. However, the clinical pathway knowledge has not been fully integrated into treatment process and thus cannot provide comprehensive support to the actual work practice. Therefore this paper proposes a knowledgebased clinical pathway management method which contributes to make use of clinical knowledge to support and optimize medical practice. We have developed a knowledgebased clinical pathway management system to demonstrate how the clinical pathway knowledge comprehensively supports the treatment process. The experiences from the use of this system show that the treatment quality can be effectively improved by the extracted and classified clinical pathway knowledge, seamless integration of patient-specific clinical pathway recommendations with medical tasks and the evaluating pathway deviations for optimization.

Integrated clinical pathway management for medical quality improvement-based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

Retrieval of sea surface temperature from space based on modeling of infrared radiative transfer: capabilities and limitations

The retrieval (estimation) of sea surface temperatures (SSTs) from space-based infrared observations is increasingly performed using retrieval coefficients derived from radiative transfer simulations of top-of-atmosphere brightness temperatures (BTs). Typically, an estimate of SST is formed from a weighted combination of BTs at a few wavelengths, plus an offset. This paper addresses two questions about the radiative transfer modeling approach to deriving these weighting and offset coefficients. How precisely specified do the coefficients need to be in order to obtain the required SST accuracy (e.g., scatter <0.3 K in week-average SST, bias <0.1 K)? And how precisely is it actually possible to specify them using current forward models? The conclusions are that weighting coefficients can be obtained with adequate precision, while the offset coefficient will often require an empirical adjustment of the order of a few tenths of a kelvin against validation data. Thus, a rational approach to defining retrieval coefficients is one of radiative transfer modeling followed by offset adjustment. The need for this approach is illustrated from experience in defining SST retrieval schemes for operational meteorological satellites. A strategy is described for obtaining the required offset adjustment, and the paper highlights some of the subtler aspects involved with reference to the example of SST retrievals from the imager on the geostationary satellite GOES-8.

Distribution of mosquitoes in the South East of Argentina and first report on the analysis based on 18S rDNA and COI sequences

Although Mar del Plata is the most important city on the Atlantic coast of Argentina, mosquitoes inhabiting such area are almost uncharacterized. To increase our knowledge in their distribution, we sampled specimens of natural populations. After the morphological identification based on taxonomic keys, sequences of DNA from small ribosomal subunit (18S rDNA) and cytochrome c oxidase I (COI) genes were obtained from native species and the phylogenetic analysis of these sequences were done. Fourteen species from the genera Uranotaenia, Culex, Ochlerotatus and Psorophora were found and identified. Our 18S rDNA and COI-based analysis indicates the relationships among groups at the supra-species level in concordance with mosquito taxonomy. The introduction and spread of vectors and diseases carried by them are not known in Mar del Plata, but some of the species found in this study were reported as pathogen vectors.

Knowledge-based design cost estimation through extending industry foundation classes

In order to overcome divergence of estimation with the same data, the proposed digital costing process adopts an integrated design of information system to design the process knowledge and costing system together. By employing and extending a widely used international standard, industry foundation classes, the system can provide an integrated process which can harvest information and knowledge of current quantity surveying practice of costing method and data. Knowledge of quantification is encoded from literatures, motivation case and standards. It can reduce the time consumption of current manual practice. The further development will represent the pricing process in a Bayesian Network based knowledge representation approach. The hybrid types of knowledge representation can produce a reliable estimation for construction project. In a practical term, the knowledge management of quantity surveying can improve the system of construction estimation. The theoretical significance of this study lies in the fact that its content and conclusion make it possible to develop an automatic estimation system based on hybrid knowledge representation approach.

A novel approach for distributed application scheduling based on prediction of communication events

The evolution of commodity computing lead to the possibility of efficient usage of interconnected machines to solve computationally-intensive tasks, which were previously solvable only by using expensive supercomputers. This, however, required new methods for process scheduling and distribution, considering the network latency, communication cost, heterogeneous environments and distributed computing constraints. An efficient distribution of processes over such environments requires an adequate scheduling strategy, as the cost of inefficient process allocation is unacceptably high. Therefore, a knowledge and prediction of application behavior is essential to perform effective scheduling. In this paper, we overview the evolution of scheduling approaches, focusing on distributed environments. We also evaluate the current approaches for process behavior extraction and prediction, aiming at selecting an adequate technique for online prediction of application execution. Based on this evaluation, we propose a novel model for application behavior prediction, considering chaotic properties of such behavior and the automatic detection of critical execution points. The proposed model is applied and evaluated for process scheduling in cluster and grid computing environments. The obtained results demonstrate that prediction of the process behavior is essential for efficient scheduling in large-scale and heterogeneous distributed environments, outperforming conventional scheduling policies by a factor of 10, and even more in some cases. Furthermore, the proposed approach proves to be efficient for online predictions due to its low computational cost and good precision. (C) 2009 Elsevier B.V. All rights reserved.

A new Home, far from Home : The assimilation process of women involved in intercultural marriages based on Internet meeting

The internet has revolutionized the way we socialize, and as a consequence the way to love. The new communication technologies have facilitated intercultural relationships. Nowadays family relations are one of the major factors in immigration to European countries. Family relations means persons who arrive as family dependents and in accordance with laws regulating family reunification. This thesis aims to apply the classical assimilation theory stated by Milton Gordon (1964), which formulates a series of assimilation stages through which an individual must pass in order to be completely assimilated. In accordance with this theory, marriage is the final phase for a newcomer to fully incorporate into the host society. Thus, based on this presumption and other contemporary theories, the present study has analysed how women who get involved in intercultural marriages based on internet meeting experience these assimilation stages and evaluated the resources used by respondents to incorporate themselves into Swedish society.The main goal of the study was to determine if jumping to the last stage of assimilation does assure the incorporation in the social or/and labour spheres and the findings demonstrate that even though husbands are a valuable resource for assimilation, several cultural issues in Swedish society make it difficult to assure success for the newcomers.On the other hand, Sweden is a country with a strong national sentiment and the assimilation of immigrants still is an important issue to deal with. The Swedish Integration Board has disappeared and major projects for integration have been left in the hands of the municipalities or the Migration Board, institutions that still do not know how to deal with this dilemma.

Knowledge based crime scenario modelling

A crucial concern in the evaluation of evidence related to a major crime is the formulation of sufficient alternative plausible scenarios that can explain the available evidence. However, software aimed at assisting human crime investigators by automatically constructing crime scenarios from evidence is difficult to develop because of the almost infinite variation of plausible crime scenarios. This paper introduces a novel knowledge driven methodology for crime scenario construction and it presents a decision support system based on it. The approach works by storing the component events of the scenarios instead of entire scenarios and by providing an algorithm that can instantiate and compose these component events into useful scenarios. The scenario composition approach is highly adaptable to unanticipated cases because it allows component events to match the case under investigation in many different ways. Given a description of the available evidence, it generates a network of plausible scenarios that can then be analysed to devise effective evidence collection strategies. The applicability of the ideas presented here are demonstrated by means of a realistic example and prototype decision support software.

Knowledge effect on firm performance in manufacturing and service firms

This thesis seeks to examine the difference between manufacturing and service firms with respect to the effects of knowledge on performance, and the influence of market turbulence in this relationship. Empirical data, resulting from a survey, was collected from more than 1,206 firms, involving several sectors. Two samples were analyzed, one with 334 manufacturing and other with 509 service firms. The findings indicate no significant difference in the importance of knowledge on performance between these sectors in the absence of market turbulence: knowledge development (KD) has a stronger effect than culture of competitiveness (CC) on firm performance. However, under market turbulence, manufacturers differ from service providers. The positive effect of KD is enhanced, while the positive effect of CC remains the same for manufacturing firms. On the other hand, the positive effect of KD is diminished, while the positive effect of CC is enhanced for service firms. This supports the argument concerning differences in the nature of manufacturing and service industries. From a managerial point of view, results confirm the importance of knowledge, irrespective of firm sector or market turbulence. However, while industrial firms should center efforts on KD, service firms must find a balance where knowledge development (e.g. norms, processes, routines) does not impair their culture of competitiveness (e.g. learning, innovation, action). The thesis contributes to existing literature by proposing that: (1) the positive effect of knowledge on performance is confirmed; (2) under turbulent markets manufacturing and service firms have different responses concerning the influence of knowledge on performance; (3) a multidimensional performance construct based on cost, profitability, and growth is an interesting way to evaluate firm sustained competitive advantage, rather than one-dimensional constructs; (4) the CC x KD interaction, found relevant for supply chains in previous studies, is not supported for firms; (5) differences in unit of analysis, e.g. from supply chains to firms, result in different effects of KD and CC on firm performance; (6) existing scales can be improved with the addition of more diverse indicators, capturing a wider range of concepts (e.g. information transfer measurement); and (7) results from previous studies are supported for Brazilian firms, contributing for theory generalization.

Ecommerce as internationalization strategy: an exploratory study based on premium fashion brazilian brands: case study of farfetch

As stated by Hoffmann and Coste-Manière (2012) “The web is a mass medium that contrast completely with the traditional codes of exclusivity associated with the luxury industry, and has long been simply rejected by the luxury industry for being an illegitimate distribution channel.” Meanwhile this market presents an incomparable pace of growth and is gradually changing the existing retailing business model and companies must be aware of this change and capable to adapt to it. The internet and cross-border sales already changed the competition throughout retailing and it will increase even more, so companies must be ready to face it. Internet has shown its great opportunity for all markets, although luxury/premium market is not yet taking the proper advantage of its potential, but the necessity to be an omnichannel business strategy is growing. This paper presents an exploratory research based on a case study of how premium fashion Brazilian brands are using Farfetch, e-commerce, as an entry market strategy and how this affects them. The research question of this study is: How is Farfetch helping on the internationalization of Brazilian premium fashion brands?, and in order to answer it was conducted an in-depth interview with the Brazilian head of business development of Farfetch, apart an extensive secondary data research. As expected the study found a list of trade-offs of using an e-commerce, luxury specialized, with a marketplace approach to the brands willing to internationalize. As stated by Altagamma and McKinsey (2015) study “[...] luxury brands have no choice but to embrace the digital era and become truly omnichannel. This will require them a radical rethinking of both their customer experience of their consumer engagement strategy.” Looking either from the Farfetch point of view, trying to understand why they offer this opportunity to the brands, or also from the brand side if this is a manageable approach. This study presents a contribution for both sides, trying to give tools to the brands on understanding the internationalization reasons and approach, as well as explaining Farfetch business model, and the advantages it can bring to them, at the same time of a general market trend analysis for Farfecth.

Analysis an development of a prototype based on media wiki and semantic media wiki integrated with a design modeling that allows modeling of organizations based on demo

In a world where organizations are ever more complex the need for the knowledge of the organizational self is a growing necessity. The DEMO methodology sets a goal in achieving the specification of the organizational self capturing the essence of the organization in way independent of its implementation and also coherent, consistent, complete, modular and objective. But having such organization self notion is of little meaning if this notion is not shared by the organization actors. To achieve this goal in a society that has grown attached to technology and where time is of utmost importance, using a tool such as a semantic Wikipedia may be the perfect way of making the information accessible. However, to establish DEMO methodology in such platform there is a need to create bridges between its modeling components and semantic Wikipedia. It’s in that aspect that our thesis focuses, trying to establish and implement, using a study case, the principles of a way of transforming the DEMO methodology diagrams in comprehensive pages on semantic Wikipedia but keeping them as abstract as possible to allow expansibility and generalization to all diagrams without losing any valuable information so that, if that is the wish, those diagrams may be recreated from the semantic pages and make this process a full cycle.

A new method for real time computation of power quality indices based on instantaneous space phasors

One of the important issues about using renewable energy is the integration of dispersed generation in the distribution networks. Previous experience has shown that the integration of dispersed generation can improve voltage profile in the network, decrease loss, etc. but can create safety and technical problems as well. This work report the application of the instantaneous space phasors and the instantaneous complex power in observing performances of the distribution networks with dispersed generators in steady state. New IEEE apparent power definition, the so-called Buchholz-Goodhue effective apparent power, as well as new proposed power quality (oscillation) index in the three-phase distribution systems with unbalanced loads and dispersed generators, are applied. Results obtained from several case studies using IEEE 34 nodes test network are presented and discussed. (C) 2006 Elsevier B.V. All rights reserved.

Structural integrity identification based on smart materials and neural networks

This paper presents a non-model based technique to detect, locate, and characterize structural damage by combining the impedance-based structural health monitoring technique with an artificial neural network. The impedance-based structural health monitoring technique, which utilizes the electromechanical coupling property of piezoelectric materials, has shown engineering feasibility in a variety of practical field applications. Relying on high frequency structural excitations (typically>30 kHz), this technique is very sensitive to minor structural changes in the near field of the piezoelectric sensors. In order to quantitatively assess the state of structures, two sets of artificial neural networks, which utilize measured electrical impedance signals for input patterns, were developed. By employing high frequency ranges and by incorporating neural network features, this technique is able to detect the damage in its early stage and to estimate the nature of damage without prior knowledge of the model of structures. The paper concludes with an experimental example, an investigation on a massive quarter scale model of a steel bridge section, in order to verify the performance of this proposed methodology.

Novel insights into the genomic basis of citrus canker based on the genome sequences of two strains of Xanthomonas fuscans subsp aurantifolii

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Population structure of the malaria vector Anopheles darlingi in Rondônia, Brazilian Amazon, based on mitochondrial DNA

Anopheles darlingi is the most important Brazilian malaria vector, with a widespread distribution in the Amazon forest. Effective strategies for vector control could be better developed through knowledge of its genetic structure and gene flow among populations, to assess the vector diversity and competence in transmitting Plasmodium. The aim of this study was to assess the genetic diversity of An. darlingi collected at four locations in Porto Velho, by sequencing a fragment of the ND4 mitochondrial gene. From 218 individual mosquitoes, we obtained 20 different haplotypes with a diversity index of 0.756, equivalent to that found in other neotropical anophelines. The analysis did not demonstrate significant population structure. However, haplotype diversity within some populations seems to be over-represented, suggesting the presence of sub-populations, but the presence of highly represented haplotypes complicates this analysis. There was no clear correlation among genetic and geographical distance and there were differences in relation to seasonality, which is important for malarial epidemiology.