Impact of recommendation updates in well-controlled patients on nonrecommended antiretroviral therapies: the Swiss HIV cohort study

BACKGROUND HIV treatment recommendations are updated as clinical trials are published. Whether recommendations drive clinicians to change antiretroviral therapy in well-controlled patients is unexplored. METHODS We selected patients with undetectable viral loads (VLs) on nonrecommended regimens containing double-boosted protease inhibitors (DBPIs), triple-nucleoside reverse transcriptase inhibitors (NRTIs), or didanosine (ddI) plus stavudine (d4T) at publication of the 2006 International AIDS Society recommendations. We compared demographic and clinical characteristics with those of control patients with undetectable VL not on these regimens and examined clinical outcome and reasons for treatment modification. RESULTS At inclusion, 104 patients were in the DBPI group, 436 in the triple-NRTI group, and 19 in the ddI/d4T group. By 2010, 28 (29%), 204 (52%), and 1 (5%) patient were still on DBPIs, triple-NRTIs, and ddI plus d4T, respectively. 'Physician decision,' excluding toxicity/virological failure, drove 30% of treatment changes. Predictors of recommendation nonobservance included female sex [adjusted odds ratio (aOR) 2.69, 95% confidence interval (CI) 1 to 7.26; P = 0.01] for DPBIs, and undetectable VL (aOR 3.53, 95% CI 1.6 to 7.8; P = 0.002) and lack of cardiovascular events (aOR 2.93, 95% CI 1.23 to 6.97; P = 0.02) for triple-NRTIs. All patients on DBPIs with documented diabetes or a cardiovascular event changed treatment. Recommendation observance resulted in lower cholesterol values in the DBPI group (P = 0.06), and more patients having undetectable VL (P = 0.02) in the triple-NRTI group. CONCLUSION The physician's decision is the main factor driving change from nonrecommended to recommended regimens, whereas virological suppression is associated with not switching. Positive clinical outcomes observed postswitch underline the importance of observing recommendations, even in well-controlled patients.

Incremental Dynamic Updates with First-class Contexts

Highly available software systems occasionally need to be updated while avoiding downtime. Dynamic software updates reduce down-time, but still require the system to reach a quiescent state in which a global update can be performed. This can be difficult for multi-threaded systems. We present a novel approach to dynamic updates using first-class contexts, called Theseus. First-class contexts make global updates unnecessary: existing threads run to termination in an old context, while new threads start in a new, updated context; consistency between contexts is ensured with the help of bidirectional transformations. We show that for multi-threaded systems with coherent memory, first-class contexts offer a practical and flexible approach to dynamic updates, with acceptable overhead.

Introduction to “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates”

Abstract Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. It is the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Economic and revenue updates.

Description based on: May 8, 2001; title from cover.

Medical Education Progress Report (Updates)

Documents detailing the LCME accreditation process, and the proposed outline for implementation of the FLorida International University College of Medicine.

Search Based Clustering for Protecting Software with Diversified Updates

Reverse engineering is usually the stepping stone of a variety of at-tacks aiming at identifying sensitive information (keys, credentials, data, algo-rithms) or vulnerabilities and flaws for broader exploitation. Software applica-tions are usually deployed as identical binary code installed on millions of com-puters, enabling an adversary to develop a generic reverse-engineering strategy that, if working on one code instance, could be applied to crack all the other in-stances. A solution to mitigate this problem is represented by Software Diversity, which aims at creating several structurally different (but functionally equivalent) binary code versions out of the same source code, so that even if a successful attack can be elaborated for one version, it should not work on a diversified ver-sion. In this paper, we address the problem of maximizing software diversity from a search-based optimization point of view. The program to protect is subject to a catalogue of transformations to generate many candidate versions. The problem of selecting the subset of most diversified versions to be deployed is formulated as an optimisation problem, that we tackle with different search heuristics. We show the applicability of this approach on some popular Android apps.

Microblogging Temporal Summarization: Filtering Important Twitter Updates for Breaking News

While news stories are an important traditional medium to broadcast and consume news, microblogging has recently emerged as a place where people can dis- cuss, disseminate, collect or report information about news. However, the massive information in the microblogosphere makes it hard for readers to keep up with these real-time updates. This is especially a problem when it comes to breaking news, where people are more eager to know “what is happening”. Therefore, this dis- sertation is intended as an exploratory effort to investigate computational methods to augment human effort when monitoring the development of breaking news on a given topic from a microblog stream by extractively summarizing the updates in a timely manner. More specifically, given an interest in a topic, either entered as a query or presented as an initial news report, a microblog temporal summarization system is proposed to filter microblog posts from a stream with three primary concerns: topical relevance, novelty, and salience. Considering the relatively high arrival rate of microblog streams, a cascade framework consisting of three stages is proposed to progressively reduce quantity of posts. For each step in the cascade, this dissertation studies methods that improve over current baselines. In the relevance filtering stage, query and document expansion techniques are applied to mitigate sparsity and vocabulary mismatch issues. The use of word embedding as a basis for filtering is also explored, using unsupervised and supervised modeling to characterize lexical and semantic similarity. In the novelty filtering stage, several statistical ways of characterizing novelty are investigated and ensemble learning techniques are used to integrate results from these diverse techniques. These results are compared with a baseline clustering approach using both standard and delay-discounted measures. In the salience filtering stage, because of the real-time prediction requirement a method of learning verb phrase usage from past relevant news reports is used in conjunction with some standard measures for characterizing writing quality. Following a Cranfield-like evaluation paradigm, this dissertation includes a se- ries of experiments to evaluate the proposed methods for each step, and for the end- to-end system. New microblog novelty and salience judgments are created, building on existing relevance judgments from the TREC Microblog track. The results point to future research directions at the intersection of social media, computational jour- nalism, information retrieval, automatic summarization, and machine learning.

Updates on communicable and non-communicable diseases in LMICs.

In this issue of African Health Sciences, we bring you diverse topics ranging from determinants of infant survival, to hernias and genes.

A HUMAN-CENTERED APPROACH TO IMPROVING THE USER EXPERIENCE OF SOFTWARE UPDATES

Software updates are critical to the security of software systems and devices. Yet users often do not install them in a timely manner, leaving their devices open to security exploits. This research explored a re-design of automatic software updates on desktop and mobile devices to improve the uptake of updates through three studies. First using interviews, we studied users’ updating patterns and behaviors on desktop machines in a formative study. Second, we distilled these findings into the design of a low-fi prototype for desktops, and evaluated its efficacy for automating updates by means of a think-aloud study. Third, we investigated individual differences in update automation on Android devices using a large scale survey, and interviews. In this thesis, I present the findings of all three studies and provide evidence for how automatic updates can be better appropriated to fit users on both desktops and mobile devices. Additionally, I provide user interface design suggestions for software updates and outline recommendations for future work to improve the user experience of software updates.

Electronic tendering: an industry perspective

The construction industry is categorised as being an information-intensive industry and described as one of the most important industries in any developed country, facing a period of rapid and unparalleled change (Industry Science Resources 1999) (Love P.E.D., Tucker S.N. et al. 1996). Project communications are becoming increasingly complex, with a growing need and fundamental drive to collaborate electronically at project level and beyond (Olesen K. and Myers M.D. 1999; Thorpe T. and Mead S. 2001; CITE 2003). Yet, the industry is also identified as having a considerable lack of knowledge and awareness about innovative information and communication technology (ICT) and web-based communication processes, systems and solutions which may prove beneficial in the procurement, delivery and life cycle of projects (NSW Government 1998; Kajewski S. and Weippert A. 2000). The Internet has debatably revolutionised the way in which information is stored, exchanged and viewed, opening new avenues for business, which only a decade ago were deemed almost inconceivable (DCITA 1998; IIB 2002). In an attempt to put these ‘new avenues of business’ into perspective, this report provides an overall ‘snapshot’ of current public and private construction industry sector opportunities and practices in the implementation and application of web-based ICT tools, systems and processes (e-Uptake). Research found that even with a reserved uptake, the construction industry and its participating organisations are making concerted efforts (fortunately with positive results) in taking up innovative forms of doing business via the internet, including e-Tendering (making it possible to manage the entire tender letting process electronically and online) (Anumba C.J. and Ruikar K. 2002; ITCBP 2003). Furthermore, Government (often a key client within the construction industry),and with its increased tendency to transact its business electronically, undoubtedly has an effect on how various private industry consultants, contractors, suppliers, etc. do business (Murray M. 2003) – by offering a wide range of (current and anticipated) e-facilities / services, including e-Tendering (Ecommerce 2002). Overall, doing business electronically is found to have a profound impact on the way today’s construction businesses operate - streamlining existing processes, with the growth in innovative tools, such as e-Tender, offering the construction industry new responsibilities and opportunities for all parties involved (ITCBP 2003). It is therefore important that these opportunities should be accessible to as many construction industry businesses as possible (The Construction Confederation 2001). Historically, there is a considerable exchange of information between various parties during a tendering process, where accuracy and efficiency of documentation is critical. Traditionally this process is either paper-based (involving large volumes of supporting tender documentation), or via a number of stand-alone, non-compatible computer systems, usually costly to both the client and contractor. As such, having a standard electronic exchange format that allows all parties involved in an electronic tender process to access one system only via the Internet, saves both time and money, eliminates transcription errors and increases speed of bid analysis (The Construction Confederation 2001). Supporting this research project’s aims and objectives, researchers set to determine today’s construction industry ‘current state-of-play’ in relation to e-Tendering opportunities. The report also provides brief introductions to several Australian and International e-Tender systems identified during this investigation. e-Tendering, in its simplest form, is described as the electronic publishing, communicating, accessing, receiving and submitting of all tender related information and documentation via the internet, thereby replacing the traditional paper-based tender processes, and achieving a more efficient and effective business process for all parties involved (NT Governement 2000; NT Government 2000; NSW Department of Commerce 2003; NSW Government 2003). Although most of the e-Tender websites investigated at the time, maintain their tendering processes and capabilities are ‘electronic’, research shows these ‘eTendering’ systems vary from being reasonably advanced to more ‘basic’ electronic tender notification and archiving services for various industry sectors. Research also indicates an e-Tender system should have a number of basic features and capabilities, including: • All tender documentation to be distributed via a secure web-based tender system – thereby avoiding the need for collating paperwork and couriers. • The client/purchaser should be able to upload a notice and/or invitation to tender onto the system. • Notification is sent out electronically (usually via email) for suppliers to download the information and return their responses electronically (online). • During the tender period, updates and queries are exchanged through the same e-Tender system. • The client/purchaser should only be able to access the tenders after the deadline has passed. • All tender related information is held in a central database, which should be easily searchable and fully audited, with all activities recorded. • It is essential that tender documents are not read or submitted by unauthorised parties. • Users of the e-Tender system are to be properly identified and registered via controlled access. In simple terms, security has to be as good as if not better than a manual tender process. Data is to be encrypted and users authenticated by means such as digital signatures, electronic certificates or smartcards. • All parties must be assured that no 'undetected' alterations can be made to any tender. • The tenderer should be able to amend the bid right up to the deadline – whilst the client/purchaser cannot obtain access until the submission deadline has passed. • The e-Tender system may also include features such as a database of service providers with spreadsheet-based pricing schedules, which can make it easier for a potential tenderer to electronically prepare and analyse a tender. Research indicates the efficiency of an e-Tender process is well supported internationally, with a significant number, yet similar, e-Tender benefits identified during this investigation. Both construction industry and Government participants generally agree that the implementation of an automated e-Tendering process or system enhances the overall quality, timeliness and cost-effectiveness of a tender process, and provides a more streamlined method of receiving, managing, and submitting tender documents than the traditional paper-based process. On the other hand, whilst there are undoubtedly many more barriers challenging the successful implementation and adoption of an e-Tendering system or process, researchers have also identified a range of challenges and perceptions that seem to hinder the uptake of this innovative approach to tendering electronically. A central concern seems to be that of security - when industry organisations have to use the Internet for electronic information transfer. As a result, when it comes to e-Tendering, industry participants insist these innovative tendering systems are developed to ensure the utmost security and integrity. Finally, if Australian organisations continue to explore the competitive ‘dynamics’ of the construction industry, without realising the current and future, trends and benefits of adopting innovative processes, such as e-Tendering, it will limit their globalising opportunities to expand into overseas markets and allow the continuation of international firms successfully entering local markets. As such, researchers believe increased knowledge, awareness and successful implementation of innovative systems and processes raises great expectations regarding their contribution towards ‘stimulating’ the globalisation of electronic procurement activities, and improving overall business and project performances throughout the construction industry sectors and overall marketplace (NSW Government 2002; Harty C. 2003; Murray M. 2003; Pietroforte R. 2003). Achieving the successful integration of an innovative e-Tender solution with an existing / traditional process can be a complex, and if not done correctly, could lead to failure (Bourn J. 2002).

Enhancing digital road map with lane details extracted from large-scale stereo aerial imagery using object-oriented image analysis

Precise, up-to-date and increasingly detailed road maps are crucial for various advanced road applications, such as lane-level vehicle navigation, and advanced driver assistant systems. With the very high resolution (VHR) imagery from digital airborne sources, it will greatly facilitate the data acquisition, data collection and updates if the road details can be automatically extracted from the aerial images. In this paper, we proposed an effective approach to detect road lane information from aerial images with employment of the object-oriented image analysis method. Our proposed algorithm starts with constructing the DSM and true orthophotos from the stereo images. The road lane details are detected using an object-oriented rule based image classification approach. Due to the affection of other objects with similar spectral and geometrical attributes, the extracted road lanes are filtered with the road surface obtained by a progressive two-class decision classifier. The generated road network is evaluated using the datasets provided by Queensland department of Main Roads. The evaluation shows completeness values that range between 76% and 98% and correctness values that range between 82% and 97%.

Chasing Reporters : Intertextuality, Entertainment and Public Knowledge

This paper examines ‘What Have We Learned From Current Affairs This Week?’: a very successful weekly segment from the ABC program The Chaser’s War on Everything. It argues that through its intertextual satire, this regular segment acts not as a traditional news program would in presenting news updates on current events, but as a text which reflects on the way news is reported and how this, in turn, may shape public discourse. While the program has been highly controversial (enduring many a loud call for it to be pulled from air), this form of light entertainment can play an important public service by encouraging citizens to ‘read through’ (Gray, 2006: 104) commercial current affairs’ façade of ‘quality’ journalism.