Clinical utility of a Web-enabled risk-assessment and clinical decision support program.

PURPOSE: Risk-stratified guidelines can improve quality of care and cost-effectiveness, but their uptake in primary care has been limited. MeTree, a Web-based, patient-facing risk-assessment and clinical decision support tool, is designed to facilitate uptake of risk-stratified guidelines. METHODS: A hybrid implementation-effectiveness trial of three clinics (two intervention, one control). PARTICIPANTS: consentable nonadopted adults with upcoming appointments. PRIMARY OUTCOME: agreement between patient risk level and risk management for those meeting evidence-based criteria for increased-risk risk-management strategies (increased risk) and those who do not (average risk) before MeTree and after. MEASURES: chart abstraction was used to identify risk management related to colon, breast, and ovarian cancer, hereditary cancer, and thrombosis. RESULTS: Participants = 488, female = 284 (58.2%), white = 411 (85.7%), mean age = 58.7 (SD = 12.3). Agreement between risk management and risk level for all conditions for each participant, except for colon cancer, which was limited to those <50 years of age, was (i) 1.1% (N = 2/174) for the increased-risk group before MeTree and 16.1% (N = 28/174) after and (ii) 99.2% (N = 2,125/2,142) for the average-risk group before MeTree and 99.5% (N = 2,131/2,142) after. Of those receiving increased-risk risk-management strategies at baseline, 10.5% (N = 2/19) met criteria for increased risk. After MeTree, 80.7% (N = 46/57) met criteria. CONCLUSION: MeTree integration into primary care can improve uptake of risk-stratified guidelines and potentially reduce "overuse" and "underuse" of increased-risk services.Genet Med 18 10, 1020-1028.

Thyroid volumes and urinary iodine in Swiss school children, 17 years after improved prophylaxis of iodine deficiency

Salt iodine content in Switzerland was raised from 7.5 to 15 mg per kg in 1980, and since then dietary iodine intake has been considered to be sufficient, even though a slight decrease due to imported food has recently been reported. The aim of this study was to establish normal values for thyroid volumes of school children who can be assumed to have had a sufficient iodine intake all their lifetime. Moreover, the present investigation was undertaken to verify that iodine sufficiency had been achieved equally in two regions each served by one of the two Swiss salt producers. Mean iodine concentration in urine spot samples from school children was 16.1 μg/dl, and it was identical in both the city of Lausanne (n=215) and the city of Solothurn (n=208). Thus it can be stated that in both cities (served by two different salt producers) iodine intake is equal and sufficient. Accordingly, thyroid volumes measured by ultrasound in school children aged 6 to 16 years were the same in both Lausanne (n=202) and Solothurn (n=207). Moreover, the age-adjusted median volumes at the 97th percentiles closely agree with and validate provisional international reference values recently proposed by the World Health Organisation and by the International Council for Control of Iodine Deficiency Disease.

A general approach to validating evacuation models with an application to EXODUS

Too often, validation of computer models is considered as a "once and forget" task. In this paper a systematic and graduated approach to evacua tion model validation is suggested.

Parallel implementation of the recurrence method for computing the power-spectral density of thin avalanche photodiodes

A simulation program has been developed to calculate the power-spectral density of thin avalanche photodiodes, which are used in optical networks. The program extends the time-domain analysis of the dead-space multiplication model to compute the autocorrelation function of the APD impulse response. However, the computation requires a large amount of memory space and is very time consuming. We describe our experiences in parallelizing the code using both MPI and OpenMP. Several array partitioning schemes and scheduling policies are implemented and tested Our results show that the OpenMP code is scalable up to 64 processors on an SGI Origin 2000 machine and has small average errors.

Computational fluid dynamics: advancements in technology for modeling iron and steelmaking processes

Computational fluid dynamics (CFD) software technology has formed the basis of many investigations into the behavior and optimization of primary iron and steelmaking processes for the last 25+ years. The objective of this contribution is to review the progress in CFD technologies over the last decade or so and how this can be brought to bear in advancing the process analysis capability of primary ferrous operations. In particular, progress on key challenges such as compute performance, fluid-structure transformation and interaction, and increasingly complex geometries are highlighted.

A fast, streaming SIMD extensions 2, logistic squashing function

Schraudolph proposed an excellent exponential approximation providing increased performance particularly suited to the logistic squashing function used within many neural networking applications. This note applies Intel's streaming SIMD Extensions 2 (SSE2), where SIMD is single instruction multiple data, of the Pentum IV class processor to Schraudolph's technique, further increasing the performance of the logistic squashing function. It was found that the calculation of the new 32-bit SSE2 logistic squashing function described here was up to 38 times faster than the conventional exponential function and up to 16 times faster than a Schraudolph-style 32-bit method on an Intel Pentum D 3.6 GHz CPU.

Venetian time and the meander

Argues that the past is necessary to architectural modernity for its self-definition. Goes on to look at Le Corbusier and the past in relation to his revolutionary architectural manifesto, 'Vers une architecture' (1923), and his and Tafuri's views on Venice. Also considers Le Corbusier's 'law of meander' as a strategy for urbanism and his Venice Hospital project

An Investigation into the Link between UK Credit Union Characterisitics, Location and their Success

The unique characteristics of credit unions reduces the information asymmetry that is prevalent in credit making decisions, enabling them to provide loans where other financial institutions cannot. This makes them a potential tool in the fight against financial exclusion. Yet, the UK credit union movement is not regarded as being successful, even though there is evidence of much financial exclusion. This study is cross sectional in form, and evaluates characteristics that may contribute to the success of the UK credit union movement at national and regional level, in 2000. The findings are used to consider the impact of recent regulatory changes on the movement. The key findings are that there is a significant relationship between the success of a credit union, its size and the deprivation of the ward from which it sources its members. More specifically, larger credit unions and those located in more affluent wards, are more successful. Affiliation to the Irish League of Credit Unions and having a common bond of occupation, are also found to be contributing factors to credit union success. These results are taken as providing support for the recent changes implemented by the Financial Services Authority (FSA), which is likely to result in the emergence of larger credit unions (through mergers), run by appropriately qualified persons, serving a more mixed-income membership base. It is, however, noted that the history of the UK movement is one of missed opportunities and only time will tell whether credit unions have the wherewithal to accept current opportunities.

Spanish Sociology and Anti-Semitism Between passed prejudice and key to civilization

There is a significant lack of sociological research in Spain about anti-Semitism. At the same time there are alarming anti-Semitic tendencies and anti-Jewish stereotypes which are above the European average. This article aims to explain this lack of sociological research about anti-Semitism in Spain. Therefore two types of explications are offered: on the one hand side some structural problems will be shown which sociology in general had since its beginnings and which complicate the understanding of anti-Semitism. Furthermore explications regarding the specific social and historic situation in Spain and of Spanish sociology in particular will be exposed. It will be shown that for its rationalistic character and with the exception of very few authors – who are considered marginalized for practical research – sociology in general has had enormous problems in understanding anti-Semitism. The specific historic situation, Francoism, the dispute about the historic memory and the delayed institutionalisation of sociology could also explain the lack of sociological interest in the topic especially in Spain. The article shows that the study of anti-Semitism is not only relevant for struggling against this burden of society in many of its variants. Furthermore, thinking about anti-Semitism can help sociology to recognise its own epistemological problems. It can serve to criticise and improve instruments of sociological research by showing the limitations of the sociological approach and to uncover the importance of interdisciplinary research for understanding specific social phenomena. In that sense, anti-Semitism, far from being a marginal subject, can be considered a key topic in the process of civilisation and it can help us to decipher the contemporary Spanish society.

Bradykinins and their precursor Cdnas from the skin of the Fire-Bellied Toad (Bombina orientalis)

Bradykinin and (Thr6)-bradykinin have been identified in the defensive skin secretion of the fire-bellied toad, Bombina orientalis. The homologous cDNAs for both peptides were cloned from a skin library using a 3'- and 5'-RACE strategy. Kininogen-1 (BOK-1) contained an open-reading frame of 167 amino acid residues encoding four repeats of bradykinin, and kininogen-2 (BOK-2) contained an open-reading frame of 161 amino acid residues encoding two repeats of (Thr6)-bradykinin. Alignment of both precursor nucleotide and amino acid sequences revealed a high degree of structural similarity. These amphibian skin kininogens/preprobradykinins are not biologically analogous to mammalian kininogens.

Pierre Bourdieu as a Sociologist of the Economy and Critic of 'Globalisation'

This article examines Pierre Bourdieu's sociology of the economy and his more recent politically engaged interventions on 'globalisation'. Many scholars regard these as not being in the same academic league as his classic studies on taste, academia, and state elites, etc., and, instead, dismiss them as a private matter or even, as the spleen of Pierre Bourdieu, the individual. This paper questions this disjunction of the 'academic' and 'politically engaged' sides of Pierre Bourdieu's work. First, it argues that his most recent interventions against a neo-liberal globalisation were the logical result of a particular definition of intellectual practice that had been outlined before in his sociology of the intellectual field. It then demonstrates that Bourdieu's economic sociology and critique of contemporary capitalism not only does not contradict his earlier research, but that it provides valuable and original insights into the current transformation of the political economy of the advanced capitalist countries. The paper concludes with a suggestion of how to strengthen the theoretical foundation of Bourdieu's analysis of contemporary capitalism by relating it to and making it compatible with alternative approaches in the tradition of critical political economy.