Real-time decision aid display

Gemstone Team Future Firefighting Advancements

When the library is located in prime real estate: a case study on the loss of space from the Duke University Medical Center Library and Archives.

The Duke University Medical Center Library and Archives is located in the heart of the Duke Medicine campus, surrounded by Duke Hospital, ambulatory clinics, and numerous research facilities. Its location is considered prime real estate, given its adjacency to patient care, research, and educational activities. In 2005, the Duke University Library Space Planning Committee had recommended creating a learning center in the library that would support a variety of educational activities. However, the health system needed to convert the library's top floor into office space to make way for expansion of the hospital and cancer center. The library had only five months to plan the storage and consolidation of its journal and book collections, while working with the facilities design office and architect on the replacement of key user spaces on the top floor. Library staff worked together to develop plans for storing, weeding, and consolidating the collections and provided input into renovation plans for users spaces on its mezzanine level. The library lost 15,238 square feet (29%) of its net assignable square footage and a total of 16,897 (30%) gross square feet. This included 50% of the total space allotted to collections and over 15% of user spaces. The top-floor space now houses offices for Duke Medicine oncology faculty and staff. By storing a large portion of its collection off-site, the library was able to remove more stacks on the remaining stack level and convert them to user spaces, a long-term goal for the library. Additional space on the mezzanine level had to be converted to replace lost study and conference room spaces. While this project did not match the recommended space plans for the library, it underscored the need for the library to think creatively about the future of its facility and to work toward a more cohesive master plan.

Narrative centrality and negative affectivity: independent and interactive contributors to stress reactions.

Reactions to stressful negative events have long been studied using approaches based on either the narrative interpretation of the event or the traits of the individual. Here, we integrate these 2 approaches by using individual-differences measures of both the narrative interpretation of the stressful event as central to one's life and the personality characteristic of negative affectivity. We show that they each have independent contributions to stress reactions and that high levels on both produce greater than additive effects. The effects on posttraumatic stress symptoms are substantial for both undergraduates (Study 1, n = 2,296; Study 3, n = 488) and veterans (Study 2, n = 104), with mean levels for participants low on both measures near floor on posttraumatic stress symptoms and those high on both measures scoring at or above diagnostic thresholds. Study 3 included 3 measures of narrative centrality and 3 of negative affectivity to demonstrate that the effects were not limited to a single measure. In Study 4 (n = 987), measures associated with symptoms of posttraumatic stress correlated substantially with either measures of narrative centrality or measures of negative affectivity. The concepts of narrative centrality and negative affectivity and the results are consistent with findings from clinical populations using similar measures and with current approaches to therapy. In broad nonclinical populations, such as those used here, the results suggest that we might be able to substantially increase our ability to account for the severity of stress response by including both concepts.

Adjunctive albuterol enhances the response to enzyme replacement therapy in late-onset Pompe disease.

Effective dosages for enzyme replacement therapy (ERT) in Pompe disease are much higher than for other lysosomal storage disorders, which has been attributed to low cation-independent mannose-6-phosphate receptor (CI-MPR) in skeletal muscle. We have previously demonstrated the benefit of increased CI-MPR-mediated uptake of recombinant human acid-α-glucosidase during ERT in mice with Pompe disease following addition of albuterol therapy. Currently we have completed a pilot study of albuterol in patients with late-onset Pompe disease already on ERT for >2 yr, who were not improving further. The 6-min walk test (6MWT) distance increased in all 7 subjects at wk 6 (30±13 m; P=0.002), wk 12 (34±14 m; P=0.004), and wk 24 (42±37 m; P=0.02), in comparison with baseline. Grip strength was improved significantly for both hands at wk 12. Furthermore, individual subjects reported benefits; e.g., a female patient could stand up from sitting on the floor much more easily (time for supine to standing position decreased from 30 to 11 s), and a male patient could readily swing his legs out of his van seat (hip abduction increased from 1 to 2+ on manual muscle testing). Finally, analysis of the quadriceps biopsies suggested increased CI-MPR at wk 12 (P=0.08), compared with baseline. With the exception of 1 patient who succumbed to respiratory complications of Pompe disease in the first week, only mild adverse events have been reported, including tremor, transient difficulty falling asleep, and mild urinary retention (requiring early morning voiding). Therefore, this pilot study revealed initial safety and efficacy in an open label study of adjunctive albuterol therapy in patients with late-onset Pompe disease who had been stable on ERT with no improvements noted over the previous several years.

A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.

BACKGROUND: Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of anticoagulation management. We describe the development and preliminary validation of such an instrument - the Duke Anticoagulation Satisfaction Scale (DASS). METHODS: The DASS is a 25-item scale addressing the (a) negative impacts of anticoagulation (limitations, hassles and burdens); and (b) positive impacts of anticoagulation (confidence, reassurance, satisfaction). Each item has 7 possible responses. The DASS was administered to 262 patients currently receiving oral anticoagulation. Scales measuring generic quality of life, satisfaction with medical care, and tendency to provide socially desirable responses were also administered. Statistical analysis included assessment of item variability, internal consistency (Cronbach's alpha), scale structure (factor analysis), and correlations between the DASS and demographic variables, clinical characteristics, and scores on the above scales. A follow-up study of 105 additional patients assessed test-retest reliability. RESULTS: 220 subjects answered all items. Ceiling and floor effects were modest, and 25 of the 27 proposed items grouped into 2 factors (positive impacts, negative impacts, this latter factor being potentially subdivided into limitations versus hassles and burdens). Each factor had a high degree of internal consistency (Cronbach's alpha 0.78-0.91). The limitations and hassles factors consistently correlated with the SF-36 scales measuring generic quality of life, while the positive psychological impact scale correlated with age and time on anticoagulation. The intra-class correlation coefficient for test-retest reliability was 0.80. CONCLUSIONS: The DASS has demonstrated reasonable psychometric properties to date. Further validation is ongoing. To the degree that dissatisfaction with anticoagulation leads to decreased adherence, poorer INR control, and poor clinical outcomes, the DASS has the potential to help identify reasons for dissatisfaction (and positive satisfaction), and thus help to develop interventions to break this cycle. As an instrument designed to be applicable across multiple models of anticoagulation management, the DASS could be crucial in the scientific comparison between those models of care.

Innovations in learning and teaching approaches using game technologies - can "The Movies" teach how to make a movie?

The use of games technology in education is not a new phenomenon. Even back in the days of 286 processors, PCs were used in some schools along with (what looks like now) primitive simulation software to teach a range of different skills and techniques – from basic programming using Logo (the turtle style car with a pen at the back that could be used to draw on the floor – always a good way of attracting the attention of school kids!) up to quite sophisticated replications of physical problems, such as working out the trajectory of a missile to blow up an enemies’ tank. So why are games not more widely used in education (especially in FE and HE)? Can they help to support learners even at this advanced stage in their education? We aim to provide in this article an overview of the use of game technologies in education (almost as a small literature review for interested parties) and then go more in depth into one particular example we aim to introduce from this coming academic year (Sept. 2006) to help with teaching and assessment of one area of our Multimedia curriculum. Of course, we will not be able to fully provide the reader with data on how successful this is but we will be running a blog (http://themoviesineducation.blogspot.com/) to keep interested parties up to date with the progress of the project and to hopefully help others to set up similar solutions themselves. We will also only consider a small element of the implementation here and cover how the use of such assessment processes could be used in a broader context. The use of a game to aid learning and improve achievement is suggested because traditional methods of engagement are currently failing on some levels. By this it is meant that various parts of the production process we normally cover in our Multimedia degree are becoming difficult to monitor and continually assess.

Investigating the use of elevators for high-rise building evacuation through computer simulation

This paper presents a description of a new agent based elevator sub-model developed as part of the buildingEXODUS software intended for both evacuation and circulation applications. A description of each component of the newly developed model is presented, including the elevator kinematics and associated pedestrian behaviour. The elevator model is then used to investigate a series of full building evacuation scenarios based on a hypothetical 50 floor building with four staircases and a population of 7,840 agents. The analysis explores the relative merits of using up to 32 elevators (arranged in four banks) and various egress strategies to evacuate the entire building population. Findings from the investigation suggest that the most efficient evacuation strategy utilises a combination of elevators and stairs to empty the building and clear the upper half of the building in minimum time. Combined stair elevator evacuation times have been shown to be as much as 50% faster than stair only evacuation times.

Duty of care and slippery floors

Reflects on the scope of a shop owner's duty of care under the Occupiers' Liability Act 1957 to keep floors clear of spillages. Reviews the principles formulated by the Court of Appeal in Ward v Tesco Stores Ltd, including the evidential burden to show the discharge of the duty, and the approach adopted in subsequent cases. Discusses the High Court ruling in Piccolo v Larkstock Ltd (t/a Chiltern Flowers) on whether a small florist on Marylebone Station concourse was obliged to keep the floor dry and petal-free at all times and notes the importance of a proper system to safeguard customers.

The UK 9/11 evacuation study: Analysis of survivors’ recognition and response phase in WTC1

The September 11th 2001 impact on the World Trade Centre (WTC) resulted in one of the most significant evacuations of a high-rise building in modern times. The UK High-rise Evacuation Evaluation Database (HEED) study aimed to capture and collate the experiences and behaviours of WTC evacuees in a database, which would facilitate and encourage future research, which in turn would influence the design construction and use of safer built environments. A data elicitation tool designed for the purpose comprised a pre-interview questionnaire followed by a one-to-one interview protocol consisting of free-flow narratives and semi-structured interviews of WTC evacuees. This paper, which is one in a series dealing with issues relating to the successful evacuations of towers 1 and 2, focuses on cue recognition and response patterns within WTC1. Results are presented by vertical floor clusters and include information regarding cues experienced, activities prior and subsequent to occupants first becoming aware that something was wrong, perceived personal risk, time taken to respond and the inter-relationships between them. The results indicate differences in occupant activities across the floor clusters and suggest that these differences can be explained in terms of the perception of risk and the nature and extent of cues received by the participants.

Inhibition of prandial and waterspray-induced rat grooming by 8-OH-DPAT

In addition to its hyperphagic effect in rats, 8-OH-DPAT also reduces grooming, but it is uncertain whether the inhibition of grooming is a specific effect or a consequence of response competition from eating. The present experiments explored the effects of 8-OH-DPAT on periprandial grooming and grooming elicited by spraying rats with water. Momentary time sampling over 30 or 60 min, with behaviour scored in one of 6 or 7 (depending on food availability) mutually exclusive categories (feeding, active, scratching, face grooming, body grooming, genital grooming and resting) at 15s intervals, was used for data collection. Non-deprived rats were tested in the presence and absence of food and baseline grooming levels were manipulated by spraying the dorsal surface of the back with water. Data were submitted to ANOVA. The first experiment confirmed that 8-OH-DPAT increased food intake and that this was associated with a parallel increase in feeding observations; active observations were also increased, but resting and total grooming observations were reduced: scratching was reduced even at 0.003mg/kg, face- and body-grooming were reduced at doses > 0.03mg/kg and genital-grooming was least sensitive, only being reduced at 0.1mg/kg. The second experiment revealed that spraying with water had no effect on food intake, feeding or resting observations, but increased total grooming (largely due to increased body-grooming) and reduced activity observations. In rats sprayed with water, 8-OH-DPAT increased food intake (0.1mg/kg) and observations of feeding (0.003 & 0.1mg/kg), but total grooming was dose-dependently inhibited, with genital-grooming most sensitive(> 0.003mg/kg), followed by face-grooming (> 0.01mg/kg) and body-grooming (>0.03mg/kg), whilst low levels of scratching were unaffected. The final experiment tested water-sprayed rats in the absence of food: 8-OH-DPAT increased resting and reduced total grooming, mostly as a consequence of reductions in face- and body-grooming, but there were also modest reductions in scratching. These results confirm that 8-OH-DPAT has a suppressant effect on all aspects of grooming, except where there are probable floor effects, and that this is independent of response competition from increased eating.

Microsporidia-nematode associations in methane seeps reveal basal fungal parasitism in the deep sea

The deep sea is Earth’s largest habitat but little is known about the nature of deep-sea parasitism. In contrast to a few characterized cases of bacterial and protistan parasites, the existence and biological significance of deep-sea parasitic fungi is yet to be understood. Here we report the discovery of a fungus-related parasitic microsporidium, Nematocenator marisprofundi n. gen. n. sp. that infects benthic nematodes at Pacific Ocean methane seeps on the Pacific Ocean floor. This infection is species-specific and has been temporally and spatially stable over two years of sampling, indicating an ecologically consistent host-parasite interaction. A high distribution of spores in the reproductive tracts of infected males and females and their absence from host nematodes’ intestines suggests a sexual transmission strategy in contrast to the fecal-oral transmission of most microsporidia. N. marisprofundi targets the host’s body wall muscles causing cell lysis, and in severe infection even muscle filament degradation. Phylogenetic analyses placed N. marisprofundi in a novel and basal clade not closely related to any described microsporidia clade, suggesting either that microsporidia-nematode parasitism occurred early in microsporidia evolution or that host specialization occurred late in an ancient deep-sea microsporidian lineage. Our findings reveal that methane seeps support complex ecosystems involving interkingdom interactions between bacteria, nematodes, and parasitic fungi and that microsporidia parasitism exists also in the deep sea biosphere.

Influence of Manufacturing Tolerance on Aircraft Direct Operating Cost (DOC)

The influence of manufacturing tolerance on direct operating cost (DOC) is extrapolated from an engine nacelle to be representative of an entire aircraft body. Initial manufacturing tolerance data was obtained from the shop floor at Bombardier Aerospace Shorts, Belfast while the corresponding costs were calculated according to various recurring elements such as basic labour and overtime labour, rework, concessions, and redeployment; along with the non-recurrent costs due to tooling and machinery, etc. The relation of tolerance to cost was modelled statistically so that the cost impact of tolerance change could be ascertained. It was shown that a relatively small relaxation in the assembly and fabrication tolerances of the wetted surfaces resulted in reduced costs of production that lowered aircraft DOC, as the incurred drag penalty was predicted and taken into account during the optimisation process.

Judging Time Intevals using a model of perceptuo-motor control

Estimating a time interval and temporally coordinating movements in space are fundamental skills, but the relationships between these different forms of timing, and the neural processes that they incur, are not well understood. While different theories have been proposed to account for time perception, time estimation, and the temporal patterns of coordination, there are no general mechanisms which unify these various timing skills. This study considers whether a model of perceptuo-motor timing, the tau(GUIDE), can also describe how certain judgements of elapsed time are made. To evaluate this, an equation for determining interval estimates was derived from the tau(GUIDE) model and tested in a task where participants had to throw a ball and estimate when it would hit the floor. The results showed that in accordance with the model, very accurate judgements could be made without vision (mean timing error -19.24 msec), and the model was a good predictor of skilled participants' estimate timing. It was concluded that since the tau(GUIDE) principle provides temporal information in a generic form, it could be a unitary process that links different forms of timing.

Neurobiological model of visuo-spatial cognition in young Williams Syndrome children: measures of dorsal-stream and frontal function

We examine hypotheses for the neural basis of the profile of visual cognition in young children with Williams syndrome (WS). These are: (a) that it is a consequence of anomalies in sensory visual processing; (b) that it is a deficit of the dorsal relative to the ventral cortical stream; (c) that it reflects deficit of frontal function, in particular of fronto-parietal interaction; (d) that it is related to impaired function in the right hemisphere relative to the left. The tests reported here are particularly relevant to (b) and (c). They form part of a more extensive programme of investigating visual, visuospatial, and cognitive function in large group of children with WS children, aged 8 months to 15 years. To compare performance across tests, avoiding floor and ceiling effects, we have measured performance in children with WS in terms of the ‘age equivalence’ for typically developing children. In this paper the relation between dorsal and ventral function was tested by motion and form coherence thresholds respectively. We confirm the presence of a subgroup of children with WS who perform particularly poorly on the motion (dorsal) task. However, such performance is also characteristic of normally developingchildren up to 5 years: thus the WS performance may reflect an overall persisting immaturity of visuospatial processing which is particularly evident in the dorsal stream. Looking at the performance on the global coherence tasks of the entire WS group, we find that there is also a subgroup who have both high form and motion coherence thresholds, relative to the performance of children of the same chronological age and verbal age on the BPVS, suggesting a more general global processing deficit. Frontal function was tested by a counterpointing task, ability to retrieve a ball from a ‘detour box’, and the Stroop-like ‘day-night’ task, all of which require inhibition of a familiar response. When considered in relation to overall development as indexed by vocabulary, the day-night task shows little specific impairment, the detour box shows a significant delay relative to controls, and the counterpointing task shows a marked and persistent deficit in many children. We conclude that frontal control processes show most impairment in WS when they are associated with spatially directed responses, reflecting a deficit of fronto-parietal processing. However, children with WS may successfully reduce the effect of this impairment by verbally mediated strategies. On all these tasks we find a range of difficulties across individual children and a small subset of WS who show very good performance, equivalent to chronological age norms of typically developing children. Neurobiological models of visuo-spatial cognition in children with WS p.4 Overall, we conclude that children with WS have specific processing difficulties with tasks involving frontoparietal circuits within the spatial domain. However, some children with WS can achieve similar performance to typically developing children on some tasks involving the dorsal stream, although the strategies and processing may be different in the two groups.

Conditional cash transfer programs and the representations of poverty in Bolivia and Peru

Bolivia and Peru adopted the same instruments of social policy —conditional cash transfer programs— to solve the same public problems under different political regimes. By means of the qualitative methodology of discourse analysis, this paper studies the representations of poverty and State made by key actors of those social programs. Underlying more differences than similarities, one demonstrates that the same social policy is linked to opposite social representations of poverty and the State role in every country. The main explanation for this is, far from being imposed by international organizations, those programs are adopted and adapted by each political regime.