Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial.

BACKGROUND It is unclear whether radial compared with femoral access improves outcomes in unselected patients with acute coronary syndromes undergoing invasive management. METHODS We did a randomised, multicentre, superiority trial comparing transradial against transfemoral access in patients with acute coronary syndrome with or without ST-segment elevation myocardial infarction who were about to undergo coronary angiography and percutaneous coronary intervention. Patients were randomly allocated (1:1) to radial or femoral access with a web-based system. The randomisation sequence was computer generated, blocked, and stratified by use of ticagrelor or prasugrel, type of acute coronary syndrome (ST-segment elevation myocardial infarction, troponin positive or negative, non-ST-segment elevation acute coronary syndrome), and anticipated use of immediate percutaneous coronary intervention. Outcome assessors were masked to treatment allocation. The 30-day coprimary outcomes were major adverse cardiovascular events, defined as death, myocardial infarction, or stroke, and net adverse clinical events, defined as major adverse cardiovascular events or Bleeding Academic Research Consortium (BARC) major bleeding unrelated to coronary artery bypass graft surgery. The analysis was by intention to treat. The two-sided α was prespecified at 0·025. The trial is registered at ClinicalTrials.gov, number NCT01433627. FINDINGS We randomly assigned 8404 patients with acute coronary syndrome, with or without ST-segment elevation, to radial (4197) or femoral (4207) access for coronary angiography and percutaneous coronary intervention. 369 (8·8%) patients with radial access had major adverse cardiovascular events, compared with 429 (10·3%) patients with femoral access (rate ratio [RR] 0·85, 95% CI 0·74-0·99; p=0·0307), non-significant at α of 0·025. 410 (9·8%) patients with radial access had net adverse clinical events compared with 486 (11·7%) patients with femoral access (0·83, 95% CI 0·73-0·96; p=0·0092). The difference was driven by BARC major bleeding unrelated to coronary artery bypass graft surgery (1·6% vs 2·3%, RR 0·67, 95% CI 0·49-0·92; p=0·013) and all-cause mortality (1·6% vs 2·2%, RR 0·72, 95% CI 0·53-0·99; p=0·045). INTERPRETATION In patients with acute coronary syndrome undergoing invasive management, radial as compared with femoral access reduces net adverse clinical events, through a reduction in major bleeding and all-cause mortality. FUNDING The Medicines Company and Terumo.

Community College Student Participation in Undergraduate Research: An Explanatory Case Study for Faculty and Research Mentors

This study adapted the current model of science undergraduate research experiences (URE's) and applied this novel modification to include community college students. Numerous researchers have examined the efficacy of URE's in improving undergraduate retention and graduation rates, as well as matriculation rates for graduate programs. However, none have detailed the experience for community college students, and few have employed qualitative methodologies to gather relevant descriptive data from URE participants. This study included perspectives elicited from both non-traditional student participants and the established laboratory community. The purpose of this study was to determine the effectiveness of the traditional model for a non-traditional student population. The research effort described here utilized a qualitative design and an explanatory case study methodology. Six non-traditional students from the Maine Community College System participated in this study. Student participants were placed in six academic research laboratories located throughout the state. Student participants were interviewed three times during their ten-week internship and asked to record their personal reflections in electronic format. Participants from the established research community were also interviewed. These included both faculty mentors and other student laboratory personnel. Ongoing comparative analysis of the textual data revealed that laboratory organizational structure and social climate significantly influence acculturation outcomes for non-traditional URE participants. Student participants experienced a range of acculturation outcomes from full integration to marginalization. URE acculturation outcomes influenced development of non-traditional students? professional and academic self-concepts. Positive changes in students? self-concepts resulted in greater commitment to individual professional goals and academic aspirations. The findings from this study suggest that traditional science URE models can be successfully adapted to meet the unique needs of a non-traditional student population – community college students. These interpretations may encourage post-secondary educators, administrators, and policy makers to consider expanded access and support for non-traditional students seeking science URE opportunities.

An extended approach for service innovation study: an empirical research

Initially, service sector was defined as complementary to manufacturing sector. This situation has changed in recent times; services growth has resulted in a dominance of employment and economic activity in most developed nations and is becoming a key process for the competitiveness of their industrial sectors. New services related to commodities have become a strategy to differentiate their value proposition (Robinson et al., 2002). The service sector's importance is evident when evaluating its share in the gross domestic product. According to the World Bank (2011), in 2009, 74.8% of GDP in the euro area and 77.5% in United States were attributed to services. Globalization and use of information and communication technology has accelerated dissemination of knowledge and increasing customer expectations about services available worldwide. Innovation becomes essential to ensure that service organizations respond with appropriate products and services for each market segment. Customized and placed on time-tomarket new services require a more developed innovation process. Service innovation and new service development process are cited as one of the priorities for academic research in the following years (Karniouchina et al., 2005) This paper has the following objectives: -To present a model for the analysis of innovation process through the service value network, -To verify its applicability through an empirical research, and -To identify the path and mode of innovation for a group of studied organizations and to compare it with previous studies.

A proposal for a modular and application-aware autonomic manager of private cloud infrastructures

Recientemente, el paradigma de la computación en la nube ha recibido mucho interés por parte tanto de la industria como del mundo académico. Las infraestructuras cloud públicas están posibilitando nuevos modelos de negocio y ayudando a reducir costes. Sin embargo, una compañía podría desear ubicar sus datos y servicios en sus propias instalaciones, o tener que atenerse a leyes de protección de datos. Estas circunstancias hacen a las infraestructuras cloud privadas ciertamente deseables, ya sea para complementar a las públicas o para sustituirlas por completo. Por desgracia, las carencias en materia de estándares han impedido que las soluciones para la gestión de infraestructuras privadas se hayan desarrollado adecuadamente. Además, la multitud de opciones disponibles ha creado en los clientes el miedo a depender de una tecnología concreta (technology lock-in). Una de las causas de este problema es la falta de alineación entre la investigación académica y los productos comerciales, ya que aquella está centrada en el estudio de escenarios idealizados sin correspondencia con el mundo real, mientras que éstos consisten en soluciones desarrolladas sin tener en cuenta cómo van a encajar con los estándares más comunes o sin preocuparse de hacer públicos sus resultados. Con objeto de resolver este problema, propongo un sistema de gestión modular para infraestructuras cloud privadas enfocado en tratar con las aplicaciones en lugar de centrarse únicamente en los recursos hardware. Este sistema de gestión sigue el paradigma de la computación autónoma y está diseñado en torno a un modelo de información sencillo, desarrollado para ser compatible con los estándares más comunes. Este modelo divide el entorno en dos vistas, que sirven para separar aquello que debe preocupar a cada actor involucrado del resto de información, pero al mismo tiempo permitiendo relacionar el entorno físico con las máquinas virtuales que se despliegan encima de él. En dicho modelo, las aplicaciones cloud están divididas en tres tipos genéricos (Servicios, Trabajos de Big Data y Reservas de Instancias), para que así el sistema de gestión pueda sacar partido de las características propias de cada tipo. El modelo de información está complementado por un conjunto de acciones de gestión atómicas, reversibles e independientes, que determinan las operaciones que se pueden llevar a cabo sobre el entorno y que es usado para hacer posible la escalabilidad en el entorno. También describo un motor de gestión encargado de, a partir del estado del entorno y usando el ya mencionado conjunto de acciones, la colocación de recursos. Está dividido en dos niveles: la capa de Gestores de Aplicación, encargada de tratar sólo con las aplicaciones; y la capa del Gestor de Infraestructura, responsable de los recursos físicos. Dicho motor de gestión obedece un ciclo de vida con dos fases, para así modelar mejor el comportamiento de una infraestructura real. El problema de la colocación de recursos es atacado durante una de las fases (la de consolidación) por un resolutor de programación entera, y durante la otra (la online) por un heurístico hecho ex-profeso. Varias pruebas han demostrado que este acercamiento combinado es superior a otras estrategias. Para terminar, el sistema de gestión está acoplado a arquitecturas de monitorización y de actuadores. Aquella estando encargada de recolectar información del entorno, y ésta siendo modular en su diseño y capaz de conectarse con varias tecnologías y ofrecer varios modos de acceso. ABSTRACT The cloud computing paradigm has raised in popularity within the industry and the academia. Public cloud infrastructures are enabling new business models and helping to reduce costs. However, the desire to host company’s data and services on premises, and the need to abide to data protection laws, make private cloud infrastructures desirable, either to complement or even fully substitute public oferings. Unfortunately, a lack of standardization has precluded private infrastructure management solutions to be developed to a certain level, and a myriad of diferent options have induced the fear of lock-in in customers. One of the causes of this problem is the misalignment between academic research and industry ofering, with the former focusing in studying idealized scenarios dissimilar from real-world situations, and the latter developing solutions without taking care about how they f t with common standards, or even not disseminating their results. With the aim to solve this problem I propose a modular management system for private cloud infrastructures that is focused on the applications instead of just the hardware resources. This management system follows the autonomic system paradigm, and is designed around a simple information model developed to be compatible with common standards. This model splits the environment in two views that serve to separate the concerns of the stakeholders while at the same time enabling the traceability between the physical environment and the virtual machines deployed onto it. In it, cloud applications are classifed in three broad types (Services, Big Data Jobs and Instance Reservations), in order for the management system to take advantage of each type’s features. The information model is paired with a set of atomic, reversible and independent management actions which determine the operations that can be performed over the environment and is used to realize the cloud environment’s scalability. From the environment’s state and using the aforementioned set of actions, I also describe a management engine tasked with the resource placement. It is divided in two tiers: the Application Managers layer, concerned just with applications; and the Infrastructure Manager layer, responsible of the actual physical resources. This management engine follows a lifecycle with two phases, to better model the behavior of a real infrastructure. The placement problem is tackled during one phase (consolidation) by using an integer programming solver, and during the other (online) with a custom heuristic. Tests have demonstrated that this combined approach is superior to other strategies. Finally, the management system is paired with monitoring and actuators architectures. The former able to collect the necessary information from the environment, and the later modular in design and capable of interfacing with several technologies and ofering several access interfaces.

The Zebrafish Information Network (ZFIN): a resource for genetic, genomic and developmental research

The Zebrafish Information Network, ZFIN, is a WWW community resource of zebrafish genetic, genomic and developmental research information (http://zfin.org). ZFIN provides an anatomical atlas and dictionary, developmental staging criteria, research methods, pathology information and a link to the ZFIN relational database (http://zfin.org/ZFIN/). The database, built on a relational, object-oriented model, provides integrated information about mutants, genes, genetic markers, mapping panels, publications and contact information for the zebrafish research community. The database is populated with curated published data, user submitted data and large dataset uploads. A broad range of data types including text, images, graphical representations and genetic maps supports the data. ZFIN incorporates links to other genomic resources that provide sequence and ortholog data. Zebrafish nomenclature guidelines and an automated registration mechanism for new names are provided. Extensive usability testing has resulted in an easy to learn and use forms interface with complex searching capabilities.

Information needs of rural health professionals: a review of the literature

This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal libraries as their main sources of information. Rural practitioners, however, tend to make less use of journals and online databases and ask fewer clinical questions; a difference that correlates with geographic and demographic factors. Rural practitioners experience pronounced barriers to information access including lack of time, isolation, inadequate library access, lack of equipment, lack of skills, costs, and inadequate Internet infrastructure. Outreach efforts to this group of underserved health professionals must be sustained to achieve equity in information access and to change information-seeking behaviors.

Using WordNet relations and semantic classes in information retrieval tasks

In this paper we explore the use of semantic classes in an existing information retrieval system in order to improve its results. Thus, we use two different ontologies of semantic classes (WordNet domain and Basic Level Concepts) in order to re-rank the retrieved documents and obtain better recall and precision. Finally, we implement a new method for weighting the expanded terms taking into account the weights of the original query terms and their relations in WordNet with respect to the new ones (which have demonstrated to improve the results). The evaluation of these approaches was carried out in the CLEF Robust-WSD Task, obtaining an improvement of 1.8% in GMAP for the semantic classes approach and 10% in MAP employing the WordNet term weighting approach.

Information systems contracts and relationships: A Spanish perspective

Despite the proliferation of academic research on information systems outsourcing, not many studies analyze the characteristics of outsourcing contracts. This research aims to provide an in-depth description of information systems outsourcing. An additional objective is to examine how these characteristics evolve over time. Finally, this study reports on the usefulness of measuring such characteristics over time to assess the maturity level of the information systems outsourcing. This study gathers the data from the responses of the information systems managers of the largest Spanish firms to a questionnaire. This longitudinal study covers 12 years of research and compares authors' previous research results with the results of this study.

Immobilization technology seminar : speaker slide copies and supporting information /

EPA symbol on cover.

Assessing the geochemical fate of deep-well-injected hazardous wastes : summaries of recent research.

"July 1990."

Funds available in 1920 in the United States of America for the encouragement of scientific research.

Mode of access: Internet.

Bees and other pollinating insects research : a directory of USDA and state projects in CRIS /

"June 1987."

Aquaculture research : a directory of USDA and state projects in CRIS /

Mode of access: Internet.

Transfer of knowledge in fertilizer research and development with special emphasis on extending the TVA fertilizer program to developing countries /

Presented at A.I.D. Workshop on Research Information Networking, October 24-25, 1974, Washington, D.C.

Research in education.

Issues for Nov. 1966-Dec. 1967 have no vol. numbering but constitute v. 1-2.