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Nested application conditions generalise the well-known negative application conditions and are important for several application domains. In this paper, we present Local Church-Rosser, Parallelism, Concurrency and Amalgamation Theorems for rules with nested application conditions in the framework of M-adhesive categories, where M-adhesive categories are slightly more general than weak adhesive high-level replacement categories. Most of the proofs are based on the corresponding statements for rules without application conditions and two shift lemmas stating that nested application conditions can be shifted over morphisms and rules.
Advanced mechatronic systems have to integrate existing technologies from mechanical, electrical and software engineering. They must be able to adapt their structure and behavior at runtime by reconfiguration to react flexibly to changes in the environment. Therefore, a tight integration of structural and behavioral models of the different domains is required. This integration results in complex reconfigurable hybrid systems, the execution logic of which cannot be addressed directly with existing standard modeling, simulation, and code-generation techniques. We present in this paper how our component-based approach for reconfigurable mechatronic systems, M ECHATRONIC UML, efficiently handles the complex interplay of discrete behavior and continuous behavior in a modular manner. In addition, its extension to even more flexible reconfiguration cases is presented.
Organizations continue building virtual working teams (Teleworkers) to become more dynamic as part of their strategic innovation, with great benefits to individuals, business and society. However, during such transformations it is important to note that effective knowledge communication is particularly difficult in distributed environments as well as in non-interactive settings, because the interlocutors cannot use gestures or mimicry and have to adapt their expressions without receiving any feedback, which may affect the creation of tacit knowledge. Collective Intelligence appears to be an encouraging alternative for creating knowledge. However, in this scenario it faces an important goal to be achieved, as the degree of ability of two or more individuals increases with the need to overcome barriers through the aggregation of separately processed information, whereby all actors follow similar conditions to participate in the collective. Geographically distributed organizations have the great challenge of managing people’s knowledge, not only to keep operations running, but also to promote innovation within the organization in the creation of new knowledge. The management of knowledge from Collective Intelligence represents a big difference from traditional methods of information allocation, since managing Collective Intelligence poses new requirements. For instance, semantic analysis has to merge information, coming both from the content itself and the social/individual context, and in addition, the social dynamics that emerge online have to be taken into account. This study analyses how knowledge-based organizations working with decentralized staff may need to consider the cognitive styles and social behaviors of individuals participating in their programs to effectively manage knowledge in virtual settings. It also proposes assessment taxonomies to analyze online comportments at the levels of the individual and community, in order to successfully identify characteristics to help evaluate higher effectiveness of communication. We aim at modeling measurement patterns to identify effective ways of interaction of individuals, taking into consideration their cognitive and social behaviors.
Economic impact of clinical decision support interventions based on electronic health records
(2020)
Background
Unnecessary healthcare utilization, non-adherence to current clinical guidelines, or insufficient personalized care are perpetual challenges and remain potential major cost-drivers for healthcare systems around the world. Implementing decision support systems into clinical care is promised to improve quality of care and thereby yield substantial effects on reducing healthcare expenditure. In this article, we evaluate the economic impact of clinical decision support (CDS) interventions based on electronic health records (EHR).
Methods
We searched for studies published after 2014 using MEDLINE, CENTRAL, WEB OF SCIENCE, EBSCO, and TUFTS CEA registry databases that encompass an economic evaluation or consider cost outcome measures of EHR based CDS interventions. Thereupon, we identified best practice application areas and categorized the investigated interventions according to an existing taxonomy of front-end CDS tools.
Results and discussion
Twenty-seven studies are investigated in this review. Of those, twenty-two studies indicate a reduction of healthcare expenditure after implementing an EHR based CDS system, especially towards prevalent application areas, such as unnecessary laboratory testing, duplicate order entry, efficient transfusion practice, or reduction of antibiotic prescriptions. On the contrary, order facilitators and undiscovered malfunctions revealed to be threats and could lead to new cost drivers in healthcare. While high upfront and maintenance costs of CDS systems are a worldwide implementation barrier, most studies do not consider implementation cost. Finally, four included economic evaluation studies report mixed monetary outcome results and thus highlight the importance of further high-quality economic evaluations for these CDS systems.
Conclusion
Current research studies lack consideration of comparative cost-outcome metrics as well as detailed cost components in their analyses. Nonetheless, the positive economic impact of EHR based CDS interventions is highly promising, especially with regard to reducing waste in healthcare.
With the spread of smart phones capable of taking high-resolution photos and the development of high-speed mobile data infrastructure, digital visual media is becoming one of the most important forms of modern communication. With this development, however, also comes a devaluation of images as a media form with the focus becoming the frequency at which visual content is generated instead of the quality of the content. In this work, an interactive system using image-abstraction techniques and an eye tracking sensor is presented, which allows users to experience diverting and dynamic artworks that react to their eye movement. The underlying modular architecture enables a variety of different interaction techniques that share common design principles, making the interface as intuitive as possible. The resulting experience allows users to experience a game-like interaction in which they aim for a reward, the artwork, while being held under constraints, e.g., not blinking. The co nscious eye movements that are required by some interaction techniques hint an interesting, possible future extension for this work into the field of relaxation exercises and concentration training.
A treemap is a visualization that has been specifically designed to facilitate the exploration of tree-structured data and, more general, hierarchically structured data. The family of visualization techniques that use a visual metaphor for parent-child relationships based “on the property of containment” (Johnson, 1993) is commonly referred to as treemaps. However, as the number of variations of treemaps grows, it becomes increasingly important to distinguish clearly between techniques and their specific characteristics. This paper proposes to discern between Space-filling Treemap TS, Containment Treemap TC, Implicit Edge Representation Tree TIE, and Mapped Tree TMT for classification of hierarchy visualization techniques and highlights their respective properties. This taxonomy is created as a hyponymy, i.e., its classes have an is-a relationship to one another: TS TC TIE TMT. With this proposal, we intend to stimulate a discussion on a more unambiguous classification of treemaps and, furthermore, broaden what is understood by the concept of treemap itself.
The demand for peer-to-peer ridesharing services increased over the last years rapidly. To cost-efficiently dispatch orders and communicate accurate pick-up times is challenging as the current location of each available driver is not exactly known since observed locations can be outdated for several seconds. The developed trajectory visualization tool enables transportation network companies to analyze dispatch processes and determine the causes of unexpected delays. As dispatching algorithms are based on the accuracy of arrival time predictions, we account for factors like noise, sample rate, technical and economic limitations as well as the duration of the entire process as they have an impact on the accuracy of spatio-temporal data. To improve dispatching strategies, we propose a prediction approach that provides a probability distribution for a driver’s future locations based on patterns observed in past trajectories. We demonstrate the capabilities of our prediction results to ( i) avoid critical delays, (ii) to estimate waiting times with higher confidence, and (iii) to enable risk considerations in dispatching strategies.
Gait analysis is an important tool for the early detection of neurological diseases and for the assessment of risk of falling in elderly people. The availability of low-cost camera hardware on the market today and recent advances in Machine Learning enable a wide range of clinical and health-related applications, such as patient monitoring or exercise recognition at home. In this study, we evaluated the motion tracking performance of the latest generation of the Microsoft Kinect camera, Azure Kinect, compared to its predecessor Kinect v2 in terms of treadmill walking using a gold standard Vicon multi-camera motion capturing system and the 39 marker Plug-in Gait model. Five young and healthy subjects walked on a treadmill at three different velocities while data were recorded simultaneously with all three camera systems. An easy-to-administer camera calibration method developed here was used to spatially align the 3D skeleton data from both Kinect cameras and the Vicon system. With this calibration, the spatial agreement of joint positions between the two Kinect cameras and the reference system was evaluated. In addition, we compared the accuracy of certain spatio-temporal gait parameters, i.e., step length, step time, step width, and stride time calculated from the Kinect data, with the gold standard system. Our results showed that the improved hardware and the motion tracking algorithm of the Azure Kinect camera led to a significantly higher accuracy of the spatial gait parameters than the predecessor Kinect v2, while no significant differences were found between the temporal parameters. Furthermore, we explain in detail how this experimental setup could be used to continuously monitor the progress during gait rehabilitation in older people.
How We Found Our IMU
(2020)
Inertial measurement units (IMUs) are commonly used for localization or movement tracking in pervasive healthcare-related studies, and gait analysis is one of the most often studied topics using IMUs. The increasing variety of commercially available IMU devices offers convenience by combining the sensor modalities and simplifies the data collection procedures. However, selecting the most suitable IMU device for a certain use case is increasingly challenging. In this study, guidelines for IMU selection are proposed. In particular, seven IMUs were compared in terms of their specifications, data collection procedures, and raw data quality. Data collected from the IMUs were then analyzed by a gait analysis algorithm. The difference in accuracy of the calculated gait parameters between the IMUs could be used to retrace the issues in raw data, such as acceleration range or sensor calibration. Based on our algorithm, we were able to identify the best-suited IMUs for our needs. This study provides an overview of how to select the IMUs based on the area of study with concrete examples, and gives insights into the features of seven commercial IMUs using real data.
Rapid decline of glomerular filtration rate estimated from creatinine (eGFRcrea) is associated with severe clinical endpoints. In contrast to cross-sectionally assessed eGFRcrea, the genetic basis for rapid eGFRcrea decline is largely unknown. To help define this, we meta-analyzed 42 genome-wide association studies from the Chronic Kidney Diseases Genetics Consortium and United Kingdom Biobank to identify genetic loci for rapid eGFRcrea decline. Two definitions of eGFRcrea decline were used: 3 mL/min/1.73m(2)/year or more ("Rapid3"; encompassing 34,874 cases, 107,090 controls) and eGFRcrea decline 25% or more and eGFRcrea under 60 mL/min/1.73m(2) at follow-up among those with eGFRcrea 60 mL/min/1.73m(2) or more at baseline ("CKDi25"; encompassing 19,901 cases, 175,244 controls). Seven independent variants were identified across six loci for Rapid3 and/or CKDi25: consisting of five variants at four loci with genome-wide significance (near UMOD-PDILT (2), PRKAG2, WDR72, OR2S2) and two variants among 265 known eGFRcrea variants (near GATM, LARP4B). All these loci were novel for Rapid3 and/or CKDi25 and our bioinformatic follow-up prioritized variants and genes underneath these loci. The OR2S2 locus is novel for any eGFRcrea trait including interesting candidates. For the five genome-wide significant lead variants, we found supporting effects for annual change in blood urea nitrogen or cystatin-based eGFR, but not for GATM or (LARP4B). Individuals at high compared to those at low genetic risk (8-14 vs. 0-5 adverse alleles) had a 1.20-fold increased risk of acute kidney injury (95% confidence interval 1.08-1.33). Thus, our identified loci for rapid kidney function decline may help prioritize therapeutic targets and identify mechanisms and individuals at risk for sustained deterioration of kidney function.