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Despite many benefits, the extensive deployment of Health Information Technology (HIT) systems by healthcare organizations has encountered many challenges, particularly in the field of telemetry concerning patient monitoring and its operational workflow. These challenges can add more layers of complexity when an unplanned software security patching is performed, affecting patient monitoring and causing disruption in daily clinical operations. This study is a reflection on what happened associated with software security patching and why it happened through the lens of an incident report to develop potential preventive and corrective strategies using qualitative analyses--inductive and deductive approaches. There is a need for such analyses to identify the underlying mechanism behind such issues since very limited research has been conducted on the study of software patching. The incident was classified as a "software functionality" issue, and the consequence was an "incident with a noticeable consequence but no patient harm", and the contributing factor was a software update, i.e., software security patching. This report describes how insufficient planning of software patching, lack of training for healthcare professionals, contingency planning on unplanned system disruption, and HIT system configuration can compromise healthcare quality and cause risks to patient safety. We propose 15 preventive and corrective strategies grouped under four key areas based on the system approach and socialtechnical aspects of the patching process. The key areas are (i) preparing, developing, and deploying patches; (ii) training the frontline operators; (iii) ensuring contingency planning; and (iv) establishing configuration and communication between systems. These strategies are expected to minimize the risk of HIT-related incidents, enhance software security patch management in healthcare organizations, and improve patient safety. However, further discussion should be continued about general HIT problems connected to software security patching. [ABSTRACT FROM AUTHOR]

• Collection efficiency estimates are necessary for accurate emissions modeling. • Measured collection efficiency data categorized and compared with current defaults. • Cover type was statistically significant indicator of collection efficiency. • Results: 41% efficiency for daily cover, 69 % for intermediate, and 71 % for final. • New defaults greatly reduce discrepancy between modeled and measured estimates. Landfill methane emissions are commonly estimated using cover-type dependent default collection efficiency values, with a first-order decay model or measured gas collection. Current default collection efficiencies used in the United States were predominately derived from 4 studies conducted during or prior to 2007 that relied on flux chambers. Flux chambers are limited by small sample sizes, placement restrictions, and the inability to measure emissions from gas or leachate collection systems. Since 2007, over 14 new studies have been completed using more advanced technologies that allow for direct measurement of methane plumes from most or all of a landfill's surface. On average, these measurements are 2–3 times greater than emissions predicted by current models and collection efficiency defaults. In lieu of measuring emissions from all landfills, updating collection efficiency defaults can bring modeled emissions into better alignment with measurements. To this end, collection efficiency estimates derived from measured data were categorized into cover types and then adjusted to account for cases where whole plume measurement was an amalgamation of multiple cover types. The resultant adjusted default values were 41% for daily cover, 69% for intermediate cover, and 71% for final cover. Direct measurement of landfill methane emissions is preferrable to account for the full range of variables driving landfill emissions, including collection system design and operation. However, applying these updated defaults back into the landfill emission models eliminates underprediction of landfill emissions for the dataset reviewed, and would provide a more accurate estimate of landfill gas emissions where measurements are unavailable. [ABSTRACT FROM AUTHOR]

Enslaved people in the US South lived in a system designed to exploit their labor in pursuit of profit. This historiographical essay considers key questions about labor and power raised in the previous two decades of scholarship on antebellum slavery. What were the forms and meanings of enslaved people's politics, and how can we track them through the archive? How was slavery connected to other phenomena including empire and capitalism in the early United States? In pursuing these questions, scholars have illuminated the history of slavery at different scales, ranging from the lived experiences of bound workers to transatlantic networks of commerce and credit through which the products of enslaved labor moved. This essay considers some of the different ways recent historians have worked to understand the institution of slavery, with a particular focus on the question of how closely their approaches bring us to understanding the shape of enslaved humanity. [ABSTRACT FROM AUTHOR]

For nearly 20 years, prominent perfusionists have called for a perfusion-centric prospective incident-reporting system to collect near-miss and patient harm incidents that occur during clinical practice in the United States. In this article, we describe the development of a widely available prospective incident-reporting system for use by perfusionists in the United States. The system was developed in three phases: literature review, system incorporation, and submission for listing as a Patient Safety Organization (PSO). It is anticipated that the knowledge gained from analysis of events contributed to this PSO-protected reporting system will lead to improvements in safety and quality of perfusion services, as well as expanding the understanding of best practices in training, equipment use, system design, and simulation scenarios. [ABSTRACT FROM AUTHOR]

Aquaponics is an agricultural practice incorporating aquaculture and hydroponic principles. This study assesses the current system design and production practices of the aquaponic industry, compares these metrics by stakeholder group, identifies trends, and provides recommendations for future development. An electronic survey of aquaponic stakeholders was conducted from December 2019 to June 2020 targeting hobbyists, producers, and educators from various aquaponic-focused professional associations, email and social media groups. Of 378 total responses, 84% came from the United States and were clustered in plant hardiness zones five to nine. Aquaponic systems were commonly homemade/do-it-yourself (DIY), many of which incorporated commercially available (turn-key) technology. Most growers used coupled systems that integrated recirculating aquaculture systems and either deep-water culture (DWC) or media bed hydroponic units. Common plant lighting sources were sunlight and light emitting diode (LED). Water sources were typically municipal or wells. Personal labor input was typically less than 20 hrs/wk. Funding sources were primarily personal funds, followed by government grants, and private investor funds. System sizes varied greatly, but the median area was 50 to 500 ft2 for hobbyists and educators and 500 to 3,000 ft2 for producers. Respondents commonly sold vegetable produce, training and education, food fish, and microgreens. Tilapia and ornamental fish were commonly grown, with 16 other species reported. Common crops were lettuce, leafy greens, basil, tomatoes, peppers, and herbs with many additional lesser-grown crops reported, including cannabis. Overall, the industry still growing, with a large portion of stakeholders having less than two years of experience. However, veteran growers have remained in operation, particularly in the producer and educator groups. The survey results suggest a shift away from outdoor systems, media beds, tomatoes, ornamental fish, and perch production, and a shift toward decoupled systems, DWC, drip irrigation, and wicking beds, larger system area, leafy greens, and trout/salmon production compared to previous industry surveys. The reduced diversity of plant species grown suggest some level of crop standardization. Commercial producers tended to sell more types of products than other stakeholders, suggesting that diversification of offerings may be key to profitability. The combined production area specified by respondents indicates the industry has grown substantially in recent years. Finally, the presence of bank loan-funded operations suggests increased knowledge and comfort with aquaponics among lenders. [ABSTRACT FROM AUTHOR]

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Radiation therapy is a critical component for curative and palliative treatment of cancer and is used in more than half of all patients with cancer. Yet there is a global shortage of access to this treatment, especially in Sub-Saharan Africa, where there is a shortage of technical staff as well as equipment. Linear accelerators (LINACs) offer state-of-the-art treatment, but this technology is expensive to acquire, operate and service, especially for low- and middle-income countries (LMICs), and often their harsh environment negatively affects the performance of LINACs, causing downtime. A global initiative was launched in 2016 to address the technology and system barriers to providing radiation therapy in LMICs through the development of a novel LINAC-based radiation therapy system designed for their challenging environments. As the LINAC prototype design phase progressed, it was recognised that additional information was needed from LMICs on the performance of LINAC components, on variables that may influence machine performance and their association, if any, with equipment downtime. Thus, a survey was developed to collect these data from all countries in Africa that have LINAC-based radiation therapy facilities. In order to understand the extent to which these performance factors are the same or different in high-income countries, facilities in Canada, Switzerland, the UK and the USA were invited to participate in the survey, as was Jordan, a middle-income country. Throughout this process, LMIC representatives have provided input on technology challenges in their respective countries. This report presents the method used to conduct this multilevel study of the macro- and microenvironments, the organisation of departments, the technology, the training and the service models that will provide input into the design of a LINAC prototype for a LINAC-based radiation therapy system that will improve access to radiation therapy and thus improve cancer treatment outcomes. It is important to note that new technology should be introduced in a contextual manner so as not to disrupt existing health systems inadvertently, especially with regards to existing staffing, infrastructure and socioeconomic issues. A detailed analysis of data is underway and will be presented in a follow-up report. Selected preliminary results of the study are the observation that LINAC-based facilities in LMICs experience downtime associated with failures in multileaf collimators and vacuum pumps, as well as power instability. Also, that there is a strong association of gross national product per capita with the number of LINACs per population. • Shortage of access to LINAC-based radiation therapy treatment in LMICs. • Addressing the technology and system barriers to providing radiation therapy in LMICs. • Building a collaboration with grassroot partners in Africa with radiation therapy-LINACs. • Surveying and collected data from all 28 countries in Africa that have LINAC-based radiation therapy. • Initial result showing downtime associated with multileaf collimators, vacuum pumps as well as power instability. • Provide input for prototype design for novel LINAC for harsh environments. [ABSTRACT FROM AUTHOR]

Objective: The Pharma Collaboration for Transparent Medical Information (phactMI™) benchmarking survey was conducted to evaluate the use of technology and websites associated with the medical information (MI) departments of 27 biopharmaceutical companies in the United States. Methods: The e-survey was administered to phactMI™ members between December 2017 and February 2018 and included closed and open-ended questions with 7 distinct categories: existence of a MI website, content type available following a search query, website functions, search engine optimization (SEO), website traffic, internal communications/analytics, and additional technology capabilities. Results: Survey findings noted that 20 companies own a MI-specific website through which MI services are provided to healthcare providers (HCPs). When asked about the dissemination of MI content through varying formats, survey results indicated Portable Document Format (PDF) to be the most common (18/27), followed by videos (8/27), presentations (5/27), infographics (3/27), and Hypertext Markup Language (3/27). Many companies have a responsive design website (19/25), webform (24/25), and a 1–800 number (22/25) for MI services. Few companies have a live chat (10/25) or a chatbot (1/25) and 9 of 25 said that content is searchable on Google™. Although website traffic varied among companies, a significant driver of this appeared to be whether the site is indexed. Conclusion: While most of the member companies have a MI website, there is significant room for improvement in content formats available as part of a search. Traditional website features, such as search functionality and webform, are commonly available on websites; however, newer technologies, such as chatbot and live chat, are less featured. Across most member companies, there is also a need for improvement in increasing website traffic, Google™ indexing, and SEO. [ABSTRACT FROM AUTHOR]

Web-based information systems designed to increase access to species occurrence data for use in research and natural resource decision-making have become more prevalent over the past few decades. The effectiveness of these systems depends on their usability and extent of use by their intended audiences. We conducted an online survey of academics and government professionals in the United States to compare their species occurrence data needs and their perceptions and use of web-based species occurrence information systems. Our results indicate that although views and perceptions held by academics and government professionals about the importance, usefulness, and ease of use of these information systems tend to be similar, there were differences in their use of species occurrence data and web-based species occurrence information systems. The baseline information obtained in this study will help inform future directions for improvements in species occurrence information systems. [ABSTRACT FROM AUTHOR]

This article develops a methodology to compare the quality of examination services in three major patent systems. Quality is defined as the extent to which patent systems comply with the patentability conditions in a transparent way. The methodology consists of a two-layer analytical framework encompassing “legal standards” (LS) and their “operational design” (OD) which includes several interdependent components that affect the stringency and transparency of the filtering process. The comparison of patent systems in Europe, Japan, and the United States shows that their operational designs differ substantially: the European system provides higher-quality and more expensive examination services than the United States one, while the Japanese Patent system is in an intermediate position. The results illustrate that different system designs lead to different outcomes in terms of backlogs, patent propensity, and the number of dubious patent rights in force. In this respect, these findings (i) provide an empirical validation of the conjecture of a vicious cycle linking the quality of examination and demand for patents and (ii) highlight the need for a multifaceted convergence of patent systems before mutual recognition is put in place. [ABSTRACT FROM PUBLISHER]

Energy systems are currently designed focusing only on minimizing their cost or, at most, including limits on greenhouse gas emissions. Unfortunately, electricity technologies performing well in global warming potential might not necessarily behave equally well across other sustainability criteria. Hence, policies focused solely on mitigating greenhouse gas emissions could potentially resolve one problem (i.e., climate change) by creating another, thereby leading to burden-shifting. Here, the occurrence and severity of burden-shifting in energy systems design are both investigated through the application of a novel approach integrating multi-objective optimization, life cycle assessment and multivariate regression based on elasticities. Environmental impacts are classified into three categories: no burden-shifting, total burden-shifting and partial burden-shifting, providing for the latter two a measure of their severity. Due to inherent trade-offs in the life cycle performance of technologies, discussed in detail in this work, the Paris Agreement 2 °C targets would lead to burden-shifting in the United States (total or partial) in up to eight environmental impacts. On the other hand, stringent carbon emissions reductions in line with the 1.5 °C targets can lead to burden-shifting in three environmental impacts. Indeed, in both cases undesirable increases in some damage categories of up to 1.64% for every percentage increase in cost can take place as a result of more stringent limits on greenhouse gas emissions compared to the least cost solution. Overall, this work aims to foster fruitful discussions on how to generate energy within the Earth's ecological capacity by expanding the analysis beyond climate change. • Policies focused solely on climate change could worsen other life cycle impacts. • A framework is developed to assess trade-offs between environmental metrics. • Five sub-categories of burden-shifting across life cycle impacts are found. • 2 °C emissions mitigation pathways could induce burden-shifting in eight impacts. • 1.5 °C emissions mitigation pathways could induce burden-shifting in three impacts. [ABSTRACT FROM AUTHOR]

• Rebalancing the bikes is the biggest contributor of CO 2 emissions for both systems. • Replacing car trip with bike sharing is critical to gain environmental benefits through BSS. • Prolonging the service time of docks is an efficient way to reduce environmental footprints of station -based systems. • Increasing the bike utilization level is key to gain environmental benefits from the dock-less systems. Bike sharing system (BSS) is growing worldwide. Although bike sharing is viewed as a sustainable transportation mode, it still has environmental footprints from its operation (e.g., bike rebalancing using automobiles) and upstream impacts (e.g., bike manufacturing). Thus, evaluating the environmental impacts of BSS from the life cycle perspective is vital to inform decision making for the system design and operation. In this study, we conducted a comparative life cycle assessment (LCA) of station-based and dock-less BSS in the U.S. The results show that dock-less BSS has a greenhouse gas (GHG) emissions factor of 118 g CO 2- eq/bike-km in the base scenario, which is 82% higher than the station-based system. Bike rebalancing is the main source of GHG emissions, accounting for 36% and 73% of the station-based and dock-less systems, respectively. However, station-based BSS has 54% higher total normalized environmental impacts (TNEI), compared to dock-less BSS. The dock manufacturing dominants the TNEI (61%) of station-based BSS and the bike manufacturing contributes 52% of TNEI in dock-less BSS. BSS can also bring environmental benefits through substituting different transportation modes. Car trip replacement rate is the most important factor. The results suggest four key approaches to improve BSS environmental performance: 1) optimizing the bike distribution and rebalancing route or repositioning bikes using more sustainable approaches, 2) incentivizing more private car users to switch to using BSSs, 3) prolonging lifespans of docking infrastructure to significantly reduce the TNEI of station-based systems, and 4) increasing the bike utilization efficiency to improve the environmental performance of dock-less systems. [ABSTRACT FROM AUTHOR]

Consumers and companies are increasingly concerned about fake reviews posted online. To make appropriate managerial decisions about online reviews, it is crucial to understand what drives consumer trust in online reviews. Research examining the linkage between online reviews and trust is sporadic and lacks a comprehensive framework. To address this gap, this research investigates the individual and joint impact of three review attributes—valence, rationality, and source—on the benevolence, ability, and integrity dimensions of trustworthiness of the reviewer, which further determines trust in online reviews. Using behavioral experiments, the study finds that positive reviews, factual reviews, and reviews appearing on social networks lead to perceptions of greater benevolence, ability, and integrity than negative reviews, emotional reviews, and reviews appearing on retailer sites, respectively. In addition, review rationality and review source moderate the link between review valence and the dimensions of reviewer trustworthiness: the effect of valence is stronger for emotional reviews than for factual reviews and for retailer sites than for social networks. Furthermore, the study analyzes data from the United States and China to examine generalizability and cultural nuances of the proposed relationships. This study provides important insights into consumer trust in online reviews and offers guidelines for decision making in communication strategy, system design, and operations by manufacturers, retailers, service providers, and online platforms to more effectively manage online reviews. [ABSTRACT FROM AUTHOR]

The majority of interface delay research and practitioner literature recommends minimizing delay as much as possible. However, a very limited number of studies have identified cultural chronism which may make the desirability of trading functionality and resources for minimal delays inappropriate within certain populations. Specifically, members of monochronic cultures highly value speed in system response, while those of polychronic cultures do not. This current study extends existing literature to investigate a previously unexplored culture and subculture, respectively, Han Chinese and African Americans, and their attitudes toward download delay and trading download delay for better functionality. [ABSTRACT FROM AUTHOR]

The article discusses possible reasons for the slow adoption of advanced manufacturing systems by the U.S. International comparisons show that in terms of employing computer-integrated manufacturing (CIM) the U.S. lags behind Japan and several Western European countries. Experts say a major cause of the slow adoption is the failure to adapt U.S. organizations and work practices to the new technologies. They recommend using a "sociotechnical systems approach" as a framework for guiding the change process.

Electronic health record (EHR) use throughout the United States has advanced considerably, but functionality to support the optimal care of children has been slower to develop and deploy. A previous team of experts systematically identified gaps in EHR functionality during collaborative work from 2010 to 2013 that produced the Children's EHR Format (Format), funded under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. After that, a team of practitioners, software developers, health policy leaders, and other stakeholders examined the Format's exhaustive list of 547 EHR functional requirements in 26 topic areas and found them to be valuable but in need of further refinement and prioritization. Work began in 2014 to develop a shortened high priority list of requirements and provide guidance to improve their use, Through a modified Delphi process that included key document review, selection criteria, multiple rounds of voting, and small group discussion, a multistakeholder work group identified and refined 47 items on the basis of earlier requirements to form the 2015 Children's EHR Format Priority List and developed 16 recommended uses of the Format. The full report of the Format enhancement activities is publicly available. In this article, we aim to promote awareness of these high priority EHR functional requirements for the care of children, sharpen industry focus on adopting these changes, and align all stakeholders in prioritizing specific health information technology functionalities including those essential for well-child preventive care, medication management, immunization tracking, and growth data for specific pediatric subgroups. [ABSTRACT FROM AUTHOR]

Control is and will continue to be a key discipline for realizing the objectives of smart grid initiatives. Research in control science and engineering is not limited to one or a few application concepts but is pervasive across the smart grid ecosystem. The principal contribution of this paper is to review, from a system-architectural perspective, how control enables smart grid applications. Application “templates” are presented for direct load control, automated demand response, microgrid optimization, control for distribution grids, wide-area control, and market-centric control. Technological developments, including in power electronics, that are enabling smart grid control research and applications are also itemized and two cross-cutting needs/opportunities for future research discussed. We conclude with a summary of a recent status report on the progress that has been made in the United States, noting also the challenges to further progress, in renewable generation, energy efficiency, and carbon reduction. [ABSTRACT FROM PUBLISHER]

Objective To describe the National Violent Death Reporting System (NVDRS). This is a surveillance system for monitoring the occurrence of homicides, suicides, unintentional firearm deaths, deaths of undetermined intent, and deaths from legal intervention (excluding legal executions) in the US. Design This report provides information about the history, scope, data variables, processes, utility, limitations, and future directions of the NVDRS. Results The NVDRS currently operates in 32 states, with the goal of future expansion to all 50 states, the District of Columbia, and US territories. The system uses existing primary data sources (death certificates, coroner/ medical examiner reports, and law enforcement reports), and links them together to provide a comprehensive picture of the circumstances surrounding violent deaths. Conclusions This report provides an overview of the NVDRS including a description of the system, discussion of its expanded capability, the use of new technologies as the system has evolved, how the data are being used for violence prevention efforts, and future directions. [ABSTRACT FROM AUTHOR]

The article discusses survey findings on the change of electronic health record (EHR) systems being used by family physicians (FPs) as of July - September 2014. Topics covered include the shift of more FP practices from the Centricity electronic medical record (EMR) system to EpiCare Ambulatory and from AllScripts Professional EHR to Praxis. Also mentioned are reasons for shifting including meaningful use (MU), additional functionality and consolidation of multiple EHRs for more savings.

Objectives The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. Design and Sample We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Measures Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Results Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Conclusion Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between sight distance parameters, crash rates, and operating speeds at low-volume single-lane roundabouts in the United States. The understanding of the interaction of design, operations, and crash performance is a step forward in the development and application of performance-based standards for roundabouts. The specific objective of this paper is to quantify the relationship between crash rates, sight distance parameters, and operating speeds to present an approach to establishing performance-based standards that highway practitioners can adopt in roundabout design. Geometric, traffic, and crash data were collected on 72 approaches to 19 low-volume single-lane roundabouts in six states. The data for these sites were broken into two groups based on the posted speed limit (at and greater than ). In addition, the associations between different sight distance parameters, crash parameters, and operating speed data were investigated. The research findings provided insight into relating the operational and safety effects of sight distance geometry at roundabouts. This research also identified a methodology that provides guidance as to the development of performance-based standards that rely on a better understanding of these relationships. In general, the research findings were consistent with previously conducted studies and indicated that exceeding sight distance thresholds increases the risk of crashes occurring. It was also found that exceeding sight distance thresholds yielded greater speed differentials between the approach and the entry to these roundabouts. The results of this research can advance the state of practice in understanding the relationships of sight distance design attributes, operational characteristics, and safety metrics for low-volume single-lane roundabouts, which is necessary to the creation of performance-based standards. [ABSTRACT FROM AUTHOR]

A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than $81 billion annually. Seven years later the empirical data on the technology's impact on health care efficiency and safety are mixed, and annual health care expenditures in the United States have grown by $800 billion. In our view, the disappointing performance of health IT to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT. We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume. [ABSTRACT FROM AUTHOR]

Acquisition of a system-of-systems can be an all new acquisition of multiple systems that are intended to operate together as a system-of-systems. Much more common in the U.S. Department of Defense (DoD) is acquisition of one or more new systems that are intended to interoperate with existing systems as a system of systems (SoS) with new capabilities. In either case, successful SoS acquisition necessarily depends on effective contracting structures and processes for SoS acquisition. In this paper, a set of issues that need to be addressed in SoS acquisition are identified, and the current findings discussed. The findings suggest maintaining an extensive systems engineering effort within the SoS acquisition and changes to the existing contracting processes, structures, and organizational structures to maximize the probability of SoS acquisition success. The resulting changes are recommended to current and future DoD SoS acquisitions. ©2012 Wiley Periodicals, Inc. Syst Eng 15 [ABSTRACT FROM AUTHOR]

Geographic information is commonly disseminated and consumed via visual representations of features and their environmental context on maps. Map design inherently involves generalizing reality, and one method by which mapmakers do so is through the use of symbols to represent features. Here we focus on the challenges associated with supporting mapmakers who need to work together to reach consensus on standardizing their map symbols. On the basis of a needs assessment study with mapmakers at the US Department of Homeland Security, we designed a new, mixed-method symbol standardization process that takes place through a web-based, asynchronous platform. A study to test this new standardization process with mapmakers at DHS revealed that our process allowed participants to identify many issues related to symbol design, meaning, and categorization. The approach elicited sustained, iterative engagement and critical thinking from participants, and results from a poststudy survey indicate that participants found it to be useful and usable. Results from our study and user feedback allow us to suggest multiple ways in which our approach and platform can be improved for future applications. [ABSTRACT FROM AUTHOR]

Fuel cycles have not historically been integrated with repository design. Four alternative combinations of fuel cycles and repository systems are assessed in the present work: (a) traditional repositories, (b) repositories with spent nuclear fuel retrievability for recycle or as insurance against unforeseen repository failure, (c) colocation and integration of reprocessing and repositories, and (d) colocated specialized disposal facilities such as boreholes for different wastes. System design choices have major impacts on fuel cycle economics, accident risk, repository performance, nonproliferation, and repository siting. Consequently, there are large incentives to understand the different ways to couple fuel cycles and repositories. The evidence suggests that a repository as only a disposal site (the current system) is the least desirable option given current requirements for the United States. There are large incentives to develop repository sites that colocate and integrate all back-end fuel cycle facilities with the repository--independent of the fuel cycles that are ultimately chosen or how these fuel cycles evolve over time. Colocation and integration change the interface requirements between facilities by eliminating many storage and transport requirements such as the need for waste forms with high waste loadings. That, in turn, can result in reductions in cost, reductions in risk, and improved repository performance. For closed fuel cycles, colocation and integration may eliminate repository safeguards. This also suggests a repository business model similar to that of many airport authorities. Airport authorities manage the runways with colocated public and private airline terminals, aircraft maintenance bases, and related operations--all enabled and benefiting from the high-value runway asset. The common high-value back-end fuel cycle asset is the repository. For the local community and state government, such a strategy couples back-end fuel cycle benefits (high-technology jobs, tax revenue, etc.) with the repository site. [ABSTRACT FROM AUTHOR]

Abstract: Scoliosis is a spinal deformity that affects millions of adolescents in the United States. Bracing is the most common non-surgical treatment method for scoliosis, but the biomechanics of such treatment is unclear. The objective of this study is to develop and validate a force logging system that can record forces at multiple locations inside a brace, as well as brace strap tension, and correlate these forces with different body positions. The force logging system can be used to investigate the biomechanics function of a brace to treat scoliosis during the treatment period. Two phases were completed in this study: design phase, involving custom development and calibration of strap tension transducers and modifications of in-brace force transducers; and validation phase, including preliminary testing on a subject with different postures. In-brace force load cell and tension transducer were tested and validated. Their sensitivities were 193.5±4.9mV/N and 35.5±0.2mV/N, respectively, with both linear correlation coefficients were 0.99, reflecting high repeatability and linearity. Qualitative validation was also completed, allowing general relationships to be found between subject posture and force distribution. This study shows an excellent functionality and utility of the developed system. [Copyright &y& Elsevier]

The damaged and sunken ships of Peari Harbor contained information response of ships and their damage control teams to modern weapons. As they were raised to be repaired, the physical evidence of damaged areas was carefully recorded. The Navy's ship design organization, the Bureau of Ships (Buships), combined the physical evidence with crew action reports to determine what worked and what did not. Buships published the results in almost 70 War Damage Reports, which were illustrated with photographs and newly prepared extent-of-damage drawings. This paper is a high-level introduction to that massive body of work. The customers of the reports were the damage control schools, the operational fleet (needing to ruthlessly remove flammable materials), the naval repair yards (installing ship alterations to overcome deficiencies), and the designers of new construction warships. The report series was continued covering ships damaged or lost in the Pacific battles. Modern warship features that are now thought of as "good practice," such as ring fire mains with one line high and the other low on the opposite side of the ship, are a result of "lessons learned" from the war damage surveys. The paper compares the 1938 design Iowa class battleships and the war design Des Moines class heavy cruisers, which incorporated the lessons learned. The differences in compartmentation and damage control fittings of the two classes are described. [ABSTRACT FROM AUTHOR]

By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care. We found that although trends in adoption of electronic health record systems across geographic regions converged from 2002 through 2011, adoption continued to lag for non-primary care specialists, physicians age fifty-five and older, and physicians in small (1-2 providers) and physician-owned practices. Federal policies are specifically aimed at encouraging primary care providers and small practices to achieve widespread use of electronic health records. To achieve their nationwide adoption, federal policies may also have to focus on encouraging adoption among non-primary care specialists, as well as addressing persistent gaps in the use of electronic record systems by practice size, physician age, and ownership status. [ABSTRACT FROM AUTHOR]

The article defines key points in designing and implementing evidence-based practice (EBP) model in a large health care system. Practice changes for organizational change, quality management methods, and a cost-benefit evaluation process in the development stage of an EBP are cited. The article concludes that a representative group of clinicians can be leveraged to create the materials and standards for system implementation so evidence-based and cost-effective patient care can be provided.

Public reports of provider performance on measures of the quality, costs, and outcomes of health care can spur improvement and help patients find the best providers. However, the likelihood that these benefits will materialize depends on the methods underlying each performance report. This paper presents a five-point methodological checklist to guide those who want to improve their performance reporting methods. The central goal is to help report makers minimize the frequency and severity of provider performance misclassification and avoid adverse unintended consequences of reporting. We believe that if those who produce the reports publicly explain how they address each checklist item, this increased transparency will encourage more rigorous methods and improve the chances that reports will lead to better, more efficient care. [ABSTRACT FROM AUTHOR]

Abstract: Fundamental understandings of how energy is consumed, monitored, and controlled are key prerequisites for an energy conservation process. Users who know exactly when energy consumption occurs and where it takes place are able to make more informed decisions about how to lower their energy consumption. Energy conservation projects in the U.S. have reported a 2–11% savings when users are presented with information on energy consumption. Engineers are increasingly turning to virtual environments to improve system design and development and optimize performance and increase efficiency during operation. A bottom-up approach to real-time energy monitoring by integrating virtual and physical domains to increase user awareness on where, when, how and why aspect of energy to make inform decisions regarding energy consumption, optimization and conservation is proposed. A virtual 3-D environment is developed to display actual space/zone/building real-time power consumption information and to allow users to easily locate equipment/loads that are in standby/inefficient and causing energy waste in the real/physical environment. The proposed system is demonstrated via a prototype board that is virtually integrated with an actual Zero Net Energy Test House (ZNETH) as part of future Net-Zero Energy buildings research. The results establish a promising tool in this filed. [Copyright &y& Elsevier]

In asymmetric conflicts, improvised explosive devices (IEDs) are a favoured tool of insurgents. They have long been used by extremists, insurgents and resistant groups and are currently a primary threat in Iraq and Afghanistan. The US military has put a great deal of effort into reducing these types of attacks, ranging from improved methods for locating the devices to social models that attempt to predict where insurgent behavior will spread. By considering behavioral aspects leading up to an IED event as a system, we are able to evaluate intervention strategies that focus on the process by which individuals become involved in insurgent IED activities. This paper presents models of the influences and the behaviors associated with individuals involved in IED-related activities and treats them as a system. This approach allows us to explore societal systems to see how motivation (and deterrents to motivation) may play out. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: Since its creation, the Transportation Security Administration, U.S Department of Homeland Security, has tested, and evaluated at least ten passenger screening technologies even though not all of them have been deployed. We evaluate the screening strategies that have been used by focusing on the performance of airport security screening checkpoint operations. A descriptive model is formulated to include design variables and performance measures of the screening process. Based on the real screening time data collected in a range of airports in the US, we develop and apply the speed of inspection operating characteristics curves in the operation simulation and validation processes. A paced system design is proposed to improve the overall performance of the airport screening operations. [Copyright &y& Elsevier]

Abstract: This article summarizes the discussions and deliberations on transformative research issues and opportunities in energy efficiency identified by a panel of experts assembled for the Civil, Mechanical, and Manufacturing Innovation Division of the US National Science Foundation. The discussions were confined to two areas – reducing energy consumption in buildings and improving energy efficiency in transportation. While these represent only a very small segment of important areas in energy efficiency, the panel considered them to be the most promising in terms of return on investment in research efforts. In the area of reducing energy consumption in buildings, high-priority research topics include information technology infrastructure for fundamental data gathering, processing and management, whole system and process integration for design and operation of smart buildings, and high-performance building components and sub-systems. In the area of energy efficiency in transportation, high-priority research topics include development of high-temperature high-performance ferrous alloys, systems design of protective coatings, fundamental understanding of surface texturing effects on friction and wear, and development of oxidatively stable bio-based lubricants. The energy challenge is serious. We need sustained investment in renewable energy, energy efficiency, and talent development in these new technologies for the future of our civilization. [ABSTRACT FROM AUTHOR]

An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system major expense. Yet, compared to other developed nations, the US lags behind. This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. ‘Poka-yokes’ (avoid (yokeru) mistakes (poka)) will be inserted to provide insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US. [ABSTRACT FROM PUBLISHER]