Clinical decision support improves physician guideline adherence for laboratory monitoring of chronic kidney disease: a matched cohort study

Sample graph page of relevant test results. (PDF 289 kb

Embodied Evolution in Collective Robotics: A Review

This paper provides an overview of evolutionary robotics techniques applied to on-line distributed evolution for robot collectives -- namely, embodied evolution. It provides a definition of embodied evolution as well as a thorough description of the underlying concepts and mechanisms. The paper also presents a comprehensive summary of research published in the field since its inception (1999-2017), providing various perspectives to identify the major trends. In particular, we identify a shift from considering embodied evolution as a parallel search method within small robot collectives (fewer than 10 robots) to embodied evolution as an on-line distributed learning method for designing collective behaviours in swarm-like collectives. The paper concludes with a discussion of applications and open questions, providing a milestone for past and an inspiration for future research.Comment: 23 pages, 1 figure, 1 tabl

A Social Service Measurement Model

The development and implementation of a measurement model for a system of social service agenci.es is discussed. The system, the Jewish Community Federation of Cleveland, is a voluntary association of a full range of human service agencies. Design and workings of the project team, analysis and structuring of the organizational system, and overall goals of the research are first presented. The measurement model itself is then delineated. Essentially, the model is a device for assembling and synthesizing information on system throughput, priorities, and indicators of quality of service. Finally, the information system which supports the model is examined and other issues relating to implementation are discussed. [Likely published circa 1972.

Long term GP opinions and involvement after a consultation-liaison intervention for mental health problems

<p>Abstract</p> <p>Background</p> <p>Shared Mental Health care between Psychiatry and Primary care has been developed to improve the care of common mental health problems but has not hitherto been adequately evaluated. The present study evaluated a consultation-liaison intervention with two objectives: to explore long-term GP opinions (relating to impact on their management and on patient medical outcome) and to determine the secondary referral rate, after a sufficient time lapse following the intervention to reflect a "real-world" primary care setting.</p> <p>Methods</p> <p>All the 139 collaborating GPs (response rate: 84.9%) were invited two years after the intervention to complete a retrospective telephone survey for each patient (181 patients; response rate: 69.6%).</p> <p>Results</p> <p>91.2% of GPs evaluated effects as positive for primary care management (mainly as support) and 58.9% noted positive effects for patient medical outcome. Two years post-intervention, management was shared care for 79.7% of patients (the GP as the psychiatric care provider) and care by a psychiatrist for 20.3% patients. Secondary referral occurred finally in 44.2% of cases.</p> <p>Conclusion</p> <p>The intervention supported GP partners in their management of patients with common mental health problems. Further studies are required on the appropriateness of the care provider.</p

Stable Isotope Tracking of Endangered Sea Turtles: Validation with Satellite Telemetry and δ15N Analysis of Amino Acids

Effective conservation strategies for highly migratory species must incorporate information about long-distance movements and locations of high-use foraging areas. However, the inherent challenges of directly monitoring these factors call for creative research approaches and innovative application of existing tools. Highly migratory marine species, such as marine turtles, regularly travel hundreds or thousands of kilometers between breeding and feeding areas, but identification of migratory routes and habitat use patterns remains elusive. Here we use satellite telemetry in combination with compound-specific isotope analysis of amino acids to confirm that insights from bulk tissue stable isotope analysis can reveal divergent migratory strategies and within-population segregation of foraging groups of critically endangered leatherback sea turtles (Dermochelys coriacea) across the Pacific Ocean. Among the 78 turtles studied, we found a distinct dichotomy in δ15N values of bulk skin, with distinct “low δ15N” and “high δ15N” groups. δ15N analysis of amino acids confirmed that this disparity resulted from isotopic differences at the base of the food chain and not from differences in trophic position between the two groups. Satellite tracking of 13 individuals indicated that their bulk skin δ15N value was linked to the particular foraging region of each turtle. These findings confirm that prevailing marine isoscapes of foraging areas can be reflected in the isotopic compositions of marine turtle body tissues sampled at nesting beaches. We use a Bayesian mixture model to show that between 82 and 100% of the 78 skin-sampled turtles could be assigned with confidence to either the eastern Pacific or western Pacific, with 33 to 66% of all turtles foraging in the eastern Pacific. Our forensic approach validates the use of stable isotopes to depict leatherback turtle movements over broad spatial ranges and is timely for establishing wise conservation efforts in light of this species’ imminent risk of extinction in the Pacific

The proinsulin C-peptide—a multirole model

The C-peptide links the insulin A and B chains in proinsulin, providing thereby a means to promote their efficient folding and assembly in the endoplasmic reticulum during insulin biosynthesis. It then facilitates the intracellular transport, sorting, and proteolytic processing of proinsulin into biologically active insulin in the maturing secretory granules of the β cells. These manifold functions impose significant constraints on the C-peptide structure that are conserved in evolution. After cleavage of proinsulin, the intact C-peptide is stored with insulin in the soluble phase of the secretory granules and is subsequently released in equimolar amounts with insulin, providing a useful independent indicator of insulin secretion. This brief review highlights many aspects of its roles in biosynthesis, as a prelude to consideration of its possible additional role(s) as a physiologically active peptide after its release with insulin into the circulation in vivo