Regulate Pollution or Land Use - Managing Toxic Air Contaminants in Southern California

A California air quality management district recently proposed to limit the location of potential receivers, in contrast with sources, of air toxics. The author argues that, although this particular proposal was later abandoned, it amounted to land use regulation. He also argues that such action usurps local control and is unwarranted

Approaches to decision-making among late-stage melanoma patients: a multifactorial investigation.

PurposeThe treatment decisions of melanoma patients are poorly understood. Most research on cancer patient decision-making focuses on limited components of specific treatment decisions. This study aimed to holistically characterize late-stage melanoma patients' approaches to treatment decision-making in order to advance understanding of patient influences and supports.Methods(1) Exploratory analysis of longitudinal qualitative data to identify themes that characterize patient decision-making. (2) Pattern analysis of decision-making themes using an innovative method for visualizing qualitative data: a hierarchically-clustered heatmap. Participants were 13 advanced melanoma patients at a large academic medical center.ResultsExploratory analysis revealed eight themes. Heatmap analysis indicated two broad types of patient decision-makers. "Reliant outsiders" relied on providers for medical information, demonstrated low involvement in decision-making, showed a low or later-in-care interest in clinical trials, and expressed altruistic motives. "Active insiders" accessed substantial medical information and expertise in their networks, consulted with other doctors, showed early and substantial interest in trials, demonstrated high involvement in decision-making, and employed multiple decision-making strategies.ConclusionWe identified and characterized two distinct approaches to decision-making among patients with late-stage melanoma. These differences spanned a wide range of factors (e.g., behaviors, resources, motivations). Enhanced understanding of patients as decision-makers and the factors that shape their decision-making may help providers to better support patient understanding, improve patient-provider communication, and support shared decision-making

Radical Technological Innovation and Perception: A Non-Physician Practitioners’ Perspective

Radical technological innovations, such as chatbots, fundamentally alter many aspects of healthcare organizations. For example, they transform how clinicians care for their patients. Despite the potential benefits, they cannot be integrated into practice without the support of the clinicians whose jobs are affected. While previous research shed important light on physicians’ perceptions, little is known on nonphysician practitioners view said innovations. This paper reports on a qualitative study, involving 10 nonphysician clinicians from Ontario, Canada, conducted to determine the perceptions and cognitions of clinicians regarding radical innovation and their previous experiences with technological change. Results indicate that clinicians as semi-autonomous agents can interpret and act upon their environment with regard to determining how innovations such as chatbots are implemented

Decision Support Facility for the APS Control System

The Advanced Photon Source is now in its fifth year of routine beam production. The EPICS-based [1] control system has entered the phase in its life cycle where new control algorithms must be implemented under increasingly stringent operational and reliability requirements. The sheer volume of the control system (~270,000 records, ~145 VME-based input-output controllers (IOCs), and ~7,000,000 lines of EPICS ASCII configuration code), presents a daunting challenge for code maintenance. The present work describes a relational database that provides an integrated view of the interacting components of the entire APS control system, including the IOC low-level logic, the physical wiring documentation, and high-level client applications. The database is extracted (booted) from the same operational CVS repository as that used to load the active IOCs. It provides site-wide decision support facilities to inspect and trace control flow and to identify client (e.g., user interface) programs involved at any selected point in the front-end logic. The relational database forms a basis for generalized documentation of global control logic and its connection with both the physical I/O and with external high-level applications

Schwartz kernel theorem for the Fourier hyperfunctions

The purpose of this paper is to give a direct proof of the Schwartz kernel theorem for the Fourier hyoerfunctions. The Schwartz kernel theorem for the Fourier hyperfunctions means that with every Fourier hyperfunction K in ..

A Hybrid Mining Approach to Facilitate Health Insurance Decision: Case Study of Non-Traditional Data Mining Applications in Taiwan NHI Databases

This study examines time-sensitive applications of data mining methods to facilitate claims review processing and provide policy information for insurance decision-making vis-à-vis the Taiwan National Health Insurance databases. In order to obtain the best payment management, a hybrid mining approach, which has been grounded on the extant knowledge of data mining projects and health insurance domain knowledge, is proposed. Through the integration of data warehousing, online analytical processing, data mining techniques and traditional data analysis in the healthcare field, an easy-to-use decision support platform, which will facilitate the health insurance decision-making process, is built. Drawing from lessons learned in case study, results showed that not only is hybrid mining approach a reliable, powerful, and user-friendly platform for diversified payment decision support, but that it also has great relevance for the practice and acceptance of evidence-based medicine. Researchers should develop hybrid mining approach combined with their own application systems in the future

Testing and Implementation Progress on the Advanced Photon Source (APS) Linear Accelerator (Linac) High-Power S-band Switching System

An S-band linear accelerator is the source of particles and the front end of the Advanced Photon Source injector. In addition, it supports a low-energy undulator test line (LEUTL) and drives a free-electron laser (FEL). A waveguide-switching and distribution system is now under construction. The system configuration was revised to be consistent with the recent change to electron-only operation. There are now six modulator-klystron subsystems, two of which are being configured to act as hot spares for two S-band transmitters each, so that no single failure will prevent injector operation. The two subsystems are also used to support additional LEUTL capabilities and off-line testing. Design considerations for the waveguide-switching subsystem, topology selection, control and protection provisions, high-power test results, and current status are describedComment: Linac 2000 paper No. THE07 3 pages with 3 figure

Solid-pseudopapillary tumor of the pancreas: MR imaging findings in 21 patients.

PURPOSE: Solid-pseudopapillary tumor (SPT) of the pancreas is a rare, low-grade malignancy, which mostly occurs in adolescent and young adult females. The goal of this study was to retrospectively analyze the magnetic resonance (MR) imaging presentation of SPT of the pancreas. METHODS: We retrospectively reviewed the preoperative MR imaging examinations and the medical, surgical and histopathological records of 21 patients who underwent surgery for SPT of the pancreas. MR imaging included T1-weighted, T2-weighted, and gadolinium chelate-enhanced MR imaging. In addition, 10 patients had diffusion-weighted (DW) MR imaging. MR examinations were retrospectively reviewed for location, size, morphological features and signal intensity of the tumors. RESULTS: Nineteen women and 2 men (median age, 23 years; range, 14-59) were included. Seven patients (7/21; 33%) presented with abdominal symptoms. The median largest tumor diameter was 53mm (range, 32-141 mm). SPTs were located in the pancreatic head, body, and tail in 9 (9/21; 43%), 5 (5/21; 24%) and 7 (7/21, 33%) patients, respectively. All patients (21/21; 100%) had a single SPT. SPTs were more frequently oval (12/21; 57%), predominantly solid (12/21; 57%), fully encapsulated (16/21; 76%), larger than 30 mm (21/21; 100%), hypointense on T1-weighted MR images (21/21, 100%), hyperintense on T2-weighted MR images (21/21; 100%) and with an enhancing capsule after gadolinium-chelate administration (21/21; 100%). CONCLUSIONS: There is trend of appearance for SPT of the pancreas on MR imaging but that variations may be observed in a number of cases. SPT uniformly presents as a single, well-demarcated and encapsulated pancreatic mass

A comparison of the hypoglycemic effect of insulin with systemic venous and portal venous administration

The hyperglycemic effect of insulin by prolonged intraportal and systemic infusion was measured in unanesthetized dogs with a modified portacaval transposition. There was no significant difference in response with the two routes of administration. The relation of these results to research directed to surgical therapy of diabetes is discussed. © 1963 W. B. Saunders Company