990 resultados para tomografia, system-on-chip, CUDA, calcolo parallelo, GPU


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QUESTION UNDER STUDY: Thirty-day readmissions can be classified as potentially avoidable (PARs) or not avoidable (NARs) by following a specific algorithm (SQLape®). We wanted to assess the financial impact of the Swiss-DRG system, which regroups some readmissions occurring within 18 days after discharge within the initial hospital stay, on PARs at our hospital. METHODS: First, PARs were identified from all hospitalisations recorded in 2011 at our university hospital. Second, 2012 Swiss-DRG readmission rules were applied, regrouped readmissions (RR) were identified, and their financial impact computed. Third, RRs were classified as potentially avoidable (PARRs), not avoidable (NARRs), and others causes (OCRRs). Characteristics of PARR patients and stays were retrieved, and the financial impact of PARRS was computed. RESULTS: A total of 36,777 hospitalisations were recorded in 2011, of which 3,140 were considered as readmissions (8.5%): 1,470 PARs (46.8%) and 1,733 NARs (53.2%). The 2012 Swiss-DRG rules would have resulted in 910 RRs (2.5% of hospitalisations, 29% of readmissions): 395 PARRs (43% of RR), 181 NARRs (20%), and 334 OCRRs (37%). Loss in reimbursement would have amounted to CHF 3.157 million (0.6% of total reimbursement). As many as 95% of the 395 PARR patients lived at home. In total, 28% of PARRs occurred within 3 days after discharge, and 58% lasted less than 5 days; 79% of the patients were discharged home again. Loss in reimbursement would amount to CHF 1.771 million. CONCLUSION: PARs represent a sizeable number of 30-day readmissions, as do PARRs of 18-day RRs in the 2012 Swiss DRG system. They should be the focus of attention, as the PARRs represent an avoidable loss in reimbursement.

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Food farming in Oyo North, Nigeria is characterised by an increasing use of Intermediary Mode of Transportation (IMT) to ease inputs and outputs mobility and farm access. To assess the influence on food farmer’s productivity, a random sample of 230 respondents was selected and data collected on their socio-economic and farm specific characteristics. Descriptive statistics, Herfindhal Index and Technical Efficiency Approach were used to analyse the data. The results indicate that majority of food farmers were in their middle age with mean age of 50 years and most of them used one plot at a location between 5 and 10km to their village of residence. They acquired land by inheritance and practiced intensive crop diversification as risk management strategy. The transportation modes used in addition to walking include bicycle, motorcycle, and car with increasing trend in the use of motorcycle. The mean Technical Efficiency (TE) of food farmers was 0.82 with significant inefficiency effects. The inefficiency analysis indicates positive effect of distance, crop diversification and un-tarred type of road on farmer’s productivity, while poor level of education among farmers, use of bicycle; trekking and weekly working time negatively affect farmer’s efficiency. The negative effect of trekking and use of bicycle and the excess working time suggest the adoption of more IMT of motorized type to optimize farming time and increase farmer’s productivity.

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Objectives: To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants: Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention: Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures: Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results: Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (p<0.001; χ2 test). MAEs occurred in 7.0% of 1473 non-intravenous doses pre-intervention and 4.3% of 1139 afterwards (p = 0.005; χ2 test). Patient identity was not checked for 82.6% of 1344 doses pre-intervention and 18.9% of 1291 afterwards (p<0.001; χ2 test). Medical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions: A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

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Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self'. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.

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Objective: To evaluate the effect of robot-mediated therapy on arm dysfunction post stroke. Design: A series of single-case studies using a randomized multiple baseline design with ABC or ACB order. Subjects (n = 20) had a baseline length of 8, 9 or 10 data points. They continued measurement during the B - robot-mediated therapy and C - sling suspension phases. Setting: Physiotherapy department, teaching hospital. Subjects: Twenty subjects with varying degrees of motor and sensory deficit completed the study. Subjects attended three times a week, with each phase lasting three weeks. Interventions: In the robot-mediated therapy phase they practised three functional exercises with haptic and visual feedback from the system. In the sling suspension phase they practised three single-plane exercises. Each treatment phase was three weeks long. Main measures: The range of active shoulder flexion, the Fugl-Meyer motor assessment and the Motor Assessment Scale were measured at each visit. Results: Each subject had a varied response to the measurement and intervention phases. The rate of recovery was greater during the robot-mediated therapy phase than in the baseline phase for the majority of subjects. The rate of recovery during the robot-mediated therapy phase was also greater than that during the sling suspension phase for most subjects. Conclusion: The positive treatment effect for both groups suggests that robot-mediated therapy can have a treatment effect greater than the same duration of non-functional exercises. Further studies investigating the optimal duration of treatment in the form of a randomized controlled trial are warranted.

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There is increasing concern that the intensification of dairy production reduces the concentrations of nutritionally desirable compounds in milk. This study therefore compared important quality parameters (protein and fatty acid profiles; α-tocopherol and carotenoid concentrations) in milk from four dairy systems with contrasting production intensities (in terms of feeding regimens and milking systems). The concentrations of several nutritionally desirable compounds (β-lactoglobulin, omega-3 fatty acids, omega-3/omega-6 ratio, conjugated linoleic acid c9t11, and/or carotenoids) decreased with increasing feeding intensity (organic outdoor ≥ conventional outdoor ≥ conventional indoors). Milking system intensification (use of robotic milking parlors) had a more limited effect on milk composition, but increased mastitis incidence. Multivariate analyses indicated that differences in milk quality were mainly linked to contrasting feeding regimens and that milking system and breed choice also contributed to differences in milk composition between production systems.

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The effect of variations in the composition for ternary catalysts of the type Pt-x(Ru-Ir)(1-x)/C on the methanol oxidation reaction in acid media for x values of 0.25, 0.50 and 0.75 is reported. The catalysts were prepared by the sol-gel method and characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), atomic absorption spectroscopy (AAS) and energy dispersive X-ray (EDX) analyses. The nanometric character (2.8-3.2 nm) of the sol-gel deposits was demonstrated by XRD and TEM while EDX and AAS analyses showed that the metallic ratio in the compounds was very near to the expected one. Cyclic voltammograms for methanol oxidation revealed that the reaction onset occur at less positive potentials in all the ternary catalysts tested here when compared to a Pt-0.75-Ru-0.25/C (E-Tek) commercial composite. Steady-state polarization experiments (Tafel plots) showed that the Pt-0.25(Ru-Ir)(0.75)/C catalyst is the more active one for methanol oxidation as revealed by the shift of the reaction onset towards lower potentials. In addition, constant potential electrolyses suggest that the addition of Ru and Ir to Pt decreases the poisoning effect of the strongly adsorbed species generated during methanol oxidation. Consequently, the Pt-0.25 (Ru-Ir)(0.75)/C Composite catalyst is a very promising one for practical applications. (c) 2007 Elsevier B.V. All rights reserved.

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Com o advento dos processos submicrônicos, a capacidade de integração de transistores tem atingido níveis que possibilitam a construção de um sistema completo em uma única pastilha de silício. Esses sistemas, denominados sistemas integrados, baseiam-se no reuso de blocos previamente projetados e verificados, os quais são chamados de núcleos ou blocos de propriedade intelectual. Os sistemas integrados atuais incluem algumas poucas dezenas de núcleos, os quais são interconectados por meio de arquiteturas de comunicação baseadas em estruturas dedicadas de canais ponto-a-ponto ou em estruturas reutilizáveis constituídas por canais multiponto, denominadas barramentos. Os futuros sistemas integrados irão incluir de dezenas a centenas de núcleos em um mesmo chip com até alguns bilhões de transistores, sendo que, para atender às pressões do mercado e amortizar os custos de projeto entre vários sistemas, é importante que todos os seus componentes sejam reutilizáveis, incluindo a arquitetura de comunicação. Das arquiteturas utilizadas atualmente, o barramento é a única que oferece reusabilidade. Porém, o seu desempenho em comunicação e o seu consumo de energia degradam com o crescimento do sistema. Para atender aos requisitos dos futuros sistemas integrados, uma nova alternativa de arquitetura de comunicação tem sido proposta na comunidade acadêmica. Essa arquitetura, denominada rede-em-chip, baseia-se nos conceitos utilizados nas redes de interconexão para computadores paralelos. Esta tese se situa nesse contexto e apresenta uma arquitetura de rede-em-chip e um conjunto de modelos para a avaliação de área e desempenho de arquiteturas de comunicação para sistemas integrados. A arquitetura apresentada é denominada SoCIN (System-on-Chip Interconnection Network) e apresenta como diferencial o fato de poder ser dimensionada de modo a atender a requisitos de custo e desempenho da aplicação alvo. Os modelos desenvolvidos permitem a estimativa em alto nível da área em silício e do desempenho de arquiteturas de comunicação do tipo barramento e rede-em-chip. São apresentados resultados que demonstram a efetividade das redes-em-chip e indicam as condições que definem a aplicabilidade das mesmas.

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Com as recentes tecnologias de fabricação é possível integrar milhões de transistores em um único chip, permitindo a criação dos chamados System-on-Chip (SoCs), que integram em um único chip um grande número de componentes (tipicamente blocos reutilizáveis conhecidos por núcleos). Quanto mais complexos forem estes sistemas, melhores técnicas de projeto serão necessárias para também reduzir o tempo e custo do projeto. Uma destas técnicas, chamada de Network-on-Chip (NoC), permite melhorar a performance da comunicação entre os núcleos e, ao mesmo tempo, fornecer uma plataforma de comunicação escalável e que pode ser reutilizada para um grande número de sistemas. Uma NoC pode ser definida como uma estrutura de roteadores e canais ponto-a-ponto que interconectam os núcleos de um sistema, provendo o suporte de comunicação entre eles. Os dados são transmitidos pela rede na forma de mensagens, que podem ser divididas em unidades menores chamadas de pacote. Uma das desvantagens desta plataforma de comunicação é o impacto na área do sistema causado pelos roteadores. Dentro deste contexto, este trabalho apresenta uma arquitetura de roteador de baixo custo, com o objetivo de permitir o uso de NoCs em sistemas onde a área do roteador representará um grande impacto no custo do sistema. A arquitetura deste roteador, chamado de Tonga, é baseada em um roteador chamado RASoC, um soft-core para SoCs. Nesta dissertação será apresentada também uma rede heterogênea, baseada na rede SoCIN, e composta por dois tipos de roteadores – RASoC e Tonga. Estes roteadores visam diferentes objetivos: Rasoc alcança uma maior performance comparada ao Tonga, mas ocupa área consideravelmente maior. Potencialmente, uma NoC heterogênea otimizada pode ser desenvolvida combinando estes roteadores, procurando o melhor compromisso entre área e latência. Os modelos desenvolvidos permitem a estimativa de área e do desempenho das arquiteturas de comunicação propostas e são apresentados resultados de performance para algumas aplicações.

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The Hazard Analysis and Critical Control Point (HACCP) is a preventive system that intends to guarantee the safety and harmlessness of food. It improves the quality of products as it eliminates possible defects during the process, and saves costs by practically eliminating final product inspection. This work describes the typical hazards encountered on the mushroom processing line for fresh consumption. Throughout the process, only the reception stage of mushrooms has been considered a critical control point (CCP). The main hazards at this stage were: the presence of unauthorised phytosanitary products; larger doses of such products than those permitted; the presence of pathogenic bacteria or thermo-stable enterotoxins. Putting into practice such knowledge would provide any industry that processes mushrooms for fresh consumption with a self-control HACCP-based system for its own productions.