Tecniche per il controllo dinamico del consumo di potenza per piattaforme system-on-chip

Providing support for multimedia applications on low-power mobile devices remains a significant research challenge. This is primarily due to two reasons: • Portable mobile devices have modest sizes and weights, and therefore inadequate resources, low CPU processing power, reduced display capabilities, limited memory and battery lifetimes as compared to desktop and laptop systems. • On the other hand, multimedia applications tend to have distinctive QoS and processing requirementswhichmake themextremely resource-demanding. This innate conflict introduces key research challenges in the design of multimedia applications and device-level power optimization. Energy efficiency in this kind of platforms can be achieved only via a synergistic hardware and software approach. In fact, while System-on-Chips are more and more programmable thus providing functional flexibility, hardwareonly power reduction techniques cannot maintain consumption under acceptable bounds. It is well understood both in research and industry that system configuration andmanagement cannot be controlled efficiently only relying on low-level firmware and hardware drivers. In fact, at this level there is lack of information about user application activity and consequently about the impact of power management decision on QoS. Even though operating system support and integration is a requirement for effective performance and energy management, more effective and QoSsensitive power management is possible if power awareness and hardware configuration control strategies are tightly integratedwith domain-specificmiddleware services. The main objective of this PhD research has been the exploration and the integration of amiddleware-centric energymanagement with applications and operating-system. We choose to focus on the CPU-memory and the video subsystems, since they are the most power-hungry components of an embedded system. A second main objective has been the definition and implementation of software facilities (like toolkits, API, and run-time engines) in order to improve programmability and performance efficiency of such platforms. Enhancing energy efficiency and programmability ofmodernMulti-Processor System-on-Chips (MPSoCs) Consumer applications are characterized by tight time-to-market constraints and extreme cost sensitivity. The software that runs on modern embedded systems must be high performance, real time, and even more important low power. Although much progress has been made on these problems, much remains to be done. Multi-processor System-on-Chip (MPSoC) are increasingly popular platforms for high performance embedded applications. This leads to interesting challenges in software development since efficient software development is a major issue for MPSoc designers. An important step in deploying applications on multiprocessors is to allocate and schedule concurrent tasks to the processing and communication resources of the platform. The problem of allocating and scheduling precedenceconstrained tasks on processors in a distributed real-time system is NP-hard. There is a clear need for deployment technology that addresses thesemulti processing issues. This problem can be tackled by means of specific middleware which takes care of allocating and scheduling tasks on the different processing elements and which tries also to optimize the power consumption of the entire multiprocessor platform. This dissertation is an attempt to develop insight into efficient, flexible and optimalmethods for allocating and scheduling concurrent applications tomultiprocessor architectures. It is a well-known problem in literature: this kind of optimization problems are very complex even in much simplified variants, therefore most authors propose simplified models and heuristic approaches to solve it in reasonable time. Model simplification is often achieved by abstracting away platform implementation ”details”. As a result, optimization problems become more tractable, even reaching polynomial time complexity. Unfortunately, this approach creates an abstraction gap between the optimization model and the real HW-SW platform. The main issue with heuristic or, more in general, with incomplete search is that they introduce an optimality gap of unknown size. They provide very limited or no information on the distance between the best computed solution and the optimal one. The goal of this work is to address both abstraction and optimality gaps, formulating accurate models which accounts for a number of ”non-idealities” in real-life hardware platforms, developing novel mapping algorithms that deterministically find optimal solutions, and implementing software infrastructures required by developers to deploy applications for the targetMPSoC platforms. Energy Efficient LCDBacklightAutoregulation on Real-LifeMultimediaAp- plication Processor Despite the ever increasing advances in Liquid Crystal Display’s (LCD) technology, their power consumption is still one of the major limitations to the battery life of mobile appliances such as smart phones, portable media players, gaming and navigation devices. There is a clear trend towards the increase of LCD size to exploit the multimedia capabilities of portable devices that can receive and render high definition video and pictures. Multimedia applications running on these devices require LCD screen sizes of 2.2 to 3.5 inches andmore to display video sequences and pictures with the required quality. LCD power consumption is dependent on the backlight and pixel matrix driving circuits and is typically proportional to the panel area. As a result, the contribution is also likely to be considerable in future mobile appliances. To address this issue, companies are proposing low power technologies suitable for mobile applications supporting low power states and image control techniques. On the research side, several power saving schemes and algorithms can be found in literature. Some of them exploit software-only techniques to change the image content to reduce the power associated with the crystal polarization, some others are aimed at decreasing the backlight level while compensating the luminance reduction by compensating the user perceived quality degradation using pixel-by-pixel image processing algorithms. The major limitation of these techniques is that they rely on the CPU to perform pixel-based manipulations and their impact on CPU utilization and power consumption has not been assessed. This PhDdissertation shows an alternative approach that exploits in a smart and efficient way the hardware image processing unit almost integrated in every current multimedia application processors to implement a hardware assisted image compensation that allows dynamic scaling of the backlight with a negligible impact on QoS. The proposed approach overcomes CPU-intensive techniques by saving system power without requiring either a dedicated display technology or hardware modification. Thesis Overview The remainder of the thesis is organized as follows. The first part is focused on enhancing energy efficiency and programmability of modern Multi-Processor System-on-Chips (MPSoCs). Chapter 2 gives an overview about architectural trends in embedded systems, illustrating the principal features of new technologies and the key challenges still open. Chapter 3 presents a QoS-driven methodology for optimal allocation and frequency selection for MPSoCs. The methodology is based on functional simulation and full system power estimation. Chapter 4 targets allocation and scheduling of pipelined stream-oriented applications on top of distributed memory architectures with messaging support. We tackled the complexity of the problem by means of decomposition and no-good generation, and prove the increased computational efficiency of this approach with respect to traditional ones. Chapter 5 presents a cooperative framework to solve the allocation, scheduling and voltage/frequency selection problem to optimality for energyefficient MPSoCs, while in Chapter 6 applications with conditional task graph are taken into account. Finally Chapter 7 proposes a complete framework, called Cellflow, to help programmers in efficient software implementation on a real architecture, the Cell Broadband Engine processor. The second part is focused on energy efficient software techniques for LCD displays. Chapter 8 gives an overview about portable device display technologies, illustrating the principal features of LCD video systems and the key challenges still open. Chapter 9 shows several energy efficient software techniques present in literature, while Chapter 10 illustrates in details our method for saving significant power in an LCD panel. Finally, conclusions are drawn, reporting the main research contributions that have been discussed throughout this dissertation.

Enabling computationally intensive bioinformatics applications on the Grid platform

Bioinformatics is a recent and emerging discipline which aims at studying biological problems through computational approaches. Most branches of bioinformatics such as Genomics, Proteomics and Molecular Dynamics are particularly computationally intensive, requiring huge amount of computational resources for running algorithms of everincreasing complexity over data of everincreasing size. In the search for computational power, the EGEE Grid platform, world's largest community of interconnected clusters load balanced as a whole, seems particularly promising and is considered the new hope for satisfying the everincreasing computational requirements of bioinformatics, as well as physics and other computational sciences. The EGEE platform, however, is rather new and not yet free of problems. In addition, specific requirements of bioinformatics need to be addressed in order to use this new platform effectively for bioinformatics tasks. In my three years' Ph.D. work I addressed numerous aspects of this Grid platform, with particular attention to those needed by the bioinformatics domain. I hence created three major frameworks, Vnas, GridDBManager and SETest, plus an additional smaller standalone solution, to enhance the support for bioinformatics applications in the Grid environment and to reduce the effort needed to create new applications, additionally addressing numerous existing Grid issues and performing a series of optimizations. The Vnas framework is an advanced system for the submission and monitoring of Grid jobs that provides an abstraction with reliability over the Grid platform. In addition, Vnas greatly simplifies the development of new Grid applications by providing a callback system to simplify the creation of arbitrarily complex multistage computational pipelines and provides an abstracted virtual sandbox which bypasses Grid limitations. Vnas also reduces the usage of Grid bandwidth and storage resources by transparently detecting equality of virtual sandbox files based on content, across different submissions, even when performed by different users. BGBlast, evolution of the earlier project GridBlast, now provides a Grid Database Manager (GridDBManager) component for managing and automatically updating biological flatfile databases in the Grid environment. GridDBManager sports very novel features such as an adaptive replication algorithm that constantly optimizes the number of replicas of the managed databases in the Grid environment, balancing between response times (performances) and storage costs according to a programmed cost formula. GridDBManager also provides a very optimized automated management for older versions of the databases based on reverse delta files, which reduces the storage costs required to keep such older versions available in the Grid environment by two orders of magnitude. The SETest framework provides a way to the user to test and regressiontest Python applications completely scattered with side effects (this is a common case with Grid computational pipelines), which could not easily be tested using the more standard methods of unit testing or test cases. The technique is based on a new concept of datasets containing invocations and results of filtered calls. The framework hence significantly accelerates the development of new applications and computational pipelines for the Grid environment, and the efforts required for maintenance. An analysis of the impact of these solutions will be provided in this thesis. This Ph.D. work originated various publications in journals and conference proceedings as reported in the Appendix. Also, I orally presented my work at numerous international conferences related to Grid and bioinformatics.

Effect of rearing techniques and feed composition on productive traits, bird welfare and quality of poultry products

The PhD project was focused on the study of the poultry welfare conditions and improvements. The project work was divided into 3 main research activities. A) Field evaluation of chicken meat rearing conditions kept in intensive farms. Considering the lack of published reports concerning the overall Italian rearing conditions of broiler chickens, a survey was carried out to assess the welfare conditions of broiler reared in the most important poultry companies in Italy to verify if they are in accordance with the advices given in the European proposal COM (2005) 221 final. Chicken farm conditions, carcass lesions and meat quality were investigated. 1. The densities currently used in Italy are in accordance with the European proposal COM 221 final (2005) which suggests to keep broilers at a density lower than 30-32 kg live weight/m2 and to not exceed 38-40 kg live weight/m2. 2. The mortality rates in summer and winter agree with the mortality score calculated following the formula reported in the EU Proposal COM 221 final (2005). 3. The incidence of damaged carcasses was very low and did not seem related to the stocking density. 4. The FPD scores were generally above the maximum limit advised by the EU proposal COM 221 final (2005), although the stocking densities were lower than 30-32 kg live weight per m2. 5. It can be stated that the control of the environmental conditions, particularly litter quality, appears a key issue to control the onset of foot dermatitis. B) Manipulation of several farm parameters, such litter material and depth, stocking density and light regimen to improve the chicken welfare conditions, in winter season. 1. Even though 2 different stocking densities were established in this study, the performances achieved from the chickens were almost identical among groups. 2. The FCR was significantly better in Standard conditions contrarily to birds reared in Welfare conditions with lower stocking density, more litter material and with a light program of 16 hours light and 8 hours dark. 3. In our trial, in Standard groups we observed a higher content of moisture, nitrogen and ammonia released from the litter. Therefore it can be assumed that the environmental characteristics have been positively changed by the improvements of the rearing conditions adopted for Welfare groups. 4. In Welfare groups the exhausted litters of the pens were dryer and broilers showed a lower occurrence of FPD. 5. The prevalence of hock burn lesions, like FPD, is high with poor litter quality conditions. 6. The combined effect of a lower stocking density, a greater amount of litter material and a photoperiod similar to the natural one, have positively influenced the chickens welfare status, as a matter of fact the occurrence of FPD in Welfare groups was the lowest keeping the score under the European threshold of the proposal COM 221 final(2005). C) The purpose of the third research was to study the effect of high or low stocking density of broiler chickens, different types of litter and the adoption of short or long lighting regimen on broiler welfare through the evaluation of their productivity and incidence of foot pad dermatitis during the hot season. 1. The feed efficiency was better for the Low Density than for High Density broilers. 2. The appearance of FPD was not influenced by stocking density. 3. The foot examination revealed that the lesions occurred more in birds maintained on chopped wheat straw than on wood shaving. 4. In conclusion, the adoptions of a short light regimen similar to that occurring in nature during summer reduces the feed intake without modify the growth rate thus improving the feed efficiency. Foot pad lesion were not affected neither by stocking densities nor by light regimens whereas wood shavings exerted a favourable effect in preserving foot pad in good condition. D) A study was carried out to investigate more widely the possible role of 25-hydroxycholecalciferol supplemented in the diet of a laying hen commercial strain (Lohmann brown) in comparison of diets supplemented with D3 or with D3 + 25- hydroxycholecalciferol. Egg traits during a productive cycle as well as the bone characteristics of the layers have been as well evaluated to determine if there the vitamin D3 may enhance the welfare status of the birds. 1. The weight of the egg and of its components is often greater in hens fed a diet enriched with 25-hydroxycholecalciferol. 2. Since eggs of treated groups are heavier and a larger amount of shell is needed, a direct effect on shell strength is observed. 3. At 30 and at 50 wk of age hens fed 25 hydroxycholecalciferol exhibited greater values of bone breaking force. 4. Radiographic density values obtained in the trial are always higher in hens fed with 25-hydroxycholecalciferol of both treatments: supplemented for the whole laying cycle (25D3) or from 40 weeks of age onward (D3+25D3).

Geographic information system-based decision support for soil conservation planning in Tajikistan

Soil erosion on sloping agricultural land poses a serious problem for the environment, as well as for production. In areas with highly erodible soils, such as those in loess zones, application of soil and water conservation measures is crucial to sustain agricultural yields and to prevent or reduce land degradation. The present study, carried out in Faizabad, Tajikistan, was designed to evaluate the potential of local conservation measures on cropland using a spatial modelling approach to provide decision-making support for the planning of spatially explicit sustainable land use. A sampling design to support comparative analysis between well-conserved units and other field units was established in order to estimate factors that determine water erosion, according to the Revised Universal Soil Loss Equation (RUSLE). Such factor-based approaches allow ready application using a geographic information system (GIS) and facilitate straightforward scenario modelling in areas with limited data resources. The study showed first that assessment of erosion and conservation in an area with inhomogeneous vegetation cover requires the integration of plot-based cover. Plot-based vegetation cover can be effectively derived from high-resolution satellite imagery, providing a useful basis for plot-wise conservation planning. Furthermore, thorough field assessments showed that 25.7% of current total cropland is covered by conservation measures (terracing, agroforestry and perennial herbaceous fodder). Assessment of the effectiveness of these local measures, combined with the RUSLE calculations, revealed that current average soil loss could be reduced through low-cost measures such as contouring (by 11%), fodder plants (by 16%), and drainage ditches (by 53%). More expensive measures such as terracing and agroforestry can reduce erosion by as much as 63% (for agroforestry) and 93% (for agroforestry combined with terracing). Indeed, scenario runs for different levels of tolerable erosion rates showed that more cost-intensive and technologically advanced measures would lead to greater reduction of soil loss. However, given economic conditions in Tajikistan, it seems advisable to support the spread of low-cost and labourextensive measures.

Eggshell colour is more strongly affected by maternal identity than by dietary antioxidants in a captive poultry system

1.Biologists have long puzzled over the apparent conspicuousness of blue-green eggshell coloration in birds. One candidate explanation is the sexual signalling hypothesis that the blue-green colour of eggshells can reveal an intrinsic aspect of females' physiological quality, with only high-quality females having sufficient antioxidant capacity to pigment their eggs with large amounts of biliverdin. Subsequent work has argued instead that eggshell colour might signal condition-dependent traits based on diet. 2.Using Araucana chickens that lay blue-green eggs, we explored (i) whether high levels of dietary antioxidants yield eggshells with greater blue-green reflectance, (ii) whether females differ from one another in eggshell coloration despite standardized environments, diets and rearing conditions, and (iii) the relative strength with which diet vs. female identity affects eggshell coloration. 3.We reared birds to maturity and then placed them on either a high- or low-antioxidant diet, differing fourfold in Vitamin E acetate and Vitamin A retinol. After 8 weeks, the treatments were reversed, such that females laid eggs on both diets in an order-balanced design. We measured the reflectance spectra of 545 eggs from 25 females. 4.Diet had a very limited effect on eggshell spectral reflectance, but individual females differed strongly and consistently from one another, despite having been reared under uniform conditions. However, predictions from avian visual modelling suggest that most of the egg colour differences between females, and nearly all of the differences between diets, are unlikely to be visually discriminable. 5.Our data suggest that eggshell reflectance spectra may carry information on intrinsic properties of the female that laid the eggs, but the utility of this coloration as a signal to conspecifics in this species may be limited by the sensitivity of a receiver to detect it.

Long-term consequences of an intensive care unit stay in older critically ill patients: design of a longitudinal study

Background Modern methods in intensive care medicine often enable the survival of older critically ill patients. The short-term outcomes for patients treated in intensive care units (ICUs), such as survival to hospital discharge, are well documented. However, relatively little is known about subsequent long-term outcomes. Pain, anxiety and agitation are important stress factors for many critically ill patients. There are very few studies concerned with pain, anxiety and agitation and the consequences in older critically ill patients. The overall aim of this study is to identify how an ICU stay influences an older person's experiences later in life. More specific, this study has the following objectives: (1) to explore the relationship between pain, anxiety and agitation during ICU stays and experiences of the same symptoms in later life; and (2) to explore the associations between pain, anxiety and agitation experienced during ICU stays and their effect on subsequent health-related quality of life, use of the health care system (readmissions, doctor visits, rehabilitation, medication use), living situation, and survival after discharge and at 6 and 12 months of follow-up. Methods/Design A prospective, longitudinal study will be used for this study. A total of 150 older critically ill patients in the ICU will participate (ICU group). Pain, anxiety, agitation, morbidity, mortality, use of the health care system, and health-related quality of life will be measured at 3 intervals after a baseline assessment. Baseline measurements will be taken 48 hours after ICU admission and one week thereafter. Follow-up measurements will take place 6 months and 12 months after discharge from the ICU. To be able to interpret trends in scores on outcome variables in the ICU group, a comparison group of 150 participants, matched by age and gender, recruited from the Swiss population, will be interviewed at the same intervals as the ICU group. Discussion Little research has focused on long term consequences after ICU admission in older critically ill patients. The present study is specifically focussing on long term consequences of stress factors experienced during ICU admission.

Practical sources of error in measuring pulmonary artery occlusion pressure: a study in participants of a special intensivist training program of The Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI)

BACKGROUND: Physiological data obtained with the pulmonary artery catheter (PAC) are susceptible to errors in measurement and interpretation. Little attention has been paid to the relevance of errors in hemodynamic measurements performed in the intensive care unit (ICU). The aim of this study was to assess the errors related to the technical aspects (zeroing and reference level) and actual measurement (curve interpretation) of the pulmonary artery occlusion pressure (PAOP). METHODS: Forty-seven participants in a special ICU training program and 22 ICU nurses were tested without pre-announcement. All participants had previously been exposed to the clinical use of the method. The first task was to set up a pressure measurement system for PAC (zeroing and reference level) and the second to measure the PAOP. RESULTS: The median difference from the reference mid-axillary zero level was - 3 cm (-8 to + 9 cm) for physicians and -1 cm (-5 to + 1 cm) for nurses. The median difference from the reference PAOP was 0 mmHg (-3 to 5 mmHg) for physicians and 1 mmHg (-1 to 15 mmHg) for nurses. When PAOP values were adjusted for the differences from the reference transducer level, the median differences from the reference PAOP values were 2 mmHg (-6 to 9 mmHg) for physicians and 2 mmHg (-6 to 16 mmHg) for nurses. CONCLUSIONS: Measurement of the PAOP is susceptible to substantial error as a result of practical mistakes. Comparison of results between ICUs or practitioners is therefore not possible.

[Neuromonitoring and neuroprotection in cardiac anaesthesia. Nationwide survey conducted by the Cardiac Anaesthesia Working Group of the German Society of Anaesthesiology and Intensive Care Medicine]

OBJECTIVE: The primary objective of this nationwide survey carried out in department of cardiac anesthesia in Germany was to identify current practice with regard to neuromonitoring und neuroprotection. METHODOLOGY: The data are based on a questionnaire sent out to all departments of cardiac anesthesia in Germany between October 2007 und January 2008. The anonymized questionnaire contained 26 questions about the practice of preoperative evaluation of cerebral vessels, intra-operative use of neuromonitoring, the nature und application of cerebral protective measures, perfusion management during cardiopulmonary bypass, postoperative evaluation of neurological status, and training in the field of cerebral monitoring. RESULTS: Of the 80 mailed questionnaires 55% were returned and 90% of department evaluated cerebral vessels preoperatively with duplex ultrasound. The methods used for intra-operative neuromonitoring are electroencephalography (EEG, 60%) for type A dissections (38.1%), for elective surgery on the thoracic and thoraco-abdominal aorta (34.1% and 31.6%, respectively) and in carotid surgery (43.2%) near infrared spectroscopy (40%), evoked potentials (30%) and transcranial Doppler sonography (17.5%), with some centers using combined methods. In most departments the central nervous system is not subjected to monitoring during bypass surgery, heart valve surgery, or minimally invasive surgery. Cerebral protective measures used comprise patient cooling on cardio-pulmonary bypass (CPB 100%), extracorporeal cooling of the head (65%) and the administration of corticosteroids (58%), barbiturates (50%) and antiepileptic drugs (10%). Neuroprotective anesthesia consists of administering inhalation anesthetics (32.5%; sevoflurane 76.5%) and intravenous anesthesia (20%; propofol and barbiturates each accounting for 46.2%). Of the departments 72.5% cool patients as a standard procedure for surgery involving cardiovascular arrest and 37.5% during all surgery using CPB. In 84.6% of department CPB flow equals calculated cardiac output (CO) under normothermia, while the desired mean arterial pressure (MAP) varies between 60 and 70 mmHg (43.9%) and between 50 and 60 mmHg (41.5%), respectively. At body temperatures less than 18 degrees C CPB flow is reduced below the calculated CO (70%) while 27% of departments use normothermic flow rates. The preferred MAP under hypothermia is between 50 and 60 mmHg (59%). The results of intra-operative neuromonitoring are documented on the anesthesia record (77%). In 42.5% of the departments postoperative neurological function is estimated by the anesthesiologist. Continuing education sessions pertaining to neuromonitoring are organized on a regular basis in 32.5% of the departments and in 37.5% individual physicians are responsible for their own neuromonitoring education. CONCLUSION: The present survey data indicate that neuromonitoring and neuroprotective therapy during CPB is not standardized in cardiac anesthesiology departments in Germany. The systemic use of available methods to implement multimodal neuromonitoring would be desirable.

Intensive Rotational Grazing of Steers at the Andrew Jackson Demonstration Farm

Fifty head of crossbred steers started grazing 51 acres of pasture on May 1 in a rotational grazing system using a variable density paddock system. Twenty-two head grazed 92 days, 27 grazed 140 days, and one steer died. A total of 11,922 pounds was produced on 5,804 animal-days of grazing. The average daily gain was 2.02 pounds for group 1 and 2.07 for group 2. The stocking rate for the first 92 days was .98 steers per acre and .53 for the final 48 days. The animal days of grazing per acre was 113 and the pounds of gain per acre was 233. Total return for land, labor and management for the demonstration was $2,829.76 or $55.49/acre.

Intensive Rotational Grazing of Steers on Highly Erodible Land at the Adams County CRP Project

Grazing yearling steers is one way to utilize the forages required for participation in the Conservation Reserve Program (CRP) after CRP contracts expire. In 1995, a stocker-steer intensive-rotational grazing study was conducted at the CRP Research and Demonstration Project near Corning, Iowa. A similar study was carried out in 1994. Seventy-five yearling crossbred steers grazed a 65- acre pasture that had been divided into 27 paddocks using electric fencing from May 4, 1995 to September 14, 1995. During this period, the 65-acre pasture system produced 9,975 animal-days of grazing and 11,403 pounds of gain. On a per-acre basis, this translates to 153.5 animal-days of grazing and 175.4 pounds of gain. The stocking rate was constant for the entire 133- day grazing season at 1.15 steers per acre. On May 4, 1995, the beginning of the grazing season, the average weight of the steers was 495.7 pounds. By the end of the grazing trial on September 14, 1995, the average weight of the steers had increased to 647.7 pounds. The average gain per steer during the 133-day grazing period was 152 pounds, and the average daily gain per steer was 1.14 pounds. The average bodyweight of the steers during the entire grazing season was 571.7 pounds.

A Time-Motion Study of Registered Nurses’ Workflow in Intensive Care Unit Remote Monitoring

Utilizing advanced information technology, Intensive Care Unit (ICU) remote monitoring allows highly trained specialists to oversee a large number of patients at multiple sites on a continuous basis. In the current research, we conducted a time-motion study of registered nurses’ work in an ICU remote monitoring facility. Data were collected on seven nurses through 40 hours of observation. The results showed that nurses’ essential tasks were centered on three themes: monitoring patients, maintaining patients’ health records, and managing technology use. In monitoring patients, nurses spent 52% of the time assimilating information embedded in a clinical information system and 15% on monitoring live vitals. System-generated alerts frequently interrupted nurses in their task performance and redirected them to manage suddenly appearing events. These findings provide insight into nurses’ workflow in a new, technology-driven critical care setting and have important implications for system design, work engineering, and personnel selection and training.

Idiographic Self-Monitoring Instruments to Empower Client Participation and Evaluate Outcome in Intensive Family Preservation Services

Intensive Family Preservation Services seek to reflect the values of focusing on client strengths and viewing clients as colleagues. To promote those values, Intensive Family Preservation Programs should include a systematic form of client self monitoring in their packages of outcome measures. This paper presents a model of idiographic self-monitoring used in time series, single system research design developed for Family Partners, a family preservation program of the School for Contemporary Education in Annandale, Virginia. The evaluation model provides a means of empowering client families to utilize their strengths and promote their status as colleague in determining their own goals, participating in the change process, and measuring their own progress.

A Compensating Anastigmatic Submillimeter Array Imaging System for STEAMR

In this paper, we present a novel technique for the removal of astigmatism in submillimeter-wave optical systems through employment of a specific combination of so-called astigmatic off-axis reflectors. This technique treats an orthogonally astigmatic beam using skew Gaussian beam analysis, from which an anastigmatic imaging network is derived. The resultant beam is considered truly stigmatic, with all Gaussian beam parameters in the orthogonal directions being matched. This is thus considered an improvement over previous techniques wherein a beam corrected for astigmatism has only the orthogonal beam amplitude radii matched, with phase shift and phase radius of curvature not considered. This technique is computationally efficient, negating the requirement for computationally intensive numerical analysis of shaped reflector surfaces. The required optical surfaces are also relatively simple to implement compared to such numerically optimized shaped surfaces. This technique is implemented in this work as part of the complete optics train for the STEAMR antenna. The STEAMR instrument is envisaged as a mutli-beam limb sounding instrument operating at submillimeter wavelengths. The antenna optics arrangement for this instrument uses multiple off-axis reflectors to control the incident radiation and couple them to their corresponding receiver feeds. An anastigmatic imaging network is successfully implemented into an optical model of this antenna, and the resultant design ensures optimal imaging of the beams to the corresponding feed horns. This example also addresses the challenges of imaging in multi-beam antenna systems.

Training in intensive care medicine. A challenge within reach.

The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities.

A Baseline Wander Tracking System for Artifact Rejection in Long-Term Electrocardiography

Long-term electrocardiogram (ECG) signals might suffer from relevant baseline disturbances during physical activity. Motion artifacts in particular are more pronounced with dry surface or esophageal electrodes which are dedicated to prolonged ECG recording. In this paper we present a method called baseline wander tracking (BWT) that tracks and rejects strong baseline disturbances and avoids concurrent saturation of the analog front-end. The proposed algorithm shifts the baseline level of the ECG signal to the middle of the dynamic input range. Due to the fast offset shifts, that produce much steeper signal portions than the normal ECG waves, the true ECG signal can be reconstructed offline and filtered using computationally intensive algorithms. Based on Monte Carlo simulations we observed reconstruction errors mainly caused by the non-linearity inaccuracies of the DAC. However, the signal to error ratio of the BWT is higher compared to an analog front-end featuring a dynamic input ranges above 15 mV if a synthetic ECG signal was used. The BWT is additionally able to suppress (electrode) offset potentials without introducing long transients. Due to its structural simplicity, memory efficiency and the DC coupling capability, the BWT is dedicated to high integration required in long-term and low-power ECG recording systems.