Impact of the introduction of real-time therapeutic drug monitoring on empirical doses of carbapenems in critically ill burn patients.

PURPOSE: Adequate empirical antibiotic dose selection for critically ill burn patients is difficult due to extreme variability in drug pharmacokinetics. Therapeutic drug monitoring (TDM) may aid antibiotic prescription and implementation of initial empirical antimicrobial dosage recommendations. This study evaluated how gradual TDM introduction altered empirical dosages of meropenem and imipenem/cilastatin in our burn ICU. METHODS: Imipenem/cilastatin and meropenem use and daily empirical dosage at a five-bed burn ICU were analyzed retrospectively. Data for all burn admissions between 2001 and 2011 were extracted from the hospital's computerized information system. For each patient receiving a carbapenem, episodes of infection were reviewed and scored according to predefined criteria. Carbapenem trough serum levels were characterized. Prior to May 2007, TDM was available only by special request. Real-time carbapenem TDM was introduced in June 2007; it was initially available weekly and has been available 4 days a week since 2010. RESULTS: Of 365 patients, 229 (63%) received antibiotics (109 received carbapenems). Of 23 TDM determinations for imipenem/cilastatin, none exceeded the predefined upper limit and 11 (47.8%) were insufficient; the number of TDM requests was correlated with daily dose (r=0.7). Similar numbers of inappropriate meropenem trough levels (30.4%) were below and above the upper limit. Real-time TDM introduction increased the empirical dose of imipenem/cilastatin, but not meropenem. CONCLUSIONS: Real-time carbapenem TDM availability significantly altered the empirical daily dosage of imipenem/cilastatin at our burn ICU. Further studies are needed to evaluate the individual impact of TDM-based antibiotic adjustment on infection outcomes in these patients.

Design of User Authentication System for Multi-operator wireless LANs

Langattomat lähiverkot ovat viime vuosikymmeninä saavuttaneet suuren suosion. Tässä työssä käsitellään käyttäjien todentamisjärjestelmän suunnittelua ja kehitystä langattomaan monioperaattoriverkkoon. Langattomassa monioperaattoriverkossa käyttäjillä on mahdollisuus käyttää eri operaattoreiden palveluita. Aluksi käsitellään olemassa olevia todentamismenetelmiä ja -järjestelmiä. minkä jälkeen kuvaillaan todentamisjärjestelmä langattomille monioperaattoriverkoille. Todentamisjärjestelmän ratkaisuvaihtoehtoja esitellään kaksi, niin sanotut moni- istunto - ja yksittäisistuntomalli. Moni-istuntomalli on normaali lähestymistapa käyttäjien todentamiseen tietokonejärjestelmissä. Siinä käyttäjän pitää tunnistautua ja todentaa itsensä jokaiselle verkon palvelulle erikseen. Yksittäisistuntomallissa pyritään parempaan luotettavuuteen ja käytettävyyteen. Siinä käyttäjä todentaa itsensä vain kerran ja voi sen jälkeen päästä useisiin palveluihin. Työn loppuosassa kuvaillaan suunnitellun järjestelmän toteutusta. Lisäksi ehdotetaan vaihtoehtoisia toteutustapoja, analysoidaan järjestelmän heikkouksia ja kerrotaan jatkokehitysmahdoillisuuksista.

Sanomayhdyskäytävän tuotetietoturva

Ohjelmistojen tietoturva on noussut viime aikoina entistä tärkeämpään rooliin. Ohjelmistojen suunnittelu pitää alusta alkaen hoitaa siten, että tietoturva tulee huomioitua. Ohjelman helppokäyttöisyys ei saisi ajaa tietoturvan edelle, eikä myöskään ohjeiden lukematta jättäminen saa tarkoittaa tietoturvan menetystä. Tärkeä osa ohjelmistojen tietoturvaa on myös ohjelmiston laillinen käyttö. Se miten laiton käyttö estetään sen sijaan on erittäin vaikeaa toteuttaa nykyjärjestelmissä. Työn tarkoituksena oli tutkia Intellitel Communications Oy:n sanomayhdyskäytävää, Intellitel Messaging Gateway, tuotetietoturvan näkökulmasta, löytää sieltä mahdolliset virheet ja myös korjata ne.

Virtuaaliset yhteisöt ja areenat: virtuaaliyhteisön kehittämisprosessi. Case: Vaikuttamo

Virtuaalinen yhteisö voidaan määritellä ihmisten, eritasoisten suhteiden, yhteisen tarkoituksen ja tietoteknisten järjestelmien muodostamaksi kokonaisuudeksi. Järjestelmäratkaisut muodostavat yhteisön toiminnan pelikentän, virtuaaliareenan. Virtuaaliareena on siten erottamaton osa virtuaalista yhteisöä. Tutkielman tarkoituksena on tutkia, millainen on virtuaalisen yhteisön kehittämisprosessi ja elinkaari. Lisäksi tutkielmassa kuvataan menetelmät, joiden avulla yhteisön jäsenten tarpeita on mahdollista kartoittaa toiminnan eri vaiheissa. Näitä menetelmiä voidaan käyttää hyväksi erityyppisten virtuaaliympäristöjen kehitystyössä. Käytännön kehittämistyötä tarkastellaan Vaikuttamo –casen kautta. Tavoitteena oli selvittää, kuinka Vaikuttamoa palveleva virtuaaliareena suunniteltiin ja mitkä tekijät ovat vauhdittaneet Vaikuttamon kehittymistä toimivaksi yhteisöksi. Tutkimusmenetelmänä käytettiin teemahaastattelua ja lisäksi hyödynnettiin toukokuussa 2003 toteutetun web-kyselyn aineistoa. Tulosten perusteella havaittiin, että kirjallisuudessa kuvattu kehittämisprosessi ei olisi soveltunut Vaikuttamon tarpeisiin, koska kyseessä oli kokonaan uudentyyppinen yhteisö. Vaikuttamon menestyksen avaintekijöinä voidaan pitää paikallisuutta, varsinaisen yhteisön ulkopuolista ohjausta sekä vahvoja sidoksia Hämeenlinnan alueen kouluihin ja opettajiin.

Statistical mechanics of multi-edge networks

Statistical properties of binary complex networks are well understood and recently many attempts have been made to extend this knowledge to weighted ones. There are, however, subtle yet important considerations to be made regarding the nature of the weights used in this generalization. Weights can be either continuous or discrete magnitudes, and in the latter case, they can additionally have undistinguishable or distinguishable nature. This fact has not been addressed in the literature insofar and has deep implications on the network statistics. In this work we face this problem introducing multiedge networks as graphs where multiple (distinguishable) connections between nodes are considered. We develop a statistical mechanics framework where it is possible to get information about the most relevant observables given a large spectrum of linear and nonlinear constraints including those depending both on the number of multiedges per link and their binary projection. The latter case is particularly interesting as we show that binary projections can be understood from multiedge processes. The implications of these results are important as many real-agent-based problems mapped onto graphs require this treatment for a proper characterization of their collective behavior.

Las auditorías, una metodología para planificar la preservación digital. Experiencias en España.

Se presentan los resultados obtenidos en la aplicación de diversas metodologías de auditoría para comprobar el estado de la preservación digital en distintas instituciones de España. Se concluye que las auditorías también se pueden usar como herramienta de ayuda a la planificación de sistemas de preservación digital.

L’experiència del CRAI de la UB en la migració consorciada a Millennium

Aquest article pretén reflectir l'experiència viscuda a la Universitat de Barcelona (UB) en el procés viscut fa poc de canvi de sistema de Catàleg Col·lectiu de les Universitats de Catalunya (CCUC) i dels catàlegs de les institucions del Consorci de Biblioteques Universitàries de Catalunya (CBUC). Es recullen les principals actuacions i fites tècniques i organitzatives que ha assolit l'equip responsable de la implementació en les diferents fases del projecte, des d'un punt de vista professional però, sobretot, des del punt de vista personal d'implicació, de repte, de satisfacció i d'esforç. Es conclou destacant, d'una banda, la rellevància del treball en equip com a factor d'èxit en el desenvolupament d'un projecte complexi, de l'altra, la necessitat d'una reflexió global sobre els processos i fluxos de treball, per tal d'explotar al màxim les possibilitats d'un sistema de gestió integral i aconseguir el màxim d'eficiència.

Virtualització de servidors i escriptoris

Aquest treball explica com una pime passa d'un entorn de servidors majoritàriament físic a un entorn virtual aprofitant la necessitat d'actualitzar la infraestructura. La plataforma de virtualització utilitzada serà VMware tant per a servidors com per a escriptoris.

Identifying Specific Cues and Contexts Related to Smoking Craving for the Development of Effective Virtual Environments

Craving is considered the main variable associated with relapse after smoking cessation. Cue Exposure Therapy (CET) consists of controlled and repeated exposure to drug-related cues with the aim of extinguishing craving responses. Some virtual reality (VR) environments, such as virtual bars or parties, have previously shown their efficacy as tools for eliciting smoking craving. However, in order to adapt this technology to smoking cessation interventions, there is a need for more diverse environments that enhance the probability of generalization of extinction in real life. The main objective of this study was to identify frequent situations that produce smoking craving, as well as detecting specific craving cues in those contexts. Participants were 154 smokers who responded to an ad hoc self-administered inventory for assessing craving level in 12 different situations. Results showed that having a drink in a bar/pub at night, after having lunch/dinner in a restaurant and having a coffee in a cafe or after lunch/dinner at home were reported as the most craving-inducing scenarios. Some differences were found with regard to participants' gender, age, and number of cigarettes smoked per day. Females, younger people, and heavier smokers reported higher levels of craving in most situations. In general, the most widely cited specific cues across the contexts were people smoking, having a coffee, being with friends, and having finished eating. These results are discussed with a view to their consideration in the design of valid and reliable VR environments that could be used in the treatment of nicotine addicts who wish to give up smoking.

Disseny i implementació d’un joc de plataformes basat en la música

L’objectiu del projecte és crear un videojoc de plataformes d’scroll automàtic en 2D basat en la música. Això vol dir que tots els elements de l’escenari i els moviments que haurà de fer el jugador per a passar-se’l estaran íntegrament lligats a la banda sonora de la pantalla. A més, el joc ha de ser compatible per als dispositius Android

Molecular Physics of Elementary Processes relevant to Hypersonics: atom-molecule, molecule-molecule and atom-surface processes.

In the present chapter some prototype gas and gas-surface processes occurring within the hypersonic flow layer surrounding spacecrafts at planetary entry are discussed. The discussion is based on microscopic dynamical calculations of the detailed cross sections and rate coefficients performed using classical mechanics treatments for atoms, molecules and surfaces. Such treatment allows the evaluation of the efficiency of thermal processes (both at equilibrium and nonequilibrium distributions) based on state-to-state and state specific calculations properly averaged over the population of the initial states. The dependence of the efficiency of the considered processes on the initial partitioning of energy among the various degrees of freedom is discussed.

User Centered Desing in E-Learning Environments : from Usability to Learner Experience

The advent of the Internet had a great impact on distance education and rapidly e-learning has become a killer application. Education institutions worldwide are taking advantage of the available technology in order to facilitate education to a growing audience. Everyday, more and more people use e-learning systems, environments and contents for both training and learning. E-learning promotes educationamong people that due to different reasons could not have access to education: people who could nottravel, people with very little free time, or withdisabilities, etc. As e-learning systems grow and more people are accessing them, it is necessary to consider when designing virtual environments the diverse needs and characteristics that different users have. This allows building systems that people can use easily, efficiently and effectively, where the learning process leads to a good user experience and becomes a good learning experience.

Capturing user behavior in e-learning environments

Peer-reviewed

Design and evaluation of learning algorithms for dynamic resource management in virtual networks

Network virtualisation is considerably gaining attentionas a solution to ossification of the Internet. However, thesuccess of network virtualisation will depend in part on how efficientlythe virtual networks utilise substrate network resources.In this paper, we propose a machine learning-based approachto virtual network resource management. We propose to modelthe substrate network as a decentralised system and introducea learning algorithm in each substrate node and substrate link,providing self-organization capabilities. We propose a multiagentlearning algorithm that carries out the substrate network resourcemanagement in a coordinated and decentralised way. The taskof these agents is to use evaluative feedback to learn an optimalpolicy so as to dynamically allocate network resources to virtualnodes and links. The agents ensure that while the virtual networkshave the resources they need at any given time, only the requiredresources are reserved for this purpose. Simulations show thatour dynamic approach significantly improves the virtual networkacceptance ratio and the maximum number of accepted virtualnetwork requests at any time while ensuring that virtual networkquality of service requirements such as packet drop rate andvirtual link delay are not affected.

Predictors of smoking craving during virtual reality exposure

Cue exposure treatment (CET) consists of controlled and repeated exposure to drugrelated stimuli in order to reduce cue-reactivity. Virtual reality (VR) has proved to be a promising tool for exposition. However, identifying the variables that can modulate the efficacy of this technique is essential for selecting the most appropriate exposure modality. The aim of this study was to determine the relation between several individual variables and self-reported craving in smokers exposed to VR environments. Fortysix smokers were exposed to seven complex virtual environments that reproduce typical situations in which people smoke. Self-reported craving was selected as the criterion variable and three types of variables were selected as the predictor variables: related to nicotine dependence, related to anxiety and impulsivity, and related to the sense of presence in the virtual environments. Sense of presence was the only predictor of self-reported craving in all the experimental virtual environments. Nicotine dependence variables added predictive power to the model only in the virtual breakfast at home. No relation was found between anxiety or impulsivity and self-reported craving. Virtual reality technology can be very helpful for improving CET for substance use disorders. However, the use of virtual environments would make sense only insofar as the sense of presence was high. Otherwise, the effectiveness of exposure might be affected. © 2012 by the Massachusetts Institute of Technology.