Pharmacokinetic variability of extended interval tobramycin in burn patients.

BACKGROUND: Aminoglycosides are mandatory in the treatment of severe infections in burns. However, their pharmacokinetics are difficult to predict in critically ill patients. Our objective was to describe the pharmacokinetic parameters of high doses of tobramycin administered at extended intervals in severely burned patients. METHODS: We prospectively enrolled 23 burned patients receiving tobramycin in combination therapy for Pseudomonas species infections in a burn ICU over 2 years in a therapeutic drug monitoring program. Trough and post peak tobramycin levels were measured to adjust drug dosage. Pharmacokinetic parameters were derived from two points first order kinetics. RESULTS: Tobramycin peak concentration was 7.4 (3.1-19.6)microg/ml and Cmax/MIC ratio 14.8 (2.8-39.2). Half-life was 6.9 (range 1.8-24.6)h with a distribution volume of 0.4 (0.2-1.0)l/kg. Clearance was 35 (14-121)ml/min and was weakly but significantly correlated with creatinine clearance. CONCLUSION: Tobramycin had a normal clearance, but an increased volume of distribution and a prolonged half-life in burned patients. However, the pharmacokinetic parameters of tobramycin are highly variable in burned patients. These data support extended interval administration and strongly suggest that aminoglycosides should only be used within a structured pharmacokinetic monitoring program.

A Multi-Project Scheduling Procedure for Transportation Projects, Part II, HR-339, 1994

The Iowa Department of Transportation (IDOT) has been requiring Critical Path Method (CPM) schedules on some larger or more schedule sensitive projects. The Office of Construction's expectations for enhanced project control and improved communication of project objectives have not been fully met by the use of CPM. Recognizing that the current procedures might not be adequate for all projects, IDOT sponsored a research project to explore the state-of-the-art in transportation scheduling and identify opportunities for improvement. The first phase of this project identified a technique known as the Linear Scheduling Method (LSM) as an alternative to CPM on certain highway construction projects. LSM graphically displays the construction process with respect to the location and the time in which each activity occurs. The current phase of this project was implemented to allow the research team the opportunity to evaluate LSM on all small groups of diverse projects. Unlike the first phase of the project, the research team was closely involved in the project from early in the planning phase throughout the completion of the projects. The research strongly suggests that the linear scheduling technique has great potential as a project management tool for both contractors and IDOT personnel. However, before this technique can become a viable weapon in the project management arsenal, a software application needs to be developed. This application should bring to linear scheduling a degree of functionality as rich and as comprehensive as that found in microcomputer based CPM software on the market today. The research team recommends that the IDOT extend this research effort to include the development of a linear scheduling application.

A Multi-Project Scheduling Procedure for Transportation Projects, Final Report, HR-339, 1993

This report proposes, that for certain types of highway construction projects undertaken by the Iowa Department of Transportation, a scheduling technique commonly referred to as linear scheduling may be more effective than the Critical Path Method scheduling technique that is currently being used. The types of projects that appear to be good candidates for the technique are those projects that have a strong linear orientation. Like a bar chart, this technique shows when an activity is scheduled to occur and like a CPM schedule it shows the sequence in which activities are expected to occur. During the 1992 construction season, the authors worked with an inlay project on Interstate 29 to demonstrate the linear scheduling technique to the Construction Office. The as-planned schedule was developed from the CPM schedule that the contractor had developed for the project. Therefore, this schedule represents what a linear representation of a CPM schedule would look like, and not necessarily what a true linear schedule would look like if it had been the only scheduling technique applied to the project. There is a need to expand the current repertoire of scheduling techniques to address those projects for which the bar chart and CPM may not be appropriate either because of the lack of control information or due to overly complex process for the actual project characteristics. The scheduling approaches used today on transportation projects have many shortcomings for properly modeling the real world constraints and conditions which are encountered. Linear project's predilection for activities with variable production rates, a concept very difficult to handle with the CPM, is easily handled and visualized with the linear technique. It is recommended that work proceed with the refinement of the method of linear scheduling described above and the development of a microcomputer based system for use by the Iowa Department of Transportation and contractors for its implementation. The system will be designed to provide the information needed to adjust schedules in a rational understandable method for monitoring progress on the projects and alerting Iowa Department of Transportation personnel when the contractor is deviating from the plan.

Energy deficit and length of hospital stay can be reduced by a two-step quality improvement of nutrition therapy: the intensive care unit dietitian can make the difference.

OBJECTIVE: Critically ill patients are at high risk of malnutrition. Insufficient nutritional support still remains a widespread problem despite guidelines. The aim of this study was to measure the clinical impact of a two-step interdisciplinary quality nutrition program. DESIGN: Prospective interventional study over three periods (A, baseline; B and C, intervention periods). SETTING: Mixed intensive care unit within a university hospital. PATIENTS: Five hundred seventy-two patients (age 59 ± 17 yrs) requiring >72 hrs of intensive care unit treatment. INTERVENTION: Two-step quality program: 1) bottom-up implementation of feeding guideline; and 2) additional presence of an intensive care unit dietitian. The nutrition protocol was based on the European guidelines. MEASUREMENTS AND MAIN RESULTS: Anthropometric data, intensive care unit severity scores, energy delivery, and cumulated energy balance (daily, day 7, and discharge), feeding route (enteral, parenteral, combined, none-oral), length of intensive care unit and hospital stay, and mortality were collected. Altogether 5800 intensive care unit days were analyzed. Patients in period A were healthier with lower Simplified Acute Physiologic Scale and proportion of "rapidly fatal" McCabe scores. Energy delivery and balance increased gradually: impact was particularly marked on cumulated energy deficit on day 7 which improved from -5870 kcal to -3950 kcal (p < .001). Feeding technique changed significantly with progressive increase of days with nutrition therapy (A: 59% days, B: 69%, C: 71%, p < .001), use of enteral nutrition increased from A to B (stable in C), and days on combined and parenteral nutrition increased progressively. Oral energy intakes were low (mean: 385 kcal*day, 6 kcal*kg*day ). Hospital mortality increased with severity of condition in periods B and C. CONCLUSION: A bottom-up protocol improved nutritional support. The presence of the intensive care unit dietitian provided significant additional progression, which were related to early introduction and route of feeding, and which achieved overall better early energy balance.

Offering planning with support of roadmapping in project business

Tämän tutkielman tavoitteena on tutkia kuinka roadmapping-tekniikkaa voidaan käyttää tarjonnan suunnittelun tukena uusien tuotteiden valmistamisen yhteydessä. Työ koostuu teoreettisesta ja käytännönläheisestä osasta. Teoreettinen runko on luotu selventämään kuinka tämän hetkisen tutkimus- ja kehitys projektit lopulta muodostavat tulevaisuuden tarjoaman. Menestyksekkään tuotetarjoaman luominen vaatii, sekä uusien teknologioiden kehittämistä, että markkinoilla olevien asiakkaiden tarpeiden ymmärtämistä. Asiakassuuntaisten tuotteiden kehittäminen vaatii toimintaympäristöstä ja asiakasrajapinnasta tulevien signaalien tunnistamista ja niiden ohjaamista tuote- ja teknologia platformeille. Strategia luodaan tukemaan päätöksentekoa prosessin eri vaiheissa. Yrityskohtainen osio koostuu analyysistä, joka on tehty teetetyn kyselyn ja haas-tattelujen pohjalta. Osana analyysia ovat Major project-yksikön tämänhetkinen tarjonnansuunnitteluprosessi, strategian soveltaminen, informaation kerääminen ja priorisointi, portfolionhallinta ja roadmap-tekniikan käyttö. Ratkaisussa on esitet-ty tarjonnan suunnitteluprosessi ja siihen liittyvät kriittiset komponentit. Roadmapping-tekniikkaaon luotu yhdistämään toimintaympäristö, tuotteet ja teknologia toisiinsa. Toimintaympäristö ja tuotteet on yhdistetty myös linked-grids-tekniikan avulla.

Toiminnanohjauksen kehittäminen toteutusaikataulun avulla

Tässä työssä tarkastellaan projektiin liittyvää toiminnanohjausta. Tutkimusongelmana on, kuinka toiminnanohjausta voitaisiin kehittää aikataulutuksen avulla. Työn yhtenä tavoitteena on luoda kokonaiskuva aikataulutuksen nykytilanteesta. Toisena tavoitteena on kartoittaa ajankohtaiset ongelmat. Kolmantena tavoitteena on luoda malli aikataulun laatimiselle kalanterin valmistuksessa.Kirjallisuustutkimuksen perusteella luotiin kuva projektiliiketoiminnasta ja projektinhallintaan sisältyvästä aikataulunhallinnasta. Haastattelututkimuksen perusteella luotiin kokonaiskuva projektin aikataulutuksesta ja siihen liittyvistä ongelmista. Tutkimusta täydennettiin analysoimalla erään projektin suunniteltua aikataulua ja toteutunutta aikataulua. Toiminnanohjauksen aikataulutustehtävä on muuttumassa yhä tarkeämmäksi toimittaessa resurssien äärirajoilla. Ajankohtaisia kysymyksiä ovat: toteutusaikataulun laatimistekniikka, projektin osittaminen, optimi suunnittelujärjestys ja kriittinen polku.Tutkimuksen perusteella kehitettiin toteutusaikataulun suunnittelun malli ja malliaikataulu. Mallin keskeiset osat ovat: projektin osittaminen tehtäviin, tärkeimpien tehtävien määrittäminen tarkempaa ohjausta varten, tehtävien välisten riippuvuuksien määrittäminen, tehtävien limitysmahdollisuuksien ja ajallisen keston arviointi, aikataulun esittäminen janakaaviona ja ulkoisten tekijöiden, kuten hankinnan asettamien vaatimusten huomioiminen malliaikataulussa. Malliaikataulua tullaan soveltamaan seuraavaan sopivaan toimitusprojektiin.

Development a distributed simulation environment on a cluster of workstations

Simulation has traditionally been used for analyzing the behavior of complex real world problems. Even though only some features of the problems are considered, simulation time tends to become quite high even for common simulation problems. Parallel and distributed simulation is a viable technique for accelerating the simulations. The success of parallel simulation depends heavily on the combination of the simulation application, algorithm and message population in the simulation is sufficient, no additional delay is caused by this environment. In this thesis a conservative, parallel simulation algorithm is applied to the simulation of a cellular network application in a distributed workstation environment. This thesis presents a distributed simulation environment, Diworse, which is based on the use of networked workstations. The distributed environment is considered especially hard for conservative simulation algorithms due to the high cost of communication. In this thesis, however, the distributed environment is shown to be a viable alternative if the amount of communication is kept reasonable. Novel ideas of multiple message simulation and channel reduction enable efficient use of this environment for the simulation of a cellular network application. The distribution of the simulation is based on a modification of the well known Chandy-Misra deadlock avoidance algorithm with null messages. The basic Chandy Misra algorithm is modified by using the null message cancellation and multiple message simulation techniques. The modifications reduce the amount of null messages and the time required for their execution, thus reducing the simulation time required. The null message cancellation technique reduces the processing time of null messages as the arriving null message cancels other non processed null messages. The multiple message simulation forms groups of messages as it simulates several messages before it releases the new created messages. If the message population in the simulation is suffiecient, no additional delay is caused by this operation A new technique for considering the simulation application is also presented. The performance is improved by establishing a neighborhood for the simulation elements. The neighborhood concept is based on a channel reduction technique, where the properties of the application exclusively determine which connections are necessary when a certain accuracy for simulation results is required. Distributed simulation is also analyzed in order to find out the effect of the different elements in the implemented simulation environment. This analysis is performed by using critical path analysis. Critical path analysis allows determination of a lower bound for the simulation time. In this thesis critical times are computed for sequential and parallel traces. The analysis based on sequential traces reveals the parallel properties of the application whereas the analysis based on parallel traces reveals the properties of the environment and the distribution.

Nichesourcing The Uralic Languages For The Benefit Of Linguistic Research And Lingual Societies

The emerging technologies have recently challenged the libraries to reconsider their role as a mere mediator between the collections, researchers, and wider audiences (Sula, 2013), and libraries, especially the nationwide institutions like national libraries, haven’t always managed to face the challenge (Nygren et al., 2014). In the Digitization Project of Kindred Languages, the National Library of Finland has become a node that connects the partners to interplay and work for shared goals and objectives. In this paper, I will be drawing a picture of the crowdsourcing methods that have been established during the project to support both linguistic research and lingual diversity. The National Library of Finland has been executing the Digitization Project of Kindred Languages since 2012. The project seeks to digitize and publish approximately 1,200 monograph titles and more than 100 newspapers titles in various, and in some cases endangered Uralic languages. Once the digitization has been completed in 2015, the Fenno-Ugrica online collection will consist of 110,000 monograph pages and around 90,000 newspaper pages to which all users will have open access regardless of their place of residence. The majority of the digitized literature was originally published in the 1920s and 1930s in the Soviet Union, and it was the genesis and consolidation period of literary languages. This was the era when many Uralic languages were converted into media of popular education, enlightenment, and dissemination of information pertinent to the developing political agenda of the Soviet state. The ‘deluge’ of popular literature in the 1920s to 1930s suddenly challenged the lexical orthographic norms of the limited ecclesiastical publications from the 1880s onward. Newspapers were now written in orthographies and in word forms that the locals would understand. Textbooks were written to address the separate needs of both adults and children. New concepts were introduced in the language. This was the beginning of a renaissance and period of enlightenment (Rueter, 2013). The linguistically oriented population can also find writings to their delight, especially lexical items specific to a given publication, and orthographically documented specifics of phonetics. The project is financially supported by the Kone Foundation in Helsinki and is part of the Foundation’s Language Programme. One of the key objectives of the Kone Foundation Language Programme is to support a culture of openness and interaction in linguistic research, but also to promote citizen science as a tool for the participation of the language community in research. In addition to sharing this aspiration, our objective within the Language Programme is to make sure that old and new corpora in Uralic languages are made available for the open and interactive use of the academic community as well as the language societies. Wordlists are available in 17 languages, but without tokenization, lemmatization, and so on. This approach was verified with the scholars, and we consider the wordlists as raw data for linguists. Our data is used for creating the morphological analyzers and online dictionaries at the Helsinki and Tromsø Universities, for instance. In order to reach the targets, we will produce not only the digitized materials but also their development tools for supporting linguistic research and citizen science. The Digitization Project of Kindred Languages is thus linked with the research of language technology. The mission is to improve the usage and usability of digitized content. During the project, we have advanced methods that will refine the raw data for further use, especially in the linguistic research. How does the library meet the objectives, which appears to be beyond its traditional playground? The written materials from this period are a gold mine, so how could we retrieve these hidden treasures of languages out of the stack that contains more than 200,000 pages of literature in various Uralic languages? The problem is that the machined-encoded text (OCR) contains often too many mistakes to be used as such in research. The mistakes in OCRed texts must be corrected. For enhancing the OCRed texts, the National Library of Finland developed an open-source code OCR editor that enabled the editing of machine-encoded text for the benefit of linguistic research. This tool was necessary to implement, since these rare and peripheral prints did often include already perished characters, which are sadly neglected by the modern OCR software developers, but belong to the historical context of kindred languages and thus are an essential part of the linguistic heritage (van Hemel, 2014). Our crowdsourcing tool application is essentially an editor of Alto XML format. It consists of a back-end for managing users, permissions, and files, communicating through a REST API with a front-end interface—that is, the actual editor for correcting the OCRed text. The enhanced XML files can be retrieved from the Fenno-Ugrica collection for further purposes. Could the crowd do this work to support the academic research? The challenge in crowdsourcing lies in its nature. The targets in the traditional crowdsourcing have often been split into several microtasks that do not require any special skills from the anonymous people, a faceless crowd. This way of crowdsourcing may produce quantitative results, but from the research’s point of view, there is a danger that the needs of linguists are not necessarily met. Also, the remarkable downside is the lack of shared goal or the social affinity. There is no reward in the traditional methods of crowdsourcing (de Boer et al., 2012). Also, there has been criticism that digital humanities makes the humanities too data-driven and oriented towards quantitative methods, losing the values of critical qualitative methods (Fish, 2012). And on top of that, the downsides of the traditional crowdsourcing become more imminent when you leave the Anglophone world. Our potential crowd is geographically scattered in Russia. This crowd is linguistically heterogeneous, speaking 17 different languages. In many cases languages are close to extinction or longing for language revitalization, and the native speakers do not always have Internet access, so an open call for crowdsourcing would not have produced appeasing results for linguists. Thus, one has to identify carefully the potential niches to complete the needed tasks. When using the help of a crowd in a project that is aiming to support both linguistic research and survival of endangered languages, the approach has to be a different one. In nichesourcing, the tasks are distributed amongst a small crowd of citizen scientists (communities). Although communities provide smaller pools to draw resources, their specific richness in skill is suited for complex tasks with high-quality product expectations found in nichesourcing. Communities have a purpose and identity, and their regular interaction engenders social trust and reputation. These communities can correspond to research more precisely (de Boer et al., 2012). Instead of repetitive and rather trivial tasks, we are trying to utilize the knowledge and skills of citizen scientists to provide qualitative results. In nichesourcing, we hand in such assignments that would precisely fill the gaps in linguistic research. A typical task would be editing and collecting the words in such fields of vocabularies where the researchers do require more information. For instance, there is lack of Hill Mari words and terminology in anatomy. We have digitized the books in medicine, and we could try to track the words related to human organs by assigning the citizen scientists to edit and collect words with the OCR editor. From the nichesourcing’s perspective, it is essential that altruism play a central role when the language communities are involved. In nichesourcing, our goal is to reach a certain level of interplay, where the language communities would benefit from the results. For instance, the corrected words in Ingrian will be added to an online dictionary, which is made freely available for the public, so the society can benefit, too. This objective of interplay can be understood as an aspiration to support the endangered languages and the maintenance of lingual diversity, but also as a servant of ‘two masters’: research and society.

The formation of conscience : pedagogy of the sacred

This qualitative study explores Thomas Green's (1999) treatise, Voices: The Educational Formation of Conscience; for the purpose of reconstruing the transformative usefulness of conscience in moral education. Conscience is "reflexive judgment about things that matter" (Green, 1999, p. 21). Paul Lehmann (1963) suggested that we must "do the conscience over or do the conscience in" (p. 327). Thomas Green "does the conscience over", arguing that a philosophy of moral education, and not a moral philosophy, provides the only framework from which governance of moral behaviour can be understood. Narratives from four one-to-one interviews and a focus group are analysed and interpreted in search of: (a) awareness and understanding of conscience, (b) voices of conscience, (c) normation, (d) reflexive emotions, and (e) the idea of the sacred. Participants in this study (ages 16-21) demonstrated an active awareness of their conscience and a willingness to engage in a reflective process of their moral behaviour. They understood their conscience to be a process of self-judgment about what is right and wrong, and that its authority comes from within themselves. Narrative accounts from childhood indicated that conscience is there "from the beginning" with evidence of selfcorrecting behaviour. A maturing conscience is accompanied by an increased cognitive capacity, more complicated life experiences, and individualization. Moral motivation was grounded in " a desire to connect with things that are most important." A model for conscience formation is proposed, which visualizes a critical path of reflexive emotions. It is argued that schools, striving to shape good citizens, can promote conscience formation through a "curriculum of moral skills"; a curriculum that embraces complexity, diversity, social criticism, and selfhood.

Decimal Multiplication using compact BCD Multiplier

Decimal multiplication is an integral part offinancial, commercial, and internet-based computations. The basic building block of a decimal multiplier is a single digit multiplier. It accepts two Binary Coded Decimal (BCD) inputs and gives a product in the range [0, 81] represented by two BCD digits. A novel design for single digit decimal multiplication that reduces the critical path delay and area is proposed in this research. Out of the possible 256 combinations for the 8-bit input, only hundred combinations are valid BCD inputs. In the hundred valid combinations only four combinations require 4 x 4 multiplication, combinations need x multiplication, and the remaining combinations use either x or x 3 multiplication. The proposed design makes use of this property. This design leads to more regular VLSI implementation, and does not require special registers for storing easy multiples. This is a fully parallel multiplier utilizing only combinational logic, and is extended to a Hex/Decimal multiplier that gives either a decimal output or a binary output. The accumulation ofpartial products generated using single digit multipliers is done by an array of multi-operand BCD adders for an (n-digit x n-digit) multiplication.

RNS based programmable multi-mode decimation filter for WCDMA and WiMAX

The recent trends envisage multi-standard architectures as a promising solution for the future wireless transceivers to attain higher system capacities and data rates. The computationally intensive decimation filter plays an important role in channel selection for multi-mode systems. An efficient reconfigurable implementation is a key to achieve low power consumption. To this end, this paper presents a dual-mode Residue Number System (RNS) based decimation filter which can be programmed for WCDMA and 802.16e standards. Decimation is done using multistage, multirate finite impulse response (FIR) filters. These FIR filters implemented in RNS domain offers high speed because of its carry free operation on smaller residues in parallel channels. Also, the FIR filters exhibit programmability to a selected standard by reconfiguring the hardware architecture. The total area is increased only by 24% to include WiMAX compared to a single mode WCDMA transceiver. In each mode, the unused parts of the overall architecture is powered down and bypassed to attain power saving. The performance of the proposed decimation filter in terms of critical path delay and area are tabulated.

Fixed Point Decimal Multiplication Using RPS Algorithm

Decimal multiplication is an integral part of financial, commercial, and internet-based computations. A novel design for single digit decimal multiplication that reduces the critical path delay and area for an iterative multiplier is proposed in this research. The partial products are generated using single digit multipliers, and are accumulated based on a novel RPS algorithm. This design uses n single digit multipliers for an n × n multiplication. The latency for the multiplication of two n-digit Binary Coded Decimal (BCD) operands is (n + 1) cycles and a new multiplication can begin every n cycle. The accumulation of final partial products and the first iteration of partial product generation for next set of inputs are done simultaneously. This iterative decimal multiplier offers low latency and high throughput, and can be extended for decimal floating-point multiplication.

Dual-mode RNS based programmable decimation filter for WCDMA and WLANa

The recent trends envisage multi-standard architectures as a promising solution for the future wireless transceivers. The computationally intensive decimation filter plays an important role in channel selection for multi-mode systems. An efficient reconfigurable implementation is a key to achieve low power consumption. To this end, this paper presents a dual-mode Residue Number System (RNS) based decimation filter which can be programmed for WCDMA and 802.11a standards. Decimation is done using multistage, multirate finite impulse response (FIR) filters. These FIR filters implemented in RNS domain offers high speed because of its carry free operation on smaller residues in parallel channels. Also, the FIR filters exhibit programmability to a selected standard by reconfiguring the hardware architecture. The total area is increased only by 33% to include WLANa compared to a single mode WCDMA transceiver. In each mode, the unused parts of the overall architecture is powered down and bypassed to attain power saving. The performance of the proposed decimation filter in terms of critical path delay and area are tabulated