998 resultados para Healthcare Simulation


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Dissertação de mestrado integrado em Civil Engineering

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The data acquisition process in real-time is fundamental to provide appropriate services and improve health professionals decision. In this paper a pervasive adaptive data acquisition architecture of medical devices (e.g. vital signs, ventilators and sensors) is presented. The architecture was deployed in a real context in an Intensive Care Unit. It is providing clinical data in real-time to the INTCare system. The gateway is composed by several agents able to collect a set of patients’ variables (vital signs, ventilation) across the network. The paper shows as example the ventilation acquisition process. The clients are installed in a machine near the patient bed. Then they are connected to the ventilators and the data monitored is sent to a multithreading server which using Health Level Seven protocols records the data in the database. The agents associated to gateway are able to collect, analyse, interpret and store the data in the repository. This gateway is composed by a fault tolerant system that ensures a data store in the database even if the agents are disconnected. The gateway is pervasive, universal, and interoperable and it is able to adapt to any service using streaming data.

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Nowadays in healthcare, the Clinical Decision Support Systems are used in order to help health professionals to take an evidence-based decision. An example is the Clinical Recommendation Systems. In this sense, it was developed and implemented in Centro Hospitalar do Porto a pre-triage system in order to group the patients on two levels (urgent or outpatient). However, although this system is calibrated and specific to the urgency of obstetrics and gynaecology, it does not meet all clinical requirements by the general department of the Portuguese HealthCare (Direção Geral de Saúde). The main requirement is the need of having priority triage system characterized by five levels. Thus some studies have been conducted with the aim of presenting a methodology able to evolve the pre-triage system on a Clinical Recommendation System with five levels. After some tests (using data mining and simulation techniques), it has been validated the possibility of transformation the pre-triage system in a Clinical Recommendation System in the obstetric context. This paper presents an overview of the Clinical Recommendation System for obstetric triage, the model developed and the main results achieved.

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This work presents a molecular-scale agent-based model for the simulation of enzymatic reactions at experimentally measured concentrations. The model incorporates stochasticity and spatial dependence, using diffusing and reacting particles with physical dimensions. We developed strategies to adjust and validate the enzymatic rates and diffusion coefficients to the information required by the computational agents, i.e., collision efficiency, interaction logic between agents, the time scale associated with interactions (e.g., kinetics), and agent velocity. Also, we tested the impact of molecular location (a source of biological noise) in the speed at which the reactions take place. Simulations were conducted for experimental data on the 2-hydroxymuconate tautomerase (EC 5.3.2.6, UniProt ID Q01468) and the Steroid Delta-isomerase (EC 5.3.3.1, UniProt ID P07445). Obtained results demonstrate that our approach is in accordance to existing experimental data and long-term biophysical and biochemical assumptions.

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Magdeburg, Univ., Fak. für Maschinenbau, Diss., 2011

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Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2011

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Zerspanung, Drehen, Kühlschmierung, Werkstücktemperatur, thermisch bedingte Abweichungen, FE-Modellierung, Inversaufgaben

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Stelmor, Simulation, Drahtabkühlung, Luftkühlstrecke, Modell, Temperaturfeld, Wärmeübergang, Modellierung, Wärmeübergangskoeffizient

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Solar cooling, absorption chiller, latent heat storage, TRNSYS, simulation, ammonia, water

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Electrochromatography, numerical simulation, electrokinetics, electroosmosis, parallel computing

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Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2011

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Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2012

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Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2012

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Background: Healthcare-associated infective endocarditis (HCA-IE), a severe complication of medical care, shows a growing incidence in literature. Objective: To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods: Observational prospective case series study (2006-2011) in a public hospital in Rio de Janeiro. Results: Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE) were included. There were 26 (49%) males (mean age of 47 ± 18.7 years), 27 (51%) females (mean age of 42 ± 20.1 years). IE was acute in 37 (70%) cases and subacute in 16 (30%) cases. The mitral valve was affected in 19 (36%) patients and the aortic valve in 12 (36%); prosthetic valves were affected in 23 (43%) patients and native valves in 30 (57%). Deep intravenous access was used in 43 (81%) cases. Negative blood cultures were observed in 11 (21%) patients, Enterococcus faecalis in 10 (19%), Staphylococcus aureus in 9 (17%), and Candida sp. in 7 (13%). Fever was present in 49 (92%) patients, splenomegaly in 12 (23%), new regurgitation murmur in 31 (58%), and elevated C-reactive protein in 44/53 (83%). Echocardiograms showed major criteria in 46 (87%) patients, and 34 (64%) patients were submitted to cardiac surgery. Overall mortality was 17/53 (32%). Conclusion: In Brazil HCA-IE affected young subjects. Patients with prosthetic and native valves were affected in a similar proportion, and non-cardiac surgery was an infrequent predisposing factor, whereas intravenous access was a common one. S. aureus was significantly frequent in native valve HCA-IE, and overall mortality was high.

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Dendritic Growth, Stefan-Problem, Finite-Element-Method, Level-Set-Method