Integrated clinical pathway management for medical quality improvement-based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

Tannin containing legumes as a model for nutraceuticals against digestive parasites in livestock

Parasitic infections with gastrointestinal nematodes (GINs) still represent a worldwide major pathological threat associated with the outdoor production of various livestock species. Because of the widespread resistance to synthetic chemical anthelmintics, there is a strong impetus to explore novel approaches for a more integrated management of the infections. The use of nutraceuticals in the control of GINs is one of the alternatives which has been widely studied for since 20 years. The objectives of this review are: i) to define and illustrate the concept of ‘nutraceutical’ in the context of veterinary parasitology based on data obtained on the most studied GIN models in small ruminants, the tannin-containing legumes (Fabaceae); ii) to illustrate how the ‘nutraceutical concept’ could be expanded to other plants, other livestock production systems and other GI parasitic diseases, and iii) to explain how this concept is opening up new research fields for better understanding the interactions between the host, the digestive parasites and the environment.

A Framework supporting collaboration on the distributed design of integrated systems

The work described in this thesis aims to support the distributed design of integrated systems and considers specifically the need for collaborative interaction among designers. Particular emphasis was given to issues which were only marginally considered in previous approaches, such as the abstraction of the distribution of design automation resources over the network, the possibility of both synchronous and asynchronous interaction among designers and the support for extensible design data models. Such issues demand a rather complex software infrastructure, as possible solutions must encompass a wide range of software modules: from user interfaces to middleware to databases. To build such structure, several engineering techniques were employed and some original solutions were devised. The core of the proposed solution is based in the joint application of two homonymic technologies: CAD Frameworks and object-oriented frameworks. The former concept was coined in the late 80's within the electronic design automation community and comprehends a layered software environment which aims to support CAD tool developers, CAD administrators/integrators and designers. The latter, developed during the last decade by the software engineering community, is a software architecture model to build extensible and reusable object-oriented software subsystems. In this work, we proposed to create an object-oriented framework which includes extensible sets of design data primitives and design tool building blocks. Such object-oriented framework is included within a CAD Framework, where it plays important roles on typical CAD Framework services such as design data representation and management, versioning, user interfaces, design management and tool integration. The implemented CAD Framework - named Cave2 - followed the classical layered architecture presented by Barnes, Harrison, Newton and Spickelmier, but the possibilities granted by the use of the object-oriented framework foundations allowed a series of improvements which were not available in previous approaches: - object-oriented frameworks are extensible by design, thus this should be also true regarding the implemented sets of design data primitives and design tool building blocks. This means that both the design representation model and the software modules dealing with it can be upgraded or adapted to a particular design methodology, and that such extensions and adaptations will still inherit the architectural and functional aspects implemented in the object-oriented framework foundation; - the design semantics and the design visualization are both part of the object-oriented framework, but in clearly separated models. This allows for different visualization strategies for a given design data set, which gives collaborating parties the flexibility to choose individual visualization settings; - the control of the consistency between semantics and visualization - a particularly important issue in a design environment with multiple views of a single design - is also included in the foundations of the object-oriented framework. Such mechanism is generic enough to be also used by further extensions of the design data model, as it is based on the inversion of control between view and semantics. The view receives the user input and propagates such event to the semantic model, which evaluates if a state change is possible. If positive, it triggers the change of state of both semantics and view. Our approach took advantage of such inversion of control and included an layer between semantics and view to take into account the possibility of multi-view consistency; - to optimize the consistency control mechanism between views and semantics, we propose an event-based approach that captures each discrete interaction of a designer with his/her respective design views. The information about each interaction is encapsulated inside an event object, which may be propagated to the design semantics - and thus to other possible views - according to the consistency policy which is being used. Furthermore, the use of event pools allows for a late synchronization between view and semantics in case of unavailability of a network connection between them; - the use of proxy objects raised significantly the abstraction of the integration of design automation resources, as either remote or local tools and services are accessed through method calls in a local object. The connection to remote tools and services using a look-up protocol also abstracted completely the network location of such resources, allowing for resource addition and removal during runtime; - the implemented CAD Framework is completely based on Java technology, so it relies on the Java Virtual Machine as the layer which grants the independence between the CAD Framework and the operating system. All such improvements contributed to a higher abstraction on the distribution of design automation resources and also introduced a new paradigm for the remote interaction between designers. The resulting CAD Framework is able to support fine-grained collaboration based on events, so every single design update performed by a designer can be propagated to the rest of the design team regardless of their location in the distributed environment. This can increase the group awareness and allow a richer transfer of experiences among them, improving significantly the collaboration potential when compared to previously proposed file-based or record-based approaches. Three different case studies were conducted to validate the proposed approach, each one focusing one a subset of the contributions of this thesis. The first one uses the proxy-based resource distribution architecture to implement a prototyping platform using reconfigurable hardware modules. The second one extends the foundations of the implemented object-oriented framework to support interface-based design. Such extensions - design representation primitives and tool blocks - are used to implement a design entry tool named IBlaDe, which allows the collaborative creation of functional and structural models of integrated systems. The third case study regards the possibility of integration of multimedia metadata to the design data model. Such possibility is explored in the frame of an online educational and training platform.

Spatial variability of soil physical properties in two management systems in sugarcane crop

O objetivo deste trabalho foi caracterizar a variabilidade espacial da densidade do solo (Ds), teor de água no solo (θ) e porosidade total (Pt) em dois sistemas de manejo da colheita da cana-de-açúcar, com queima e sem queima, em um Latossolo Vermelho, na camada de 0-0,20 m. A área de estudo está localizada no município de Rio Brilhante-MS, na Usina Eldorado. A parcela de cada talhão apresentou malha com comprimento de 180 m e largura de 145,6 m, perfazendo 90 pontos distribuídos na forma de uma grade de nove colunas por dez linhas, com pontos distanciados 20 m de seu vizinho. Foram coletadas amostras de solo na camada de 0-0,20 m, nos anos agrícolas de 2007/2008 e 2008/2009. O sistema de colheita com queima apresentou maior densidade em relação ao mecanizado, nos dois períodos de análise. O teor de água no solo, assim como a porosidade, teve aumento proporcional com relação à diminuição da densidade do sistema de colheita com queima para com o mecanizado.

Effects of different soil tillage systems and coverages on soybean crop in the Botucatu Region in Brazil

Nowadays, agricultural practices should combine high yields with a sustainable use of resources. Different tillage practices and crop covers, if combined, may help to achieve both objectives. In this work, several traits of a soybean (Glycine max L. Merr) cultivar were studied under different conditions of tillage and previous soil coverages. The experiment was installed at Lageado Research Station, Botucatu county, SP, Brazil, on a Paleudult. It consisted of nine treatments (combining three systems of soil tillage and three cover crops) and 4 replicates, yielding 36 plots of a randomized block experimental design. The soil tillage systems considered were: (i) conventional tillage with two heavy harrowing and a levelling harrowing; (ii) chiseling, and (iii) no-tillage with chemical drying of vegetation. The three cover crops used were: black oat, sorghum and spontaneous vegetation. Analyzed variables were: plant height, initial and final plant densities, height of first pod insertion, weight of a thousand grains, number of pods per plant, number of grains per pod, and crop yield. No significant differences were observed for most of the analyzed variables; however, conventional tillage produced significantly heavier grains and a higher number of pods per plant. The selected covers were considered an excellent coverage prior to planting soybean in a crop rotation. The three tillage systems can be used for deployment of culture without compromising the development of soybean.

The primary sources of carbon loss during the crop-establishment period in a subtropical Oxisol under contrasting tillage systems

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The Brazilian Seismographic Integrated Systems (BRASIS): Infrastructure and data management

In geophysics and seismology, raw data need to be processed to generate useful information that can be turned into knowledge by researchers. The number of sensors that are acquiring raw data is increasing rapidly. Without good data management systems, more time can be spent in querying and preparing datasets for analyses than in acquiring raw data. Also, a lot of good quality data acquired at great effort can be lost forever if they are not correctly stored. Local and international cooperation will probably be reduced, and a lot of data will never become scientific knowledge. For this reason, the Seismological Laboratory of the Institute of Astronomy, Geophysics and Atmospheric Sciences at the University of São Paulo (IAG-USP) has concentrated fully on its data management system. This report describes the efforts of the IAG-USP to set up a seismology data management system to facilitate local and international cooperation. © 2011 by the Istituto Nazionale di Geofisica e Vulcanologia. All rights reserved.

Evaluation of integrated inverter topologies for low power PV systems

This work presents the stage integration in power electronics converters as a suitable solution for solar photovoltaic inverters. The rated voltages available in Photovoltaic (PV) modules have usually low values for applications such as regulated output voltages in stand-alone or grid-connected configurations. In these cases, a boost stage or a transformer will be necessary. Transformers have low efficiencies, heavy weights and have been used only when galvanic isolation is mandatory. Furthermore, high-frequency transformers increase the converter complexity. Therefore, the most usual topologies use a boost stage and one inverter stage cascaded. However, the complexity, size, weight, cost and lifetime might be improved considering the integration of both stages. These are the expected features to turn attractive this kind of integrated structures. Therefore, some integrated converters are analyzed and compared in this paper in order to support future evaluations and trends for low power single-phase inverters for PV systems. © 2011 IEEE.

A comparative study of MPPT strategies and a novel singlephase integrated buck-boost inverter for small wind energy conversion systems

This paper presents the analysis of some usual MPPT (Maximum Power Point Tracking) strategies intended for small wind energy conversion (up to 1kW) based on permanent magnet synchronous generators (PMSG), considering the stand-alone application for a novel buck-boost integrated inverter. Each MPPT method is analytically introduced and then it is simulated using MatLab/Simulink considering standard conditions of wind and also commercially available turbines and generators. The extracted power in each case is compared with the maximum available power, so the tracking factor is calculated for each method. Thus, the focus is on the application to improve the efficiency of stand-alone wind energy conversion systems (WECS) with battery chargers and AC load supplied by inverter. Therefore, for this purpose a novel single phase buck-boost integrated inverter is introduced. Finally, the main experimental results for the introduced inverter are presented. © 2011 IEEE.

Sistemas de organización administrativa para el desarrollo integrado de cuencas hidráulicas = Systems of administrative organization for the integrated development of river basins

Incluye Bibliografía

Soil and crop residue CO2-C emission under tillage systems in sugarcane-producing areas of southern Brazil

Appropriate management of agricultural crop residues could result in increases on soil organic carbon (SOC) and help to mitigate gas effect. To distinguish the contributions of SOC and sugarcane (Saccharum spp.) residues to the short-term CO2-C loss, we studied the infl uence of several tillage systems: heavy offset disk harrow (HO), chisel plow (CP), rotary tiller (RT), and sugarcane mill tiller (SM) in 2008, and CP, RT, SM, moldboard (MP), and subsoiler (SUB) in 2009, with and without sugarcane residues relative to no-till (NT) in the sugarcane producing region of Brazil. Soil CO2-C emissions were measured daily for two weeks after tillage using portable soil respiration systems. Daily CO2-C emissions declined after tillage regardless of tillage system. In 2008, total CO2-C from SOC and/or residue decomposition was greater for RT and lowest for CP. In 2009, emission was greatest for MP and CP with residues, and smallest for NT. SOC and residue contributed 47% and 41%, respectively, to total CO2-C emissions. Regarding the estimated emissions from sugarcane residue and SOC decomposition within the measurement period, CO2-C factor was similar to sugarcane residue and soil organic carbon decomposition, depending on the tillage system applied. Our approach may define new emission factors that are associated to tillage operations on bare or sugarcane-residue-covered soils to estimate the total carbon loss.

Informe del Seminario Internacional sobre Sistemas Integrados para el Desarrollo y Gestión de Cuencas Hidrográficas en la Región Andina de América Latina = Report of the International Seminar on Integrated Systems for the Development and Management of River Basins in the Andean Region of Latin America

Contiene organización de los trabajos, resumen de los debates y recomendaciones y conclusiones. Incluye además, definición de términos utilizados; criterios para definir las principales características y necesidades de las zonas altas de la Región Andina; lista de participantes y lista de documentos presentados en el Seminario.

Report of the International Seminar on Integrated Systems for the Development and Management of River Basins in the Andean Region of Latin America

Includes bibliography

Integrated transport systems in Latin America and the Caribbean: converging initiatives

The year 1998 is shaping up to be a year of grand regional initiatives focusing on the setting up of regional integrated transport systems. The past six months have seen intense activity in Latin America and the Caribbean. It would seem that the public and private sectors have agreed to launch converging initiatives, each from its own perspectives. In Central America, a multimodal transport project is already under way, while a new transport master plan put forward by the Permanent Secretariat of the General Treaty on Central American Economic Integration (SIECA) is being prepared; in South America, the Latin American Integration Association (LAIA) and Latin American Railways Association (ALAF) have launched a prefeasability study concerning a plan for the sustainable development of transport; the second Summit of the Americas adopted a plan of action that now takes in the work of the Executive Committee of the Western Hemisphere Transport Initiative; and the private sector also held its regional meeting in São Paulo, Brazil, with Intermodal 98, the fourth in a series. These initiatives are taking shape around similar lines of thought and action; their backgrounds are similar, and they tend towards the same goal: taking action in the immediate environment with a view to expanding linkages with the global economy. The background is the observation that after several years of growth, transport infrastructure, equipment and services appear unable to satisfy the growing demand of international trade in the region. The goal is to implement the requisite reforms in the transport sector so as to meet the challenges posed by global competition. This issue of the Bulletin is devoted to news about recent initiatives and possible future developments.

Sistemas de cultivo antecessores e doses de nitrogênio em cobertura no feijoeiro em plantio direto = cover crop systems and nitrogen topdressing on common bean in no tillage

The objective of this work was to evaluate the grass cover crop production in crop systems involving maize and Urochloa ruziziensis, and the influence of topdressing nitrogen rates in the yield and agronomic efficiency on common-bean cultivated in succession in no-tillage. The experiments were conducted in Jaboticabal-SP, in a eutrophic red latosol, in the second year of no-tillage system implementation. The IPR 139 cultivar was used in split plot design with three replications, in randomized block. The plots had been composed for three crop systems in the summer season, with maize exclusive, maize intercropped with U. ruziziensis and U. ruziziensis exclusive. The subplots had been constituted for five nitrogen rates (0, 40, 80, 120 and 160 kg ha(-1)), applied as topdressing at V4-4 in irrigated common-bean cultivated in the winter-spring season. The use of U. ruziziensis in crops systems, exclusive or intercropped with maize favors the grass cover crop production sufficiently to total soli surface covered, possibility similar grain yield compared to maize exclusive. The topdressing nitrogen application doesn't affect the common-bean yield in succession to maize and U. ruziziensis intercropped. The increase of nitrogen rates in common-bean in succession to maize exclusive improves the yield, although decreases the agronomic efficiency.