Transmission of Mycobacterium chimaera from Heater-Cooler Units during Cardiac Surgery despite an Ultraclean Air Ventilation System.

Heater-cooler units (HCUs) were recently identified as a source of Mycobacterium chimaera causing surgical site infections. We investigated transmission of this bacterium from HCUs to the surgical field by using a thermic anemometer and particle counter, videotape of an operating room equipped with an ultraclean laminar airflow ventilation system, and bacterial culture sedimentation plates in a nonventilated room. Smoke from the HCU reached the surgical field in 23 s by merging with ultraclean air. The HCU produced on average 5.2, 139, and 14.8 particles/min in the surgical field at positions Off, On/oriented toward, and On/oriented away, respectively. Culture plates were positive for M. chimaera <5 m from the HCU in the test room. These experiments confirm airborne transmission of M. chimaera aerosols from a contaminated HCU to an open surgical field despite ultraclean air ventilation. Efforts to mitigate infectious risks during surgery should consider contamination from water sources and airflow-generating devices.

INFLUENCE OF A CLINIC BASED IMMUNIZATION INFORMATION SYSTEM ON INFANT IMMUNIZATIONS

This study focuses on the impact of a clinic-based intervention program on the immunization status of limited-income urban children. The intervention program consisted of an information session for clinic health care providers and the placement of individualized immunization information labels on clinic notes at the time of each visit. The degree of impact of the intervention on immunization administration was ascertained through a comparison of two similar groups of infants born in the same months of the year immediately before (N = 201) and after (N = 203) the information session and initiation of the labeling system. The timeliness of administration of each diphtheria, pertussis, tetanus and trivalent oral polio vaccine (DPT/TOPV) in the first year series of three was compared pre- to postintervention. Significantly more third immunizations were given the postintervention subjects within ten days of the recommended time of application ( p = .0361). Life table analysis indicated that the probability of an infant's passing one year of age without the administration of the third immunization decreased for postintervention infants (p = .0515). The intervention was most successful in assuring administration of the series of immunizations in those infants who were seen by the health care provider for at least 50% of their first year visits. Results indicate that minor changes in the format of information given a relatively continuous provider can increase completion of immunization series in infants. ^

Atlas of cancer mortality in the United Arab Emirates aided by application of geographic information system methods

The aim of this study was to determine cancer mortality rates for the United Arab Emirates (UAE) and to create an atlas of cancer mortality for the UAE. This atlas is the first of its kind in the Gulf country and the Middle East. Death certificates were reviewed for a period from January 1, 1990 to December 31, 1999 and cancer deaths were identified. Cancer mortality cases were verified by comparing with medical records. Age-adjusted cancer mortality rates were calculated by gender, emirate/medical district and nationality (UAE nationals and overall UAE population). Individual rates for each emirate were compared to the overall rate of the corresponding population for the same cancer site and gender. Age-adjusted rates were mapped using MapInfo software. High rates for liver, lung and stomach cancer were observed in Abu Dhabi, Dubai and the northern emirates, respectively. Rates for UAE nationals were greater compared to the overall UAE population. Several factors were suggested that may account for high rates of specific cancers observed in certain emirates. It is hoped that this atlas will provide leads that will guide further epidemiologic and public health activities aimed at preventing cancer. ^

Cost analysis of opt-in consent procedures for the Texas statewide immunization information system, ImmTrac

Background. Childhood immunization programs have dramatically reduced the morbidity and mortality associated with vaccine-preventable diseases. Proper documentation of immunizations that have been administered is essential to prevent duplicate immunization of children. To help improve documentation, immunization information systems (IISs) have been developed. IISs are comprehensive repositories of immunization information for children residing within a geographic region. The two models for participation in an IIS are voluntary inclusion, or "opt-in," and voluntary exclusion, or "opt-out." In an opt-in system, consent must be obtained for each participant, conversely, in an opt-out IIS, all children are included unless procedures to exclude the child are completed. Consent requirements for participation vary by state; the Texas IIS, ImmTrac, is an opt-in system.^ Objectives. The specific objectives are to: (1) Evaluate the variance among the time and costs associated with collecting ImmTrac consent at public and private birthing hospitals in the Greater Houston area; (2) Estimate the total costs associated with collecting ImmTrac consent at selected public and private birthing hospitals in the Greater Houston area; (3) Describe the alternative opt-out process for collecting ImmTrac consent at birth and discuss the associated cost savings relative to an opt-in system.^ Methods. Existing time-motion studies (n=281) conducted between October, 2006 and August, 2007 at 8 birthing hospitals in the Greater Houston area were used to assess the time and costs associated with obtaining ImmTrac consent at birth. All data analyzed are deidentified and contain no personal information. Variations in time and costs at each location were assessed and total costs per child and costs per year were estimated. The cost of an alternative opt-out system was also calculated.^ Results. The median time required by birth registrars to complete consent procedures varied from 72-285 seconds per child. The annual costs associated with obtaining consent for 388,285 newborns in ImmTrac's opt-in consent process were estimated at $702,000. The corresponding costs of the proposed opt-out system were estimated to total $194,000 per year. ^ Conclusions. Substantial variation in the time and costs associated with completion of ImmTrac consent procedures were observed. Changing to an opt-out system for participation could represent significant cost savings. ^

El estado como eje articulador de las relaciones sociales

El presente trabajo intenta realizar una síntesis de cómo se fue articulando la sociedad a partir del modelo capitalista de producción en el período histórico que transcurre desde el impulso desarrollado en la Segunda Revolución Industrial, a finales del siglo XIX , hasta la primera década del siglo XXI. Este período determinará una forma de integración social que va estar vinculada al trabajo asalariado y ligada a un Estado más presente, articulador y distribuidor de la riqueza social. Algunos de los elementos constitutivos que sostuvieron este modelo fueron el New Deal y la política económica keynesiana, que van a perdurar hasta bien entrada la década de 1970. En esta etapa, la relación capital-trabajo va a entrar en crisis; el modelo keynesiano de pleno empleo no le es útil al capitalismo; y, por lo tanto, el Estado va a permitir la incorporación de un nuevo discurso, enarbolado por los denominados economistas liberales ortodoxos y, ya en la última década del siglo XX , por el economista norteamericano John Williamson, relacionado con un movimiento intelectual denominado "Consenso de Washington"; esto dando lugar una nueva forma de estructuración social en la que van a coexistir ganadores y perdedores del sistema. Se intenta explicar, además, el impacto que provocó en la Argentina adherir al modelo neoliberal a través de una economía abierta (1989-2002). Por último, describimos la situación de la Provincia de San Luis; los dispositivos y mecanismos que utilizó para contrarrestar los dos dígitos de desocupación producidos después del año 2002; para ello, nos referimos al Plan de Inclusión Social, expuesto a través de datos estadísticos tomados del INDEC y de la Dirección Provincial de Estadísticas y Censos de la Provincia de San Luis

El estado como eje articulador de las relaciones sociales

El presente trabajo intenta realizar una síntesis de cómo se fue articulando la sociedad a partir del modelo capitalista de producción en el período histórico que transcurre desde el impulso desarrollado en la Segunda Revolución Industrial, a finales del siglo XIX , hasta la primera década del siglo XXI. Este período determinará una forma de integración social que va estar vinculada al trabajo asalariado y ligada a un Estado más presente, articulador y distribuidor de la riqueza social. Algunos de los elementos constitutivos que sostuvieron este modelo fueron el New Deal y la política económica keynesiana, que van a perdurar hasta bien entrada la década de 1970. En esta etapa, la relación capital-trabajo va a entrar en crisis; el modelo keynesiano de pleno empleo no le es útil al capitalismo; y, por lo tanto, el Estado va a permitir la incorporación de un nuevo discurso, enarbolado por los denominados economistas liberales ortodoxos y, ya en la última década del siglo XX , por el economista norteamericano John Williamson, relacionado con un movimiento intelectual denominado "Consenso de Washington"; esto dando lugar una nueva forma de estructuración social en la que van a coexistir ganadores y perdedores del sistema. Se intenta explicar, además, el impacto que provocó en la Argentina adherir al modelo neoliberal a través de una economía abierta (1989-2002). Por último, describimos la situación de la Provincia de San Luis; los dispositivos y mecanismos que utilizó para contrarrestar los dos dígitos de desocupación producidos después del año 2002; para ello, nos referimos al Plan de Inclusión Social, expuesto a través de datos estadísticos tomados del INDEC y de la Dirección Provincial de Estadísticas y Censos de la Provincia de San Luis

El estado como eje articulador de las relaciones sociales

El presente trabajo intenta realizar una síntesis de cómo se fue articulando la sociedad a partir del modelo capitalista de producción en el período histórico que transcurre desde el impulso desarrollado en la Segunda Revolución Industrial, a finales del siglo XIX , hasta la primera década del siglo XXI. Este período determinará una forma de integración social que va estar vinculada al trabajo asalariado y ligada a un Estado más presente, articulador y distribuidor de la riqueza social. Algunos de los elementos constitutivos que sostuvieron este modelo fueron el New Deal y la política económica keynesiana, que van a perdurar hasta bien entrada la década de 1970. En esta etapa, la relación capital-trabajo va a entrar en crisis; el modelo keynesiano de pleno empleo no le es útil al capitalismo; y, por lo tanto, el Estado va a permitir la incorporación de un nuevo discurso, enarbolado por los denominados economistas liberales ortodoxos y, ya en la última década del siglo XX , por el economista norteamericano John Williamson, relacionado con un movimiento intelectual denominado "Consenso de Washington"; esto dando lugar una nueva forma de estructuración social en la que van a coexistir ganadores y perdedores del sistema. Se intenta explicar, además, el impacto que provocó en la Argentina adherir al modelo neoliberal a través de una economía abierta (1989-2002). Por último, describimos la situación de la Provincia de San Luis; los dispositivos y mecanismos que utilizó para contrarrestar los dos dígitos de desocupación producidos después del año 2002; para ello, nos referimos al Plan de Inclusión Social, expuesto a través de datos estadísticos tomados del INDEC y de la Dirección Provincial de Estadísticas y Censos de la Provincia de San Luis

Open multi-technology building energy management system

Energy Efficiency is one of the goals of the Smart Building initiatives. This paper presents an Open Energy Management System which consists of an ontology-based multi-technology platform and a wireless transducer network using 6LoWPAN communication technology. The system allows the integration of several building automation protocols and eases the development of different kind of services to make use of them. The system has been implemented and tested in the Energy Efficiency Research Facility at CeDInt-UPM.

BatNet: a 6LoWPAN-based sensors and actuators network

Improving energy efficiency in buildings is one of the goals of the Smart City initiatives and a challenge for the European Union. This paper presents a 6LoWPAN wireless transducer network (BatNet) as part of an open energy management system. This network has been designed to operate in buildings, to collect environmental information (temperature, humidity, illumination and presence) and electrical consumption in real time (voltage, current and power factor). The system has been implemented and tested in the Energy Efficiency Research Facility at CeDInt-UPM.

Bat-MP: An Ontology-Based Energy Management Platform

This paper presents an Ontology-Based multi-technology platform as part of an open energy management system which also comprises a wireless transducer network for control and monitoring. The platform allows the integration of several building automation protocols, eases the development and implementation of different kinds of services and allows sharing of the data of a building. The system has been implemented and tested in the Energy Efficiency Research Facility at CeDInt-UPM.

ClimApp: A Novel Approach of an Intelligent HVAC Control System

This paper describes a novel deployment of an intelligent user-centered HVAC (Heating, Ventilating and Air Conditioner) control system. The main objective of this system is to optimize user comfort and to reduce energy consumption in office buildings. Existing commercial HVAC control systems work in a fixed and predetermined way. The novelty of the proposed system is that it adapts dynamically to the user and to the building environment. For this purpose the system architecture has been designed under the paradigm of Ambient Intelligence. A prototype of the system proposed has been tested in a real-world environment.

An online failure prediction system for private IaaS platforms

The size and complexity of cloud environments make them prone to failures. The traditional approach to achieve a high dependability for these systems relies on constant monitoring. However, this method is purely reactive. A more proactive approach is provided by online failure prediction (OFP) techniques. In this paper, we describe a OFP system for private IaaS platforms, currently under development, that combines di_erent types of data input, including monitoring information, event logs, and failure data. In addition, this system operates at both the physical and virtual planes of the cloud, taking into account the relationships between nodes and failure propagation mechanisms that are unique to cloud environments.

Caracterización de Sistemas intensivos en Software desde un punto de vista de innovación=Characterizing Software-intensive Systems from the innovation point of view

La innovación en Sistemas Intesivos en Software está alcanzando relevancia por múltiples razones: el software está presente en sectores como automóvil, teléfonos móviles o salud. Las empresas necesitan conocer aquellos factores que afectan a la innovación para incrementar las probabilidades de éxito en el desarrollo de sus productos y, la evaluación de productos sofware es un mecanismo potente para capturar este conocimiento. En consecuencia, las empresas necesitan evaluar sus productos desde la perpectiva de innovación para reducir la distancia entre los productos desarrollados y el mercado. Esto es incluso más relevante en el caso de los productos intensivos en software, donde el tiempo real, la oportunidad, complejidad, interoperabilidad, capacidad de respuesta y compartción de recursos son características críticas de los nuevos sistemas. La evaluación de la innovación de productos ya ha sido estudiada y se han definido algunos esquemas de evaluación pero no son específicos para Sistemas intensivos en Sofwtare; además, no se ha alcanzado consenso en los factores ni el procedimiento de evaluación. Por lo tanto, tiene sentido trabajar en la definición de un marco de evaluación de innovación enfocado a Sistemas intesivos en Software. Esta tesis identifica los elementos necesarios para construir in marco para la evaluación de de Sistemas intensivos en Software desde el punto de vista de la innovación. Se han identificado dos componentes como partes del marco de evaluación: un modelo de referencia y una herramienta adaptativa y personalizable para la realización de la evaluación y posicionamiento de la innovación. El modelo de referencia está compuesto por cuatro elementos principales que caracterizan la evaluación de innovación de productos: los conceptos, modelos de innovación, cuestionarios de evaluación y la evaluación de productos. El modelo de referencia aporta las bases para definir instancias de los modelos de evaluación de innovación de productos que pueden se evaluados y posicionados en la herramienta a través de cuestionarios y que de forma automatizada aporta los resultados de la evaluación y el posicionamiento respecto a la innovación de producto. El modelo de referencia ha sido rigurosamente construido aplicando modelado conceptual e integración de vistas junto con la aplicación de métodos cualitativos de investigación. La herramienta ha sido utilizada para evaluar productos como Skype a través de la instanciación del modelo de referencia. ABSTRACT Innovation in Software intensive Systems is becoming relevant for several reasons: software is present embedded in many sectors like automotive, robotics, mobile phones or heath care. Firms need to have knowledge about factors affecting the innovation to increase the probability of success in their product development and the assessment of innovation in software products is a powerful mechanism to capture this knowledge. Therefore, companies need to assess products from an innovation perspective to reduce the gap between their developed products and the market. This is even more relevant in the case of SiSs, where real time, timeliness, complexity, interoperability, reactivity, and resource sharing are critical features of a new system. Many authors have analysed product innovation assessment and some schemas have been developed but they are not specific to SiSs; in addition, there is no consensus about the factors or the procedures for performing an assessment. Therefore, it has sense to work in the definition of a customized software product innovation evaluation framework. This thesis identifies the elements needed to build a framework to assess software products from the innovation perspective. Two components have been identified as part of the framework to assess Software intensive Systems from the innovation perspective: a reference-model and an adaptive and customizable tool to perform the assessment and to position product innovation. The reference-model is composed by four main elements characterizing product innovation assessment: concepts, innovation models, assessment questionnaires and product assessment. The reference model provides the umbrella to define instances of product innovation assessment models that can be assessed and positioned through questionnaires in the proposed tool that also provides automation in the assessment and positioning of innovation. The reference-model has been rigorously built by applying conceptual modelling and view integration integrated with qualitative research methods. The tool has been used to assess products like Skype through models instantiated from the reference-model.

Aplicación de la metodología GloBeM al servicio de cloud Hydra

El presente Proyecto de Fin de Máster consiste en crear una herramienta software capaz de monitorizar y gestionar la actividad de Hydra, una herramienta de gestión de entornos distribuidos, para que su estrategia de balanceo de carga se adecúe al modelo creado por GloBeM, una metodología de análisis de entornos distribuidos. GloBeM, que es una metodología externa, puede analizar y crear un modelo de máquina de estados finitos a partir de un sistema distribuido concreto. Hydra, una herramienta también externa, es un sistema de gestión de entornos cloud recientemente desarrollado y de código abierto, con un sistema de balanceo de carga efectivo pero algo limitado. El software construido recoge el modelo creado por GloBeM y lo analiza. A partir de ahí, monitoriza en tiempo real y a una frecuencia determinada la actividad de Hydra y el sistema cloud que ésta gestiona, y reconfigura sus parámetros para que su desempeño se ciña a lo estipulado por el modelo de GloBeM, extendiendo así el sistema de balanceo de carga original de Hydra.---ABSTRACT---This Master's Thesis Project involves creating a software able to monitor and manage the activity of Hydra, a tool for managing distributed environments, in order to adjust its load balancing strategy to the model created by GloBeM, an analysis methodology for distributed environments. GloBeM, which is an external methodology, can analyse and create a finite-state machine model from a particular cloud system. Hydra, also an external tool, is an open source management system for cloud environments recently developed, with a relatively limited system of load balancing. The created software gets the model created by GloBeM as an input and analyses it. From there, it monitors in real time and at a certain frequency Hydra’s activity and the cloud system that it manages, and reconfigures its parameters to adjust its performance to the stipulations by the GloBeM’s model, extending Hydra's original load balancing system.

Creating a Web-accessible, point-of-care, team-based information system (PoinTIS): the librarian as publisher*

The Internet has created new opportunities for librarians to develop information systems that are readily accessible at the point of care. This paper describes the multiyear process used to justify, fund, design, develop, promote, and evaluate a rehabilitation prototype of a point-of-care, team-based information system (PoinTIS) and train health care providers to use this prototype for their spinal cord injury and traumatic brain injury patient care and education activities. PoinTIS is a successful model for librarians in the twenty-first century to serve as publishers of information created or used by their parent organizations and to respond to the opportunities for information dissemination provided by recent technological advances.