968 resultados para Administrative Data Processing
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"Prepared by: Staff Development Unit, Administrative Management Section, Management Coordination Branch, Divison of Accounting Operations."
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Cover title.
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Maltose-binding protein is the periplasmic component of the ABC transporter responsible for the uptake of maltose/maltodextrins. The Xanthomonas axonopodis pv. citri maltose-binding protein MalE has been crystallized at 293 Kusing the hanging-drop vapour-diffusion method. The crystal belonged to the primitive hexagonal space group P6(1)22, with unit-cell parameters a = 123.59, b = 123.59, c = 304.20 angstrom, and contained two molecules in the asymetric unit. It diffracted to 2.24 angstrom resolution.
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Network control systems (NCSs) are spatially distributed systems in which the communication between sensors, actuators and controllers occurs through a shared band-limited digital communication network. However, the use of a shared communication network, in contrast to using several dedicated independent connections, introduces new challenges which are even more acute in large scale and dense networked control systems. In this paper we investigate a recently introduced technique of gathering information from a dense sensor network to be used in networked control applications. Obtaining efficiently an approximate interpolation of the sensed data is exploited as offering a good tradeoff between accuracy in the measurement of the input signals and the delay to the actuation. These are important aspects to take into account for the quality of control. We introduce a variation to the state-of-the-art algorithms which we prove to perform relatively better because it takes into account the changes over time of the input signal within the process of obtaining an approximate interpolation.
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Cooperating objects (COs) is a recently coined term used to signify the convergence of classical embedded computer systems, wireless sensor networks and robotics and control. We present essential elements of a reference architecture for scalable data processing for the CO paradigm.
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Los eventos transitorios únicos analógicos (ASET, Analog Single Event Transient) se producen debido a la interacción de un ión pesado o un protón de alta energía con un dispositivo sensible de un circuito analógico. La interacción del ión con un transistor bipolar o de efecto de campo MOS induce pares electrón-hueco que provocan picos que pueden propagarse a la salida del componente analógico provocando transitorios que pueden inducir fallas en el nivel sistema. Los problemas más graves debido a este tipo de fenómeno se dan en el medioambiente espacial, muy rico en iones pesados. Casos típicos los constituyen las computadoras de a bordo de satélites y otros artefactos espaciales. Sin embargo, y debido a la continua contracción de dimensiones de los transistores (que trae aparejado un aumento de sensibilidad), este fenómeno ha comenzado a observarse a nivel del mar, provocado fundamentalmente por el impacto de neutrones atmosféricos. Estos efectos pueden provocar severos problemas a los sistemas informáticos con interfaces analógicas desde las que obtienen datos para el procesamiento y se han convertido en uno de los problemas más graves a los que tienen que hacer frente los diseñadores de sistemas de alta escala de integración. Casos típicos son los Sistemas en Chip que incluyen módulos de procesamiento de altas prestaciones como las interfaces analógicas.El proyecto persigue como objetivo general estudiar la susceptibilidad de sistemas informáticos a ASETs en sus secciones analógicas, proponiendo estrategias para la mitigación de los errores.Como objetivos específicos se pretende: -Proponer nuevos modelos de ASETs basados en simulaciones en el nivel dispositivo y resueltas por el método de elementos finitos.-Utilizar los modelos para identificar las secciones más propensas a producir errores y consecuentemente para ser candidatos a la aplicación de técnicas de endurecimiento a radiaciones.-Utilizar estos modelos para estudiar la naturaleza de los errores producidos en sistemas de procesamiento de datos.-Proponer soluciones novedosas para la mitigación de estos efectos en los mismos circuitos analógicos evitando su propagación a las secciones digitales.-Proponer soluciones para la mitigación de los efectos en el nivel sistema.Para llevar a cabo el proyecto se plantea un procedimiento ascendente para las investigaciones a realizar, comenzando por descripciones en el nivel físico para posteriormente aumentar el nivel de abstracción en el que se encuentra modelado el circuito. Se propone el modelado físico de los dispositivos MOS y su resolución mediante el Método de Elementos Finitos. La inyección de cargas en las zonas sensibles de los modelos permitirá determinar los perfiles de los pulsos de corriente que deben inyectarse en el nivel circuito para emular estos efectos. Estos procedimientos se realizarán para los distintos bloques constructivos de las interfaces analógicas, proponiendo estrategias de mitigación de errores en diferentes niveles.Los resultados esperados del presente proyecto incluyen hardware para detección de errores y tolerancia a este tipo de eventos que permitan aumentar la confiabilidad de sistemas de tratamiento de la información, así como también nuevos datos referentes a efectos de la radiación en semiconductores, nuevos modelos de fallas transitorias que permitan una simulación de estos eventos en el nivel circuito y la determinación de zonas sensibles de interfaces analógicas típicas que deben ser endurecidas para radiación.
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There is described data processing at the flaw detector with combined multisectional eddy-current transducer and heterofrequency magnetic field. The application of this method for detecting flaws in rods and pipes under the conditions of significant transverse displacements is described.
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Background. The use of hospital discharge administrative data (HDAD) has been recommended for automating, improving, even substituting, population-based cancer registries. The frequency of false positive and false negative cases recommends local validation. Methods. The aim of this study was to detect newly diagnosed, false positive and false negative cases of cancer from hospital discharge claims, using four Spanish population-based cancer registries as the gold standard. Prostate cancer was used as a case study. Results. A total of 2286 incident cases of prostate cancer registered in 2000 were used for validation. In the most sensitive algorithm (that using five diagnostic codes), estimates for Sensitivity ranged from 14.5% (CI95% 10.3-19.6) to 45.7% (CI95% 41.4-50.1). In the most predictive algorithm (that using five diagnostic and five surgical codes) Positive Predictive Value estimates ranged from 55.9% (CI95% 42.4-68.8) to 74.3% (CI95% 67.0-80.6). The most frequent reason for false positive cases was the number of prevalent cases inadequately considered as newly diagnosed cancers, ranging from 61.1% to 82.3% of false positive cases. The most frequent reason for false negative cases was related to the number of cases not attended in hospital settings. In this case, figures ranged from 34.4% to 69.7% of false negative cases, in the most predictive algorithm. Conclusions. HDAD might be a helpful tool for cancer registries to reach their goals. The findings suggest that, for automating cancer registries, algorithms combining diagnoses and procedures are the best option. However, for cancer surveillance purposes, in those cancers like prostate cancer in which care is not only hospital-based, combining inpatient and outpatient information will be required.
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Position du problème: La mise en place de la tarification à l'activité pour les hôpitaux de court séjour pourrait entraîner une diminution des durées de séjour pour raisons financières. L'impact potentiel de ce phénomène sur la qualité des soins n'est pas connu. Les réadmissions identifiées à l'aide des données administratives hospitalières sont, pour certaines situations cliniques, des indicateurs de qualité des soins valides. Méthode: Étude rétrospective du lien entre la durée de séjour et la survenue de réadmissions imprévues liées au séjour initial, pour les cholécystectomies simples et les accouchements par voie basse sans complication, à partir des données du programme de médicalisation des systèmes d'information de l'Assistance publique-Hôpitaux de Paris des années 2002 à 2005. Résultats: Pour les deux procédures, la probabilité de réadmission suit une courbe en " J ". Après ajustement sur l'âge, le sexe, les comorbidités associées, l'hôpital et l'année d'admission, la probabilité de réadmission est plus élevée pour les durées de séjour les plus courtes : pour les cholécystectomies, odds ratio : 6,03 [IC95 % : 2,67-13,59] pour les hospitalisations d'un jour versus trois jours ; pour les accouchements, odds ratio : 1,74 [IC95 % : 1,05-2,91] pour les hospitalisations de deux jours versus trois jours. Conclusion: Pour deux pathologies communes, les durées de séjour les plus courtes sont associées à des probabilités de réadmission plus élevées. L'utilisation routinière des données du programme de médicalisation des systèmes d'information peut permettre d'assurer le suivi de la relation entre la réduction de la durée de séjour et les réadmissions. The prospective payment system for the French short-stay hospitals creates a financial incentive to reduce length of stay. The potential impact of the resulting decrease in length of stay on the quality of healthcare is unknown. Readmission rates are valid outcome indicators for some clinical procedures. Methods: Retrospective study of the association between length of stay and unplanned readmissions related to the initial stay, for two procedures: cholecystectomy and vaginal delivery. Data: Administrative diagnosis-related groups database of "Assistance publique-Hopitaux de Paris", a large teaching hospital, for years 2002 to 2005. Results: The risk of readmission according to length of stay, taking age, sex, comorbidity, hospital and year of admission into account, followed a J-shaped curve for both procedures. The probability of readmission was higher for very short stays, with odds ratios and 95% confidence intervals of 6.03 [2.67-13.59] for cholecystectomies (1- versus 3-night stays), and of 1.74 [1.05-2.91] for vaginal deliveries (2- versus 3-night stays). Conclusion: For both procedures, the shortest lengths of stay are associated with a higher readmission probability. Suitable indicators derived from administrative databases would enable monitoring of the association between length of stay and readmissions.
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Objective: The Agency for Healthcare Research and Quality (AHRQ) developed Patient Safety Indicators (PSIs) for use with ICD-9-CM data. Many countries have adopted ICD-10 for coding hospital diagnoses. We conducted this study to develop an internationally harmonized ICD-10 coding algorithm for the AHRQ PSIs. Methods: The AHRQ PSI Version 2.1 has been translated into ICD-10-AM (Australian Modification), and PSI Version 3.0a has been independently translated into ICD-10-GM (German Modification). We converted these two country-specific coding algorithms into ICD-10-WHO (World Health Organization version) and combined them to form one master list. Members of an international expert panel-including physicians, professional medical coders, disease classification specialists, health services researchers, epidemiologists, and users of the PSI-independently evaluated this master list and rated each code as either "include," "exclude," or "uncertain," following the AHRQ PSI definitions. After summarizing the independent rating results, we held a face-to-face meeting to discuss codes for which there was no unanimous consensus and newly proposed codes. A modified Delphi method was employed to generate a final ICD-10 WHO coding list. Results: Of 20 PSIs, 15 that were based mainly on diagnosis codes were selected for translation. At the meeting, panelists discussed 794 codes for which consensus had not been achieved and 2,541 additional codes that were proposed by individual panelists for consideration prior to the meeting. Three documents were generated: a PSI ICD-10-WHO version-coding list, a list of issues for consideration on certain AHRQ PSIs and ICD-9-CM codes, and a recommendation to WHO to improve specification of some disease classifications. Conclusion: An ICD-10-WHO PSI coding list has been developed and structured in a manner similar to the AHRQ manual. Although face validity of the list has been ensured through a rigorous expert panel assessment, its true validity and applicability should be assessed internationally.
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BACKGROUND: Co-morbidity information derived from administrative data needs to be validated to allow its regular use. We assessed evolution in the accuracy of coding for Charlson and Elixhauser co-morbidities at three time points over a 5-year period, following the introduction of the International Classification of Diseases, 10th Revision (ICD-10), coding of hospital discharges.METHODS: Cross-sectional time trend evaluation study of coding accuracy using hospital chart data of 3'499 randomly selected patients who were discharged in 1999, 2001 and 2003, from two teaching and one non-teaching hospital in Switzerland. We measured sensitivity, positive predictive and Kappa values for agreement between administrative data coded with ICD-10 and chart data as the 'reference standard' for recording 36 co-morbidities.RESULTS: For the 17 the Charlson co-morbidities, the sensitivity - median (min-max) - was 36.5% (17.4-64.1) in 1999, 42.5% (22.2-64.6) in 2001 and 42.8% (8.4-75.6) in 2003. For the 29 Elixhauser co-morbidities, the sensitivity was 34.2% (1.9-64.1) in 1999, 38.6% (10.5-66.5) in 2001 and 41.6% (5.1-76.5) in 2003. Between 1999 and 2003, sensitivity estimates increased for 30 co-morbidities and decreased for 6 co-morbidities. The increase in sensitivities was statistically significant for six conditions and the decrease significant for one. Kappa values were increased for 29 co-morbidities and decreased for seven.CONCLUSIONS: Accuracy of administrative data in recording clinical conditions improved slightly between 1999 and 2003. These findings are of relevance to all jurisdictions introducing new coding systems, because they demonstrate a phenomenon of improved administrative data accuracy that may relate to a coding 'learning curve' with the new coding system.
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OBJECTIVE: As part of the WHO ICD-11 development initiative, the Topic Advisory Group on Quality and Safety explores meta-features of morbidity data sets, such as the optimal number of secondary diagnosis fields. DESIGN: The Health Care Quality Indicators Project of the Organization for Economic Co-Operation and Development collected Patient Safety Indicator (PSI) information from administrative hospital data of 19-20 countries in 2009 and 2011. We investigated whether three countries that expanded their data systems to include more secondary diagnosis fields showed increased PSI rates compared with six countries that did not. Furthermore, administrative hospital data from six of these countries and two American states, California (2011) and Florida (2010), were analysed for distributions of coded patient safety events across diagnosis fields. RESULTS: Among the participating countries, increasing the number of diagnosis fields was not associated with any overall increase in PSI rates. However, high proportions of PSI-related diagnoses appeared beyond the sixth secondary diagnosis field. The distribution of three PSI-related ICD codes was similar in California and Florida: 89-90% of central venous catheter infections and 97-99% of retained foreign bodies and accidental punctures or lacerations were captured within 15 secondary diagnosis fields. CONCLUSIONS: Six to nine secondary diagnosis fields are inadequate for comparing complication rates using hospital administrative data; at least 15 (and perhaps more with ICD-11) are recommended to fully characterize clinical outcomes. Increasing the number of fields should improve the international and intra-national comparability of data for epidemiologic and health services research, utilization analyses and quality of care assessment.