Impact of an intervention to control risk associated with patient transfer.

QUESTION UNDER STUDY: Hospitals transferring patients retain responsibility until admission to the new health care facility. We define safe transfer conditions, based on appropriate risk assessment, and evaluate the impact of this strategy as implemented at our institution. METHODS: An algorithm defining transfer categories according to destination, equipment monitoring, and medication was developed and tested prospectively over 6 months. Conformity with algorithm criteria was assessed for every transfer and transfer category. After introduction of a transfer coordination centre with transfer nurses, the algorithm was implemented and the same survey was carried out over 1 year. RESULTS: Over the whole study period, the number of transfers increased by 40%, chiefly by ambulance from the emergency department to other hospitals and private clinics. Transfers to rehabilitation centres and nursing homes were reassigned to conventional vehicles. The percentage of patients requiring equipment during transfer, such as an intravenous line, decreased from 34% to 15%, while oxygen or i.v. drug requirement remained stable. The percentage of transfers considered below theoretical safety decreased from 6% to 4%, while 20% of transfers were considered safer than necessary. A substantial number of planned transfers could be "downgraded" by mutual agreement to a lower degree of supervision, and the system was stable on a short-term basis. CONCLUSION: A coordinated transfer system based on an algorithm determining transfer categories, developed on the basis of simple but valid medical and nursing criteria, reduced unnecessary ambulance transfers and treatment during transfer, and increased adequate supervision.

Arquitetura inteligente fuzzy para monitoramento de sinais vitais de pacientes: um estudo de caso em UTI

The area of the hospital automation has been the subject a lot of research, addressing relevant issues which can be automated, such as: management and control (electronic medical records, scheduling appointments, hospitalization, among others); communication (tracking patients, staff and materials), development of medical, hospital and laboratory equipment; monitoring (patients, staff and materials); and aid to medical diagnosis (according to each speciality). This thesis presents an architecture for a patient monitoring and alert systems. This architecture is based on intelligent systems techniques and is applied in hospital automation, specifically in the Intensive Care Unit (ICU) for the patient monitoring in hospital environment. The main goal of this architecture is to transform the multiparameter monitor data into useful information, through the knowledge of specialists and normal parameters of vital signs based on fuzzy logic that allows to extract information about the clinical condition of ICU patients and give a pre-diagnosis. Finally, alerts are dispatched to medical professionals in case any abnormality is found during monitoring. After the validation of the architecture, the fuzzy logic inferences were applied to the trainning and validation of an Artificial Neural Network for classification of the cases that were validated a priori with the fuzzy system

Wireless sensor networks Zigbee applied on sewage treatment station

The good efficiency in a sewage treatment plant (WWTP) is a great importance to the environment. The management of electromechanical equipment installed in these stations is a major challenge due to the fact that they are installed on areas of difficult access and maintenance unhealthy and making the time for the correction of any faults is extended. This paper proposes the development of a Wireless Sensor Network (WSN), in order to monitor electromechanical equipment, allowing the Concessionaire a predictive control in real time. The design of a wireless sensors network for monitoring equipment requires not only the development and assembly of the sensor modules, but must also include the development of software for managing the data collected. Thus, this work includes a Zigbee WSN, small, adapted for monitoring of electromechanical equipment and environmental conditions of a WWTP, type stabilization pond, installed in an area of approximately 0.15 km 2 and the average flow of 320 liters of treatment per second. The experimental results show that this monitoring system can perform with the collection of parameters of performance and quality assessment at the station.

Design of a labVIEW system applied to predictive maintenance

The implementation of vibration analysis techniques based on virtual instrumentation has spread increasingly in the academic and industrial branch, since the use of any software for this type of analysis brings good results at low cost. Among the existing software for programming and creation of virtual instruments, the LabVIEW was chosen for this project. This software has good interface with the method of graphical programming. In this project, it was developed a system of rotating machine condition monitoring. This monitoring system is applied in a test stand, simulating large scale applications, such as in hydroelectric, nuclear and oil exploration companies. It was initially used a test stand, where an instrumentation for data acquisition was inserted, composed of accelerometers and inductive proximity sensors. The data collection system was structured on the basis of an NI 6008 A/D converter of National Instruments. An electronic circuit command was developed through the A/D converter for a remote firing of the test stand. The equipment monitoring is performed through the data collected from the sensors. The vibration signals collected by accelerometers are processed in the time domain and frequency. Also, proximity probes were used for the axis orbit evaluation and an inductive sensor for the rotation and trigger measurement. © (2013) Trans Tech Publications, Switzerland.

Analise de defeitos em motores através de vibração mecânica: estudo de caso

Revolving machines are among the most used equipment in general industry and therefore expenditures on this equipment class are a significant portion of the total amount spent by the company. If there is an unscheduled stop of some of this equipment, industrial plants can lose huge amounts of money caused by interrupted production and parts delay. Others may increase significantly maintenance costs due to consequences elsewhere not affected before. Even plant and people safety can be in danger if there is an operation interruption without a backup system start. This work is focused on a rotating system case study which is monitored by vibration analysis that shows that is possible to determine when is the most appropriate time for equipment intervention without any reliability loss just by using a simple and cheap system which is not much used because professionals are not aware to its utility. Industrial facilities were evaluated by fail detection and historical analysis in some equipment in order to show feasibility of vibration analysis through a before-during-after process. The plant evaluated is part of a chemical multinational located in Guaratinguetá-SP. At this time, that plant had around 650 critical equipment monthly monitored and no unscheduled shutdown was registered in one year period due to equipment monitoring

International online survey to assess current practice in equine anaesthesia.

REASONS FOR PERFORMING STUDY Multicentre Confidential Enquiries into Perioperative Equine Fatalities (CEPEF) have not been conducted since the initial CEPEF Phases 1-3, 20 years ago. OBJECTIVES To collect data on current practice in equine anaesthesia and to recruit participants for CEPEF-4. STUDY DESIGN Online questionnaire survey. METHODS An online questionnaire was prepared and the link distributed internationally to veterinarians possibly performing equine anaesthesia, using emails, posters, flyers and an editorial. The questionnaire included 52 closed, semiclosed and open questions divided into 8 subgroups: demographic data, anaesthetist, anaesthesia management (preoperative, technical equipment, monitoring, drugs, recovery), areas of improvements and risks and motivation for participation in CEPEF-4. Descriptive statistics and Chi-squared tests for comparison of categorical variables were performed. RESULTS A total of 199 questionnaires were completed by veterinarians from 14 different countries. Of the respondents, 43% worked in private hospitals, 36% in private practices and 21% in university teaching hospitals. In 40 institutions (23%) there was at least one diplomate of the European or American colleges of veterinary anaesthesia and analgesia on staff. Individual respondents reported routinely employ the following anaesthesia monitoring modalities: electrocardiography (80%), invasive arterial blood pressures (70%), pulse oximetry (60%), capnography (55%), arterial blood gases (47%), composition of inspired and expired gases (45%) and body temperature (35%). Drugs administered frequently or routinely as part of a standard protocol were: acepromazine (44%), xylazine (68%), butorphanol (59%), ketamine (96%), diazepam (83%), isoflurane (76%), dobutamine (46%), and, as a nonsteroidal anti-inflammatory drug, phenylbutazone (73%) or flunixin meglumine (66%). Recovery was routinely assisted by 40%. The main factors perceived by the respondents to affect outcome of equine anaesthesia were the preoperative health status of the animal and training of the anaesthetist. CONCLUSIONS Current practice in equine anaesthesia varies widely, and the study has highlighted important topics relevant for designing a future prospective multicentre cohort study (CEPEF-4). The Summary is available in Chinese - see Supporting information.

ENABLING HARDWARE TECHNOLOGIES FOR AUTONOMY IN TINY ROBOTS: CONTROL, INTEGRATION, ACTUATION

The last two decades have seen many exciting examples of tiny robots from a few cm3 to less than one cm3. Although individually limited, a large group of these robots has the potential to work cooperatively and accomplish complex tasks. Two examples from nature that exhibit this type of cooperation are ant and bee colonies. They have the potential to assist in applications like search and rescue, military scouting, infrastructure and equipment monitoring, nano-manufacture, and possibly medicine. Most of these applications require the high level of autonomy that has been demonstrated by large robotic platforms, such as the iRobot and Honda ASIMO. However, when robot size shrinks down, current approaches to achieve the necessary functions are no longer valid. This work focused on challenges associated with the electronics and fabrication. We addressed three major technical hurdles inherent to current approaches: 1) difficulty of compact integration; 2) need for real-time and power-efficient computations; 3) unavailability of commercial tiny actuators and motion mechanisms. The aim of this work was to provide enabling hardware technologies to achieve autonomy in tiny robots. We proposed a decentralized application-specific integrated circuit (ASIC) where each component is responsible for its own operation and autonomy to the greatest extent possible. The ASIC consists of electronics modules for the fundamental functions required to fulfill the desired autonomy: actuation, control, power supply, and sensing. The actuators and mechanisms could potentially be post-fabricated on the ASIC directly. This design makes for a modular architecture. The following components were shown to work in physical implementations or simulations: 1) a tunable motion controller for ultralow frequency actuation; 2) a nonvolatile memory and programming circuit to achieve automatic and one-time programming; 3) a high-voltage circuit with the highest reported breakdown voltage in standard 0.5 μm CMOS; 4) thermal actuators fabricated using CMOS compatible process; 5) a low-power mixed-signal computational architecture for robotic dynamics simulator; 6) a frequency-boost technique to achieve low jitter in ring oscillators. These contributions will be generally enabling for other systems with strict size and power constraints such as wireless sensor nodes.

Cooperative research and development agreement with Graseby/Nutech Corporation : monitoring equipment for volatile organic compounds.

Mode of access: Internet.

Procedures for monitoring the importation of motor vehicles and motor vehicle equipment : as provided in Title 19-Code of Federal Regulations 12.80.

DOT HS 803 546

Monitoring equipment for hydrocarbon ozone precursors and for hazardous volatile organic compounds : cooperative research and development agreement with Perkin-Elmer Corporation.

Mode of access: Internet.

Procedures for monitoring the importation of motor vehicles and motor vehicle equipment.

Mode of access: Internet.

Evaluation of air cleaning and monitoring equipment used in recirculation systems /

Contract No. 210-78-0011.