3,804 research outputs found
Solid state television camera system Patent
Solid state television camera system consisting of monolithic semiconductor mosaic sensor and molecular digital readout system
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Implementing a perioperative efficiency initiative for orthopedic surgery instrumentation at an academic center: A comparative before-and-after study.
Optimizing surgical instrumentation may contribute to value-based care, particularly in commonly performed procedures. We report our experience in implementing a perioperative efficiency program in 2 types of orthopedic surgery (primary total-knee arthroplasty, TKA, and total-hip arthroplasty, THA).A comparative before-and-after study with 2 participating surgeons, each performing both THA and TKA, was conducted. Our objective was to evaluate the effect of surgical tray optimization on operating and processing time, cost, and waste associated with preparation, delivery, and staging of sterile surgical instruments. The study was designed as a prospective quality improvement initiative with pre- and postimplementation operational measures and a provider satisfaction survey.A total of 96 procedures (38 preimplementation and 58 postimplementation) were assessed using time-stamped performance endpoints. The number and weight of trays and instruments processed were reduced substantially after the optimization intervention, particularly for TKA. Setup time was reduced by 23% (6 minutes, P = .01) for TKA procedures but did not differ for THA. The number of survey respondents was small, but satisfaction was high overall among personnel involved in implementation.Optimizing instrumentation trays for orthopedic procedures yielded reduction in processing time and cost. Future research should evaluate patient outcomes and incremental/additive impact on institutional quality measures
Trusty URIs: Verifiable, Immutable, and Permanent Digital Artifacts for Linked Data
To make digital resources on the web verifiable, immutable, and permanent, we
propose a technique to include cryptographic hash values in URIs. We call them
trusty URIs and we show how they can be used for approaches like
nanopublications to make not only specific resources but their entire reference
trees verifiable. Digital artifacts can be identified not only on the byte
level but on more abstract levels such as RDF graphs, which means that
resources keep their hash values even when presented in a different format. Our
approach sticks to the core principles of the web, namely openness and
decentralized architecture, is fully compatible with existing standards and
protocols, and can therefore be used right away. Evaluation of our reference
implementations shows that these desired properties are indeed accomplished by
our approach, and that it remains practical even for very large files.Comment: Small error corrected in the text (table data was correct) on page
13: "All average values are below 0.8s (0.03s for batch mode). Using Java in
batch mode even requires only 1ms per file.
Provenance-Centered Dataset of Drug-Drug Interactions
Over the years several studies have demonstrated the ability to identify
potential drug-drug interactions via data mining from the literature (MEDLINE),
electronic health records, public databases (Drugbank), etc. While each one of
these approaches is properly statistically validated, they do not take into
consideration the overlap between them as one of their decision making
variables. In this paper we present LInked Drug-Drug Interactions (LIDDI), a
public nanopublication-based RDF dataset with trusty URIs that encompasses some
of the most cited prediction methods and sources to provide researchers a
resource for leveraging the work of others into their prediction methods. As
one of the main issues to overcome the usage of external resources is their
mappings between drug names and identifiers used, we also provide the set of
mappings we curated to be able to compare the multiple sources we aggregate in
our dataset.Comment: In Proceedings of the 14th International Semantic Web Conference
(ISWC) 201
Redesigning Systems of Care for Older Adults with Alzheimer' Disease
Best-practice models of dementia care have evolved from strategies focused on family caregivers to guidelines predicated on supporting the patient-caregiver dyad along the care continuum. These models have grown in complexity to encompass medical and team-based care that is designed to coordinate dementia care across settings and providers for a defined population of patients. Although there is evidence that the models can improve outcomes, they have not been widely adopted. Barriers to the models' increased adoption include workforce limitations, the cost of necessary practice redesign, and limited evidence of their potential cost-effectiveness. We summarize the origins, evidence base, and common components of best-practice models of dementia care, and we discuss barriers to their implementation. We conclude by describing two current efforts to implement such models on a broad scale, supported by the Center for Medicare and Medicaid Innovation. Taken together, these models seek to demonstrate improved dementia care quality and outcomes, accompanied by cost savings, in both community-based and institutional care settings
Nursing Home Staff Palliative Care Knowledge and Practices: Results of a Large Survey of Frontline Workers
CONTEXT: Deficits in quality end-of-life care for nursing home (NH) residents are well known. Palliative care is promoted as an approach to improve quality. The Palliative Care Survey (PCS) is designed to measure NH staff palliative care knowledge and practice.
OBJECTIVES: To comparing palliative care knowledge and practices across NH staff roles using the PCS, and to examine relationships between facility characteristics and PCS scores.
METHODS: The PCS was administered to frontline NH staff-certified nursing assistants (CNAs), licensed practical nurses (LPNs), registered nurses (RNs), and social workers (SWs)-in 51 facilities in 2012. Descriptive statistics were calculated by job role. Linear mixed effects models were used to identify facility and individual factors associated with palliative care practice and knowledge.
RESULTS: The analytic sample included 1200 surveys. CNAs had significantly lower practice and knowledge scores compared to LPNs, RNs, and SWs (P < 0.05). LPNs had significantly lower psychological, end-of-life, and total knowledge scores than RNs (P < 0.05 for all). Although knowledge about physical symptoms was uniformly high, end-of-life knowledge was notably low for all staff. A one-point higher facility star rating was significantly associated with a 0.06 increase in family communication score (P = 0.003; 95% CI: 0.02-0.09; SE = 0.02). Higher penetration of hospice in the NH was associated with higher end-of-life knowledge (P = 0.003; parameter estimate = 0.006; 95% CI: 0.002-0.010; SE = 0.002). Sixty-two percent of respondents stated that, with additional training, they would be interested in being leaders in palliative care.
CONCLUSION: Given observed differences in palliative care practice and knowledge scores by staff training, it appears the PCS is a useful tool to assess NH staff. Low end-of-life knowledge scores represent an important target for quality improvement
Hydrologic and Water Quality Monitoring on Turkey Creek Watershed, Francis Marion National Forest, SC
2008 S.C. Water Resources Conference - Addressing Water Challenges Facing the State and Regio
Transitions in Care in a Nationally Representative Sample of Older Americans with Dementia
OBJECTIVES: To describe transitions in care for older adults with dementia identified from a nationally representative cohort and to describe transition rates in those with more-severe levels of cognitive and functional impairment.
DESIGN: Longitudinal cohort study.
SETTING: Health and Retirement Study (HRS).
PARTICIPANTS: HRS respondents aged 65 and older whose survey data were linked with Medicare claims from 1999 to 2008 (N = 16,186).
MEASUREMENTS: Transitions in care between home, home with formal services, hospital, and nursing facility care; cognitive function; activities of daily living; and mortality.
RESULTS: The 3,447 (21.3%) HRS subjects who were ever diagnosed with dementia experienced frequent transitions. Of subjects transitioning from a hospital stay, 52.2% returned home without home care services, and 33.8% transitioned to a nursing facility. Of subjects transitioning from a nursing facility, 59.2% transitioned to the hospital, and 25.3% returned home without services. There were 2,139 transitions to death, and 58.7% of HRS subjects with dementia died at home. Even in persons with moderate to severe dementia, multiple transitions in care were documented, including transitions from the hospital to home and back to the hospital.
CONCLUSION: In this nationally representative sample of older adults, subjects diagnosed with dementia experience frequent transitions. Persons with dementia who are cared for at home and who transition back to home often have moderate to severe impairments in function and cognition
A well-separated pairs decomposition algorithm for k-d trees implemented on multi-core architectures
Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.Variations of k-d trees represent a fundamental data structure used in Computational Geometry with numerous applications in science. For example particle track tting in the software of the LHC experiments, and in simulations of N-body systems in the study of dynamics of interacting galaxies, particle beam physics, and molecular dynamics in biochemistry. The many-body tree methods devised by Barnes and Hutt in the 1980s and the Fast Multipole Method introduced in 1987 by Greengard and Rokhlin use variants of k-d trees to reduce the computation time upper bounds to O(n log n) and even O(n) from O(n2). We present an algorithm that uses the principle of well-separated pairs decomposition to always produce compressed trees in O(n log n) work. We present and evaluate parallel implementations for the algorithm that can take advantage of multi-core architectures.The Science and Technology Facilities Council, UK
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