Knowledge-based clinical pathway for medical quality improvement

Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis of clinical pathways is a promising strategy to improve medical quality effectively. However, the clinical pathway knowledge has not been fully integrated into treatment process and thus cannot provide comprehensive support to the actual work practice. Therefore this paper proposes a knowledgebased clinical pathway management method which contributes to make use of clinical knowledge to support and optimize medical practice. We have developed a knowledgebased clinical pathway management system to demonstrate how the clinical pathway knowledge comprehensively supports the treatment process. The experiences from the use of this system show that the treatment quality can be effectively improved by the extracted and classified clinical pathway knowledge, seamless integration of patient-specific clinical pathway recommendations with medical tasks and the evaluating pathway deviations for optimization

Simulated and Measured Effect of Rectangular Obstructions on Carbon Dioxide Gas Dispersion in a Scaled Swine Building

Gas dispersion from shallow manure storage pits was experimentally measured and mathematically modeled in a 1:6-scale ventilation chamber. The chamber represents a geometrically scaled model of a production swine grower facility. Gas injection was simulated from shallow pits using carbon dioxide (CO2). The results indicate significant differences in gas concentration between the animal-occupied zone (AOZ) and human-occupied zones (HOZ), especially at ventilation rates representative of mild weather conditions. AOZ CO2 concentrations were 12 times higher than HOZ during minimum ventilation conditions and six times higher during mild weather ventilation conditions. Large variations in normalized CO2 concentration were found as a function of both vertical location from the floor and horizontal location from the inlet, especially at vertical locations representative of the AOZ. Rectangular obstructions, physically representing the overall size of 60 kg pigs, did significantly (p \u3c 0.01) affect gas dispersion at high ventilation rates, but did not significantly (p \u3e 0.05) affect gas dispersion at low ventilation rates, implying that airflow patterns near the AOZ were significantly affected by the presence of rectangular obstructions at high ventilation rates. The mathematical model provided excellent prediction of the measured results. Vertical profiles were closely predicted with large gradients near the floor, in agreement with the measured results

A hybrid single-mode laser based on slotted silicon waveguides

An InGaAsP-Si hybrid single-mode laser based on etched slots in silicon waveguides was demonstrated operating at 1543 nm. The InGaAsP gain structure was bonded onto a patterned silicon-on-insulator wafer by selective area metal bonding method. The mode-selection mechanism based on a slotted silicon waveguide was applied, in which the parameters were designed using the simulation tool cavity modeling framework. The III-V lasers employed buried ridge stripe structure. The whole fabrication process only needs standard photolithography and inductively coupled plasma etching technology, which reduces cost for ease in technology transfer. At room temperature, a single mode of 1543-nm wavelength at a threshold current of 21 mA with a maximum output power of 1.9 mW in continuous-wave regime was obtained. The side mode suppression ratio was larger than 35 dB. The simplicity and flexibility of the fabrication process and a low cost make the slotted hybrid laser a promising light source