Inventory Control System

This report explains the paper inventory control system designed and developed for Venetian Marble and Granite. The system implements new methods in generating work orders, new labels for the marble pieces, new clipboard stations for tracking, new storage rack numbering, and Microsoft Access as the foundation to the entire system. The group highly recommends that Venetian integrates the paper inventory control system into their company as soon as possible in order to reap its benefits

Migrating to Cloud-Native Architectures Using Microservices: An Experience Report

Migration to the cloud has been a popular topic in industry and academia in recent years. Despite many benefits that the cloud presents, such as high availability and scalability, most of the on-premise application architectures are not ready to fully exploit the benefits of this environment, and adapting them to this environment is a non-trivial task. Microservices have appeared recently as novel architectural styles that are native to the cloud. These cloud-native architectures can facilitate migrating on-premise architectures to fully benefit from the cloud environments because non-functional attributes, like scalability, are inherent in this style. The existing approaches on cloud migration does not mostly consider cloud-native architectures as their first-class citizens. As a result, the final product may not meet its primary drivers for migration. In this paper, we intend to report our experience and lessons learned in an ongoing project on migrating a monolithic on-premise software architecture to microservices. We concluded that microservices is not a one-fit-all solution as it introduces new complexities to the system, and many factors, such as distribution complexities, should be considered before adopting this style. However, if adopted in a context that needs high flexibility in terms of scalability and availability, it can deliver its promised benefits

Effects Of Implementing A Clinical Pharmacist Service In A Mixed Norwegian Icu

Цели: Неприемливо висок процент пациенти, приети в отделения по интензивно лечение (ОИЛ), развиват свързани с приема на лекарства проблеми (СЛП). СЛП могат да причинят увреждания и да увеличат разноските и продължителността на престоя. Доказано е, че въвеждането на клинично фармацевтично обслужване разкрива голям брой СЛП и ефективно допринася за разрешаването на същите в различни системи на здравеопазване. Обаче това не е проучено в перспектива в смесени третични норвежки ОИЛ.Методи: През 12-месечен период от м. октомври 2012 г. насетне един клиничен фармацевт се посвети на прегледи на лекарства 3 часа на ден (от понеделник до петък). СЛП бяха докладвани на срещата на ОИЛ и включваха консултация от страна на фармацевта за всеки отделен случай. Всички СЛП бяха категоризирани и клиничното въздействие бе документирано за по-нататъшен анализ. Бяха категоризирани свързаните с лекарства въпроси от страна на персонала и бе даден отговор на същите.Резултати: 363 от 549 приети в ОИЛ пациенти получиха рецензии за лекарствата. Бяха установени 641 СЛП у 194 от тези пациенти (средно по 1,8 СЛП на пациент, диапазон 0-25). Сред най-често установените СЛП бяха твърде високи дози, значими взаимодействия на лекарства и ненужни или неподходящи лекарства. 87% от консултациите, дадени от страна на фармацевта, бяха приети или взети предвид. Типичните въпроси от страна на медицинските сестри бяха свързани с приготвянето на лекарства, генерични еквиваленти и прием на лекарства. Въпросите от страна на лекарите най-често бяха свързани с дозировката на лекарствата, ефикасността и нежеланите ефекти.Изводи: Добавянето на специален клиничен фармацевт към екипа на ОИЛ подобрява качеството и безопасността на лекарствата в смесеното норвежко ОИЛ.Objectives: An unacceptably high proportion of patients admitted to intensive care units (ICUs) develop drug-related problems (DRPs). DRPs might cause harm and increase costs and length of stay. The implementation of a clinical pharmacist service has been shown to detect a high number of DRPs and contributes effectively to solving these across different healthcare systems. However, this has not been prospectively studied in a mixed tertiary Norwegian ICU.Methods: During a 12-month period from October 2012, a clinical pharmacist was dedicated to review medications 3 h daily (Monday to Friday). DRPs were reported at the ICU conference and included advice by the pharmacist for each case. All DRPs were categorized and the clinical impact was documented for later analysis. Drug-related questions from the staff were categorised and answered.Results: 363 of 549 patients admitted to the ICU received medication reviews. 641 DRPs were detected in 194 of these patients (mean 1.8 DRPs per patient, range 0-25). Too high a dose, significant drug interactions and unnecessary or inappropriate drugs were among the most frequently detected DRPs. 87% of advice given by the pharmacist was accepted or taken into consideration. Typical questions from the nursing staff were related to drug preparation, generic equivalents and drug administration. Questions from doctors were most frequently related to drug dosage, efficiency and adverse effects.Conclusions: The addition of a dedicated clinical pharmacist to the ICU team improves the quality and safety of medication in a mixed Norwegian ICU

Asymmetrical distribution of non-conserved regulatory sequences at PHOX2B is reflected at the ENCODE loci and illuminates a possible genome-wide trend

<p>Abstract</p> <p>Background</p> <p>Transcriptional regulatory elements are central to development and interspecific phenotypic variation. Current regulatory element prediction tools rely heavily upon conservation for prediction of putative elements. Recent <it>in vitro </it>observations from the ENCODE project combined with <it>in vivo </it>analyses at the zebrafish <it>phox2b </it>locus suggests that a significant fraction of regulatory elements may fall below commonly applied metrics of conservation. We propose to explore these observations <it>in vivo </it>at the human <it>PHOX2B </it>locus, and also evaluate the potential evidence for genome-wide applicability of these observations through a novel analysis of extant data.</p> <p>Results</p> <p>Transposon-based transgenic analysis utilizing a tiling path proximal to human <it>PHOX2B </it>in zebrafish recapitulates the observations at the zebrafish <it>phox2b </it>locus of both conserved and non-conserved regulatory elements. Analysis of human sequences conserved with previously identified zebrafish <it>phox2b </it>regulatory elements demonstrates that the orthologous sequences exhibit overlapping regulatory control. Additionally, analysis of non-conserved sequences scattered over 135 kb 5' to <it>PHOX2B</it>, provides evidence of non-conserved regulatory elements positively biased with close proximity to the gene. Furthermore, we provide a novel analysis of data from the ENCODE project, finding a non-uniform distribution of regulatory elements consistent with our <it>in vivo </it>observations at <it>PHOX2B</it>. These observations remain largely unchanged when one accounts for the sequence repeat content of the assayed intervals, when the intervals are sub-classified by biological role (developmental versus non-developmental), or by gene density (gene desert versus non-gene desert).</p> <p>Conclusion</p> <p>While regulatory elements frequently display evidence of evolutionary conservation, a fraction appears to be undetected by current metrics of conservation. <it>In vivo </it>observations at the <it>PHOX2B </it>locus, supported by our analyses of <it>in vitro </it>data from the ENCODE project, suggest that the risk of excluding non-conserved sequences in a search for regulatory elements may decrease as distance from the gene increases. Our data combined with the ENCODE data suggests that this may represent a genome wide trend.</p

Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis

AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations (variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis. METHODS: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI. RESULTS: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality (OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites (OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy. CONCLUSION: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed

Late Pleistocene hydrological settings at world heritage Tsodilo Hills (NW Kalahari, Botswana), a site of ancient human occupation

Based on genetic studies, a Pleistocene Kalahari “palaeo-wetland”, which spanned the region of the Okavango Delta and the Makgadikgadi Basin, was recently considered the geographic origin of evolutionary modern humans. It was proposed that subsequent out-of-homeland migration was induced by climate shifts. The Tsodilo Hills, which are in relative proximity to the Okavango Delta, represent a site of ancient human occupation since at least 100 ka. Local hydrological dynamics were predominately controlled by climate variability and are archived in the sediments of Palaeolake Tsodilo. This study seeks to better understand the Late Pleistocene environments of the ancient Tsodilo people with a focus on palaeo-hydrological settings, which played a major role for their livelihoods. Our multidisciplinary approach included different remote sensing and geophysical methods, comprehensive application of differential GPS, and sedimentological analyses concentrating on the lake beds. Four palaeo-shorelines could be identified, three of which indicate highstands during which the Tamacha palaeo-river drained Palaeolake Tsodilo towards the Okavango Panhandle. Two highstands during MIS 3b and LGM are related to periods of largely increased fish consumption by humans as has been documented by archaeologists. The palaeolake was likely most extended about 100 ka ago or earlier, when it covered ca. 70 km2 and was 16 m deep. A single (neo-)tectonic fault could be detected. We assume that the Tamacha palaeo-river was a gateway for ancient humans to reach the Tsodilo Hills from these palaeo-wetlands. The people took advantage of the Tsodilo Hills as shelter from weather hazards and as a natural fortress against predators and elephants. Geologically, the Tsodilo Hills were comparatively calm. They represented a relatively safe haven where the social behaviour of early modern humans could evolve to a higher complexity, which relates to the fundamental question when and where modern human behaviour began

An obstetric sphincter injury risk identification system (OSIRIS): is this a clinically useful tool?

INTRODUCTION AND HYPOTHESIS: To establish the contribution of maternal, fetal and intrapartum factors to the risk of incidence of obstetric anal sphincter injuries (OASIS) and assess the feasibility of an OASIS risk prediction model based on variables available to clinicians prior to birth. METHODS: This was a population-based, retrospective cohort study using single-site data from the birth database of Aarhus University Hospital, Denmark. The participants were all women who had a singleton vaginal birth during the period 1989 to 2006. Univariate and multivariate logistic regression analyses were performed using multiple imputations for missing data and internally validated using bootstrap methods. The main outcome measures were the contributions of maternal, fetal and intrapartum events to the incidence of OASIS. RESULTS: A total of 71,469 women met the inclusion criteria, of whom 1,754 (2.45 %) sustained OASIS. In the multivariate analysis of variables known prior to birth, maternal age 20 – 30 years (OR 1.65, 95 % CI 1.44 – 1.89) and ≥30 years (OR 1.60, 95 % CI 1.39 – 1.85), occipitoposterior fetal position (OR 1.34, 95 % CI 1.06 – 1.70), induction/augmentation of labour (OR 1.46, 95 % CI 1.32 – 1.62), and suspected macrosomia (OR 2.20, 95 % CI 1.97 – 2.45) were independent significant predictors of OASIS, with increasing parity conferring a significant protective effect. The ‘prebirth variable’ model showed a 95 % sensitivity and a 24 % specificity in predicting OASIS with 1 % probability, and a 3 % sensitivity and a 99 % specificity in predicting OASIS with a 10 % probability. CONCLUSIONS: Our model identified several significant OASIS risk factors that are known prior to actual birth. The prognostic model shows potential for ruling out OASIS (high sensitivity with a low risk cut-off value), but is not useful for ruling in the event. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00192-016-3125-2) contains supplementary material, which is available to authorized users

A Phase-Field Model of Spiral Dendritic Growth

Domains of condensed-phase monolayers of chiral molecules exhibit a variety of interesting nonequilibrium structures when formed via pressurization. To model these domain patterns, we add a complex field describing the tilt degree of freedom to an (anisotropic) complex-phase-field solidification model. The resulting formalism allows for the inclusion of (in general, non-reflection symmetric) interactions between the tilt, the solid-liquid interface, and the bond orientation. Simulations demonstrate the ability of the model to exhibit spiral dendritic growth.Comment: text plus Four postscript figure file