Performance evaluation of multiple-beam free space optics in tropical rainy weather

Free space optics (FSO) has the potential to replace optical fiber as a solution for the last mile problem. FSO is favored because of its cheap maintenance costs and quick deployment time as compared to other communication system such as fiber optics. Atmospheric attenuation is a problem for FSOs with classic single beam systems, especially when it rains heavily specially in tropical region like Malaysia. As a result, a multibeam FSO transceiver system has become popular as a solution to this problem. The purpose of this study is to compare the standard single beam FSO system with the suggested multibeam FSO system. At a bit error rate (BER) of 10-9, the comparison is made in terms of received optical power, channel distance, and geometrical losses. Rain intensity data is gathered over a six-month period. To evaluate the performance of both systems, the average rain attenuation is calculated from this data and exposed to single beam and multibeam FSO systems. The multibeam FSO approach was found to increase the system's performance. The results show that employing up to four beams improves the quality of received power and increases the channel distance to 1150 m when compared to a single beam FSO system with a channel distance of only 830 m

Emerging Biomarkers of Illness Severity: Urinary Metabolites Associated with Sepsis and Necrotizing Methicillin‐Resistant Staphylococcus aureus Pneumonia

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138419/1/phar1973.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138419/2/phar1973_am.pd

Robotic Assistance in Coordination of Patient Care

We conducted a study to investigate trust in and dependence upon robotic decision support among nurses and doctors on a labor and delivery floor. There is evidence that suggestions provided by embodied agents engender inappropriate degrees of trust and reliance among humans. This concern is a critical barrier that must be addressed before fielding intelligent hospital service robots that take initiative to coordinate patient care. Our experiment was conducted with nurses and physicians, and evaluated the subjects’ levels of trust in and dependence on high- and low-quality recommendations issued by robotic versus computer-based decision support. The support, generated through action-driven learning from expert demonstration, was shown to produce high-quality recommendations that were ac- cepted by nurses and physicians at a compliance rate of 90%. Rates of Type I and Type II errors were comparable between robotic and computer-based decision support. Furthermore, em- bodiment appeared to benefit performance, as indicated by a higher degree of appropriate dependence after the quality of recommendations changed over the course of the experiment. These results support the notion that a robotic assistant may be able to safely and effectively assist in patient care. Finally, we conducted a pilot demonstration in which a robot assisted resource nurses on a labor and delivery floor at a tertiary care center.National Science Foundation (U.S.) (Grant 2388357

Characteristics of Children With Cancer Discharged or Admitted From the Emergency Department

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136395/1/pbc25872_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136395/2/pbc25872.pd

Characteristics of Children With Cancer Discharged or Admitted From the Emergency Department

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136395/1/pbc25872_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136395/2/pbc25872.pd

Epidemiology of Methicillin‐Resistant \u3cem\u3eStaphylococcus aureus\u3c/em\u3e Bacteremia in Gaborone, Botswana

This cross‐sectional study at a tertiary‐care hospital in Botswana from 2000 to 2007 was performed to determine the epidemiologic characteristics of Staphylococcus aureus bacteremia. We identified a high prevalence (11.2% of bacteremia cases) of methicillin‐resistant S. aureus (MRSA) bacteremia. MRSA isolates had higher proportions of resistance to commonly used antimicrobials than did methicillin‐susceptible isolates, emphasizing the need to revise empiric prescribing practices in Botswana

Observation‐status patients in children's hospitals with and without dedicated observation units in 2011

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111995/1/jhm2339.pd

Pediatric observation status: Are we overlooking a growing population in children's hospitals?

BACKGROUND: Inpatient administrative datasets often exclude observation stays, as observation is considered to be outpatient care. The extent to which this status is applied to pediatric hospitalizations is not known. OBJECTIVE: To characterize trends in observation status code utilization and 1‐day stays among children admitted from the emergency department (ED), and to compare patient characteristics and outcomes associated with observation versus inpatient stays. DESIGN: Retrospective longitudinal analysis of the 2004–2009 Pediatric Health Information System (PHIS). SETTING: Sixteen US freestanding children's hospitals contributing outpatient and inpatient data to PHIS. PATIENTS: Admissions to observation or inpatient status following ED care in study hospitals. MEASUREMENTS: Proportions of observation and 1‐day stays among all admissions from the ED were calculated each year. Top ranking discharge diagnoses and outcomes of observation were determined. Patient characteristics, discharge diagnoses, and return visits were compared for observation and 1‐day stays. RESULTS: The proportion of short‐stays (including both observation and 1‐day stays) increased from 37% to 41% between 2004 and 2009. Since 2007, observation stays have outnumbered 1‐day stays. In 2009, more than half of admissions from the ED for 6 of the top 10 ranking discharge diagnoses were short‐stays. Fewer than 25% of observation stays converted to inpatient status. Return visits and readmissions following observation were no more frequent than following 1‐day stays. CONCLUSIONS: Children admitted under observation status make up a substantial proportion of acute care hospitalizations. Analyses of inpatient administrative databases that exclude observation stays likely result in an underestimation of hospital resource utilization for children. Journal of Hospital Medicine 2012; © 2012 Society of Hospital MedicinePeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93720/1/1923_ftp.pd

Translational profiling of hypocretin neurons identifies candidate molecules for sleep regulation

Hypocretin (orexin; Hcrt)-containing neurons of the hypothalamus are essential for the normal regulation of sleep and wake behaviors and have been implicated in feeding, anxiety, depression, and reward. The absence of these neurons causes narcolepsy in humans and model organisms. However, little is known about the molecular phenotype of these cells; previous attempts at comprehensive profiling had only limited sensitivity or were inaccurate. We generated a Hcrt translating ribosome affinity purification (bacTRAP) line for comprehensive translational profiling of all ribosome-bound transcripts in these neurons in vivo. From this profile, we identified >6000 transcripts detectably expressed above background and 188 transcripts that are highly enriched in these neurons, including all known markers of the cells. Blinded analysis of in situ hybridization databases suggests that ∼60% of these are expressed in a Hcrt marker-like pattern. Fifteen of these were confirmed with double labeling and microscopy, including the transcription factor Lhx9. Ablation of this gene results in a >30% loss specifically of Hcrt neurons, without a general disruption of hypothalamic development. Polysomnography and activity monitoring revealed a profound hypersomnolence in these mice. These data provide an in-depth and accurate profile of Hcrt neuron gene expression and suggest that Lhx9 may be important for specification or survival of a subset of these cells

Dysfunction of the Intestinal Microbiome in Inflammatory Bowel Disease and Treatment

Background: The inflammatory bowel diseases (IBD) Crohn's disease and ulcerative colitis result from alterations in intestinal microbes and the immune system. However, the precise dysfunctions of microbial metabolism in the gastrointestinal microbiome during IBD remain unclear. We analyzed the microbiota of intestinal biopsies and stool samples from 231 IBD and healthy subjects by 16S gene pyrosequencing and followed up a subset using shotgun metagenomics. Gene and pathway composition were assessed, based on 16S data from phylogenetically-related reference genomes, and associated using sparse multivariate linear modeling with medications, environmental factors, and IBD status. Results: Firmicutes and Enterobacteriaceae abundances were associated with disease status as expected, but also with treatment and subject characteristics. Microbial function, though, was more consistently perturbed than composition, with 12% of analyzed pathways changed compared with 2% of genera. We identified major shifts in oxidative stress pathways, as well as decreased carbohydrate metabolism and amino acid biosynthesis in favor of nutrient transport and uptake. The microbiome of ileal Crohn's disease was notable for increases in virulence and secretion pathways. Conclusions: This inferred functional metagenomic information provides the first insights into community-wide microbial processes and pathways that underpin IBD pathogenesis