Pneumonia identification using nursing home records

Pneumonia is a leading cause of death among nursing home residents; consequently, prevention and treatment are important for quality improvement. To be pragmatic, quality improvement depends on sensitive case identification using nursing home records; however, no studies have examined the reliability of different methods of pneumonia case finding from records. The current authors compared three established strategies for defining pneumonia using records from 1,119 residents across 16 nursing homes: recorded diagnosis of pneumonia, modified McGeer criteria (chest x-ray infiltrate plus specified signs/symptoms), and antibiotic prescription plus pneumonia-specific signs. Chart diagnosis detected 107 cases, modified McGeer criteria detected 84 cases, and antibiotic prescription detected 47 cases. Diagnosis included all cases identified by the McGeer criteria and all but one case identified by antibiotic use. Based on findings, recorded diagnosis of pneumonia is a highly sensitive and pragmatic method to ascertain pneumonia in nursing homes, and is recommended for use in quality improvement and research

Velocity-space sensitivity of the time-of-flight neutron spectrometer at JET

The velocity-space sensitivities of fast-ion diagnostics are often described by so-called weight functions. Recently, we formulated weight functions showing the velocity-space sensitivity of the often dominant beam-target part of neutron energy spectra. These weight functions for neutron emission spectrometry (NES) are independent of the particular NES diagnostic. Here we apply these NES weight functions to the time-of-flight spectrometer TOFOR at JET. By taking the instrumental response function of TOFOR into account, we calculate time-of-flight NES weight functions that enable us to directly determine the velocity-space sensitivity of a given part of a measured time-of-flight spectrum from TOFOR

Relationship of edge localized mode burst times with divertor flux loop signal phase in JET

A phase relationship is identified between sequential edge localized modes (ELMs) occurrence times in a set of H-mode tokamak plasmas to the voltage measured in full flux azimuthal loops in the divertor region. We focus on plasmas in the Joint European Torus where a steady H-mode is sustained over several seconds, during which ELMs are observed in the Be II emission at the divertor. The ELMs analysed arise from intrinsic ELMing, in that there is no deliberate intent to control the ELMing process by external means. We use ELM timings derived from the Be II signal to perform direct time domain analysis of the full flux loop VLD2 and VLD3 signals, which provide a high cadence global measurement proportional to the voltage induced by changes in poloidal magnetic flux. Specifically, we examine how the time interval between pairs of successive ELMs is linked to the time-evolving phase of the full flux loop signals. Each ELM produces a clear early pulse in the full flux loop signals, whose peak time is used to condition our analysis. The arrival time of the following ELM, relative to this pulse, is found to fall into one of two categories: (i) prompt ELMs, which are directly paced by the initial response seen in the flux loop signals; and (ii) all other ELMs, which occur after the initial response of the full flux loop signals has decayed in amplitude. The times at which ELMs in category (ii) occur, relative to the first ELM of the pair, are clustered at times when the instantaneous phase of the full flux loop signal is close to its value at the time of the first ELM

Comparative Evaluation of Fine- and Coarse-Grain Approaches for Software Distributed Shared Memory

Symmetric multiprocessors (SMPs) connected with low-latency networks provide attractive building blocks for software distributed shared memory systems. Two distinct approaches have been used: the fine-grain approach that instruments application loads and stores to support a small coherence granularity, and the coarse-grain approach based on virtual memory hardware that provides coherence at a page granularity. Fine-grain systems offer a simple migration path for applications developed on hardware multiprocessors by supporting coherence protocols similar to those implemented in hardware. On the other hand, coarse-grain systems can potentially provide higher performance through more optimized protocols and larger transfer granularities, while avoiding instrumentation overheads. Numerous studies have examined each approach individually, but major differences in experimental platforms and applications make comparison of the approaches difficult. This paper presents a detailed comparison of two mature systems, Shasta and Cashmere, representing the fine- and coarse-grain approaches, respectively. Both systems are tuned to run on the same commercially available, state-of-the-art cluster of AlphaServer SMPs connected via a Memory Channel network. As expected, our results show that Shasta provides robust performance for applications tuned for hardware multiprocessors, and can better tolerate fine-grain synchronization. In contrast, Cashmere is highly sensitive to fine-grain synchronization, but provides a performance edge for applications with coarse-grain behavior. Interestingly, we found that the performance gap between the systems can often be bridged by program modifications that address coherence and synchronization granularity. In addition, our study reveals some unexpected results related to the interaction of current compiler technology with application instrumentation, and the ability of SMP-aware protocols to avoid certain performance disadvantages of coarse-grain approaches