Reducing Hospital-Acquired Pressure Injury in an Inpatient Medical-Surgical Telemetry Adult Unit by Educating and Encouraging Basic Wound Care Prior to Wound Care Consult

Problem: A medical center in the Diablo Service Area had one of the highest rates in hospital-acquired pressure injury (HAPI), benchmarking with other facilities, with the project unit one of the top offenders. The patients and the medical center both suffered from the harm. Barriers to HAPI prevention included lack of patient turnings, skin assessment, and early standard wound care treatment. Context: This project focused on the primary care team standardizing early wound care treatment to avoid wound progression. Interventions: Interventions included re-educating the primary care team on early basic wound care using a standard wound care guideline created by a multidisciplinary team. Measures: The outcome measure of the project was the monthly HAPI incidence on the unit. The process measures included wounds treated by the primary care team appropriately and nursing knowledge on basic wound care. The balancing measure included wounds treated by the primary care team inappropriately. Result: The outcome measure was met in both May and June, with zero HAPI incidence. The process measure of wound treatment was not met in May (5%), but it was met in June (26%). Nursing knowledge on basic wound care increased from 70% to 90% (post project). The balancing measure remained at 0% throughout the 2 months. Conclusions: HAPI prevention should continue to be a focus in the medical center. Patient harm was reduced, hospital’s financial burden was lessened, and the frontline staff were inspired due to ownership of the project. Further efforts will be made to spread the performance improvement project to other units to align with the medical center’s Magnet journey

Student lodges report against UPM guards

A student of Universiti Putra Malaysia (UPM) who twice aborted attempts to make police reports on Saturday for the return of his laptop, hand phone and other belongings seized bu the universiti's security personnel, lodged a report yesterday

Stochastic Downsampling for Cost-Adjustable Inference and Improved Regularization in Convolutional Networks

It is desirable to train convolutional networks (CNNs) to run more efficiently during inference. In many cases however, the computational budget that the system has for inference cannot be known beforehand during training, or the inference budget is dependent on the changing real-time resource availability. Thus, it is inadequate to train just inference-efficient CNNs, whose inference costs are not adjustable and cannot adapt to varied inference budgets. We propose a novel approach for cost-adjustable inference in CNNs - Stochastic Downsampling Point (SDPoint). During training, SDPoint applies feature map downsampling to a random point in the layer hierarchy, with a random downsampling ratio. The different stochastic downsampling configurations known as SDPoint instances (of the same model) have computational costs different from each other, while being trained to minimize the same prediction loss. Sharing network parameters across different instances provides significant regularization boost. During inference, one may handpick a SDPoint instance that best fits the inference budget. The effectiveness of SDPoint, as both a cost-adjustable inference approach and a regularizer, is validated through extensive experiments on image classification

Dichlorido{μ3-6,6′-dieth­oxy-2,2′-[ethane-1,2-diylbis(nitrilo­methyl­idyne)]diphenolato}octa­methyldi-μ3-oxido-tetra­tin(IV)

In the title tetra­nuclear tin(IV) complex, [Sn4(CH3)8(C20H22N2O4)Cl2O2], there are three completely different tin-atom coordinations. One metal atom (site symmetry 2) adopts a distorted penta­gonal-bipyramidal SnC2N2O3 coordination arising from the N,N′,O,O′-tetra­dentate deprotonated Schiff base, two methyl groups in the axial sites and a μ3-O atom that also bonds to two further Sn atoms. Two symmetry-equivalent Sn atoms adopt very distorted SnC2O4 arrangements that could be described as penta­gonal-bipyramidal with one equatorial vertex missing and the C atoms in the axial site. The final Sn atom (site symmetry 2) adopts an SnC2Cl2O trigonal-bipyramidal arrangement, with Cl atoms in the axial sites. As well as the two Sn atoms, one O atom lies on a twofold rotation rotation axis, and another is disordered about the axis. The terminal eth­oxy group is disordered over two sets of sites with equal occupancy