321 research outputs found
Procurement System In Drug Design Pharmacies Healthy Development
Pharmacy is an important effort inhealth. Pharmacy is a community service facilities in providing medicines and supplies other information. Therefore, the above functions requires good management pharmacies and tidy in order to support the progress of these pharmacies. Such efforts will be realized when data recording is done well by a section of the warehouse, sales, purchasing and others. At the Healthy Community Pharmacy purchasing system is still done manually, especially in the issuance of purchase orders and reports. And frequent delays in ordering products.Basically every company expects the existence of a data processing is true and accurate to resolve the problems in data processing and to support decision-making on the part of the company. Therefore in this paper, the authors tried to computerize the processing of data, especially data processing, letter creation process purchase orders and preparing reports using tools for system development. The tools that are used to design the purchasing system in this paper are: FOD, context diagram, DFD, ERD, and Normalization.Given the design of the system is done, the writer tries to mengkomputerisasi purchases of data processing is a discussion of this research writing
User centered neuro-fuzzy energy management through semantic-based optimization
This paper presents a cloud-based building energy management system, underpinned by semantic middleware, that integrates an enhanced sensor network with advanced analytics, accessible through an intuitive Web-based user interface. The proposed solution is described in terms of its three key layers: 1) user interface; 2) intelligence; and 3) interoperability. The system’s intelligence is derived from simulation-based optimized rules, historical sensor data mining, and a fuzzy reasoner. The solution enables interoperability through a semantic knowledge base, which also contributes intelligence through reasoning and inference abilities, and which are enhanced through intelligent rules. Finally, building energy performance monitoring is delivered alongside optimized rule suggestions and a negotiation process in a 3-D Web-based interface using WebGL. The solution has been validated in a real pilot building to illustrate the strength of the approach, where it has shown over 25% energy savings. The relevance of this paper in the field is discussed, and it is argued that the proposed solution is mature enough for testing across further buildings
Effect of Ankaferd Blood Stopper on Early Bone Tissue Healing in Extraction Sockets: An Experimental In vivo Study
Purpose: To investigate the effect of Ankaferd blood stopper (ABS) on early bone healing of extraction sockets in rats.Method: Twenty-eight male Wistar rats were divided into four groups. The maxillary right first molar tooth of the rats was extracted under general anesthesia. Two groups (C-1, n = 6 and C-2, n = 6) received saline solutions in the extraction sockets immediately and one day after the extraction, respectively, while two groups (A-1, n = 8 and A-2, n = 8) received ABS. The rats in A-1 and C-1 groups were sacrificed after 7 days of post-extraction while the rats in A-2 and C-2 groups were sacrificed after 28 days. Bone samples were taken from the maxillas, and tissues were prepared for histopathological analysis. Osteoid tissue (OT), mineralized bone tissue (MT), remaining area (RA), and inflammatory cell infiltration (ICI) were determined. The histomorphometric results were analyzed statistically using analysis of variance (ANOVA).Results Osteoid formation was highest in C-1 group (39.71 ± 9.68, p < 0.05). Differences in OT among other groups were not significant (p > 0.05). MT was higher in C-2 group (47.73 ± 12.15) than in other groups (p < 0.05). RA was highest in C-1 group (59.95 ± 12.75). ICI was significantly lower in control (C1 and C-2) groups than in ABS (A-1 and A-2) groups (p < 0.05).Conclusion: ABS administered topically to extraction sockets immediately after extraction has no effect on bone healing; in fact, ABS increases inflammation in vivo
Analysis of Episodes of Care in Medicare Beneficiaries Newly Diagnosed with Alzheimer’s Disease
OBJECTIVES: To study transitions between healthcare settings and quantify the cost burdens associated with different combinations of transitions during a 6-month period before initial Alzheimer’s disease (AD) diagnosis so as to investigate how using an episode-of-care approach to payment for specific disease states might apply in AD.
DESIGN: A retrospective observational cohort study.
SETTING: United States.
PARTICIPANTS: A random sample of 8,995 individuals aged 65 to 100 with a diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 331.0) were identified from the Medicare database between January 1, 2011, and June 30, 2014. This analysis identified individuals with AD diagnosed in inpatient (18%), skilled nursing facility (SNF) (1%), hospice (4%), and home and outpatient (77%) settings and analyzed episodes that began in the index setting (defined as the care setting in which the individual was first diagnosed with AD).
MEASUREMENTS: Study outcomes included number of transitions between settings, primary discharge diagnoses, and total all-cause healthcare costs during the 6 months after the AD diagnosis.
RESULTS: The average numbers of transitions between care settings were 2.8 originating from an inpatient setting, 2.4 from a SNF, 0.3 from a hospice setting and 0.7 from a home or outpatient setting during 6 months post-AD diagnosis. The overall cost burden during the 6 months after AD diagnosis (including costs incurred at the index setting) was high for individuals diagnosed in a nonambulatory setting (mean 12,597 in costs during the same period.
CONCLUSION: Episodes of care can be defined and studied in individuals with AD. An episode-of-care approach to payment could encourage providers to use the continuum of care needed for quality medical management in AD more efficiently
Economic Burden, Mortality, and Institutionalization in Patients Newly Diagnosed with Alzheimer’s Disease
Background: Current information is scarce regarding comorbid conditions, treatment, survival, institutionalization, and health care utilization for Alzheimer’s disease (AD) patients.
Objectives: Compare all-cause mortality, rate of institutionalization, and economic burden between treated and untreated newly-diagnosed AD patients.
Methods: Patients aged 65–100 years with ≥1 primary or ≥2 secondary AD diagnoses (ICD-9-CM:331.0] with continuous medical and pharmacy benefits for ≥12 months pre-index and ≥6 months post-index date (first AD diagnosis date) were identified from Medicare fee-for-service claims 01JAN2011–30JUN2014. Patients with AD treatment claims or AD/ADrelated dementia diagnosis during the pre-index period were excluded. Patients were assigned to treated and untreated cohorts based on AD treatment received post-index date. Total 8,995 newly-diagnosed AD patients were identified; 4,037 (44.8%)
were assigned to the treated cohort. Time-to-death and institutionalization were assessed using Cox regression. To compare health care costs and utilizations, 1 : 1 propensity score matching (PSM) was used.
Results: Untreated patients were older (83.85 versus 81.44 years; p \u3c 0.0001), with more severe comorbidities (mean Charlson comorbidity index: 3.54 versus 3.22; p \u3c 0.0001). After covariate adjustment, treated patients were less likely to die (hazard ratio[HR] = 0.69; p \u3c 0.0001) and were associated with 20% lower risk of institutionalization (HR = 0.801; p = 0.0003). After PSM, treated AD patients were less likely to have hospice visits (3.25% versus 9.45%; p \u3c 0.0001), and incurred lower annual all-cause costs (30,110; p = 0.0162).
Conclusion: After controlling for comorbidities, treated AD patients have better survival, lower institutionalization, and sometimes fewer resource utilizations, suggesting that treatment and improved care management could be beneficial for newly-diagnosed AD patients from economic and clinical perspectives
Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report
Primary heart neoplasms are rare occurring with an estimated incidence of 0.0017-0.19%. Myxoma is the most prevalent primary heart tumor. The right atrium is an unusual localization, occurring only in 15-20% of myxoma cases. We report a rare case of a massive right atrial myxoma causing tricuspid valve obstruction and presenting as syncope and exertional dyspnea. This case illustrates the influence of myxoma's size, position and mobility as well as patient's body posture and respiration to the development of signs and symptoms. Three-dimensional echocardiography proved useful in surgery planning, allowing a better definition of the tumor outline and attachment
A Multi-Objective Optimization for Supply Chain Network Using the Bees Algorithm
A supply chain is a complex network which involves the products, services and information flows between suppliers and customers. A typical supply chain is composed of different levels, hence, there is a need to optimize the supply chain by finding the optimum configuration of the network in order to get a good compromise between the multi-objectives such as cost minimization and lead-time minimization. There are several multi-objective optimization methods which have been applied to find the optimum solutions set based on the Pareto front line. In this study, a swarm-based optimization method, namely, the bees algorithm is proposed in dealing with the multi-objective supply chain model to find the optimum configuration of a given supply chain problem which minimizes the total cost and the total lead-time. The supply chain problem utilized in this study is taken from literature and several experiments have been conducted in order to show the performance of the proposed model; in addition, the results have been compared to those achieved by the ant colony optimization method. The results show that the proposed bees algorithm is able to achieve better Pareto solutions for the supply chain problem
Vortices and chirality of magnetostatic modes in quasi-2D ferrite disk particles
In this paper we show that the vortex states can be created not only in
magnetically soft "small" (with the dipolar and exchange energy competition)
cylindrical dots, but also in magnetically saturated "big" (when the exchange
is neglected) cylindrical dots. A property associated with a vortex structure
becomes evident from an analysis of confinement phenomena of magnetic
oscillations in a ferrite disk with a dominating role of magnetic-dipolar
(non-exchange-interaction) spectra. In this case the scalar
(magnetostatic-potential) wave functions may have a phase singularity in a
center of a dot. A non-zero azimuth component of the flow velocity demonstrates
the vortex structure. The vortices are guaranteed by the chiral edge states of
magnetic-dipolar modes in a quasi-2D ferrite disk
Lymph node metastasis in grossly apparent clinical stage Ia epithelial ovarian cancer: Hacettepe experience and review of literature
Background Lymphadenectomy is an integral part of the staging system of epithelial ovarian cancer. However, the extent of lymphadenectomy in the early stages of ovarian cancer is controversial. The objective of this study was to identify the lymph node involvement in unilateral epithelial ovarian cancer apparently confined to the one ovary (clinical stage Ia). Methods A prospective study of clinical stage I ovarian cancer patients is presented. Patient's characteristics and tumor histopathology were the variables evaluated. Results Thirty three ovarian cancer patients with intact ovarian capsule were evaluated. Intraoperatively, neither of the patients had surface involvement, adhesions, ascites or palpable lymph nodes (supposed to be clinical stage Ia). The mean age of the study group was 55.3 ± 11.8. All patients were surgically staged and have undergone a systematic pelvic and paraaortic lymphadenectomy. Final surgicopathologic reports revealed capsular involvement in seven patients (21.2%), contralateral ovarian involvement in two (6%) and omental metastasis in one (3%) patient. There were two patients (6%) with lymph node involvement. One of the two lymph node metastasis was solely in paraaortic node and the other metastasis was in ipsilateral pelvic lymph node. Ovarian capsule was intact in all of the patients with lymph node involvement and the tumor was grade 3. Conclusion In clinical stage Ia ovarian cancer patients, there may be a risk of paraaortic and pelvic lymph node metastasis. Further studies with larger sample size are needed for an exact conclusion.PubMedWoSScopu
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