Oral neglect as a marker of broader neglect: a cross-sectional investigation of orodental consultation letter of leukemic admitted patients in Iran

Background Leukemia is the main malignant hematologic disease of children with different oral manifestations and clinical features. Attention to the oral manifestations is essential for better management. This study assessed the oral and dental consultations conducted in the admitted leukemic patients of an Iranian teaching hospital. Methods In this descriptive cross-sectional study, medical records of patients admitted in Yazd Shahid Sadoughi Hospital were evaluated. Records of 300 patients with leukemia were randomly selected. Data including demographic information on age, sex, type of oral problems, prescribed instructions and leukemia type were extracted from archived records and registered on the checklist. Finally, Data were analyzed by SPSS17 using Chi-square test. Results The results showed the average age ± SD of patients were 24.36 ± 23.91 with a range of 4 days to 86 years. Among 300 files, 167 belonged to males (55.7%) and 133 pertained to females (44.3%). The most prevalent type of underlying disease was ALL (Acute lymphocytic leukemia) with the frequency of 180 persons (60%). Only 12 (4%) of patients were referred to a specialist due to oral problems. Of all cases of consultation requests, 75% received consultation because of dental problems and 25% for mucosal problems. There was a statistically significant difference between age and consultation request (P = 0.002). Conclusions According to the results of this study, orodental consultation request rate for admitted leukemic patients was low. Pediatric hematologist and oncologists to some extent had more interest to consult due to oral and dental problems rather than others.

Improving Fairness for Distributed Interactive Applications in Software-Defined Networks

With the popularization of distributed interactive applications (DIAs), for getting good interactive experience among participants, efficient and fair allocation of network resource should be considered. In software-defined networks, the presence of central controllers provides novel solution to deploy customizable routing for interactive applications, which allows fine-grained resource allocation for DIAs to achieve fairness among participants. But opportunities always come with challenges, the wide spread user locations often require distribution of controllers to meet the requirements of applications. Hence, the latency involved among participants is directly affected by the processing time of controllers. In this context, we address the DIAs’ fair resource provisioning problems on computing and links load with the objective of balancing the achievable request rate and fairness among multiple flows in SDN networks. We firstly formulate the problems as a combination of controller loading and routing optimization. Then, we propose proactive assignment controller algorithm based on deep learning and fairness path allocation algorithm to share the bottleneck links. Compared with the state-of-the-art greedy assignment algorithm and priority order allocating algorithm, the final result is proven to get better fairness on controller and link load among DIAs’ participants by trace driven simulation.

Topology dependence of on-demand ride-sharing

Traffic is a challenge in rural and urban areas alike with negative effects ranging from congestion to air pollution. Ride-sharing poses an appealing alternative to personal cars, combining the traffic-reducing ride bundling of public transport with much of the flexibility and comfort of personal cars. Here we study the effects of the underlying street network topology on the viability of ride bundling analytically and in simulations. Using numerical and analytical approaches we find that system performance can be measured in the number of scheduled stops per vehicle. Its scaling with the request rate is approximately linear and the slope, that depends on the network topology, is a measure of the ease of ridesharing in that topology. This dependence is caused by the different growth of the route volume, which we compute analytically for the simplest networks served by a single vehicle.

Inventory Sharing Strategy for Disposable Medical Items between Two Hospitals

When urgent situations occur (e.g., inaccurate demand forecast, traffic accidents, or infectious disease outbreaks), the stock of rescue medical items in the hospital might not be enough to cater to the drastically increased demand. Comparing with placing an expensive emergent replenishment order with dealers, requesting inventory sharing from another hospital with excessive stocks could save time and cost. This paper investigates the operation of the inventory sharing mechanism between two independent hospitals with the consideration of patient behavior. We first identified the inventory decisions when hospitals are under a no-sharing scenario, and derive hospitals’ sharing policies and inventory policies under the sharing scenario. Through numerical experiments, we found that the inventory sharing option is profitable for hospitals compared to emergent replenishment. Furthermore, we investigated the effects of patient behavior, safety inventory level of the hospital, and other cost parameters on inventory decisions. Under the sharing policy, the increase of hospital j’s emergent request rate and safety inventory level increased the optimal initial inventory level of hospital i, while the increase of hospital j’s initial inventory level decreased the optimal inventory level of hospital i. This paper provides more practical suggestions for hospitals’ inventory sharing operation.

Implementing Prescribing Guidelines for Upper Extremity Orthopedic Procedures: A Prospective Analysis of Postoperative Opioid Consumption and Satisfaction

Background: A lack of established opioid-prescribing guidelines has prompted recent studies to propose preliminary guidelines to mitigate inadvertent overprescribing, diversion, and abuse. The purpose of our study was to assess the efficacy of a specific set of opioid-prescribing guidelines by prospective evaluation of patient consumption and satisfaction. Methods: During a consecutive period, all patients undergoing outpatient upper extremity surgical procedures were postoperatively prescribed opioids based on published guidelines that were specific to the anatomical location and procedure being performed. At the first postoperative visit, surgical details, opioid consumption patterns, and prescription efficacy and satisfaction were recorded. Results: A total of 201 patients reported any amount of prescription use, resulting in a mean consumption of 5.5 pills. Patients who underwent soft tissue procedures reported the lowest requirement (4.2 pills) compared with those who underwent fracture repairs (6.7 pills) or arthroscopy and arthroplasty/fusion procedures (8.7 pills). Patients undergoing hand procedures consumed fewer opioids (3.9 pills) compared with those undergoing wrist (6.3 pills) or elbow (8.1 pills) procedures. Of the patients requiring opioids, 82% reported being satisfied or at least neutral to the prescribed quantity ( P < .001), and 92% reported being satisfied or at least neutral to the prescribed opioid analgesic efficacy ( P < .001). Overall, the study refill request rate was 13%. Conclusions: Although the proposed guidelines tended to exceed patient need, the study confirmed strong patient satisfaction and an overall refill request rate of only 13%. We conclude that following anatomical and procedure-specific opioid-prescribing guidelines is an effective method of prescribing opioids postoperatively after upper extremity.

Performa Kinerja Web Server Berbasis Ubuntu Linux Dan Turnkey Linux

ABSTRACT One of the most frequently used server service functions is to provide a website access service, called a web server. In this study, we use two servers with Ubuntu operating system and Turnkey Linux with its objective to compare web performance to get parameters of response time value and throughput value. The test is carried out with a request rate of 10 to 100 with 1000 and 2000 connections. Based on the results obtained, Web server which uses Ubuntu Linux is better than Turnkey Linux, it is indicated by the value of small response time which means fast response and large throughput value, and this means good. A Web server that has 1000 connections generates a response time and a good throughput value, while the 2000 number of connections generates a response time value and a reduced throughput value, it is because for more than 1000 connections can affect the speed of the system. Keywords : performance, web server, response time, thoughput ABSTRAK Salah satu fungsi layanan server yang sering digunakan adalah menyediakan layanan akses situs web, yang disebut sebagai web server. Dalam penelitian ini menggunakan dua server dengan sistem operasi Ubuntu dan Turnkey Linux dengan tujuan membandingkan performa kinerja web untuk mendapatkan parameter nilai responsese time dan nilai throughput. Pengujian dilakukan dengan request rate sebanyak 10 sampai 100 dengan jumlah 1000 koneksi dan 2000 koneksi. Berdasarkan hasil pengujian diperoleh bahwa Web server yang menggunakan Ubuntu Linux lebih baik dari Turnkey Linux yang ditunjukkan oleh nilai response time kecil yang berarti response cepat dan nilai throughput besar yang berarti baik. Web server yang memiliki jumlah 1000 koneksi menghasilkan nilai response time dan nilai throughput yang cukup baik, sedangkan jumlah 2000 koneksi menghasilkan nilai response time dan nilai throughput yang menurun karena jumlah koneksi yang lebih dari 1000 dapat mempengaruhi kecepatan sistem . Kata kunci : performa, web server, response time, throughput

The age of accountability of consultation liaison, an example from a big referral hospital

CL is a subspecialty in psychiatry and provides a variety of consultation services including diagnosis, therapeutic and teaching efforts of a psychiatrist in none psychiatric units or hospitals.ObjectivesThis is a retrospective descriptive study that evaluated the consultation liaison (CL) psychiatry services in Imam Khomeini hospital, during two recent years.MethodsThe information has been obtained from reviews of medical profiles of patients who attended the hospital.ResultsA total of 681 patients (365 patients were male) received CL services during the study period. The most prevalent diagnosis groups were mood disorder (37.91%), delirium (13.6%) and anxiety (12.64%). Our study revealed that cardiovascular unit, infectious disease unit and general surgery units frequently requested for consultations among all hospital wards. Pediatrics unit had the lowest request rate for psychiatric consultation.ConclusionCL is on the rise in general hospitals, specifically in internal medicine and surgery units which alarm us to pay more attention to preventive strategies focused on the most referred problems including mood disorders, delirium and anxiety disorders in patients who attended general hospitals.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Special Consideration in Post-Secondary Institutions: Trends at a Canadian University

This study examined trends in the practice of granting special consideration for missed tests and late papers in colleges and universities. We analyzed a database of 4,183 special consideration requests at a large Canadian university between 1998 and 2008. Results show a growing rate of requests per enrolment between 2001 and 2007. Although university officials and faculty are concerned that request making is excessive, an in-depth investigation of request making by the number of requests per student, request rate by course difficulty, grade point average, and illness-related work absences in the general population fails to support suspicions of dishonest behaviour. Furthermore, demographic variables—aside from part-time versus full-time student status, and to a lesser degree socio-economic status—do not distinguish students who made frequent requests from those who made few. We discuss potential explanations for the increase in requests for special consideration.

An Efficient Adaptive Load Balancing Algorithm for Cloud Computing Under Bursty Workloads

Cloud computing is a recent, emerging technology in the IT industry. It is an evolution of previous models such as grid computing. It enables a wide range of users to access a large sharing pool of resources over the internet. In such complex system, there is a tremendous need for an efficient load balancing scheme in order to satisfy peak user demands and provide high quality of services. One of the challenging problems that degrade the performance of a load balancing process is bursty workloads. Although there are a lot of researches proposing different load balancing algorithms, most of them neglect the problem of bursty workloads. Motivated by this problem, this paper proposes a new burstness-aware load balancing algorithm which can adapt to the variation in the request rate by adopting two load balancing algorithms: RR in burst and Random in non-burst state. Fuzzy logic is used in order to assign the received request to a balanced VM. The algorithm has been evaluated and compared with other algorithms using Cloud Analyst simulator. Results show that the proposed algorithm improves the average response time and average processing time in comparison with other algorithms.