Projects intensive care

LaPointe DR, Arnold AD, Eichelberger WJ, 2002. Quality improvement projects to enhance safety and efficacy of gentamicin in a neonatal intensive care unit. ASHP Midyear Clinical Meeting, Adanta, GA. 

An expert system shell developed in the MYCIN project is EMYCIN, which was used to develop other expert systems. One of these systems is PUEE, designed for the domain of heart disorders. Another outcome was the ventilator manager (VM) program developed as a collaborative research project between Stanford University and Pacific Medical Center in San Francisco within the scope of a Ph.D. thesis by Lawrence M. Fagan [6]. VM was designed to interpret on-line quantitative data in the intensive care unit. The system measures the patient s heart rate, blood pressure, and the status of operation of a mechanical ventilator that assists the patient s breathing. Based on this information, the system controls the ventilator and makes necessary adjustments. 

Careful planning of the initial investigation activities is very important because this task sets the stage for future decisions and actions. Physical site characteristics, extent and intensity of contamination, cultural features, and historical background are confirmed in this project phase. Cleanup levels, potential remedial schemes, and probable costs are established with the data derived from the initial work. Regulators typically set conservative closure standards to assure public safety. Once these are established, it is difficult to modify them. Therefore, a truly representative site investigation must be completed before any remediation levels are set. 

In Figure 23b, the gel has been exchanged twice with D2O and dried at 100 °C, with considerable care being taken to avoid subsequent water adsorption. As can be seen from the figure, there is a very marked decrease in the intensity of the heteronuclear connectivity, but there is still a residual interaction arising from the trace amounts of hydroxy protons indicated in the projection of FI. It is this situation that leads to the possible ambiguities in the one-dimensional experiments described above. 

Obviously, the above algorithms are not suitable when transients of the finer scale model are involved (Raimondeau and Vlachos, 2000), as, for example, during startup, shut down, or at a short time after perturbations in macroscopic variables have occurred. The third coupling algorithm attempts fully dynamic, simultaneous solution of the two models where one passes information back and forth at each time step. This method is computationally more intensive, since it involves continuous calls of the microscopic code but eliminates the need for a priori development of accurate surfaces. As a result, it does not suffer from the problem of accuracy as this is taken care of on-the-fly. In dynamic simulation, one could take advantage of the fast relaxation of a finer (microscopic) model. What the separation of time scales between finer and coarser scale models implies is that in each (macroscopic) time step of the coarse model, one could solve the fine scale model for short (microscopic) time intervals only and pass the information into the coarse model. These ideas have been discussed for model systems in Gear and Kevrekidis (2003), Vanden-Eijnden (2003), and Weinan et al. (2003) but have not been implemented yet in realistic MC simulations. The term projective method was introduced for a specific implementation of this approach (Gear and Kevrekidis, 2003). 

Deisenhofer was independent, too. This project was not simple crystallography, not at all. It was a most complex structure determination. Even the methods of measuring the intensities were not automated at the time. We had developed instruments. X-ray cameras and methods for that purpose also. We had a small workshop at that time, with a mechanic and an electronics person. One day the mechanic had a stroke. A week later the electronics person had a heart attack. They were very important in servicing the instruments. I was the only one in my department able to service the instruments. It was at a critical time for the photosynthetic reaction center work, around 1983, and I spent much time each day taking care of the instruments. It is a side issue, not even a scientific one, but it shows you that things may look different from the perspective of today s possibilities than they actually were. The work at that time required a background also concerning the availability of the samples for isomorphous replacement and methods to apply them. I have made many of these samples and I built up an enormous collection. 

In the synthesis of the scene, considerable effort was made to achieve realistic and accurate representation and extreme care was taken over the construction of the object, the simulation of the illumination and atmosphere, and the projection of the background. The solid models were not only correctly painted but were carefully textured relative to their full-scale equivalent. Correct illumination, at the right intensity, was achieved for most applications by a mixture of directional and diffuse lighting but a great deal of trouble also had to be taken to ensure that it was the right colour temperature (see glossary). Atmospheric effects were found to be particularly difficult to calculate and recreate. 

Crucial to the success of ab initio structure determinations is the collection of 3-D diffraction data. The conventional TEM sample holders can handle limited rotation (up to 35° e.g., in some HREM), which leaves a wedge-shaped gap in reciprocal space. Special holders used for tomography with a large rotation range can be used to address this problem. The diffraction patterns recorded at different rotations are merged to produce the 3-D data set. Special care must be taken to normalize the diffraction intensities because of the 3-D shape of the crystal and possible dynamic diffraction effects. In the absence of 3-D diffraction data set, diffraction patterns can be recorded along zone-axis orientations and reconstructed to obtain the projection maps. These maps then... 

The selection of the type of contract (turnkey vs non-turnkey) is one of the key decisions to be taken by the buyer when embarking on a nuclear power project. The decision should, therefore, be carefully considered, based on the analysis of all relevant factors, paramount among which are the experience and competence level of the utility organization in the area of large project management. Since a nuclear project is likely to be the most complex and capital intensive project in the history of most utilities, they will not have sufficient project experience at the necessary level. In this case, a turnkey contract is the advisable form for the implementation of the project, especially the first one. 

The peak positions are at the projections of the positions of the points of the reciprocal lattice of the crystal that is studied. The peak positions determine the unit cell s size and symmetry, while a careful analysis of the intensities of the different reflections yields the positions of the atoms within the unit cell. 

---