Measuring antibiotic timing for pneumonia in the emergency department: Another nail in the coffin
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ABSTRACT: This paper presents a new method to implement a multiplier using the Quasi Delay Insensitive (QDI) approach. QDI circuits allow unbounded delays on wires and gates, and require the difference among the delays in forks to be less than the delays of their terminating gates. To implement the Booth multiplier following the QDI approach, we considered Martin's method. In this method, an asynchronous circuit is considered as a set of cells that communicate through a handshaking protocol, and is synthesized from a high level definition through different levels of translation. The main problem related to the resulting circuits their considerable overhead due to the implementation of handshaking protocols. In our proposed method, the overhead is reduced 50% by separating the control and data path units. This solution increases the forks, and causes complexity in physical implementation. By applying some of the rules derived from Martin's method, the forks became locally limited to ease up the physical implementation.
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ABSTRACT: Being critical in terms of time and complexity, emergency medicine is exposed to an emerging imperative for quality improvement strategies. We review current concepts and recent advances in the management of quality in emergency medicine. There is a strong interdependence between quality of emergency healthcare provision and the education of emergency healthcare providers. Introduction of emergency medical residencies and highly qualified triage liaison physicians helps prevent the overcrowding of emergency departments, accelerate access to emergency medical care and improve patient satisfaction. New advances in detecting and reducing patient management errors include the collection of healthcare provider complaints and the classification of unpreventable and preventable deaths of patients within 1 week of admission via the emergency department. Medical record review and video recording have revealed that frequent patient management problems relate to shortcomings in the diagnostic process, clinical tasks, patient factors, and poor teamwork. Communication skills and patient data/documentation systems may effectively resolve these problems. According to the available evidence, more performance improvement strategies need to be tested to delineate which process changes would be most effective in improving patient outcome in emergency medicine.Current Opinion in Anaesthesiology 05/2008; 21(2):233-9. DOI:10.1097/ACO.0b013e3282f5d8eb · 2.53 Impact Factor
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ABSTRACT: The importance of antibiotic timing is a common clinical question encountered in emergency medicine practice for patients who have severe infections. Various studies in the medical literature have reported associations between early antibiotic timing and improved survival for meningitis, pneumonia, and septic shock. Understanding the evidence behind antibiotic timing and survival is vital to emergency physicians, because they must balance the potential benefits of early antibiotic administration and the potential for antibiotic overuse and misuse. The measurement of antibiotic timing in pneumonia has been shown to be associated with antibiotic misuse in emergency departments. Quality organizations should study carefully the intended and unintended consequences of measuring and reporting antibiotic timing to make policy decisions on current and future performance measures in this area.Emergency Medicine Clinics of North America 06/2008; 26(2):245-57, vii. DOI:10.1016/j.emc.2008.01.004 · 0.85 Impact Factor