Journal of thrombosis and thrombolysis, Jan 26, 2016
Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-ris... more Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of ...
Advanced Traffic Management Systems constitute one of the major envisaged applications of Intelli... more Advanced Traffic Management Systems constitute one of the major envisaged applications of Intelligent Transport Systems. Various architectures and approaches have been proposed and tested in projects of R&D programmes of the European Commission in recent years, as for example ARTIS, KITS and ENTERPRICE, just to mention a few. An approach shared by all of them has been the conception of
Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing in... more Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. The treatment of VTE is undergoing tremendous changes with the introduction of the new direct oral anticoagulants and clinicians need to understand new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. In this chapter, we address the management of patients presenting with venous thrombosis in unusual sites, such as cerebral vein thrombosis, splanchnic vein thrombosis, and retinal vein occlusion. These events are less common than venous thrombosis of the lower limbs or pulmonary embolism, but are often more challenging, both for the severity of clinical presentations and outcomes and for the substantial lack of adequate evidence from clinical trials. Based on the available data, we suggest anticoagulant treatment for all patients with cere...
Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity... more Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity and mortality, and an incidence that is expected to double in the next forty years. The advent of direct oral anticoagulants (DOACs) has catalyzed significant changes in the therapeutic landscape of VTE treatment. As such, it is imperative that clinicians become familiar with and appropriately implement new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance for VTE treatment with the DOACs. When possible, guidance statements are supported by existing published evidence and guidelines. In instances where evidence or guidelines are lacking, guidance statements represent the consensus opinion of all authors of this manuscript and are endorsed by the Board of Directors of the Anticoagulation Forum.The authors of this manuscript first developed a list of pivotal practical questions related to real-world clinical scenarios involving the us...
Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging chang... more Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging changes in incidence, diagnosis and treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. We address a) the appropriate workup to search for occult malignancy in patients with idiopathic VTE, b) identification of high-risk cancer patients for primary thromboprophylaxis, c) the appropriate immediate and long-term treatment for people with cancer diagnosed with acute thromboembolism, d) the appropriate duration of anticoagulation and e) the appropriate treatment strategy in patients with recurrent VTE on anticoagulation. Areas of controversy and future directions in this field are highlighted.
The problem of manufacturing systems scheduling by means of dispatching rules is that these rules... more The problem of manufacturing systems scheduling by means of dispatching rules is that these rules depend on the state in which the system is in every moment. Therefore it would be interesting to use in every state of the system, the most adequate dispatching rule to that state. To achieve this goal, it is presented in this paper a scheduling approach which uses machine learning. This approach, according to the previous performance of the system (training examples), is capable of working out the most appropriate dispatching rule for every state of the system.
Conference Record of 1998 IEEE Industry Applications Conference. Thirty-Third IAS Annual Meeting (Cat. No.98CH36242), 1998
This paper presents a computationally scalable real-time observer, which allows the evolution of ... more This paper presents a computationally scalable real-time observer, which allows the evolution of temperature distribution within slabs reheated in continuous furnaces to be tracked. Accurate tracking of skidmarks requires the use of two-dimensional models, which demand high computational power, generally provided by multiprocessor computers. To evaluate the behaviour of the observer under both typical and extreme operational conditions, a simulator of a complete furnace is presented. The emulation of extreme operational conditions using a real furnace would be impossible, due to the material waste and the cost of delaying normal production. This furnace simulator is the simplest method of generating the variables of the temperatures in the various furnace zones, which are fed to the observer during its operation in real time. Finally, in order to configure the observer, a simple and efficient graphic method is proposed. The method generates an optimum solution, minimizing the number of processors required to fulfil the specifications and maximize their utilization under all operational conditions
Wikipedia is a community-created encyclopedia that contains information about notable people from... more Wikipedia is a community-created encyclopedia that contains information about notable people from different countries, epochs and disciplines and aims to document the world's knowledge from a neutral point of view. However, the narrow diversity of the Wikipedia editor community has the potential to introduce systemic biases such as gender biases into the content of Wikipedia. In this paper we aim
This article describes an architecture that enables vi- sual prototyping of real-time audio appli... more This article describes an architecture that enables vi- sual prototyping of real-time audio applications and plugins. Visual prototyping means that a developer can build a working application, including user in- terface and processing core, just by assembling el- ements together and changing their properties in a visual way. The article addresses the problem of hav- ing to bind interactive user
In a recent report, seek to identify the impact of attending charter schools on student achieveme... more In a recent report, seek to identify the impact of attending charter schools on student achievement using data from Arizona. Based on a sophisticated statistical analysis, these authors report that charter school attendance increases test score gains of students. This note raises some questions about the interpretation of the results reported and some questions about the empirical approach and underlying data. First, the report relies on a 2-x-2 evaluation design with type of school (charter or traditional) attended in a base year as the rows and type of school in the ensuing year as the columns. The report compares the observations in a cell of the design matrix to all other cells. This note questions the validity of that approach and suggests that the way that the data were constructed allows comparisons only across the rows. Second, the note questions whether grade level was used in the data matching procedure used to construct the comparison sample. Third, the note questions whether sex was used as a covariate in the outcomes equation and whether building or district fixed effects were used to control for unobservable factors at those aggregate levels. Finally, the note suggests that marginal costs are more appropriate for a cost-benefit or cost effectiveness analysis than average costs, which were used in the summary section of the report.
Proceedings. 6th International Conference on Parallel Interconnects (PI'99) (Formerly Known as MPPOI), 1999
Future I/O provides a high-performance switched-fabric interconnect to enable both host-to-host a... more Future I/O provides a high-performance switched-fabric interconnect to enable both host-to-host and host-to-I/O node communication. Providing inherent redundancy characteristics, 1 GB/sec data rates and support for legacy IP, this architecture will satisfy bandwidth requirements for a number of applications for years to come. The architecture enables very low-cost implementations for adapter vendors and also scales to very high-end IPC and
Hematology / the Education Program of the American Society of Hematology. American Society of Hematology. Education Program, 2013
A 44-year-old otherwise healthy woman has completed 3 months of anticoagulation therapy for a fir... more A 44-year-old otherwise healthy woman has completed 3 months of anticoagulation therapy for a first episode of unprovoked pulmonary embolism. At the time of diagnosis and before the initiation of anticoagulation, she was found to have an elevated IgG anticardiolipin antibody (ACLA), which was measured at 42 IgG phospholipid (GPL) units (reference range, <15 GPL units) with negative lupus anticoagulant (LAC) testing. Should this laboratory finding affect the recommended duration of anticoagulant therapy?
Journal of thrombosis and thrombolysis, Jan 26, 2016
Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-ris... more Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of ...
Advanced Traffic Management Systems constitute one of the major envisaged applications of Intelli... more Advanced Traffic Management Systems constitute one of the major envisaged applications of Intelligent Transport Systems. Various architectures and approaches have been proposed and tested in projects of R&D programmes of the European Commission in recent years, as for example ARTIS, KITS and ENTERPRICE, just to mention a few. An approach shared by all of them has been the conception of
Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing in... more Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. The treatment of VTE is undergoing tremendous changes with the introduction of the new direct oral anticoagulants and clinicians need to understand new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. In this chapter, we address the management of patients presenting with venous thrombosis in unusual sites, such as cerebral vein thrombosis, splanchnic vein thrombosis, and retinal vein occlusion. These events are less common than venous thrombosis of the lower limbs or pulmonary embolism, but are often more challenging, both for the severity of clinical presentations and outcomes and for the substantial lack of adequate evidence from clinical trials. Based on the available data, we suggest anticoagulant treatment for all patients with cere...
Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity... more Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity and mortality, and an incidence that is expected to double in the next forty years. The advent of direct oral anticoagulants (DOACs) has catalyzed significant changes in the therapeutic landscape of VTE treatment. As such, it is imperative that clinicians become familiar with and appropriately implement new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance for VTE treatment with the DOACs. When possible, guidance statements are supported by existing published evidence and guidelines. In instances where evidence or guidelines are lacking, guidance statements represent the consensus opinion of all authors of this manuscript and are endorsed by the Board of Directors of the Anticoagulation Forum.The authors of this manuscript first developed a list of pivotal practical questions related to real-world clinical scenarios involving the us...
Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging chang... more Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging changes in incidence, diagnosis and treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. We address a) the appropriate workup to search for occult malignancy in patients with idiopathic VTE, b) identification of high-risk cancer patients for primary thromboprophylaxis, c) the appropriate immediate and long-term treatment for people with cancer diagnosed with acute thromboembolism, d) the appropriate duration of anticoagulation and e) the appropriate treatment strategy in patients with recurrent VTE on anticoagulation. Areas of controversy and future directions in this field are highlighted.
The problem of manufacturing systems scheduling by means of dispatching rules is that these rules... more The problem of manufacturing systems scheduling by means of dispatching rules is that these rules depend on the state in which the system is in every moment. Therefore it would be interesting to use in every state of the system, the most adequate dispatching rule to that state. To achieve this goal, it is presented in this paper a scheduling approach which uses machine learning. This approach, according to the previous performance of the system (training examples), is capable of working out the most appropriate dispatching rule for every state of the system.
Conference Record of 1998 IEEE Industry Applications Conference. Thirty-Third IAS Annual Meeting (Cat. No.98CH36242), 1998
This paper presents a computationally scalable real-time observer, which allows the evolution of ... more This paper presents a computationally scalable real-time observer, which allows the evolution of temperature distribution within slabs reheated in continuous furnaces to be tracked. Accurate tracking of skidmarks requires the use of two-dimensional models, which demand high computational power, generally provided by multiprocessor computers. To evaluate the behaviour of the observer under both typical and extreme operational conditions, a simulator of a complete furnace is presented. The emulation of extreme operational conditions using a real furnace would be impossible, due to the material waste and the cost of delaying normal production. This furnace simulator is the simplest method of generating the variables of the temperatures in the various furnace zones, which are fed to the observer during its operation in real time. Finally, in order to configure the observer, a simple and efficient graphic method is proposed. The method generates an optimum solution, minimizing the number of processors required to fulfil the specifications and maximize their utilization under all operational conditions
Wikipedia is a community-created encyclopedia that contains information about notable people from... more Wikipedia is a community-created encyclopedia that contains information about notable people from different countries, epochs and disciplines and aims to document the world's knowledge from a neutral point of view. However, the narrow diversity of the Wikipedia editor community has the potential to introduce systemic biases such as gender biases into the content of Wikipedia. In this paper we aim
This article describes an architecture that enables vi- sual prototyping of real-time audio appli... more This article describes an architecture that enables vi- sual prototyping of real-time audio applications and plugins. Visual prototyping means that a developer can build a working application, including user in- terface and processing core, just by assembling el- ements together and changing their properties in a visual way. The article addresses the problem of hav- ing to bind interactive user
In a recent report, seek to identify the impact of attending charter schools on student achieveme... more In a recent report, seek to identify the impact of attending charter schools on student achievement using data from Arizona. Based on a sophisticated statistical analysis, these authors report that charter school attendance increases test score gains of students. This note raises some questions about the interpretation of the results reported and some questions about the empirical approach and underlying data. First, the report relies on a 2-x-2 evaluation design with type of school (charter or traditional) attended in a base year as the rows and type of school in the ensuing year as the columns. The report compares the observations in a cell of the design matrix to all other cells. This note questions the validity of that approach and suggests that the way that the data were constructed allows comparisons only across the rows. Second, the note questions whether grade level was used in the data matching procedure used to construct the comparison sample. Third, the note questions whether sex was used as a covariate in the outcomes equation and whether building or district fixed effects were used to control for unobservable factors at those aggregate levels. Finally, the note suggests that marginal costs are more appropriate for a cost-benefit or cost effectiveness analysis than average costs, which were used in the summary section of the report.
Proceedings. 6th International Conference on Parallel Interconnects (PI'99) (Formerly Known as MPPOI), 1999
Future I/O provides a high-performance switched-fabric interconnect to enable both host-to-host a... more Future I/O provides a high-performance switched-fabric interconnect to enable both host-to-host and host-to-I/O node communication. Providing inherent redundancy characteristics, 1 GB/sec data rates and support for legacy IP, this architecture will satisfy bandwidth requirements for a number of applications for years to come. The architecture enables very low-cost implementations for adapter vendors and also scales to very high-end IPC and
Hematology / the Education Program of the American Society of Hematology. American Society of Hematology. Education Program, 2013
A 44-year-old otherwise healthy woman has completed 3 months of anticoagulation therapy for a fir... more A 44-year-old otherwise healthy woman has completed 3 months of anticoagulation therapy for a first episode of unprovoked pulmonary embolism. At the time of diagnosis and before the initiation of anticoagulation, she was found to have an elevated IgG anticardiolipin antibody (ACLA), which was measured at 42 IgG phospholipid (GPL) units (reference range, <15 GPL units) with negative lupus anticoagulant (LAC) testing. Should this laboratory finding affect the recommended duration of anticoagulant therapy?
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