Open AccessAvailable online http://ccforum.com/content/10/1/R11Page 1 of 7(page number not for citation purposes)Vol 10 No 1ResearchThe clinical value of daily routine chest radiographs in a mixed medical–surgical intensive care unit is lowMarleen E Graat1, Goda Choi1,2, Esther K Wolthuis1,3, Johanna C Korevaar4, Peter E Spronk5, Jaap Stoker6, Margreeth B Vroom1 and Marcus J Schultz1,7,81Medical student, Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands2Resident, Departments of Intensive Care Medicine and Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands3Resident, Departments of Intensive Care Medicine and Anesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands4Clinical Epidemiologist, Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands5Internist-intensivist, Department of Intensive Care Medicine, Gelre Hospital (Location Lukas), Apeldoorn, The Netherlands6Radiologist, Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands7Anaesthsiologist-intensivist, Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands8Internist-intensivist, Research Coordinator, Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsCorresponding author: Marcus J Schultz, m.j.schultz@amc.uva.nlReceived: 3 Oct 2005 Revisions received: 24 Nov 2005 Accepted: 28 Nov 2005 Published: 30 Dec 2005Critical Care 2006, 10:R11 (doi:10.1186/cc3955)This article is online at: http://ccforum.com/content/10/1/R11© 2005 Graat et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.AbstractIntroduction The clinical value of daily routine chestradiographs (CXRs) in critically ill patients is unknown. Weconducted this study to evaluate how frequently unexpectedpredefined major abnormalities are identified with daily routineCXRs, and how often these findings lead to a change in care forintensive care unit (ICU) patients.Method This was a prospective observational study conductedin a 28-bed, mixed medical–surgical ICU of a university hospital.Results Over a 5-month period, 2,457 daily routine CXRs weredone in 754 consecutive ICU patients. The majority of theseCXRs did not reveal any new predefined major finding. In only5.8% of daily routine CXRs (14.3% of patients) was one or morenew and unexpected abnormality encountered, including largeatelectases (24 times in 20 patients), large infiltrates (23 in 22),severe pulmonary congestion (29 in 25), severe pleural effusion(13 in 13), pneumothorax/pneumomediastinum (14 in 13), andmalposition of the orotracheal tube (32 in 26). Fewer than halfof the CXRs with a new and unexpected finding were ultimatelyclinically relevant; in only 2.2% of all daily routine CXRs (6.4%of patients) did these radiologic abnormalities result in a changeto therapy. Subgroup analysis Enthusiasm is the master value Enthusiasm is the master value Bởi: Joe Tye “Every memorable act in the history of the world is a triumph of enthusiasm Nothing great was ever achieved without it because it gives any challenge or any occupation, no matter how frightening or difficult, a new meaning Without enthusiasm you are doomed to a life of mediocrity but with it you can accomplish miracles.” Og Mandino: The Greatest Salesman in the World Enthusiasm is Core Action Value #10 in the course I teach on The Twelve Core Action Values, but sometimes I think I should have placed it first because I am increasingly convinced that enthusiasm is the master value When people are enthusiastic, it makes everything easier: enthusiastic people have the courage to take risks, the determination to persevere their way through obstacles and setbacks, are more committed to service, and tend to become natural leaders But without enthusiasm, everything is more difficult – making it through the day is like swimming across a pool filled with Jell-O Enthusiasm is the ultimate sales pitch Aren’t you more likely to buy from someone who is cheerful, optimistic, and passionate than you are to buy from a negative, bitter, cynical and sarcastic pickle sucker – even if they are both reading from the very same sales script? Here are ten actions you can take to be more enthusiastic and cultivate a more positive attitude – beginning with yourself and then sharing with others at home and at work: Recognize that enthusiasm is a series of choices The most important development in human evolution was not the offsetting thumb or the enlarged brain It was the realization that by conscious will, the mind can be disciplined, that people not have to be slaves to their thoughts and emotions We each have the power to consciously decide how we perceive the world, and to discipline how we react to what we see By conscious will we can decide whether to be an optimist or a pessimist; whether to accept personal responsibility or blame others; whether to see in adversity a door closing in our face or another door opening to exciting new opportunities; whether to become an educated skeptic or an ignorant cynic 1/3 Enthusiasm is the master value Be a visionary, not a victim You can be a victim complaining about past injustices, or you can be a visionary dreaming about future accomplishments, but you cannot be both Visionaries are usually bubbling over with enthusiasm, while victims are more likely to suck the enthusiasm out of everyone around them Choose to be a visionary and walk toward your future with passion and enthusiasm, and never to be a victim dragging around a sad past behind you Turn off the TV.Just in case you hadn’t already been given enough reasons to turn off your television set, researchers have demonstrated that watching TV is positively correlated with being depressed; the more time a person spends in front of the boob tube, the more likely they are to be discouraged, depressed, and unenthusiastic about life Turn off the plug-in drug and get a life! Be an energy faucet.Are you an energy faucet or an energy drain? When you leave a group, people feel energized or exhausted by your recent presence? People like to be around others who energize them, and seek to avoid those who sap their energy The best way to become an energy faucet is to truly take an interest in the concerns of others, and to elevate their confidence and ability to address those concerns Make it a point of smiling and saying hello to everyone you pass in the hallways Your enthusiastic smile might be the best gift they have received all day! Erase the Graffiti of Negative Self-Talk.Nothing can sap your energy and enthusiasm more quickly and thoroughly than your own negative self-talk In his book The Evolving Self: A Psychology for the New Millennium, Dr Mihaly Csikszentmihalyi showed that for a variety of evolutionary reasons, the human mind automatically gravitates toward negative, frightening, and depressing thoughts It is your challenge to confront these self-inhibiting notions before they interfere with your pursuit of your future vision Pay attention to all of the negative self-talk going through your mind Hint: it will almost always be in the second person (“You are an idiot,” not “I am an idiot”) Every time your inner critic verbally abuses you, stand up to it The inner critic is a bully, and bullies always buckle when confronted with courage Whenever your spoiled inner brat tells you that you’re not good enough, that you can’t achieve great goals, or otherwise puts you down, erase that mental graffiti and replace it with a positive (and more likely to be truthful) self-talk saying exactly the opposite Get enough sleep.Sleep deprivation can increase anxiety and worry, says James Mass in Power Sleep When you skimp on sleep, you can end up with “overwhelming feelings of not being able to cope, even with simple problems or moderate workloads; increase in worry, frustration, ...Federal Reserve Bank of New York Staff Reports Which Bank Is the “Central” Bank? An Application of Markov Theory to the Canadian Large Value Transfer System Morten L. Bech James T. E. Chapman Rod Garratt Staff Report no. 356 November 2008 This paper presents preliminary findings and is being distributed to economists and other interested readers solely to stimulate discussion and elicit comments. The views expressed in the paper are those of the authors and are not necessarily reflective of views at the Federal Reserve Bank of New York or the Federal Reserve System. Any errors or omissions are the responsibility of the authors. Which Bank Is the “Central” Bank? An Application of Markov Theory to the Canadian Large Value Transfer System Morten L. Bech, James T. E. Chapman, and Rod Garratt Federal Reserve Bank of New York Staff Reports, no. 356 November 2008 JEL classification: C11, E50, G20 Abstract Recently, economists have argued that a bank’s importance within the financial system depends not only on its individual characteristics but also on its position within the banking network. A bank is deemed to be “central” if, based on our network analysis, it is predicted to hold the most liquidity. In this paper, we use a method similar to Google’s PageRank procedure to rank banks in the Canadian Large Value Transfer System (LVTS). In doing so, we obtain estimates of the payment processing speeds for the individual banks. These differences in processing speeds are essential for explaining why observed daily distributions of liquidity differ from the initial distributions, which are determined by the credit limits selected by banks. Key words: federal funds, network, topology, interbank, money markets Bech: Federal Reserve Bank of New York (e-mail: morten.bech@ny.frb.org). Chapman: Bank of Canada (e-mail: jchapman@bankofcanada.ca). Garratt: University of California, Santa Barbara (e-mail: garratt@econ.ucsb.edu). The authors would like to thank Ben Fung, Carlos Arango, Thor Koeppl, and Paul Corrigan for useful comments and suggestions. The views expressed in this paper are those of the authors and do not necessarily reflect the position of the Federal Reserve Bank of New York or the Federal Reserve System. 1 Introduction Recently, economists have argued that the importance of banks within the financial system cannot be determined in isolation. In addition to its individual characteristics, the p osition of a bank within the banking network matters. 1 In this paper we examine the payments network defined by credit controls in the Canadian Large Value Transfer System (LVTS). We provide a ranking of LVTS participants with respect to predicted daily liquidity holdings, which we derive from the network structure. A bank is deemed to be “central” if, based on our network analysis, it is predicted to hold the most liquidity. 2 We focus on the Tranche 2 component of the LVTS. 3 In this component, participants set bilateral credit limits (BCLs) with each other that determine, via these limits and an associated multilateral constraint, the maximum amount of money any one participant can transfer to any other without offsetting funds. Because banks start off the day with zero outside The Dissertation Committee for Fang Yin Certifies that this is the approved version of the following dissertation: Business Value of Information Technology in the Internet Economy Committee: Andrew B. Whinston, Supervisor Anitesh Barua, Co-Supervisor Eleanor Jordan Prabhudev Konana Li Gan Business Value of Information Technology in the Internet Economy by Fang Yin, B.A. Dissertation Presented to the Faculty of the Graduate School of The University of Texas at Austin in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy The University of Texas at Austin August, 2002 UMI Number: 3108540 ________________________________________________________ UMI Microform 3108540 Copyright 2004 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ____________________________________________________________ ProQuest Information and Learning Company 300 North Zeeb Road PO Box 1346 Ann Arbor, MI 48106-1346 Dedication To my parents, Jinpei Yin and Rongdi Zhou v Acknowledgements I am greatly indebted to my supervisors Dr. Andrew B. Whinston and Dr. Anitesh Barua, who have taught and guided me during the past four years. They inspired great ideas about my research and helped me finish the whole process. I am also grateful to Dr. Prabhudev Konana for his excellent advice and support. My sincere thanks also go to Dr. Eleanor Jordan, who has given me valuable advice for my graduate study, and Dr. Li Gan, from whom I learned a lot about econometrics. I could not have completed this work without the encouragement and support from my wife, whose love is the most valuable to me. vi Business Value of Information Technology in the Internet Economy Publication No._____________ Fang Yin, Ph.D. The University of Texas at Austin, 2002 Supervisors: Andrew B. Whinston & Anitesh Barua This dissertation consists of three essays that address the issue of the business value of Information Technology (IT) in the context of the Internet economy. The first essay studies the productivity of IT in the context of pure Internet based companies or dot coms. Various dot coms are divided into two groups: “digital” dot coms whose product and service can be distributed in digital form, and “physical” dot coms whose product needs to be physically shipped to customers. Compared to digital dot coms, physical dot coms have lower extent of digitization due to the restriction of the physical nature of their product. Therefore, it is hypothesized that IT capital contributes more to the performance of digital dot coms than to that of physical dot coms. This hypothesis is supported vii by a production economics based analysis based on data from publicly traded dot coms. The second essay studies the transformation of the traditional companies toward the Internet-enabled electronic business. A holistic, process-oriented theoretical model is proposed to link IT applications and complementary factors to firm performance. The model postulates that What is the price of a mousetrap? The assessment of value from cloud services. By Ernie Zibert Copyright 2012 Ernie Zibert Smashwords Edition Smashwords Edition, License Notes Thank you for downloading this free ebook. Although this is a free book, it remains the copyrighted property of the author, and may not be reproduced, copied and distributed for commercial or non- commercial purposes. If you enjoyed this book, please encourage your friends to download their own copy at Smashwords.com, where they can also discover other works by this author. Thank you for your support. Discover other titles by Ernie Zibert at Smashwords.com. Table of Contents Value from your Cloud provider? The price of a Mousetrap If it were only as simple as a mousetrap IT Infrastructure is a tumour of the modern corporation Conclusion In this ebook, I discuss one functional transformation that has taken placed as a result of cloud services, namely; the impact on the assessment of value. This is a timely discourse as the vast majority of customers are using cloud services. In fact, numerous recent surveys confirm that more than 80% of customers are using cloud services (http://www.wired.com/cloudline/2012/03/cloud-here- to-stay/, http://venturebeat.com/2012/05/10/cloud-services-data/). Moreover, several surveys have replicated the finding that four out of every five customers believe that cloud services met their flexible infrastructure needs. The bottom line is cloud services are here to stay and customers must be able to articulate the value of their cloud investment. How do you know if you are getting value from your cloud services provider? In the traditional model, most customers would simply compare their existing IT costs against their cloud services costs. This is best seen as a ‘generation one’ performance measure. This measure is no longer suitable for the assessment of value from cloud services. It is akin to undertaking a Return on Investment (ROI) without taking into consideration the time value of money, or where applicable, foreign currency exposure. The title of this ebook hints at the error in this traditional performance measure. Why would you want to know the price of a mousetrap? Customers no longer need to know the price of servers, software and the rest of the parts making up the IT service stack. This knowledge is as useful as knowing the price of a mousetrap. Customers, however, must know the price of the equivalent services from other cloud providers. This is the crucial performance measure. It is only this performance measure that constitutes a true apples- to-apples comparison for the assessment of cloud service value. In addition, the traditional performance measure is not relevant because it doesn’t factor in agility/flexibility. Attempts to incorporate this into the traditional performance measure are absurd. It is pure guesswork to forecast IT demand over a multi-year period and translate that back to IT costs. How many and what types of servers are needed, together with all the other pieces, to manage current demand, new projects, forecasted growth, end-of-life IT services, mobility moves, etc? Who Available online http://arthritis-research.com/content/11/5/253 Page 1 of 11 (page number not for citation purposes) Abstract Although infections are a major concern in patients with primary systemic vasculitis, actual knowledge about risk factors and evidence concerning the use of anti-infective prophylaxis from clinical trials are scarce. The use of high dose glucocorticoids and cyclophosphamide pose a definite risk for infections. Bacterial infections are among the most frequent causes of death, with Staphylococcus aureus being the most common isolate. Concerning viral infections, cytomegalovirus and varicella-zoster virus reactivation represent the most frequent complications. The only prophylactic measure that is widely accepted is trimethoprim/sulfamethoxazole to avoid Pneumocystis jiroveci pneumonia in small vessel vasculitis patients with generalised disease receiving therapy for induction of remission. Introduction In patients with small vessel vasculitis (SVV), infectious complications are at least as often the cause of death as uncontrolled disease activity. For example, in the recently published MEPEX-trial about 25% of the patients did not survive the first year, and most of the deaths were attributable to overwhelming infectious complications [1]. Despite the fact that infections substantially contribute to morbidity and mortality in patients with primary systemic vasculitis (PSV), data on risk factors and on the burden of specific infectious agents are scarce. In oncology, recommendations for anti- infective chemoprophylaxis (AIP) are often derived from randomised controlled trials evaluating the effectiveness of the prophylactic intervention itself [2,3]. Such data are widely missing in PSV. However, some conclusions might be drawn from therapeutic trials and cohort studies. For this purpose we analysed 35 such trials [4-37], which were selected according to quality, patient number and availability of at least some data on infectious complications (Table 1). Regarding AIP, these data still have to be interpreted with caution: infection rates are documented and published with varying degrees of accuracy depending on the design of the studies. Mild and moderate infections - that is, those not requiring hospitalisation - appear to be underestimated, whereas it can be assumed that deaths due to infections are reported thoroughly. Furthermore, there are great variations in the use of AIP: some trials used routine prophylaxis against Pneumocystis jiroveci pneumonia (PCP; formerly named Pneumocystis carinii), other fungi and cytomegalovirus (CMV), and others did not. Most protocols left the use of AIP optional and in many the actual use was not even recorded, or at least not reported. Finally, the therapeutic intervention is given infrequently in sufficient detail; for example, the cumulative dose of glucocorticoids (GCs) is usually not mentioned. When thinking about AIP, both the individual risk for the patient and the evidence for the efficiency and safety of the prophylactic intervention must be taken into account. Factors influencing susceptibility to infections Because, to date, no PSV trials have used infection as the primary endpoint, information on possible risk factors can only be retrieved from adverse event reporting in cohort studies or therapeutic trials. In Table 1 the rates of infections, serious infections and fatal infections in different entities and under distinct medication are summarised. In conjunction with data from other medical conditions the following conclu- sions might be drawn. Review Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence? Frank Moosig, Julia U Holle and Wolfgang L Gross Department of Rheumatology, University Hospital of Schleswig Holstein and Klinikum Bad Bramstedt, Oskar Alexander Str. 26, 24576 Bad Bramstedt, Germany Corresponding author: Frank Moosig, moosig@klinikumbb.de Published: 28 October 2009 Arthritis Research & Therapy ... group.Sociologists tell us that one of the most important, if not the most important, influences on our lives is the people we spend time with, the people with whom we identify This is what they call... around others who energize them, and seek to avoid those who sap their energy The best way to become an energy faucet is to truly take an interest in the concerns of others, and to elevate their... night The process of sleep,” says Maas, “provides tremendous power It restores, rejuvenates, and energizes the body and the brain.” Turning off the TV and setting aside 2/3 Enthusiasm is the master