background: renal complication of leptospirosis is common and its clinical manifestations vary from urinary sediment changes to acute renal failure. the aim of this study was to determine the final outcome of renal involvement in leptospirosis. methods: this longitudinal prospective study included all serologically confirmed cases of leptospirosis with evidence of renal failure. all patients we...

OBJECTIVES To examine the effect of skilled nursing facility (SNF) use on hospitalizations in patients with heart failure (HF) and to examine predictors of hospitalization in patients with HF admitted to a SNF. PATIENTS AND METHODS Olmsted County, Minnesota, residents with first-ever HF from January 1, 2000, through December 31, 2010, were identified, and clinical data were linked to SNF util...

Skilled nursing facilities (SNFs) are organizations that represent complex adaptive systems, offering barriers to the implementation of quality improvement (QI) initiatives. The current article describes the authors' efforts to use the approach of reflective adaptive process to implement a new model of care (i.e., the Skilled Heart Unit Program) for effective heart failure (HF) care in one SNF....

Human error and incorrect software (a.k.a. soft-failure) are key impediments to dependability of Internet services. To address the challenge, storage providers need to provide rapid recovery techniques to retrieve data from a time-based recovery point. Motivated by it, a snapshot facility at the block level called SnapChain is introduced. Compared with former implementations, when managing diff...

the development of optimization and mathematical models for closed loop supply chain (clsc) design has attracted considerable interest over the past decades. however, the uncertainties that are inherent in the network design and the complex interactions among various uncertain parameters are challenging the capabilities of the developed tools. the aim of this paper, therefore, is to propose a n...

introduction: identifying training needs and implementing appropriate courses is one of the important steps to empower managers and experts specialists. this has the most important role in improving organizational performance. in this study, considering the importance of training programs effectiveness, the training needs of managers and experts and their relation to individual and institutiona...

this article addresses a single row facility layout problem where the objective is to optimize the arrangement of some rectangular facilities with different dimensions on a line. regarding the np-hard nature of the considered problem, a hybrid meta-heuristic algorithm based on simulated annealing has been proposed to obtain a near optimal solution. a number of test problems are randomly generat...

ObjectiveExamine associations between soldiers’ eating behaviors, compliance with body composition and fitness standards, physical performance.DesignCross-sectional study.SettingEight Army installations.ParticipantsUS Soldiers (n = 1,591; 84% male).Main Outcome MeasuresCharacteristics, level were assessed via questionnaire.AnalysisBivariate multivariable logistic regression.ResultsEating mostly...

Various analytical approaches to performance-based earthquake engineering are in development. This paper summarizes the approach being pursued by the Pacific Earthquake Engineering Research (PEER) Center. It works in four stages: hazard analysis, structural analysis, damage analysis, and loss analysis. In the hazard analysis, one evaluates the seismic hazard at the facility site, producing samp...