A High Speed Redundant IO Bus for Energy Power Controller System

This paper designs and implements a High Speed Redundant IO Bus for Energy Power Controller System. The physical layer adopts multi-point low-voltage differential signal standard. This bus has the characteristics of high real-time, high throughput and easy expansion. The controller communicates with IO module by A/B bus alternately, monitors link status in real time and collects IO module data. Non real time slots can be used to control non real time messages for IO modules such as time synchronizing and memory monitoring. The controller ARM core runs QNX real-time operating system, and transmits the message needed to communicate with IO modules to the FPGA through DMA. After receiving the message, the FPGA parses the message and automatically fills in the CRC check code and frame end flag at the end of the message. When the FPGA receives the data feedback from the IO module, it performs CRC verification. If the verification passes, it fills the corresponding module receiving buffer. Otherwise, it fills the CRC verification error flag in the register of the corresponding IO module to reduce the load of the arm core.

112. Prescriber Perceptions on Utilization of the Antibiotic Self-Stewardship Time Out Program (SSTOP) at Veterans Affairs Medical Centers (VAMC): A Strategy for Improved Antibiotic Use

Background Evidence is lacking on how to implement effective and sustainable antibiotic stewardship strategies. The Antibiotic Self-Stewardship Time Out Program (SSTOP) evaluated the implementation at VAMCs of an “Antibiotic Timeout” 3 days after the initiation of antibiotics to encourage providers to review continued use of broad-spectrum antibiotics. Methods Sites launched the SSTOP note templates in a rolling fashion from June 2019-March 2020. Clinical pharmacists largely drove the implementation. The vancomycin note template was implemented at 6 of 8 sites and the antipseudomonal note template across 4 of 8 sites. Two sites were unable to launch the note templates due to lack of resources, however they utilized SSTOP principles/guided tools. From Sept 2019-Nov 2020 we conducted post-launch qualitative interviews with Antibiotic Stewardship Program (ASP) champions involved in implementation across the 8 VAMCs. Interviews were transcribed and analyzed for thematic content. Results Feedback from ASP providers suggests prescribers had mixed reviews on the note template, but overall liked the process and deemed it to be straightforward. Many valued the algorithm, indicating it was helpful in both thinking about antibiotics prior to initiation, and identification of appropriate antibiotics. Barriers included staffing (e.g., rotating residents/turnover), surgery service, information technology (IT) support, COVID-19, and the need to remind providers to use the template. Facilitators consisted of strong stewardship, local champions (e.g., ID Fellow), medicine service, and SSTOP data feedback reports. Recommendations largely centered on improvements to the note template usability and to SSTOP feedback reports (e.g., inclusion of patient/provider-level data). Conclusion Overall, the SSTOP note templates were considered acceptable and straightforward. By guiding providers to prescribe more appropriate antibiotics, they act as influencers for practice change, and may strengthen provider/ASP relations. Plans for continued utilization of the note templates after the project concludes suggest SSTOP may serve as a way to achieve sustainable promotion of antibiotic use improvements. Disclosures Matthew B. Goetz, MD, Nothing to disclose

Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study

ObjectivesTo investigate the feasibility of establishing hospital-based antimicrobial stewardship (AMS) programmes comprising action-planning, educational interventions and data feedback in two provincial-level hospitals in Viet Nam.Design and settingThis was an implementation research using participatory action process and existing resources from the Duke Antimicrobial Stewardship Outreach Network with local adjustments. A national stakeholder meeting and Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis were conducted to identify gaps and potential interventions.ParticipantsHospital AMS staff implemented activities throughout the study phases. Routinely collected patient data were analysed to support planning, implementation and evaluation.InterventionsHospitals were considered as a complex adaptive system and leveraged their unique characteristics and interconnections to develop 1-year plans containing core interventions (data use, educational training, prospective audit with feedback (PAF) and evaluations).Outcome measuresWe assessed feasibility using outputs from stakeholder meeting, SWOT analysis, baseline data, planning process and implementation.ResultsThe stakeholder meeting identified three gaps for AMS at national level: supportive policies, AMS training and core competencies and collaboration. At the hospitals, AMS programmes took 1 year for planning due to lack of hospital-specific procedures and relevant staff competencies. Baseline data (January–December 2019) showed variations in antibiotic consumption: 951 days of therapy (DOT) per 1000 days present in the control and 496 in the intervention wards in hospital 1, and 737 and 714 in hospital 2, respectively. During 1-year implementation, clinical pharmacists audited 1890 antibiotic prescriptions in hospital 1 (June 2020–May 2021) and 1628 in hospital 2 (July 2020–July 2021), and will continue PAF in their daily work.ConclusionOur data confirmed the need to contextualise AMS programmes in low-income and middle-income countries (LMICs) and demonstrated the usefulness of implementation research design in assessing programme feasibility. Developing staff competencies, using local data to stimulate actions and integrating programme activities in routine hospital work are key to success in LMICs.

Challenges, Facilitators, and Recommendations for Implementation of Home Dialysis in the Veterans Health Administration: Patient, Caregiver, and Clinician Perceptions

BackgroundHome dialysis confers similar survival and greater quality of life than in-center hemodialysis for adults with ESKD but remains underutilized. We examined challenges and facilitators to implementation of home dialysis and identified stakeholder-centered strategies for improving it.MethodsWe conducted a qualitative, cross-sectional, multisite evaluation that included five geographically dispersed Veterans Health Administration (VHA) home dialysis programs. Participants included patients with ESKD receiving home dialysis, their informal caregivers, and home dialysis staff. Semistructured telephone interviews were conducted and audio-recorded from 2017 through 2018, to assess perceived barriers and facilitators to patient home dialysis use in VHA. Transcribed interviews were analyzed thematically by each participant group.ResultsParticipants included 22 patients receiving home dialysis (18 on peritoneal dialysis [PD] and four hemodialysis [HD]); 20 informal caregivers, and 19 home dialysis program staff. Ten themes emerged as challenges to implementing home dialysis, of which six (60%) spanned all groups: need for sterility, burden of home dialysis tasks, lack of suitable home environment, physical side effects of home dialysis, negative psychosocial effects of home dialysis, and loss of freedom. Four themes (40%), identified only by staff, were insufficient self-efficacy, diminished peer socialization, geographic barriers, and challenging health status. Twelve themes emerged as facilitators to implementing home dialysis, of which seven (58%) spanned all groups: convenience, freedom, avoidance of in-center HD, preservation of autonomy, adequate support, favorable disposition, and perceptions of improved health. Two themes (17%) common among patients and staff were adequate training and resources, and physical and cognitive skills for home dialysis. Recommendations to promote implementation of home dialysis common to all participant groups entailed incorporating mental health care services, offering peer-to-peer coaching, increasing home visits, providing health data feedback, and reducing patient burden.ConclusionsStakeholder-centered challenges were rigorously identified. Facilitators and recommendations can inform efforts to support home dialysis implementation.

Effect of a Virtual Reality-Based Restorative Environment on the Emotional and Cognitive Recovery of Individuals with Mild-to-Moderate Anxiety and Depression

In this study, restorative environment theory and virtual reality (VR) technology were combined to build different 3D dynamic VR interactive scenes. We discuss the effects of a VR restorative environment on the emotional and cognitive recovery of individuals with mild-to-moderate anxiety and depression. First, we built a VR restorative garden scene, divided into four areas: forest, lawn, horticultural planting, and water features. The scene was verified to have a good recovery effect in 26 participants. Then, 195 participants with mild-to-moderate anxiety and depression were selected as experimental subjects. Through psychological testing and EMG (Electromyography) and EEG (Electroencephalography) data feedback, we further explored the differences in the sense of presence in VR restorative scenes and their effect on individual emotional and cognitive recovery. The results showed that (1) both the restorative environment images and the VR scenes had a healing effect (the reduction in negative emotions and the recovery of positive emotions and cognition), with no difference in the subjective feeling of recovery among the different scenes, but the recovery score of the VR urban environment was higher than that of the natural environment (differing from the results in real environments); (2) a high sense of presence can be experienced in different VR scenes, and interactive activities in VR scenes can provide a great presence experience; (3) the recovery effects of VR restorative environment on emotion and self-efficacy are realized through the presence of VR scenes; (4) a VR restorative environment is helpful for the emotional improvement and cognitive recovery of individuals with mild-to-moderate anxiety and depression. VR urban scenes also have good recovery effects. In terms of cognitive recovery, self-efficacy improved significantly. In addition, from the perspective of EEG indicators, the VR restorative scene experience activated the prefrontal lobe, which is conducive to cognitive recovery in individuals with mild-to-moderate anxiety and depression. In terms of emotional improvement, negative emotions were significantly reduced in the different VR scene groups. In conclusion, we further explored ways to help individuals with mild-to-moderate anxiety and depression, in order to promote the development and application of mental health.

Acceptability and feasibility of an app-based just-in-time-adaptive self-management intervention for care partners: Protocol for the CareQOL pilot trial (Preprint)

BACKGROUND Care partners (i.e., informal family caregivers) of individuals with health problems are faced with considerable physical and emotional stress, often with substantial negative impact on the health-related quality of life (HRQOL) of both the care partner and care-recipient. Given that these individuals are often overwhelmed by their caregiving responsibilities, low burden self-management interventions are needed to support caregivers to ensure better patient outcomes. OBJECTIVE The primary objective of this study is to describe an intensive data collection protocol that involves the delivery of a personalized just-in-time adaptive intervention (JITAI) that incorporates passive mobile sensor data feedback (sleep and activity data from a Fitbit®), and real-time self-reporting of HRQOL via a study specific app called CareQOL to provide personalized feedback via app alert. METHODS Participants from three diverse care partner groups will be enrolled (care partners of persons with spinal cord injury [SCI]; care partners of persons with Huntington disease [HD]; and care partners of persons with hematopoietic cell transplantation [HCT]). Participants are randomized either to a control group, where they will wear the Fitbit® and provide daily reports of HRQOL over a three-month (90 day) period (without the personalized feedback), or the JITAI group, where they will wear the Fitbit®, provide daily reports of HRQOL and receive personalized pushes for 3 months. At the end of the study, participants complete a feasibility and acceptability questionnaire, and metrics regarding adherence and attrition will be calculated. RESULTS This trial opened for recruitment in November 2020. Data collection was completed in June 2021, and the primary results are expected to be published in winter 2021. CONCLUSIONS This trial will determine the feasibility and acceptability of an intensive app-based intervention in three distinct caregiver groups: care partners for persons with a chronic condition that was caused by a traumatic event (i.e., SCI); 2) care partners for persons with a progressive, fatal neurodegenerative disease (i.e., HD); and 3) care partners for persons with an episodic cancer condition that requires intense, prolonged inpatient and outpatient treatment (persons with HCT). CLINICALTRIAL ClinicalTrial.gov NCT04556591; https://clinicaltrials.gov/ct2/show/NCT04556591

Kontrol Keseimbangan Robot Hexapod EILERO menggunakan Fuzzy Logic

ABSTRAKPenelitian dengan topik robot hexapod telah banyak dikembangkan, namun sampai saat ini masih sedikit yang mengulas tentang kontrol keseimbangannya. Permasalahan yang kerap muncul adalah ketika robot berada dalam bidang miring, robot dapat terjatuh jika robot tidak dapat menyeimbangkan badan. Begitu pula dengan robot hexapod EILERO yang telah kami bangun. Untuk mengatasi permasalahan itu, selain pemodelan kinematik dan kinematika terbalik yang tepat, juga diperlukan suatu sistem keseimbangan yang baik. Dalam penelitian ini, kami menggunakan fuzzy logic untuk mengontrol keseimbangan robot EILERO dengan umpan balik data kemiringan dari sebuah sensor IMU. Setelah melalui beberapa pengujian yang komprehensif, didapatkan hasil bahwa robot dapat menyeimbangkan diri pada kondisi kemiringan papan pijakan antara -15° dan 15° pada orientasi kemiringan roll dan pitch. Robot mampu merespon dengan capaian steady state di bawah 3000 ms. Dengan demikian, robot EILERO semakin stabil dalam melintasi bidang yang tidak datar.Kata kunci: hexapod, EILERO, kinematika terbalik, fuzzy logic ABSTRACTResearch on the topic of the hexapod robot has been developed a lot, but until now there is little that has been discussed about balance control. The problem that often arises is that when the robot is on an inclined plane, the robot can fall if the robot cannot balance its body. Likewise with the EILERO hexapod robot that we have built. To solve this problem, besides proper kinematic modeling and inverse kinematic modeling, a good balance system is also needed. In this study, we used fuzzy logic to control the balance of the EILERO robot, with tilt data feedback from an IMU sensor. After going through several comprehensive tests, the results show that the robot can balance itself on the slope of the stepboards between -15 ° and 15 ° in the orientation of roll and pitch tilt. The robot is able to respond with steady state achievements below 3000 ms. Thus, the EILERO robot is increasingly stable in traversing uneven planes.Keywords: hexapod, EILERO, inverse kinematic, fuzzy logic

Reporting Key Performance Indicator for Driver Using Whatsapp

Employee performance is very important at the company, because employees are the main assets of the company, many companies pay less attention to this, even though this is closely related to customer satisfaction in service and company policy to determine the employee's future. PT. XYZ is a company that provides organized professional services and strict recruitment principles, even before starting work for drivers it must do training for 3 days. However, the facts in the field are different, there are still customers who complain because of poor driver's obligations, such as arriving late or not being good. Because there is no application yet to assess performance, this causes companies to collect complaints data and conduct performance evaluations based on facts in the field in real time. With this problem, the whatsapp chat application is chosen as media reporting, because according to the statistics of active media users, whatsapp will make it easier for drivers and customers to connect with the company's customer service (ChatBOT) in real time. The purpose of this study is to create and manage Key Performance Indicators by getting data feedback from the driver or customer per day that will be obtained at the end of the monthly period. Data obtained from feedback will be given to customers who provide material for companies to make decisions to determine work contracts and awards for drivers who work well

Impact of telephone support programme using telemonitoring on stage of change towards healthy eating and active exercise in people with prediabetes

Introduction This study evaluated the impact of a telephone support programme with telemonitoring on changes in healthy eating and active exercise in adults with prediabetes using the stage of change framework. Methods We performed a post hoc analysis using data from the Japan Diabetes Outcome Trial-1. A total of 2607 participants aged 20–65 years with impaired fasting glucose were recruited from the workplace/community in Japan and randomized to a 1-year telephone support programme intervention arm ( n = 1240) or self-directed control arm ( n = 1367). Participants in both arms received monthly data feedback from a weight scale and pedometer. The main outcome measure was the stages of change toward healthy eating and active exercise. The secondary outcome was fasting plasma glucose (FPG). Results After the 1-year intervention, the adjusted odds ratio of progressing to the action/maintenance stage in the intervention vs. control arm for healthy eating was 1.31 (95% confidence interval (CI) 1.21–1.43; p < 0.001), but that for active exercise was 1.07 (95% CI 0.99–1.15; p = 0.062). The intervention decreased FPG levels in participants in the contemplation stage, but not in the precontemplation, preparation and action/maintenance stages. Discussion These findings suggest that the telephone support programme by healthcare providers advanced the stage of changes toward healthy eating in people with prediabetes. In particular, it decreased FPG levels in the contemplation stage.