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With companies now recognizing how artificial intelligence (AI), digitalization, the internet of things (IoT), and data science affect value creation and the maintenance of a competitive advantage, their demand for talented individuals with both management skills and a strong understanding of technology will grow dramatically. There is a need to prepare and train our current and future decision makers and leaders to have an understanding of AI and data science, the significant impact these technologies are having on business, how to develop AI strategies, and the impact all of this will have on their employees' roles. This paper discusses how business schools can fulfill this need by incorporating AI into their business curricula, not only as stand-alone courses but also integrated into traditional business sequences, and establishing interdisciplinary efforts and collaborative industry partnerships. This article describes how the College of Business and Public Policy (CBPP) at the University of Alaska Anchorage is implementing multiple approaches to meet these needs and prepare future leaders and decision makers. These approaches include a detailed description of CBPP's first AI course and related student successes, the integration of AI into additional business courses such as entrepreneurship and GSCM, and the creation of an AI and Data Science Lab in partnership with the College of Engineering and an investment firm.

This report describes a librarian's development of an interactive and competitive trivia game using Poll Everywhere, an audience response system software. The trivia game was implemented during a live lecture session on drug information mobile applications taught to first-year pharmacy students. To add a fun and engaging reference for students, the librarian decided to model the game after HQ, a free trivia gaming app. Development of the session, student response, changes to future iterations, and lessons learned by the librarian are described.

Background Sedentary behaviors are associated with numerous adverse physiological health outcomes, morbidity and mortality, although with limited knowledge in young adults. Aim To assess the association between sedentary behavior, muscular strength and body composition in male and female young adult college students. Methods A cross-sectional pilot study was conducted among 94 college students (20.2 ± 1.6 years, 46 males and 48 females) from a University in the Mid-Atlantic region, US. Students were assessed for sedentary behavior, physical activity and objective physiological variables including lean body mass (LBM), fat% and muscular strength [1-Repetition Maximum (1-RM)]. Descriptive statistics and linear regression analysis were conducted. Results Sedentary behavior (sitting time ≥ 6 h/day) was prevalent in 69% of females and in 46% of males, p = .036, although most students (84–94%) met the physical activity recommendations. Sitting time inversely correlated with LBM (r = −0.58, p = .01) and trending for positive correlation with fat% in females, whereas in males, sitting time inversely correlated with 1-RM upper body strength (r = −0.46, p = .017). Female students who sat ≥7.5 h/day had approximately 10-fold increased chance of being obese [odds ratio = 9.6, 95% confidence interval (1.5 to 62.7), p = .019] compared to non-sedentary. Conclusions Although most students were physically active, considerable prevalence of sedentary behavior was observed. The novel findings showed that, sedentary behavior was associated with compromised physiological health determinants of body composition in females and muscular strength in males. Reducing sedentary behavior among active college students could be a public health strategy for health promotion and chronic disease prevention.

Purpose The accuracy of cost savings and reimbursement predictions for medications added to an academic medical center formulary was assessed. Methods Formulary changes over a 5-year period were reviewed by the investigators. Medications were included if the medication was added to formulary and the monograph included cost savings or reimbursement data that indicated a positive net margin. The primary endpoints were percent predicted cost savings and net margin per medication based on medication cost only. Secondary endpoints included the percent of medications with at least 100% predicted cost savings or net margin and evaluation of median percent predicted savings or net margin individually. Results The pharmacy and therapeutics committee reviewed 558 formulary agenda items, 184 of which were selected for further analysis. In total, 19 medications were identified as having a predicted monetary advantage. The endpoints of percent predicted cost savings and net margin yielded a median of 76.5% (range 72.9-188.71%) (n = 3) and 148.2% (IQR 108.9-543.3%) (n = 16), respectively. For 13 (68%) of 19 medications, the percent predicted cost savings or net margin was at least 100%. Conclusion Economic predictions utilized for formulary management at an academic medical center generated net positive monetary value for medications where predicted cost savings or reimbursement factored into the decision to add a medication to the formulary.

Resume Objectif Les dernieres innovations en termes de dispositifs medicaux et les procedures associees impactent le budget des etablissements de sante. L’objectif de ce travail a ete d’evaluer le cout des dispositifs medicaux utilises lors de differentes interventions chirurgicales au regard des recettes percues issues de la cotation du sejour patient. Methode Une analyse prospective des dispositifs medicaux utilises au bloc operatoire a ete realisee pour differents types d’interventions chirurgicales programmees. Pendant cinq semaines, les references des dispositifs medicaux steriles a usage unique utilises au cours des interventions ont ete colligees. Resultats Les depenses en dispositifs medicaux utilises pendant l’acte de chirurgie representaient 5,7 % de la valorisation du sejour pour une cure de hernie inguinale, 12 % pour une cholecystectomie, 9,35 % pour une colectomie, 14,5 % pour une hepatectomie et 7 % pour une pancreatectomie, tout indice de severite confondu. Les correlations les plus importantes existaient entre la duree de l’acte et le niveau de severite du patient et entre la duree du temps operatoire et les depenses en consommables. Conclusion Les pistes d’optimisation des couts s’orientent vers les equivalences de certaines gammes de dispositifs medicaux, les achats regroupes via des groupements nationaux et vers de potentielles diminutions de temps operatoires liees a l’utilisation de nouveaux dispositifs medicaux de technologie innovante.

Background and objectives The Cochrane Central Register of Controlled Trials (CENTRAL) is compiled from a number of sources, including PubMed and Embase. Since 2017, we have increased the number of sources feeding into CENTRAL and improved the efficiency of our processes through the use of application programming interfaces, machine learning, and crowdsourcing.Our objectives were twofold: (1) Assess the effectiveness of Cochrane's centralized search and screening processes to correctly identify references to published reports which are eligible for inclusion in Cochrane systematic reviews of randomized controlled trials (RCTs). (2) Identify opportunities to improve the performance of Cochrane's centralized search and screening processes to identify references to eligible trials. Methods We identified all references to RCTs (either published journal articles or trial registration records) with a publication or registration date between 1st January 2017 and 31st December 2018 that had been included in a Cochrane intervention review. We then viewed an audit trail for each included reference to determine if it had been identified by our centralized search process and subsequently added to CENTRAL. Results We identified 650 references to included studies with a publication year of 2017 or 2018. Of those, 634 (97.5%) had been captured by Cochrane's Centralised Search Service. Sixteen references had been missed by the Cochrane's Centralised Search Service: six had PubMed-not-MEDLINE status, four were missed by the centralized Embase search, three had been misclassified by Cochrane Crowd, one was from a journal not indexed in MEDLINE or Embase, one had only been added to Embase in 2019, and one reference had been rejected by the automated RCT machine learning classifier. Of the sixteen missed references, eight were the main or only publication to the trial in the review in which it had been included. Conclusion This analysis has shown that Cochrane's centralized search and screening processes are highly sensitive. It has also helped us to understand better why some references to eligible RCTs have been missed. The CSS is playing a critical role in helping to populate CENTRAL and is moving us toward making CENTRAL a comprehensive repository of RCTs.

Purpose The paper aims to present the advanced mathematical and numerical models of conjugated heat and mass transfer in a multi-layer protective clothing, human skin and muscle subjected to incident external radiative heat flux. Design/methodology/approach The garment was made of three layers of porous fabric separated by the air gaps, whereas in the tissue, four skin sublayers and muscle layer were distinguished. The mathematical model accounted for the coupled heat transfer by conduction and thermal radiation with the associated phase transition of the bound water in the fabric fibres and diffusion of the water vapour in the clothing layers and air gaps. The skin and muscle were modelled with two equation model which accounted for heat transfer in the tissue and arterial blood. Complex thermal and mass transfer conditions at the internal or external boundaries between the fabric layers, air gaps and skin were assumed. Special attention was paid to modelling of thermal radiation emitted by external heat source, for example, a fire, penetrating through the protective clothing and being absorbed by the skin and muscle. Findings Temporal and spatial variations of temperature in the protective garment, skin and muscle, as well as volume fractions of the water vapour and bound water in the clothing, were calculated for various intensity of incident radiative heat flux. The results of numerical simulation were used to estimate the risk of the first-, second- and third-degree burns. Research limitations/implications Because of the small thickness of the considered system in comparison to its lateral dimensions, the presented model was limited to 1D heat and moisture transfer. The convective heat transfer through the clothing was neglected. Practical implications The model may be applied for design of the new protective clothing and for assessment of thermal performance of the various types of protective garments. Additionally, the proposed approach may be used in the medicine for estimation of degree of thermal destruction of the tissue during treatment of burns. Originality/value The novel advanced thermal model of the multi-layer protective garment, skin and muscle layer was developed. For the first time, non-grey optical properties and various optical phenomena at the internal or external boundaries between the fabric layers, air gaps and skin were accounted for during simulation of thermal interactions between the external heat source (e.g. a fire), protective clothing and human skin.

Background and purpose Hospital pharmacists routinely receive and answer drug information questions via telephone while performing order verification. This report describes the development, implementation, and evaluation of a mock learning experience for student performance of these tasks in a health-systems pharmacy laboratory course. Educational activity and setting An active learning skills-based exercise involving students receiving and answering a standardized drug information question via telephone during an order verification activity, referred to as a cold-call exercise, was developed and implemented. Data collected included student grades on a baseline assessment, the cold call exercise, order verification exercises, and student perceptions from a voluntary post-exercise survey. Student performance on the cold-call exercise was further evaluated via individual sections of the cold-call rubric. Data were summarized using descriptive statistics. Thematic analysis of student opinion and an estimate of faculty time were also executed. Findings Student grades on the cold call and order verification exercises were 86.14% and 88.8%, respectively. Students often failed to ask category-specific questions because they did not categorize the ultimate question appropriately. Students found the activity organized and applicable. Time dedicated to creation was extensive, but execution and grading were reasonable. Summary Students performed well on the drug information exercise as well as the order verification component. Students and faculty enjoyed the experience, and students found the exercise relevant and challenging. This exercise could be implemented into any pharmacy curriculum in order to prepare students using authentic learning experiences.

This study assessed the efficacy of an interactive Moodle lesson teaching the subject of references commonly used to answer drug information (DI) questions on pharmacy student performance and retention. Students were randomized to receive education via either the lesson or a recorded lecture. Students completed a baseline knowledge assessment, an assignment following instruction, the same baseline assessment at the end of the semester to assess retention, and a survey on their experience with the assigned education technique. The differences of median grades on assessments and survey results between groups were compared via Mann-Whitney U tests. Student performance on the baseline assessment was comparable between groups (n = 40 per group; 47.22% vs. 48.61%). Retention of knowledge was less in students in the lesson group (63.89%) than in the lecture group (75%). Students taught by lecture performed better (90.63%) than those taught by lesson (87.5%) on the post-instruction assignment. Survey results from participants (n = 32/80) showed more students in the lecture group (n = 16) agreed time associated with educational technique was reasonable (69% vs. 31%), technique was valuable to learning (75% vs. 44%), and experience was satisfying (56% vs. 31%). These results show student retention of knowledge was not improved with use of a Moodle lesson in comparison with a recorded lecture. Student performance was better immediately following education when taught by lecture and more lecture-taught students agreed the educational technique was time-appropriate, valuable, and satisfying.

The ability to evaluate clinical literature is a key skill for pharmacy students and pharmacists to develop. This chapter provides considerations when reading an article to help readers develop this ability. The structure of this chapter mimics that of a standard article in addition to highlighting many other considerations as it relates to clinical literature publishing and evaluation.

Objective Recent studies suggesting clinical superiority of linezolid over vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia led to a change in our institution's clinical pathway/order form for hospital-acquired pneumonia, positioning linezolid as the preferred agent. Our objective was to assess the impact of this change within our institution. Design Retrospective electronic medical records review. Methods The analysis for this observational study included eligible patients admitted to our medical center between May 1, 2011, and August 31, 2014, with ICD-9 codes for MRSA and pneumonia. Included patients were at least 18 years of age and had vancomycin or linezolid initiated at least 2 days after admission and continued for at least 2 consecutive days. The primary end points were extent of antibiotic use before and after order form change and length of stay (LOS) and hospital charges in the two treatment groups. A secondary aim was to detect any gross discrepancies in patient outcomes such as treatment duration, mechanical ventilation duration, all-cause mortality rate, nephrotoxicity, and 30-day readmission between the two treatment groups. Measurements and Main Results Outcomes in 227 patients were assessed. Linezolid use increased 16.2% subsequent to the change in the order form. Although not statistically significant, the median hospital admission charge was $6200 lower in patients treated with linezolid compared with those treated with vancomycin ($25,900 vs $32,100). Hospital LOS was significantly associated with Charlson Comorbidity Index score (p

Long-term daylight deprivation such as during the Antarctic winter has been shown to lead to delayed sleep timing and sleep fragmentation. We aimed at testing whether retinal sensitivity, sleep and circadian rest-activity will change during long-term daylight deprivation on two Antarctic bases (Concordia and Halley VI) in a total of 25 healthy crew members (mean age: 34 ± 11y; 7f). The pupil responses to different light stimuli were used to assess retinal sensitivity changes. Rest-activity cycles were continuously monitored by activity watches. Overall, our data showed increased pupil responses under scotopic (mainly rod-dependent), photopic (mainly L-/M-cone dependent) as well as bright-blue light (mainly melanopsin-dependent) conditions during the time without direct sunlight. Circadian rhythm analysis revealed a significant decay of intra-daily stability, indicating more fragmented rest-activity rhythms during the dark period. Sleep and wake times (as assessed from rest-activity recordings) were significantly delayed after the first month without sunlight (p

Medical devices innovations and associated procedures represent a large part of health facilities budget. The aim of this work was to evaluate the cost of medical devices used during different surgical procedures. This cost was compare with the revenue collected from hospital stay pricing.A prospective analysis of the medical devices used in operating room was carried out for different types of programmed surgeries. For five weeks, references of sterile single-use medical devices used during the interventions were collected.Expenditure on medical devices used during surgical procedures represented 5.7 % of the hospitalization value for an inguinal hernia repair, 12 % for a cholecystectomy, 9.35 % for a colectomy, 14.5 % for a hepatectomy and 7 % for pancreatectomy, any severity index combined. The most important correlations existed between act duration and patient's level of severity and between operating times and consumables expenditure.Cost optimization opportunities are equivalence of some medical devices ranges, purchases with national groupings and potential decreases in operating times related to the use of innovative medical devices.

Made available in DSpace on 2018-11-26T15:27:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-09-01 Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) Water samples were collected quarterly for 1 year from the newly created Osamu Utsumi uranium mine pit lake, Brazil, which is affected by acid mine drainage (AMD). The water presented mean pH values of 3.8, high mean electrical conductivity values (2391 A mu S/cm), manganese (74 mg/L), sulfate (1413 mg/L) and uranium (3 mg/L). The density of rotifera was significantly higher than that of cladoceran. Rotifera Keratella americana, K. cochlearis and the Cladocera Bosminopsis deitersi, Bosmina sp., are being reported for the first time in samples from a uranium pit lake with AMD. Of the species registered, the order Bdelloidea was the most important in terms of density (17,500-77,778 ind/m(3)), since it occurred throughout the whole sampling period. The combined effect of moderately acidic pH and other potential stress factors, such as high concentrations of stable and radioactive contaminants, probably influenced the zooplankton species composition in the pit lake. Brazilian Nucl Energy Commiss, Pocos de Caldas Lab, Radioecol Lab, BR-37701970 Pocos De Caldas, MG, Brazil Alfenas Fed Univ, Dept Biol, Limnol Lab, BR-37130000 Alfenas, MG, Brazil Univ Estadual Paulista, Dept Environm Engn, BR-12247004 Sao Jose Dos Campos, SP, Brazil Brazilian Nucl Energy Commiss, Pocos de Caldas Lab, Chem Anal Lab, BR-37701970 Pocos De Caldas, MG, Brazil Univ Estadual Paulista, Dept Environm Engn, BR-12247004 Sao Jose Dos Campos, SP, Brazil FAPEMIG: APQ-7807-5.04/07

Introduction To describe multimedia presentation development and assess impact of use on student and educator performance in a drug information course. Methods Slides were modified from bullet-point format to simplified pictorial format and three-slide handouts became outlined Word documents. Student performance, via exam scores and class average, and educator evaluation scores were compared between 2013 and 2014. Results Presentation revision resulted in a similar number of slides per presentation and smaller handout packets. Class average and final exam scores decreased (86.65% vs. 85.91%, p = 0.222; 84.88% vs. 84.08%, p = 0.053) while midterm exam scores improved (85.81% vs. 87.80%, p = 0.007). Assessment of teacher effectiveness (scale of 1 = strongly disagree to 5 = strongly agree) rose from a median of 3–4 (p = 0.06). Conclusion Simplifying presentations provided anecdotal value but did not impact student performance nor student perception of educator effectiveness.

Purpose The collaboration between a drug information center (DIC) and an academic detailing program is described. Methods An agreement was reached between the South Carolina Offering Prescribing Excellence (SCORxE) academic detailing program and the Medical University of South Carolina (MUSC) Drug Information Center (DIC) to provide responses to drug information (DI) questions pharmacists received on academic detailing visits. Questions received were analyzed to determine the impact that the collaboration had on MUSC DIC requests. Results From May 2009 to October 2012, the MUSC DIC answered 2727 DI questions, 62 (2.3%) of which were generated by SCORxE. Compared with DIC questions received from other sources, academic detailing questions were more likely to be therapeutic consultations, reference searches, or dosage queries and less likely to be about formulation or drug interactions. When comparing the deadline for the 62 academic detailing requests with the deadline for all other requests, the academic detailing requests allowed for a longer median time to deadline per request (21.2 days versus 27.1 hours). The majority of SCORxE questions (68%) were completed by students or residents. Benefits of the collaboration for the DIC included advanced educational opportunities for learners, increased dissemination of provided information, external funding, and scholarship opportunities. SCORxE has benefited from increased access to information and efficiency. Conclusion Collaboration between an academic detailing program and an academic medical center DIC has proven beneficial for both parties. Questions have been communicated by a simple and effective process and have required more research than queries received from other sources.

Objective: A retrospective study was conducted to assess the diagnosis and treatment of urinary tract infections (UTIs) using urinalyses (UA)s at a psychiatric hospital. Method: Patients admitted between July 2010 and June 2011 receiving at least one UA during inpatient psychiatric hospitalization were included. Pregnant patients and those with a UA receiving antibiotic treatment in the emergency department were excluded. The primary objective of the study was to characterize and assess the appropriateness of UAs ordered for the diagnosis of UTIs. Secondary objectives included analyzing frequency of cultures obtained, appropriateness of empiric antibiotics, and de-escalation of therapy if warranted. Results: Thirty-nine percent ( n = 891/2292) of patients admitted received a UA at least once during their hospitalization. Of 203 patients further evaluated, 78% were asymptomatic, 11% were older than 65 years of age with altered mental status (AMS) or dementia, and 11% had typical UTI symptoms. Thirty-one patients were given antibiotics for a UTI during their stay, with a majority of those being asymptomatic ( n = 19/31). Conclusions: A significant proportion of UAs ordered at a psychiatric hospital were inappropriate. When patients were treated, empiric antibiotic selection and length of treatment were appropriate in most instances.

Resume L’objectif de ce travail est d’evaluer la conformite des pratiques d’implantation des valves cardiaques aortiques percutanees par rapport aux indications reglementaires et aux recommandations de l’HAS, ainsi que de verifier les tracabilites sanitaire et financiere. Notre analyse est retrospective et exhaustive pour tous les patients ayant beneficie de ces implants jusqu’au 30 juin 2011. L’etude a inclus 54 patients. Les valves ont ete implantees avec succes dans 50 cas et la mortalite a 30 jours etait de 14,8 %. Malgre des criteres parfois non conformes aux recommandations ou meme manquants, l’indication de pose de valves percutanees etait toujours respectee de par la presence de comorbidites. Une preuve de remise d’information de tracabilite sanitaire au patient n’est retrouvee que dans cinq cas, la tracabilite sanitaire est retrouvee dans 49 cas et la cotation financiere dans 45 cas. Les indications d’implantations sont toujours respectees, mais certaines lacunes sont mises en evidence, en particulier dans le suivi a long terme des patients et dans la remise d’information de tracabilite sanitaire. Notre enquete de pratique professionnelle a permis une sensibilisation aux questions de tracabilite et une recuperation financiere consequente. Des mesures d’amelioration ont egalement ete mises en place afin d’ameliorer les criteres de tracabilite.

The purpose of this investigation was to describe the just noticeable difference (JND) in perceived exertion during cycle exercise. Males (n = 20) and females (n = 26) (21.4 ± 3.1 year) performed load-incremented cycle exercise to peak intensity. At the end of each minute, subjects rated their overall-body perceived exertion using the OMNI (0-10) rating of perceived exertion (RPE) scale. Individual regression derived the power output (PO) corresponding to RPE 5. This PO served as the standard stimulus (SS). On a separate occasion, four 5-min cycling bouts were performed with 5 min rest between bouts. During bouts 1 and 3 subjects cycled at the SS. During bouts 2 and 4 subjects adjusted the resistance to achieve a level of exertion just noticeably above/below the SS. The difference in final 30-s oxygen consumption (VO2) and PO between each JND bout and the previous SS were the above (JND-A) and below (JND-B) perceived exertion JNDs. JND-A and JND-B were compared between genders and between subjects exhibiting lower versus higher ventilatory threshold (VT) and VO(2PEAK) within genders for VO2 (l · min(-1), %VO(2PEAK)) and PO (W, %SS). JND-B was significantly (P0.05) greater than JND-A for VO2 and PO, when expressed in absolute (l · min(-1), W) and relative units (%VO(2PEAK), %SS). Males exhibited greater JND values than females in absolute, but not relative, units. Subjects with lower and higher VT and VO(2)PEAK exhibited similar JND values. The JND can serve as an effective tool to measure perceptual acuity and to determine individual ability to self-regulate prescribed exercise intensities.

OBJECTIVE: To determine the optimal approach for transitioning therapy to aripiprazole from other antipsychotics in schizophrenia and to describe these strategies. DATA SOURCES: MEDLINE (January 2000-March 2012) and PubMed (January 2000-March 2012) searches were conducted using the search terms aripiprazole, switch, and switching. Citations from references were reviewed to identify additional primary literature. STUDY SELECTION AND DATA EXTRACTION: Articles identified as primary literature were considered for inclusion. Case series, opinion papers, and review articles were also examined. Literature was required to be in English. For evaluation purposes, included articles were randomized trials specifically comparing different switching strategies from an alternative antipsychotic to aripiprazole. Randomized trials and single-arm studies that evaluated the effect of a change to aripiprazole and reported switching methods were also reviewed but not evaluated. DATA SYNTHESIS: Aripiprazole, an atypical antipsychotic agent with a unique mechanism of action, causes fewer adverse effects when compared with other atypical antipsychotics. Patients unable to tolerate or unresponsive to their current regimens might benefit from a change to aripiprazole, but the best method for switching is unknown. Four randomized trials were identified that compared the efficacy, safety, and tolerability of at least 2 different switching strategies. The 5 strategies used a combination of immediate or titrated initiation of aripiprazole with immediate or tapered discontinuation of the current antipsychotic. A significant worsening of symptoms in the abrupt discontinuation group when compared with the combined tapered discontinuation groups was seen in 1 trial at week 2; however, all other comparisons yielded no significant differences among switching strategies. CONCLUSIONS: Strategies for transitioning therapy to aripiprazole from alternative antipsychotics in schizophrenia have been investigated in randomized trials, but studies have failed to establish a preferred method. Despite the lack of evidence, experts recommend an overlap strategy that includes maintaining the current antipsychotic dosage while titrating to a therapeutic dose of aripiprazole.

Resume Introduction Les lesions des nerfs peripheriques, particulierement de la main, ont des consequences lourdes. Les guides de repousse nerveuse ont permis une amelioration en termes de qualite de vie pour de nombreux patients. Patients et methodes Ces dispositifs sont implantes au CHU de Strasbourg depuis plusieurs annees. Il etait donc interessant de realiser un etat des lieux de leur utilisation, en termes de resultats cliniques et de valorisation economique. Resultats Vingt-cinq patients ont ete inclus dans cette etude retrospective de septembre 2007 a janvier 2010. Un benefice important a ete observe dans 32 % des cas, le recul etait insuffisant mais des ameliorations etaient en cours dans 24 % des cas, l’intervention avait reussi sans amelioration notable dans 24 % des cas, la prise en charge avait echoue dans 12 % des cas et l’information etait indisponible dans 8 % des cas. Certains patients (44 % des cas) ont presente des complications de gravite variable. En tenant compte d’un tarif moyen du Neurolac ® , la part du dispositif dans la valorisation totale du sejour etait inferieure a 50 % pour cinq patients, comprise entre 50 et 100 % pour 14 patients et superieure a 100 % dans sept cas. Conclusion Tous les guides du marche ne sont pas strictement equivalents, mais certains se distinguent des autres par leurs qualites, l’aspect economique devant necessairement etre pris en compte dans le contexte de la tarification a l’activite.

Summary Objective Surgical treatment of drug-resistant epilepsy is the last resort to reduce or completely cure epilepsy. The objectives of this study were firstly, to study the different profiles and postoperative complications for patients managed at our institution and also to estimate the cost of explorative study by stereoelectroencephalographic electrodes (SEEG). Method A retrospective study was conducted on patients operated between 2003 and 2008 and followed by the Neurology Department. Results A total of 104 medical records were analyzed. The average patient age at surgery was 34 years (range 10–70 years) and mean duration of epilepsy before surgery 21 years (range: 3–56 years). In 80% of cases, type temporal epilepsy was encountered, mainly treated by temporal resection (72%). One year after surgery, 60% of patients were seizure-free(Engel class I), 62% of the patients could resume their work or school and 26% of patients had permanent postoperative complications, minor and expected in the majority of them; no deaths have been reported. Discussion/conclusion Two types of medical devices are used in the management of epilepsy surgery: the left vagus nerve stimulation (8900 € paid besides hospital benefits) and the electrodes of stereo-electroencephalography (SEEG) in possible prior to conventional surgery. Having introduced the use of SEEG electrodes in our institution in 2004, for epilepsy surgery an average of 11 electrodes (eight to 15 electrodes) is required at an average cost of € 4284 per patient. These electrodes represent 58% of average tariff, of the disease-related groups found among patients (€ 7418). In our study, epilepsy surgery appears to be of significant clinical benefit. However, the cost-effectiveness of conventional surgery for epilepsy post-SEEG must be reevaluated to confirm the long-term interest.

Objective: To describe a method for creating an electronic document management (EDM) system at a drug information (DI) center based at an academic medical center to improve efficiency and provide increased availability through remote access. Summary: At DI centers, written materials not available electronically are often stored in file cabinets and retrieved by an individual when required. This process can be time-consuming and inefficient. Various EDM programs were evaluated and compared based on capabilities, cost of implementation and maintenance, and efficiency. Following program selection, documents were scanned onto a dedicated personal computer (PC) and organized according to a predetermined hierarchy of folders. Specialists then performed optical character recognition (OCR) and entered authors, titles, and assigned key words for each new electronic file. Results: It was determined that Adobe Acrobat software fulfilled all requirements at minimal expense. A specialist is able to scan and electronically file 72 documents (496 pages) per hour, perform OCR on 40 documents per hour, and attach titles, authors, and key words to newly scanned documents at a rate of 10 articles per hour. This EDM system is capable of storing in excess of 70,000 documents on a PC with 250 GB of hard disk space and 4 GB of random access memory, which can be accessed remotely from any computer through a secure virtual private network connection. Conclusions: Adobe Acrobat software, when combined with a high-resolution scanner, provides an inexpensive method for EDM that allows for immediate document retrieval, expansion of operations, and remote access.

Resume Objectif Le traitement chirurgical de l’epilepsie pharmacoresistante constitue le dernier recours vers la reduction, voire la guerison totale de l’epilepsie. Les objectifs de ce travail etaient, d’une part, d’etudier les differents profils et les complications postoperatoires des patients pris en charge dans notre etablissement et d’autre part d’estimer le cout des explorations par les electrodes de stereo-electroencephalographie (SEEG). Methode Une etude retrospective a ete menee sur les patients operes entre 2003 et 2008 et suivis par le service de neurologie. Resultats Au total, 104 dossiers medicaux ont ete analyses. La moyenne d’âge des patients lors de l’intervention etait de 34 ans (extremes : 10–70 ans) et la duree moyenne de l’epilepsie avant l’operation de 21 ans (extremes : 3–56 ans). Dans 80 % des cas, l’epilepsie rencontree etait de type temporal, principalement traitee par une resection temporale (72 %). Un an apres la chirurgie, 60 % des patients etaient libres de crises (classe I d’Engel), 62 % des patients ont pu reprendre leur activite professionnelle ou scolaire et 26 % des patients avaient des complications postoperatoires permanentes, mineures et attendues chez la majorite d’entre eux ; aucun deces n’a ete rapporte. Discussion/Conclusion Deux types de dispositifs medicaux existent pour la prise en charge de la chirurgie de l’epilepsie : la stimulation du nerf vague gauche (8900 € pris en charge en sus des prestations d’hospitalisation) et les electrodes de SEEG en prealable possible a la chirurgie conventionnelle. Ayant debutee dans notre etablissement en 2004, l’utilisation des electrodes de SEEG pour la chirurgie de l’epilepsie necessite en moyenne 11 electrodes (de 8–15 electrodes) pour un cout moyen de 4284 € par patient. Ces electrodes representent 58 % du tarif moyen des groupes homogenes de sejours (GHS) retrouves chez les patients (7418 €). Selon notre etude, la chirurgie de l’epilepsie semble presenter un benefice clinique important. Neanmoins, le rapport cout–efficacite de la chirurgie conventionnelle de l’epilepsie post-SEEG doit etre reevalue a long terme pour en confirmer l’interet.