Protocols

External ventricular drains (EVDs) are commonly used to facilitate removal of cerebrospinal fluid in patients with neurologic dysfunction. Despite a high risk for infection (upward of 45%), many hospitals lack strict protocols for EVD placement and maintenance. In addition, EVD infections are typically not tracked with the same diligence as central-line catheter infections, because there are no widely accepted standards for routine management of EVDs. The purpose of this review is to provide a guide for the development of a standardized, best practice EVD protocol for catheter insertion, care, and maintenance to reduce ventriculostomy-related infections. A secondary goal of this review is to provide support for the future development of guidelines for the consistent tracking of EVD insertion and maintenance practices. At an academic medical center, an interdisciplinary team of nurses, advanced practice nurses, and neurointensivists reviewed recent medical and nursing literature as well as research-based institutional protocols on EVD insertion and maintenance from the United States and abroad to determine global best practices. The goal of this literature review was to identify key areas of focus in EVD insertion and maintenance as well as to identify recent studies that have shown success in managing EVDs with low rates of infection. The following terms were used in this search: EVD, externalized ventricular drains, EVD infections, EVD insertion, EVD Care and Maintenance, Nursing and EVDS. The following databases were utilized by each member of the interdisciplinary team to establish a state of the science on EVD management: American Association of Neurosurgical Surgeons, CINAHL, Cochrane, National Guidelines Clearinghouse, and PubMed. The following common EVD themes were identified: preinsertion hair removal and skin preparation, aseptic technique, catheter selection, monitoring of EVD insertion technique using a ''bundle'' approach, postinsertion dressing type and frequency of dressing changes, techniques for maintenance and cerebrospinal fluid sampling, duration of catheter placement, staff education/competence, and surveillance.

Mobile IPv6 is the protocol defined by the Internet Engineering Task Force (IETF) to enable nodes to roam between IP subnets. Its specification requires the mobile node to be configured with at least a Home prefix to discover a home agent address, a home address and the cryptographic materials needed to protect mobile IPv6 signaling. In a real deployment perspective,

We introduce models for cooperative mitigating response strategies to suppress large scale Internet worm attack. In our models, cooperating members communicate with oth- ers using a "friend protocol" that spreads attack reports to potentially vulnerable uninfected sites. We use mathemati- cal models for the simplest strategies and a simulation for more complex models of mitigation. We investigate the per- formance

In this paper different optimization of Ad-hoc routing algorithm is surveyed and a new method using training based optimization algorithm for reducing the complexity of routing algorithms is suggested. A binary matrix is assigned to each node in the network and gets updated after each data transfer using the protocols.

The use of optimization algorithm in routing algorithm can reduce the complexity of routing to the least amount possible.

The key issue of the localization study is that how we can minimize the energy consumption of devices with guaranteeing high degree of accuracy. In this paper, we show that the collaboration among proxy devices with short range communication is helpful to energy-efficiently localize their locations in time-average sense by analyzing the device proximity including real GPS trace of students in KAIST and NCSU campuses. Next, we deliberate what is the best method for selfish mobile users to collaborate for the energy-efficient localization, and formulate an optimization problem which considers the energy efficiency and/or user fairness. However, optimizing this problem is tricky since it requires a global knowledge of sets of proxy devices and also solving a NP-hard problem to select devices which directly measure locations. This paper makes a contribution towards presenting a practical and fully distributed location sharing protocol based on competition for turning off GPS, and an opt...

The video game market is currently the fastest growing form of E-entertainment. Today's players want more from their experience, like massively multiplayer online games and the ability to play anytime/anywhere using cell phones, PDAs, and consoles. For developing multiplayer ...