MatLab(®) has often been considered an excellent environment for fast algorithm development but is generally perceived as slow and hence not fit for routine medical image processing, where large data sets are now available e.g., high-resolution CT image sets with typically hundreds of 512x512 slices. Yet, with proper programming practices - vectorization, pre-allocation and specialization - applications in MatLab(®) can run as fast as in C language. In this article, this point is illustrated with fast implementations of bilinear interpolation, watershed segmentation and volume rendering.
Background: Enterprise resource planning (ERP) is critical to enhancing the ability to control commercial activities and results in a competitive advantage when combined with an organisation's existing competitive advantages. However, our practise review reveals that end users resist ERP implementation because the resulting changes will alter the current status quo. The implementation of an ERP system in an organisation is complex as it affects multiple areas of the business. Resistance to change is cited as a factor of ERP failure. Methods: In this study, we conducted a systematic literature review using Transfield's five stages and established a conceptual framework for ERP system implementation in science and technology parks (STPs). Articles collected from Emerald, Science Direct, ProQuest and Scopus databases between 1 st June 2021 and 15 th June 2021. Two authors were assigned to check the suitability of the articles in order to avoid risk of bias. Articles were analysed based on components of a research paper and the data was tabulated using MS Excel. Results: Only eight papers (0.011% of all the papers) appeared when we searched for papers related to ERP with a focus on post ERP Implementation, end-user behaviours, organisational performance, and the accelerated SAP (system application and product) methodology. We found that there are hardly any articles on ERP post implementations in STP context particularly based on the evaluation part of accelerated SAP. Conclusions: Results indicate the lack of studies in this field, particularly those addressing issues related to STP. This study attempted to broaden the understanding of the ERP's effectiveness, particularly in terms of an organisation's operational performance.
Objective: To evaluate the impact of pharmacist-led warfarin management and standardized treatment protocol.
Methods: A retrospective cohort study was carried out in a cardiology referral hospital located in central Kuala Lumpur, Malaysia, from 2009 to 2014. The inclusion criteria were: adult patients who were diagnosed and treated for atrial fibrillation (AF) with warfarin, attended the warfarin medication therapy adherence clinic (WMTAC) for at least 12 weeks, and with at least four international normalized ratio (INR) readings. The electronic medical records were reviewed for demographics, type of AF, warfarin dose, INRs, adverse events, co-morbidities, and drug-drug interactions. The outcome measures included the mean time to therapeutic INR, the mean percentage of time in therapeutic range (TTR), bleeding events, and common drug interactions.
Results: Out of 473 patients, 151 patients fulfilled the inclusion criteria. The findings revealed that there were significant associations between the usual medical care (UMC) group and pharmacist-led WMTAC in terms of TTR (p = 0.01) and INR (p = 0.02) levels. A positive impact of pharmacists' involvement in the WMTAC clinic was where the "pharmacist's recommendation accepted" (p = 0.01) and "expanded therapeutic INR range" (p = 0.04) were statistically significantly higher in the WMTAC group.
Conclusion: There was a significant positive association between the pharmacist-led WMTAC and anticoagulation effect (therapeutic TTR, INR). The identified findings revealed that expanded role of pharmacist in pharmacist-managed warfarin therapy is beneficial to optimize the warfarin therapy. This study also highlighted the critical roles that pharmacists can actively play to ensure optimal anticoagulation pharmaceutical care.
Key messages: What is already known on this subject?
• Pharmacist-managed warfarin therapy is beneficial for optimizing warfarin therapy. In such therapy, recommendations such as dose adjustment and safer alternative drugs (given drug-drug interactions and/or food-drug interactions) are made.
• The active involvement of pharmacists in warfarin adherence clinics could significantly improve adherence.
• However, the warfarin treatment outcomes from UMC, pharmacist-and-physician-led care and pharmacist-led care have not been studied.
• The impact of the implementation of the standardized protocol for the warfarin adherence clinic has not been assessed.
What this study adds?
• INR levels among UMC group and WMTAC group were significantly different.
• Though the TTR level for the WMTAC group was not significantly different than the UMC group, it was higher and close to the targeted 60% level.
• The identified findings show that pharmacists' focus on intervention for missed doses, adherence and dose adjustment provide positive impact on patients' warfarin therapy.