BackgroundAcute medical care often demands timely, accurate decisions in complex situations. Computerized clinical decision support systems (CCDSSs) have many features that could help. However, as for any medical intervention, claims that CCDSSs improve care processes and patient outcomes need to be rigorously assessed. The objective of this review was to systematically review the effects of CCDSSs on process of care and patient outcomes for acute medical care.MethodsWe conducted a decision-maker-researcher partnership systematic review. MEDLINE, EMBASE, Evidence-Based Medicine Reviews databases (Cochrane Database of Systematic Reviews, DARE, ACP Journal Club, and others), and the Inspec bibliographic database were searched to January 2010, in all languages, for randomized controlled trials (RCTs) of CCDSSs in all clinical areas. We included RCTs that evaluated the effect on process of care or patient outcomes of a CCDSS used for acute medical care compared with care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.ResultsThirty-six studies met our inclusion criteria for acute medical care. The CCDSS improved process of care in 63% (22/35) of studies, including 64% (9/14) of medication dosing assistants, 82% (9/11) of management assistants using alerts/reminders, 38% (3/8) of management assistants using guidelines/algorithms, and 67% (2/3) of diagnostic assistants. Twenty studies evaluated patient outcomes, of which three (15%) reported improvements, all of which were medication dosing assistants.ConclusionThe majority of CCDSSs demonstrated improvements in process of care, but patient outcomes were less likely to be evaluated and far less likely to show positive results.

We compare the procedures and structures for supporting results measurement and evaluation between the Norwegian aid administration, the World Bank, Danida and Department for International Development. We find an important systematic difference in how agencies embed results measurement into their projects and programmes between the partner-led and the agency-led approach. There are clear limitations to the former in results documentation and major challenges in making it work to that end. The findings suggest that the main proponent of the partner-led system, Norway, should undertake revise procedures in order to be able to document results. Finally, we discuss the importance of leadership in ensuring results measurement systems work effectively.

Thermal management systems are integral to electric and hybrid vehicle battery packs for maximising safety and performance since high and irregular battery temperatures can be detrimental to these criteria. Lithium-ion batteries are the most commonly used in the electric vehicle (EV) industry because of their high energy and power density and long life cycle. Liquid cooling provides superior performance with low power draw and high heat transfer coefficient. Two liquid cooling designs-the Linear Channel Design (LCD) and Helical Channel Design (HCD)-underwent multiple numerical and geometrical optimisations, where inlet mass flow rate, channel diameter, and inlet and outlet locations were analysed using CFD (computational fluid dynamics). The primary objectives were to maintain maximum temperatures and thermal uniformity within the operational limits derived from the literature. These were both achieved with the LCD using a mass flow rate of 7.50E-05 kgs−1. The Tmax goal was met for the HCD but not the thermal uniformity goal. The LCD achieved 1.796 K lower in maximum temperature and 8.740 K lower in temperature difference compared to the HCD, proving itself superior in both metrics. The HCD required a higher mass flow rate than the LCD to regulate temperatures, resulting in an undesirably high power consumption.

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