Nanophotonic is a promising solution for on-chip interconnection due to its intrinsic low-latency and low-power features. Future tiled chip multiprocessors (CMPs) for rich
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devices can receive energy benefits from this technology but we show that great care has to be put in the integration of the various involved facets to avoid queuing and serialization issues and obtain the rated potential advantages.
We evaluate different management strategies for accessing a simple, shared photonic path (ring), working in conjunctions with a standard electronic mesh or alone, in a tiled CMP. Our results highlight that a careful selection of the most latency-critical messages to be routed in photonics and the use of a conflict-free access scheme is crucial for obtaining performance/power advantages when the available bandwidth is limited.
We identify the design point where all the traffic can be routed on the photonic path and thus the electronic network can be suppressed. At this point, the ring achieves 20--25% speedup and 84% energy consumption improvement over the electronic baseline.
Then we investigate the same trade-offs when the number of rings is increased up to eight, allowing to raise performance benefits up to 40% or reaching up to 80% energy reduction. We finally explore the effects of deploying a given optical parallelism split between a higher number of waveguides for further improving energy savings.
Assessing the effects of an antimicrobial stewardship program (ASP) implemented in a 78-bed Internal Medicine ward of an Italian mid-sized acute care hospital of 296 beds (26,820 bed days/year in 2015 and 26,653 in 2016). The ASP, implemented in May 2016, included: (a) formulation and dissemination of local guidelines on empiric antibiotic therapy; (b) educational training; and (c) restrictive control on the use of carbapenems. We included in the study all the patients who had received at least one systemic antibiotic as empiric therapy and who were discharged in two comparable time periods (Oct-Nov 2015: period 1 and Oct-Nov 2016: period 2), before and after the implementation of the ASP. Clinical data were collected to compare the two study periods. The percentage of patients treated with antibiotics was significantly lower in period 2 (272/635 = 42.8% vs 238/648 = 36.7%, - 6.1%, p < 0.01). A similar reduction was observed in terms of defined daily doses per 100 bed days (from 49.5 to 46.9; - 5.3%). In period 2, we observed a significant reduction of patients treated with carbapenems (5.7 vs 2.1%, p < 0.05). The length of hospital stay and in-hospital mortality was similar in the two study periods. The implementation of an ASP in our Internal Medicine ward has been associated with a significant reduction of patients treated with antibiotics. The reduction was particularly relevant for carbapenems, antibiotics which should be used only in selected cases. These results have been obtained without increasing length of hospital stay and in-hospital mortality.
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