Time-dependent Hyperstar algorithm for robust vehicle navigation in time-dependent stochastic road networks.

The vehicle navigation problem studied in Bell (2009) is revisited and a time-dependent reverse Hyperstar algorithm is presented. This minimises the expected time of arrival at the destination, and all intermediate nodes, where expectation is based on a pessimistic (or risk-averse) view of unknown link delays. This may also be regarded as a hyperpath version of the Chabini and Lan (2002) algorithm, which itself is a time-dependent A* algorithm. Links are assigned undelayed travel times and maximum delays, both of which are potentially functions of the time of arrival at the respective link. The driver seeks probabilities for link use that minimise his/her maximum exposure to delay on the approach to each node, leading to the determination of the pessimistic expected time of arrival. Since the context considered is vehicle navigation where the driver is not making repeated trips, the probability of link use may be interpreted as a measure of link attractiveness, so a link with a zero probability of use is unattractive while a link with a probability of use equal to one will have no attractive alternatives. A solution algorithm is presented and proven to solve the problem provided the node potentials are feasible and a FIFO condition applies for undelayed link travel times. The paper concludes with a numerical example.

Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA).

Background Good blood pressure (BP) control reduces the risk of recurrence of stroke/transient ischaemic attack (TIA). Although there is strong evidence that BP telemonitoring helps achieve good control, none of the major trials have considered the effectiveness in stroke/TIA survivors. We therefore conducted a feasibility study for a trial of BP telemonitoring for stroke/ TIA survivors with uncontrolled BP in primary care. Method Phase 1 was a pilot trial involving 55 patients stratified by stroke/TIA randomised 3:1 to BP telemonitoring for 6 months or usual care. Phase 2 was a qualitative evaluation and comprised semi-structured interviews with 16 trial participants who received telemonitoring and 3 focus groups with 23 members of stroke support groups and 7 carers. Results Overall, 125 patients (60 stroke patients, 65 TIA patients) were approached and 55 (44%) patients were randomised including 27 stroke patients and 28 TIA patients. Fifty-two participants (95%) attended the 6-month follow-up appointment, but one declined the second daytime ambulatory blood pressure monitoring (ABPM) measurement resulting in a 93% completion rate for ABPM − the proposed primary outcome measure for a full trial. Adherence to telemonitoring was good; of the 40 participants who were telemonitoring, 38 continued to provide readings throughout the 6 months. There was a mean reduction of 10.1 mmHg in systolic ABPM in the telemonitoring group compared with 3.8 mmHg in the control group, which suggested the potential for a substantial effect from telemonitoring. Our qualitative analysis found that many stroke patients were concerned about their BP and telemonitoring increased their engagement, was easy, convenient and reassuring Conclusions A full-scale trial is feasible, likely to recruit well and have good rates of compliance and follow-up.