The Impact of Admissions for the Management of End-stage renal disease on hospital bed occupancy

BACKGROUND:

End-stage renal disease (ESRD) is increasingly prevalent but the inpatient costs associated with this condition are poorly defined due to limitations with data extraction and failure to differentiate between hospitalisation for renal and non-renal disease reasons. The impact of admissions primarily for the management of ESRD on hospital bed utilisation was assessed over a 5-year period in a large teaching hospital.

METHODS:

All admission episodes were reviewed and the ESRD group was identified by a primary International Classification of Diseases code for ESRD or a non-specific primary renal failure code with a secondary code for ESRD. The frequency and duration of hospitalisation and contribution to bed day occupancy of this group with ESRD was determined.

RESULTS:

There were 70,808 patients responsible for a total of 116,915 admissions and 919,212 bed days over the study period. Of these, 988 (1.4%) patients were admitted for the management of ESRD, accounting for 2,387 (2.0%) of admissions and utilisation of 23,011 (2.5%) bed days. After adjustment for age and gender, those admitted for ESRD management were significantly more likely to have a prolonged admission exceeding 30 days (odds ratio 1.46, 95% confidence interval 1.23-1.72, p < 0.001). When the admission was an emergency rather than an elective event, the patient was 4.6 times more likely to be hospitalised for over 30 days.

CONCLUSIONS:

Persons admitted for ESRD management are hospitalised more frequently and for longer than the overall inpatient population, occupying a substantial number of bed days.

Prognostic significance of thymidylate synthase, dihydropyrimidine dehydrogenase and thymidine phosphorylase protein expression in colorectal cancer patients treated with or without 5-fluorouracil-based chemotherapy

Background: Low tumour expression levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD) and thymidine phosphorylase (TP) have been linked with improved outcome for colorectal cancer (CRC) patients treated with 5-fluorouracil (5-FU). It is unclear whether this occurs because such tumours have better prognosis or they are more sensitive to 5-FU treatment.

ARTICLE: Property and the Definition of Slavery

Currently there is no clear understanding of the meaning of ‘slavery’ in modern international law. While generally it is accepted that the
authoritative definition of slavery is provided by Article 1 of the Slavery Convention 1926, in recent times slavery has been understood in such a wide variety of ways that effectively it is a meaningless term. This paper reflects on this interpretation problem and aims to redress this balance by reclaiming the core meaning of the legal definition. It applies property law perspectives to explain the conception of ownership invoked by Article 1, to argue that it remains relevant and to explore how it might be applied in identifying modern cases of slavery.

Layered RF Phantom Characterization for Wireless Medical Vital Sign Monitors

Wearable antenna performance measurements were used to characterize a synthetic variable layered phantom testbed, representative of human tissue for operation in the 868/915 MHz, and 2400 MHz industrial, scientific and medical frequency bands. Antenna radiation efficiency measurements on the phantom were compared with measurements on the thorax region of a human test subject. The results show that the phantom is representative of the human body for the application of wireless vital sign monitors, where conductive connections are made to the tissue.

An Evaluation of 1D Design Methods for the Off-Design Performance Prediction of Automotive Turbocharger Compressors

Several one-dimensional design methods have been used to predict the off-design performance of three modern centrifugal compressors for automotive turbocharging. The three methods used are single-zone, two-zone, and a more recent statistical method. The predicted results from each method are compared against empirical data taken from standard hot gas stand tests for each turbocharger. Each of the automotive turbochargers considered in this study have notably different geometries and are of varying application. Due to the non-adiabatic test conditions, the empirical data has been corrected for the effect of heat transfer to ensure comparability with the 1D models. Each method is evaluated for usability and accuracy in both pressure ratio and efficiency prediction. The paper presents an insight into the limitations of each of these models when applied to one-dimensional automotive turbocharger design, and proposes that a corrected single-zone modelling approach has the greatest potential for further development, whilst the statistical method could be immediately introduced to a design process where design variations are limited.

Wearable antennas for medical monitoring systems

A wearable silver nano particle inkjet printed antenna suitable for wireless biomedical sensing is presented. The performance is evaluated on a synthetic variable layered phantom test-bed, representative of human tissue for operation in the 868/915 MHz, and 2400 MHz industrial, scientific and medical frequency bands. Antenna radiation efficiency measurements on the phantom were compared with antennas prototyped with copper. Total radiation efficiencies up to ???6.5 dB are reported, with less than 0.5 dB difference in performance between copper and silver nano particle variants, showing promising application for low-cost disposable wireless sensing.