Modelling the flow of congestive heart failure patients through a hospital system

The number of hospital admissions in England due to heart failure is projected to increase by over 50% during the next 25 years. This will incur greater pressures on hospital managers to allocate resources in an effective manner. A reliable indicator for measuring the quantity of resources consumed by hospital patients is their length of stay (LOS) in care. This paper proposes modelling the length of time heart failure patients spend in hospital using a special type of Markov model, where the flow of patients through hospital can be thought of as consisting of three stages of care—short-, medium- and longer-term care. If it is assumed that new admissions into the ward are replacements for discharges, such a model may be used to investigate the case-mix of patients in hospital and the expected patient turnover during some specified period of time. An example is illustrated by considering hospital admissions to a Belfast hospital in Northern Ireland, between 2000 and 2004.

Fate of inflammatory neutrophils within the joint

OBJECTIVE: Impaired flow-mediated dilation (FMD) occurs in disease states associated with atherosclerosis, including SLE. The primary hemodynamic determinant of FMD is wall shear stress, which is critically dependent on the forearm microcirculation. We explored the relationship between FMD, diastolic shear stress (DSS), and the forearm microcirculation in 32 patients with SLE and 19 controls. METHODS AND RESULTS: DSS was calculated using (mean diastolic velocity x 8 x blood viscosity)/baseline brachial artery diameter. Doppler velocity envelopes from the first 15 seconds of reactive hyperemia were analyzed for resistive index (RI), and interrogated in the frequency domain to assess forearm microvascular hemodynamics. FMD was significantly impaired in SLE patients (median, 2.4%; range, -2.1% to 10.7% versus median 5.8%; range, 1.9% to 14%; P

Delayed failure of a deep cutting in lodgement till

Recent research on the delayed failure of cuttings in clay clearly recognises and predicts progressive delayed failure of deep cuttings. This is due to a combination of strain-softening, weathering, dissipation of negative excess pore water pressure generated at the time of excavation, and frequent occurrence of prolonged periods of wet weather. There have been several slope failures of this kind in Northern Ireland. This paper discusses a case study based on a failure of a deep cutting, excavated at a slope of 1 in 2, on the A1 near Dromore (County Down) in Northern Ireland. The cutting was in lodgement till, a stiff, heavily overconsolidated clay. The failure occurred approximately 30 years after the cutting was excavated, following a prolonged period of heavy rainfall. An analysis of the failure, together with laboratory test data on soil samples taken from the site, confirmed that by using long-term soil strength parameters the factor of safety of this slope was unity. The conclusion of the analysis is that slopes excavated in this soil should be designed (and assessed) on long-term strength parameters.

Noninvasive Detection of Brushless Exciter Rotating Diode Failure

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Proteomic Analysis of Recurrent Joint Inflammation in Juvenile Idiopathic Arthritis

The synovial fluid proteome in juvenile idiopathic arthritis was investigated to isolate joint-specific biomarkers that are expressed in patients displaying recurrent joint inflammation. To identify the synovial specific proteome, matched synovial fluid and plasma samples were subjected to protein separation by 2-dimension electrophoresis (2DE). Forty-three protein spots, overexpressed in the joint, were identified. Synovial fluids from children with single-event knee joint inflammation were then compared with a group with recurrent knee disease. Nine synovial specific proteins were significantly differentially expressed in the recurrent group. Proteolytic fragments of collagen X, fibrin beta-chain, and T-cell receptor alpha-region have been identified among this protein cluster. Putative biomarkers, overexpressed in the joint and differentially expressed in children with recurrent joint inflammation, have been identified. These proteins may play a significant role determining the pathological state within the chronically inflamed joint and influence disease progression in JIA. This is the first study of the synovial proteome in children.

Joint measurements and Bell inequalities

Joint quantum measurements of noncommuting observables are possible, if one accepts an increase in the measured variances. A necessary condition for a joint measurement to be possible is that a joint probability distribution exists for the measurement. This fact suggests that there may be a link with Bell inequalities, as these will be satisfied if and only if a joint probability distribution for all involved observables exists. We investigate the connections between Bell inequalities and conditions for joint quantum measurements to be possible. Mermin's inequality for the three-particle Greenberger-Horne-Zeilinger state turns out to be equivalent to the condition for a joint measurement on two out of the three quantum systems to exist. Gisin's Bell inequality for three coplanar measurement directions, meanwhile, is shown to be less strict than the condition for the corresponding joint measurement.