Outpatient Quick Diagnosis Units for the evaluation of suspected severe diseases: an observational, descriptive study

Background: Hospitals in countries with public health systems have recently adopted organizational changes to improve efficiency and resource allocation, and reducing inappropriate hospitalizations has been established as an important goal. AIMS: Our goal was to describe the functioning of a Quick Diagnosis Unit in a Spanish public university hospital after evaluating 1,000 consecutive patients. We also aimed to ascertain the degree of satisfaction among Quick Diagnosis Unit patients and the costs of the model compared to conventional hospitalization practices. DESIGN: Observational, descriptive study. METHODS: Our sample comprised 1,000 patients evaluated between November 2008 and January 2010 in the Quick Diagnosis Unit of a tertiary university public hospital in Barcelona. Included patients were those who had potentially severe diseases and would normally require hospital admission for diagnosis but whose general condition allowed outpatient treatment. We analyzed several variables, including time to diagnosis, final diagnoses and hospitalizations avoided, and we also investigated the mean cost (as compared to conventional hospitalization) and the patients' satisfaction. RESULTS: In 88% of cases, the reasons for consultation were anemia, anorexia-cachexia syndrome, febrile syndrome, adenopathies, abdominal pain, chronic diarrhea and lung abnormalities. The most frequent diagnoses were cancer (18.8%; mainly colon cancer and lymphoma) and Iron-deficiency anemia (18%). The mean time to diagnosis was 9.2 days (range 1 to 19 days). An estimated 12.5 admissions/day in a one-year period (in the internal medicine department) were avoided. In a subgroup analysis, the mean cost per process (admission-discharge) for a conventional hospitalization was 3,416.13 Euros, while it was 735.65 Euros in the Quick Diagnosis Unit. Patients expressed a high degree of satisfaction with Quick Diagnosis Unit care. CONCLUSIONS: Quick Diagnosis Units represent a useful and cost-saving model for the diagnostic study of patients with potentially severe diseases. Future randomized study designs involving comparisons between controls and intervention groups would help elucidate the usefulness of Quick Diagnosis Units as an alternative to conventional hospitalization.

Space and momentum representation analysis of Hartman's effect in wave packet transmission

The Hartman effect is analyzed in both the position and momentum representations of the problem. The importance of Wigner tunneling and deep tunneling is singled out. It is shown quantitatively how the barrier acts as a filter for low momenta (quantum speed up) as the width increases, and a detailed mechanism is proposed. Superluminal transmission is also discussed.

Approximation and support theorem for a wave equation in two space dimensions

We prove a characterization of the support of the law of the solution for a stochastic wave equation with two-dimensional space variable, driven by a noise white in time and correlated in space. The result is a consequence of an approximation theorem, in the convergence of probability, for equations obtained by smoothing the random noise. For some particular classes of coefficients, approximation in the Lp-norm for p¿1 is also proved.

Space Competition and Time Delays in Human Range Expansions. Application to the Neolithic Transition

Space competition effects are well-known in many microbiological and ecological systems. Here we analyze such an effectin human populations. The Neolithic transition (change from foraging to farming) was mainly the outcome of a demographic process that spread gradually throughout Europe from the Near East. In Northern Europe, archaeological data show a slowdown on the Neolithic rate of spread that can be related to a high indigenous (Mesolithic) population density hindering the advance as a result of the space competition between the two populations. We measure this slowdown from a database of 902 Early Neolithic sites and develop a time-delayed reaction-diffusion model with space competition between Neolithic and Mesolithic populations, to predict the observed speeds. The comparison of the predicted speed with the observations and with a previous non-delayed model show that both effects, the time delay effect due to the generation lag and the space competition between populations, are crucial in order to understand the observations

Meta-structure correlation in protein space unveils different selection rules for folded and intrinsically disordered proteins

The number of existing protein sequences spans a very small fraction of sequence space. Natural proteins have overcome a strong negative selective pressure to avoid the formation of insoluble aggregates. Stably folded globular proteins and intrinsically disordered proteins (IDP) use alternative solutions to the aggregation problem. While in globular proteins folding minimizes the access to aggregation prone regions IDPs on average display large exposed contact areas. Here, we introduce the concept of average meta-structure correlation map to analyze sequence space. Using this novel conceptual view we show that representative ensembles of folded and ID proteins show distinct characteristics and responds differently to sequence randomization. By studying the way evolutionary constraints act on IDPs to disable a negative function (aggregation) we might gain insight into the mechanisms by which function - enabling information is encoded in IDPs.

Nonpoint source pollution, space, time and asymetric information - a deposit refund approach

The incorporation of space allows the establishment of a more precise relationship between a contaminating input, a contaminating byproduct and emissions that reach the final receptor. However, the presence of asymmetric information impedes the implementation of the first-best policy. As a solution to this problem a site specific deposit refund system for the contaminating input and the contaminating byproduct are proposed. Moreover, the utilization of a successive optimization technique first over space and second over time enables definition of the optimal intertemporal site specific deposit refund system

Reflexiones sobre el espacio público = Thoughts on Public Space

En este artículo planteamos una aproximación a la idea de espacio público como articulador del conjunto de acontecimientos que intervienen en la vida de las ciudades. Entendemos este fenómeno como una red poliédrica y multidimensional, cuyo estudio pasa por el análisis de diversas problemáticas: la identificación de los límites entre espacio público y esfera pública; la conformación del espacio público construido; la aproximación teórica al fenómeno desde la contemporaneidad; la dimensión social del espacio público; y finalmente la perspectiva de la gestión de las ciudades. Todas estas dimensiones expresan una mirada crítica del objeto i ponen en valor niveles de trabajo interdisciplinar y multiescala, fundamentales para entender e intervenir en el espacio público de la ciudad contemporánea.

Public Art, strategies for the regeneration of public space

This paper discusses some of the key concepts in the consideration of public art as a central element in urban regeneration processes, especially in reference to its role in the processes of citizen participation.

Reflexiones sobre el espacio público = Thoughts on Public Space

En este artículo planteamos una aproximación a la idea de espacio público como articulador del conjunto de acontecimientos que intervienen en la vida de las ciudades. Entendemos este fenómeno como una red poliédrica y multidimensional, cuyo estudio pasa por el análisis de diversas problemáticas: la identificación de los límites entre espacio público y esfera pública; la conformación del espacio público construido; la aproximación teórica al fenómeno desde la contemporaneidad; la dimensión social del espacio público; y finalmente la perspectiva de la gestión de las ciudades. Todas estas dimensiones expresan una mirada crítica del objeto i ponen en valor niveles de trabajo interdisciplinar y multiescala, fundamentales para entender e intervenir en el espacio público de la ciudad contemporánea.

Space Manifold dynamics

The term Space Manifold Dynamics (SMD) has been proposed for encompassing the various applications of Dynamical Systems methods to spacecraft mission analysis and design, ranging from the exploitation of libration orbits around the collinear Lagrangian points to the design of optimal station-keeping and eclipse avoidance manoeuvres or the determination of low energy lunar and interplanetary transfers

Space Manifold dynamics

The term Space Manifold Dynamics (SMD) has been proposed for encompassing the various applications of Dynamical Systems methods to spacecraft mission analysis and design, ranging from the exploitation of libration orbits around the collinear Lagrangian points to the design of optimal station-keeping and eclipse avoidance manoeuvres or the determination of low energy lunar and interplanetary transfers

Enhanced MDIR receiver for space-time dispersive channels

A particular property of the matched desiredimpulse response receiver is introduced in this paper, namely,the fact that full exploitation of the diversity is obtained withmultiple beamformers when the channel is spatially and timelydispersive. This particularity makes the receiver specially suitablefor mobile and underwater communications. The new structureprovides better performance than conventional and weightedVRAKE receivers, and a diversity gain with no needs of additionalradio frequency equipment. The baseband hardware neededfor this new receiver may be obtained through reconfigurabilityof the RAKE architectures available at the base station. Theproposed receiver is tested through simulations assuming UTRAfrequency-division-duplexing mode.

Space-time front-ends for RAKE receivers in the FDD mode of UTRA

A unified and general vision of different space-time processors is presented. Many popular receivers can beaccomodated, like V-RAKE receivers, weighted V-RAKE, or spatial narrowband beamforming. By makingappropriate assumptions on the space/time characteristic of the interference it is possible to enhance theperformance of the receiver through spatial/temporal pre-processors. These receivers will be tested in the FDDmode of UTRA.

Hybrid turbo FEC/ARQ systems and distributed space-time coding for cooperative transmission

Cooperative transmission can be seen as a "virtual" MIMO system, where themultiple transmit antennas are in fact implemented distributed by the antennas both at the source and the relay terminal. Depending on the system design, diversity/multiplexing gainsare achievable. This design involves the definition of the type of retransmission (incrementalredundancy, repetition coding), the design of the distributed space-time codes, the errorcorrecting scheme, the operation of the relay (decode&forward or amplify&forward) and thenumber of antennas at each terminal. Proposed schemes are evaluated in different conditionsin combination with forward error correcting codes (FEC), both for linear and near-optimum(sphere decoder) receivers, for its possible implementation in downlink high speed packetservices of cellular networks. Results show the benefits of coded cooperation over directtransmission in terms of increased throughput. It is shown that multiplexing gains areobserved even if the mobile station features a single antenna, provided that cell wide reuse of the relay radio resource is possible.