The application of statistical process control charts to the detection and monitoring of hospital-acquired infections

The monitoring of infection control indicators including hospital-acquired infections is an established part of quality maintenance programmes in many health-care facilities. However, surveillance data use can be frustrated by the infrequent nature of many infections. Traditional methods of analysis often provide delayed identification of increasing infection occurrence, placing patients at preventable risk. The application of Shewhart, Cumulative Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) statistical process control charts to the monitoring of indicator infections allows continuous real-time assessment. The Shewhart chart will detect large changes, while CUSUM and EWMA methods are more suited to recognition of small to moderate sustained change. When used together, Shewhart and EWMA methods are ideal for monitoring bacteraemia and multiresistant organism rates. Shewhart and CUSUM charts are suitable for surgical infection surveillance.

Advances in application of climate prediction in agriculture

Agricultural ecosystems and their associated business and government systems are diverse and varied. They range from farms, to input supply businesses, to marketing and government policy systems, among others. These systems are dynamic and responsive to fluctuations in climate. Skill in climate prediction offers considerable opportunities to managers via its potential to realise system improvements (i.e. increased food production and profit and/or reduced risks). Realising these opportunities, however, is not straightforward as the forecasting skill is imperfect and approaches to applying the existing skill to management issues have not been developed and tested extensively. While there has been much written about impacts of climate variability, there has been relatively little done in relation to applying knowledge of climate predictions to modify actions ahead of likely impacts. However, a considerable body of effort in various parts of the world is now being focused on this issue of applying climate predictions to improve agricultural systems. In this paper, we outline the basis for climate prediction, with emphasis on the El Nino-Southern Oscillation phenomenon, and catalogue experiences at field, national and global scales in applying climate predictions to agriculture. These diverse experiences are synthesised to derive general lessons about approaches to applying climate prediction in agriculture. The case studies have been selected to represent a diversity of agricultural systems and scales of operation. They also represent the on-going activities of some of the key research and development groups in this field around the world. The case studies include applications at field/farm scale to dryland cropping systems in Australia, Zimbabwe, and Argentina. This spectrum covers resource-rich and resource-poor farming with motivations ranging from profit to food security. At national and global scale we consider possible applications of climate prediction in commodity forecasting (wheat in Australia) and examine implications on global wheat trade and price associated with global consequences of climate prediction. In cataloguing these experiences we note some general lessons. Foremost is the value of an interdisciplinary systems approach in connecting disciplinary Knowledge in a manner most suited to decision-makers. This approach often includes scenario analysis based oil simulation with credible models as a key aspect of the learning process. Interaction among researchers, analysts and decision-makers is vital in the development of effective applications all of the players learn. Issues associated with balance between information demand and supply as well as appreciation of awareness limitations of decision-makers, analysts, and scientists are highlighted. It is argued that understanding and communicating decision risks is one of the keys to successful applications of climate prediction. We consider that advances of the future will be made by better connecting agricultural scientists and practitioners with the science of climate prediction. Professions involved in decision making must take a proactive role in the development of climate forecasts if the design and use of climate predictions are to reach their full potential. (C) 2001 Elsevier Science Ltd. All rights reserved.

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.

High-performance L-band series and parallel switches using low-cost p-i-n diodes

Low-cost UHF-band p-i-n diodes are used to develop high-performance L-band series and parallel switches. To stop the rectification of large RF, signals, the diodes are biased at a large reverse-bias voltage. Parasitic elements of the diodes are tuned out using LC circuits in biasing circuits without increasing the size of the switches. (C) 2002 John Wiley Sons, Inc.

Analysis of a circular patch antenna radiating in a parallel-plate radial guide

A field matching method is described to analyze a recessed circular cavity radiating into a radial waveguide. Using the wall impedance approach, the analysis is divided into two separate problems of the cavity and its external environment. Based on this analysis, a computer algorithm is developed for determining wall admittances as seen at the edge of the patch in the cavity, the radial admittance matrix for the two-probe feed arrangement, and the input impedance as observed from the coaxial line feeding the cavity. This algorithm is tested against the general-purpose Hewlett-Packard finite-element High Frequency Structure Simulator as well as against measured results. Good agreement in all considered cases is noted.

Molecular rates parallel diversification contrasts between carnivorous plant sister lineages

In the carnivorous plant family Lentibulariaceae, the bladderwort lineage (Utricularia and Genlisea) is substantially more species-rich and morphologically divergent than its sister lineage, the butterworts (Pinguicula). Bladderworts have a relaxed body plan that has permitted the evolution of terrestrial, epiphytic, and aquatic forms that capture prey in intricately designed suction bladders or corkscrew-shaped lobster-pot traps. In contrast, the flypaper-trapping butterworts maintain vegetative structures typical of angiosperms. We found that bladderwort genomes evolve significantly faster across seven loci (the trnL intron, the second trnL exon, the trnL-F intergenic spacer, the rps16 intron, rbcL, coxI, and 5.8S rDNA) representing all three genomic compartments. Generation time differences did not show a significant association. We relate these findings to the contested speciation rate hypothesis, which postulates a relationship between increased nucleotide substitution and increased cladogenesis. (C) 2002 The Willi Hennig Society.

A new technique for the quantification of peripheral edema with application in both unilateral and bilateral cases

Current noninvasive techniques for the routine and frequent quantification of peripheral lymphedema in patients are total limb volume measurement (by water immersion or by circumferential measurements) and bioelectrical impedance analysis (BIA). However both of these techniques require standardizing the measurement using a contralateral measurement from the unaffected limb, Hence these techniques are essentially restricted to unilateral lymphedema. This paper describes the results from a preliminary study to investigate an alternative approach to the analysis of the data from multiple frequency BIA to produce an index of lymphedema without the need for normalization to another body segment. Twenty patients receiving surgical treatment for breast cancer were monitored prior to surgery and again after diagnosis with unilateral lymphedema. The data recorded were total limb volume, by circumferential measurements; and BIA measurements of both limbs. From these measurements total limb volumes and extracellular fluid volumes were calculated and expressed as ratios of the affected limb to that of the unaffected limb. An index of the ratio of the extracellular fluid volume to the intracellular fluid volume was determined. This ECW/ICW index was calculated for both the affected and unaffected limbs at both measurement times. Results confirmed that the established techniques of total limb volume and extracellular fluid volume normalized to the unaffected contralateral limb were accurate in the detection of lymphedema (p < 10(-6)). Comparison of the ECW/ICW index from the affected limb after diagnosis with that from the pre-surgery measurement revealed a significant (p< 10(-6)) and considerable (75%) increase. The results of this pilot study suggest that by using multiple frequency bioelectrical impedance analysis, an index of the ECW/ICW ratio can be obtained and this index appears to have an equal, or better, sensitivity, than the other techniques in detecting lymphedema. More importantly, this index does not require normalization to another body segment and can be used to detect all types of peripheral edema including both unilateral and bilateral lymphedema.

Expert system application on preliminary design of water retaining structures

Design of liquid retaining structures involves many decisions to be made by the designer based on rules of thumb, heuristics, judgment, code of practice and previous experience. Various design parameters to be chosen include configuration, material, loading, etc. A novice engineer may face many difficulties in the design process. Recent developments in artificial intelligence and emerging field of knowledge-based system (KBS) have made widespread applications in different fields. However, no attempt has been made to apply this intelligent system to the design of liquid retaining structures. The objective of this study is, thus, to develop a KBS that has the ability to assist engineers in the preliminary design of liquid retaining structures. Moreover, it can provide expert advice to the user in selection of design criteria, design parameters and optimum configuration based on minimum cost. The development of a prototype KBS for the design of liquid retaining structures (LIQUID), using blackboard architecture with hybrid knowledge representation techniques including production rule system and object-oriented approach, is presented in this paper. An expert system shell, Visual Rule Studio, is employed to facilitate the development of this prototype system. (C) 2002 Elsevier Science Ltd. All rights reserved.

Novel application of biological glue in the management of a complicated pneumothorax in cystic fibrosis

Spontaneous pneumothorax is a frequent complication in advanced lung disease of cystic fibrosis. We describe a case of a complicated pneumothorax in a 21-year old-woman with cystic fibrosis who was effectively treated with the application of biological glue via a minithoracotomy. (C) 2002 Wiley-Liss, Inc.

A compartmental model of hepatic disposition kinetics: 1. Model development and application to linear kinetics

The conventional convection-dispersion model is widely used to interrelate hepatic availability (F) and clearance (Cl) with the morphology and physiology of the liver and to predict effects such as changes in liver blood flow on F and Cl. The extension of this model to include nonlinear kinetics and zonal heterogeneity of the liver is not straightforward and requires numerical solution of partial differential equation, which is not available in standard nonlinear regression analysis software. In this paper, we describe an alternative compartmental model representation of hepatic disposition (including elimination). The model allows the use of standard software for data analysis and accurately describes the outflow concentration-time profile for a vascular marker after bolus injection into the liver. In an evaluation of a number of different compartmental models, the most accurate model required eight vascular compartments, two of them with back mixing. In addition, the model includes two adjacent secondary vascular compartments to describe the tail section of the concentration-time profile for a reference marker. The model has the added flexibility of being easy to modify to model various enzyme distributions and nonlinear elimination. Model predictions of F, MTT, CV2, and concentration-time profile as well as parameter estimates for experimental data of an eliminated solute (palmitate) are comparable to those for the extended convection-dispersion model.

Application of spatial analysis techniques to adjust for fertility trends and identify interplot competition in early stage sugarcane selection trials

Most sugarcane breeding programs in Australia use large unreplicated trials to evaluate clones in the early stages of selection. Commercial varieties that are replicated provide a method of local control of soil fertility. Although such methods may be useful in detecting broad trends in the field, variation often occurs on a much smaller scale. Methods such as spatial analysis adjust a plot for variability by using information from immediate neighbours. These techniques are routinely used to analyse cereal data in Australia and have resulted in increased accuracy and precision in the estimates of variety effects. In this paper, spatial analyses in which the variability is decomposed into local, natural, and extraneous components are applied to early selection trials in sugarcane. Interplot competition in cane yield and trend in sugar content were substantial in many of the trials and there were often large differences in the selections between the spatial and current method used by the Bureau of Sugar Experiment Stations. A joint modelling approach for tonnes sugar per hectare in response to fertility trends and interplot competition is recommended.