Modelling Patient Duration of Stay to Facilitate Resource Management of Geriatric Hospitals

A fundamental aspect of health care management is the effective allocation of resources. This is of particular importance in geriatric hospitals where elderly patients tend to have more complex needs. Hospital managers would benefit immensely if they had advance knowledge of patient duration of stay in hospital. Managers could assess the costs of patient care and make allowances for these in their budget. In this paper, we tackle this important problem via a model which predicts the duration of stay distribution of patients in hospital. The approach uses phase-type distributions conditioned on a Bayesian belief network.

Using Coxian Phase-Type Distributions to Identify Patient Characteristics for Duration of Stay in Hospital

Coxian phase-type distributions are a special type of Markov model that describes duration until an event occurs in terms of a process consisting of a sequence of latent phases. This paper considers the use of Coxian phase-type distributions for modelling patient duration of stay for the elderly in hospital and investigates the potential for using the resulting distribution as a classifying variable to identify common characteristics between different groups of patients according to their (anticipated) length of stay in hospital. The identification of common characteristics for patient length of stay groups would offer hospital managers and clinicians possible insights into the overall management and bed allocation of the hospital wards.

Multi-pulse scheme for enhancing electron localization through vibrational wavepacket manipulation

A novel scheme for enhancing electron localization in intense-field dissociation is outlined. Through manipulation of a bound vibrational wavepacket in the exemplar deuterium molecular ion, simulations demonstrate that the application of multiple phase-locked, few-cycle IR pulses can provide a powerful scheme for directing the molecular dissociation pathway. By tuning the time delay and carrier–envelope–phase for a sequence of pulse interactions, the probability of the electron being localized to a chosen nucleus can be enhanced to above 80%.

Diagnostic based modelling of radio-frequency driven atmospheric pressure plasmas

Diagnostic based modelling (DBM) actively combines complementary advantages of numerical plasma simulations and relatively simple optical emission spectroscopy (OES). DBM is employed to determine absolute atomic oxygen ground state densities in a helium–oxygen radio-frequency driven atmospheric pressure plasma jet. A comparatively simple one-dimensional simulation yields detailed information on electron properties governing the population dynamics of excited states. Important characteristics of the electron dynamics are found to be largely insensitive to details of the chemical composition and to be in very good agreement with space and phase-resolved OES. Benchmarking the time and space resolved simulation allows us to subsequently derive effective excitation rates as the basis for DBM with simple space and time integrated OES. The population dynamics of the upper O 3p 3P (? = 844 nm) atomic oxygen state is governed by direct electron impact excitation, dissociative excitation, radiation losses and collisional induced quenching. Absolute values for atomic oxygen densities are obtained through tracer comparison with the upper Ar 2p1 (? = 750.4 nm) state. The presented results for the atomic oxygen density show excellent quantitative agreement with independent two-photon laser-induced fluorescence measurements.

Characterisation of virus transport and attenuation in epikarst using short pulse and prolonged injection multi-tracer testing

Attenuation processes controlling virus fate and transport in the vadose zone of karstified systems can strongly influence groundwater quality. This research compares the breakthrough of two bacteriophage tracers (H40/1 and T7), with contrasting properties, at subsurface monitoring points following application onto an overlying composite sequence of thin organic soil and weathered limestone (epikarst). Short pulse multi-tracer test results revealed that T7 (Source concentration, Co=1.8x106pfu/mL) and H40/1(Co=5.9x106pfu/mL) could reach sampling points 10m below ground less than 30 minutes after tracer application. Contrasting deposition rates, determined from simulated tracer responses, reflected the potential of the ground to differentially attenuate viruses. Prolonged application of both T7 (Co=2.3x104pfu/mL) and H40/1 (Co=1.3x105pfu/mL) over a five hour period during a subsequent test, in which ionic strength levels observed at monitoring points rose consistently, corresponded to a rapid rise in T7 levels, followed by a gradual decline before the end of tracer injection; this reflected reaction-limited deposition in the system. T7’s response contrasted with that of H40/1, whose concentration remained constant over a three hour period before declining dramatically prior to the end of tracer injection. Subsequent application of lower ionic strength tracer-free flush water generated a rapid rise in H40/1 levels and a more gradual release of T7. Results highlight the benefits of employing prolonged injection multi-tracer tests for identifying processes not apparent from conventional short pulse tests. Study findings demonstrate that despite rapid transport rates, the epikarst is capable of physicochemical filtration of viruses and their remobilization, depending on virus type and hydrochemical conditions.

Experimenting with the Coxian Phase-Type Distribution to Uncover Suitable Fits

In the past few decades, Coxian phase-type distributions have become increasingly more popular as a means of representing survival times. In healthcare, they are considered suitable for modelling the length of stay of patients in hospital and more recently for modelling the patient waiting times in Accident and Emergency Departments. The Coxian phase-type distribution has not only been shown to provide a good representation of real survival data, but its interpretation seems reasonably initiative to the medical experts. The drawback, however, is fitting the distribution to the data. There have been many attempts at accurately estimating the Coxian phase-type parameters. This paper wishes to examine the most promising of the approaches reported in the literature to determine the most accurate. Three performance measures are introduced to assess the fitting process of the algorithms along with the likelihood values and AIC to examine the goodness of fit and complexity of the model. Previous research suggests that the fitting process is strongly influenced by the initial parameter estimates and the data itself being quite variable. To overcome this, one experiment in this research paper will use the same initial parameter values for each estimation and perform the fits on the data simulated from a Coxian phase-type distribution with known parameters.

Formulation of Locally Reacting Surfaces in FDTD/K-DWM Modelling of Acoustic Spaces

In this paper, we present new methods for constructing and analysing formulations of locally reacting surfaces that can be used in finite difference time domain (FDTD) simulations of acoustic spaces. Novel FDTD formulations of frequency-independent and simple frequency-dependent impedance boundaries are proposed for 2D and 3D acoustic systems, including a full treatment of corners and boundary edges. The proposed boundary formulations are designed for virtual acoustics applications using the standard leapfrog scheme based on a rectilinear grid, and apply to FDTD as well as Kirchhoff variable digital waveguide mesh (K-DWM) methods. In addition, new analytic evaluation methods that accurately predict the reflectance of numerical boundary formulations are proposed. numerical experiments and numerical boundary analysis (NBA) are analysed in time and frequency domains in terms of the pressure wave reflectance for different angles of incidence and various impedances. The results show that the proposed boundary formulations structurally adhere well to the theoretical reflectance. In particular, both reflectance magnitude and phase are closely approximated even at high angles of incidence and low impedances. Furthermore, excellent agreement was found between the numerical boundary analysis and the experimental results, validating both as tools for researching FDTD boundary formulations.

On the Distribution of Signal Phase in Body Area Networks

In this letter, we investigate the distribution of the phase component of the complex received signal observed in practical experiments using body area networks. Two phase distributions, the recently proposed kappa-mu and eta-mu probability densities, which together encompass the most widely used fading models, namely Semi-Gaussian, Rayleigh, Hoyt, Rice, and Nakagami-m, have been compared with measurement data. The kappa-mu distribution has been found to provide the best fit over a range of on-body links, while the user was mobile. The experiments were carried out in two dissimilar indoor environments at opposite ends of the multipath spectrum. It has also been found that the uniform phase distribution has not arisen in anyone of the experiments.

Rapid confirmatory method for the determination of sixteen synthetic growth promoters and bisphenol A in bovine milk using dispersive solid-phase extraction and liquid chromatography-tandem mass spectrometry

A rapid liquid chromatographic-tandem mass spectrometric (LC-MS/MS) multi-residue method for the simultaneous quantitation and identification of sixteen synthetic growth promoters and bisphenol A in bovine milk has been developed and validated. Sample preparation was straightforward, efficient and economically advantageous. Milk was extracted with acetonitrile followed by phase separation with NaCl. After centrifugation, the extract was purified by dispersive solid-phase extraction with C18 sorbent material. The compounds were analysed by reversed-phase LC-MS/MS using both positive and negative ionization and operated in multiple reaction monitoring (MRM) mode, acquiring two diagnostic product ions from each of the chosen precursor ions for unambiguous confirmation. Total chromatographic run time was less than 10 min for each sample. The method was validated at a level of 1 mu g L-1. A wide variety of deuterated internal standards were used to improve method performance. The accuracy and precision of the method were satisfactory for all analytes. The confirmative quantitative liquid chromatographic tandem mass spectrometric (LC-MS/MS) method was validated according to Commission Decision 2002/657/EC. The decision limit (CC alpha) and the detection capability (CC beta) were found to be below the chosen validation level of 1 mu g L-1 for all compounds. (C) 2010 Elsevier B.V. All rights reserved.

Applying species distribution modelling to identify areas of high conservation value for endangered species: A case study using Margaritifera margaritifera (L.)

The development and implementation of a population supplementation and restoration plan for any endangered species should involve an understanding of the species’ habitat requirements prior to the release of any captive bred individuals. The freshwater pearl mussel, Margaritifera margaritifera, has undergone dramatic declines over the last century and is now globally endangered. In Northern Ireland, the release of captive bred individuals is being used to support wild populations and repatriate the species in areas where it once existed. We employed a combination of maximum entropy modelling (MAXENT) and Generalized Linear Mixed Models (GLMM) to identify ecological parameters necessary to support wild populations using GIS-based landscape scale and ground-truthed habitat scale environmental parameters. The GIS-based landscape scale model suggested that mussel occurrence was associated with altitude and soil characteristics including the carbon, clay, sand, and silt content. Notably, mussels were associated with a relatively narrow band of variance indicating that M. margaritifera has a highly specific landscape niche. The ground-truthed habitat scale model suggested that mussel occurrence was associated with stable consolidated substrates, the extent of bankside trees, presence of indicative macrophyte species and fast flowing water. We propose a three phase conservation strategy for M. margaritifera identifying suitable areas within rivers that (i) have a high conservation value yet needing habitat restoration at a local level, (ii) sites for population supplementation of existing populations and (iii) sites for species reintroduction to rivers where the mussel historically occurred but is now locally extinct. A combined analytical approach including GIS-based landscape scale and ground-truthed habitat scale models provides a robust method by which suitable release sites can be identified for the population supplementation and restoration of an endangered species. Our results will be highly influential in the future management of M. margaritifera in Northern Ireland.

Automated nonlinear system modelling with multiple neural networks

This article discusses the identification of nonlinear dynamic systems using multi-layer perceptrons (MLPs). It focuses on both structure uncertainty and parameter uncertainty, which have been widely explored in the literature of nonlinear system identification. The main contribution is that an integrated analytic framework is proposed for automated neural network structure selection, parameter identification and hysteresis network switching with guaranteed neural identification performance. First, an automated network structure selection procedure is proposed within a fixed time interval for a given network construction criterion. Then, the network parameter updating algorithm is proposed with guaranteed bounded identification error. To cope with structure uncertainty, a hysteresis strategy is proposed to enable neural identifier switching with guaranteed network performance along the switching process. Both theoretic analysis and a simulation example show the efficacy of the proposed method.

On the Capacity of Non-Uniform Phase MIMO Nakagami-m Fading Channels

This letter investigates the ergodic capacity of MIMO Nakagami-m fading channels with both uniformly and non-uniformly distributed phases. We first obtain a tight capacity upper bound for the channel and then derive exact expressions for the low signal-to-noise ratio (SNR) capacity metrics, based on which we examine the impact of fading parameter m on the capacity.

An integrated multi-sensor data fusion algorithm and autopilot iImplementation in an uninhabited surface craft

Unmanned surface vehicles (USVs) are able to accomplish difficult and challenging tasks both in civilian and defence sectors without endangering human lives. Their ability to work round the clock makes them well-suited for matters that demand immediate attention. These issues include but not limited to mines countermeasures, measuring the extent of an oil spill and locating the source of a chemical discharge. A number of USV programmes have emerged in the last decade for a variety of aforementioned purposes. Springer USV is one such research project highlighted in this paper. The intention herein is to report results emanating from data acquired from experiments on the Springer vessel whilst testing its advanced navigation, guidance and control (NGC) subsystems. The algorithms developed for these systems are based on soft-computing methodologies. A novel form of data fusion navigation algorithm has been developed and integrated with a modified optimal controller. Experimental results are presented and analysed for various scenarios including single and multiple waypoints tracking and fixed and time-varying reference bearings. It is demonstrated that the proposed NGC system provides promising results despite the presence of modelling uncertainty and external disturbances.

Phase transformations in maraging steels

Research on the kinetics of precipitate formation and austenite reversion in maraging steels has received great attention due to their importance to steel properties. Judging from the literature in recent years, research into maraging steels has been very active, mainly extending to new types of steels, for new applications beyond the traditional strength requirements. This chapter provides an in-depth overview of the literature in this area. In addition, the kinetics of precipitate formation are analysed using the Johnson–Mehl–Avrami (JMA) theory.