Tracking the patient journey by combining multiple hospital database systems

With new national targets for patient flow in public hospitals designed to increase efficiencies in patient care and resource use, better knowledge of events affecting length of stay will support improved bed management and scheduling of procedures. This paper presents a case study involving the integration of material from each of three databases in operation at one tertiary hospital and demonstrates it is possible to follow patient journeys from admission to discharge. What is known about this topic? At present, patient data at one Queensland tertiary hospital are assembled in three information systems: (1) the Hospital Based Corporate Information System (HBCIS), which tracks patients from in-patient admission to discharge; (2) the Emergency Department Information System (EDIS) containing patient data from presentation to departure from the emergency department; and (3) Operation Room Management Information System (ORMIS), which records surgical operations. What does this paper add? This paper describes how a new enquiry tool may be used to link the three hospital information systems for studying the hospital journey through different wards and/or operating theatres for both individual and groups of patients. What are the implications for practitioners? An understanding of the patients’ journeys provides better insight into patient flow and provides the tool for research relating to access block, as well as optimising the use of physical and human resources.

Design of a TDD Multisector TDM MAC for the WiFiRe Proposal for Rural Broadband Access

The WiFiRe (WiFi Rural Extension) proposal for rural broadband access is being developed under the aegis of CEWIT. The system leverages the widely available, and highly cost-reduced, WiFi chipsets. However, only the physical layer from these chipsets is retained. A single base station carries several WiFi transceivers, each serving one sector of the cell, and all operating on the same WiFi channel in a time division duplex (TDD) manner. We replace the contention based WiFi MAC with a single-channel TDD multisector TDM MAC similar to the WiMax MAC. In this paper we discuss in detail the issues in designing such a MAC for the purpose of carrying packet voice telephony and for Internet access. The problem of determining the optimal spatial reuse is formulated and the optimal spatial reuse and the corresponding cell size is derived. Then the voice and data scheduler is designed. It is shown how throughput fairness can be implemented in the data scheduler. A capacity assessment of the system is also provided.

Microgrid frequency control using multiple battery energy storage system (BESSs)

The work is a report of research on using multiple inverters of Battery Energy Storage Systems with angle droop controllers to share real power in an isolated micro grid system consisting of inertia based Distributed Generation units and variable load. The proposed angle droop control method helps to balance the supply and demand in the micro grid autonomous mode through charging and discharging of the Battery Energy Storage Systems while ensuring that the state of charge of the storage devices is within safe operating conditions. The proposed method is also studied for its effectiveness for frequency control. The proposed control system is verified and its performance validated with simulation software MATLAB/SIMULINK.

Universal Access-NY User’s Guide

What is Universal Access-NY? Universal Access-NY is a complete online planning toolkit, www.UniversalAccessNY.org, where a One-Stop Delivery System can assess its practices, and develop work plans to improve physical and programmatic accessibility for all One-Stop customers. This web site and manual was developed by Cornell University’s Employment and Disability Institute, through the support and guidance of the New York State Department of Labor, with funding from two U.S. Department of Labor Work Incentive Grants (WIG 1 and 2). This web site was designed for use in a collaborative manner, bringing together One-Stop personnel, agency partners, business leaders and customers with disabilities. Universal Access-NY supports continuous improvement, with features that encourage multiple uses and incremental systems change.

Evaluation of a remote drafting system for regulating sheep access to supplement

Remote drafting technology now available for sheep makes possible targeted supplementation of individuals within a grazing flock. This system was evaluated by using 68 Merino wethers grazing dry-season, native Mitchell grass pasture (predominantly Astrebla spp.) as a group and receiving access to lupin grain through a remote drafter 0, 1, 2, 4 or 7 days/week for 8 weeks. The sole paddock watering point was separately fenced and access was via a one-way flow gate. Sheep exited the watering point through a remote drafter operated by solar power and were drafted by radio frequency identification (RFID) tag, according to treatment, either back into the paddock or into a common supplement yard where lupins were provided ad libitum in a self-feeder. Sheep were drafted into the supplement yard on only their first time through the drafter during the prescribed 24-h period and exited the supplement yard via one-way flow gates in their own time. The remote drafter operated with a high accuracy, with only 2.1% incorrect drafts recorded during the experimental period out of a total of 7027 sheep passes through the remote drafter. The actual number of accesses to supplement for each treatment group, in order, were generally less than that intended, i.e. 0.02, 0.69, 1.98, 3.35 and 6.04 days/week. Deviations from the intended number of accesses to supplement were mainly due to sheep not coming through to water on their allocated day of treatment access, although some instances were due to incorrect drafts. There was a non-linear response in growth rate to increased frequency of access to lupins with the growth rate response plateauing at similar to 3 actual accesses per week, corresponding to a growth rate of 72.5 g/head. day. This experiment has demonstrated the application of the remote drafting supplementation system for the first time under grazing conditions and with the drafter operated completely from solar power. The experiment demonstrates a growth response to increasing frequency of access to supplement and provides a starting point with which to begin to develop feeding strategies to achieve sheep weight-change targets.

Divide-and-Correct Algorithm for Division in a Negative Base

A divide-and-correct algorithm is described for multiple-precision division in the negative base number system. In this algorithm an initial quotient estimate is obtained from suitable segmented operands; this is then corrected by simple rules to arrive at the true quotient.

Divide-and-Correct Algorithm for Division in a Negative Base

A divide-and-correct algorithm is described for multiple-precision division in the negative base number system. In this algorithm an initial quotient estimate is obtained from suitable segmented operands; this is then corrected by simple rules to arrive at the true quotient.

Electronic Building Passport - Final Report: Project 2 National Energy Efficient Building Project Phase 2

The National Energy Efficient Building Project (NEEBP) Phase One report, published in December 2014, investigated “process issues and systemic failures” in the administration of the energy performance requirements in the National Construction Code. It found that most stakeholders believed that under-compliance with these requirements is widespread across Australia, with similar issues being reported in all states and territories. The report found that many different factors were contributing to this outcome and, as a result, many recommendations were offered that together would be expected to remedy the systemic issues reported. To follow up on this Phase 1 report, three additional projects were commissioned as part of Phase 2 of the overall NEEBP project. This Report deals with the development and piloting of an Electronic Building Passport (EBP) tool – a project undertaken jointly by pitt&sherry and a team at the Queensland University of Technology (QUT) led by Dr Wendy Miller. The other Phase 2 projects cover audits of Class 1 buildings and issues relating to building alterations and additions. The passport concept aims to provide all stakeholders with (controlled) access to the key documentation and information that they need to verify the energy performance of buildings. This trial project deals with residential buildings but in principle could apply to any building type. Nine councils were recruited to help develop and test a pilot electronic building passport tool. The participation of these councils – across all states – enabled an assessment of the extent to which these councils are currently utilising documentation; to track the compliance of residential buildings with the energy performance requirements in the National Construction Code (NCC). Overall we found that none of the participating councils are currently compiling all of the energy performance-related documentation that would demonstrate code compliance. The key reasons for this include: a major lack of clarity on precisely what documentation should be collected; cost and budget pressures; low public/stakeholder demand for the documentation; and a pragmatic judgement that non-compliance with any regulated documentation requirements represents a relatively low risk for them. Some councils reported producing documentation, such as certificates of final completion, only on demand, for example. Only three of the nine council participants reported regularly conducting compliance assessments or audits utilising this documentation and/or inspections. Overall we formed the view that documentation and information tracking processes operating within the building standards and compliance system are not working to assure compliance with the Code’s energy performance requirements. In other words the Code, and its implementation under state and territory regulatory processes, is falling short as a ‘quality assurance’ system for consumers. As a result it is likely that the new housing stock is under-performing relative to policy expectations, consuming unnecessary amounts of energy, imposing unnecessarily high energy bills on occupants, and generating unnecessary greenhouse gas emissions. At the same time, Councils noted that the demand for documentation relating to building energy performance was low. All the participant councils in the EBP pilot agreed that documentation and information processes need to work more effectively if the potential regulatory and market drivers towards energy efficient homes are to be harnessed. These findings are fully consistent with the Phase 1 NEEBP report. It was also agreed that an EBP system could potentially play an important role in improving documentation and information processes. However, only one of the participant councils indicated that they might adopt such a system on a voluntary basis. The majority felt that such a system would only be taken up if it were: - A nationally agreed system, imposed as a mandatory requirement under state or national regulation; - Capable of being used by multiple parties including councils, private certifiers, building regulators, builders and energy assessors in particular; and - Fully integrated into their existing document management systems, or at least seamlessly compatible rather than a separate, unlinked tool. Further, we note that the value of an EBP in capturing statistical information relating to the energy performance of buildings would be much greater if an EBP were adopted on a nationally consistent basis. Councils were clear that a key impediment to the take up of an EBP system is that they are facing very considerable budget and staffing challenges. They report that they are often unable to meet all community demands from the resources available to them. Therefore they are unlikely to provide resources to support the roll out of an EBP system on a voluntary basis. Overall, we conclude from this pilot that the public good would be well served if the Australian, state and territory governments continued to develop and implement an Electronic Building Passport system in a cost-efficient and effective manner. This development should occur with detailed input from building regulators, the Australian Building Codes Board (ABCB), councils and private certifiers in the first instance. This report provides a suite of recommendations (Section 7.2) designed to advance the development and guide the implementation of a national EBP system.

A Kalman filter based strategy for linear structural system identification based on multiple static and dynamic test data

The problem of identification of stiffness, mass and damping properties of linear structural systems, based on multiple sets of measurement data originating from static and dynamic tests is considered. A strategy, within the framework of Kalman filter based dynamic state estimation, is proposed to tackle this problem. The static tests consists of measurement of response of the structure to slowly moving loads, and to static loads whose magnitude are varied incrementally; the dynamic tests involve measurement of a few elements of the frequency response function (FRF) matrix. These measurements are taken to be contaminated by additive Gaussian noise. An artificial independent variable τ, that simultaneously parameterizes the point of application of the moving load, the magnitude of the incrementally varied static load and the driving frequency in the FRFs, is introduced. The state vector is taken to consist of system parameters to be identified. The fact that these parameters are independent of the variable τ is taken to constitute the set of ‘process’ equations. The measurement equations are derived based on the mechanics of the problem and, quantities, such as displacements and/or strains, are taken to be measured. A recursive algorithm that employs a linearization strategy based on Neumann’s expansion of structural static and dynamic stiffness matrices, and, which provides posterior estimates of the mean and covariance of the unknown system parameters, is developed. The satisfactory performance of the proposed approach is illustrated by considering the problem of the identification of the dynamic properties of an inhomogeneous beam and the axial rigidities of members of a truss structure.

A Low ML-Decoding Complexity, High Coding Gain, Full-Rate, Full-Diversity STBC for 4 x 2 MIMO System

This paper proposes a full-rate, full-diversity space-time block code(STBC) with low maximum likelihood (ML) decoding complexity and high coding gain for the 4 transmit antenna, 2 receive antenna (4 x 2) multiple-input multiple-output (MIMO) system that employs 4/16-QAM. For such a system, the best code known is the DjABBA code and recently, Biglieri, Hong and Viterbo have proposed another STBC (BHV code) for 4-QAM which has lower ML-decoding complexity than the DjABBA code but does not have full-diversity like the DjABBA code. The code proposed in this paper has the same ML-decoding complexity as the BHV code for any square M-QAM but has full-diversity for 4- and 16-QAM. Compared with the DjABBA code, the proposed code has lower ML-decoding complexity for square M-QAM constellation, higher coding gain for 4- and 16-QAM, and hence a better codeword error rate (CER) performance. Simulation results confirming this are presented.

Medium access control schemes for local area networks with multiple priority function

This paper deals with the development and performance evaluation of three modified versions of a scheme proposed for medium access control in local area networks. The original scheme implements a collision-free and fair medium arbitration by using a control wire in conjunction with a data bus. The modifications suggested in this paper are intended to realize the multiple priority function in local area networks.

Defining the pathway to insulin-like growth factor system targeting in cancer

The insulin-like growth factors (IGEs; IGF-1 and IGF-2) play central roles in cell growth, differentiation, survival, transformation and metastasis. The biologic effects of the IGFs are mediated by the IGF-1 receptor (IGF-1R), a receptor tyrosine kinase with homology to the insulin receptor (IR). Dysregulation of the ICE system is well recognized as a key contributor to the progression of multiple cancers, with IGF-1R activation increasing the tumorigenic potential of breast, prostate, lung, colon and head and neck squamous cell carcinoma (HNSCC). Despite this relationship, targeting the IGF-1R has only recently undergone development as a molecular cancer therapeutic. As it has taken hold, we are witnessing a robust increase and interest in targeting the inhibition of IGF-1R signaling. This is accentuated by the list of over 30 drugs, including monoclonal antibodies (mAbs) and tyrosine kinase inhibitors (TKIs) that are under evaluation as single agents or in combination therapies 1]. The ICE-binding proteins (IGFBPs) represent the third component of the ICE system consisting of a class of six soluble secretory proteins. They represent a unique class of naturally occurring ICE-antagonists that bind to and sequester IGF-1 and IGF-2, inhibiting their access to the IGF-1R. Due to their dual targeting of the IGFs without affecting insulin action, the IGFBPs are an untapped ``third'' class of IGF-1R inhibitors. in this commentary, we highlight some of the significant aspects of and prospects for targeting the IGF-1R and describe what the future may hold. (C) 2010 Elsevier Inc. All rights reserved.

Particle filters for structural system identification using multiple test and sensor data: A combined computational and experimental study

The problem of structural system identification when measurements originate from multiple tests and multiple sensors is considered. An offline solution to this problem using bootstrap particle filtering is proposed. The central idea of the proposed method is the introduction of a dummy independent variable that allows for simultaneous assimilation of multiple measurements in a sequential manner. The method can treat linear/nonlinear structural models and allows for measurements on strains and displacements under static/dynamic loads. Illustrative examples consider measurement data from numerical models and also from laboratory experiments. The results from the proposed method are compared with those from a Kalman filter-based approach and the superior performance of the proposed method is demonstrated. Copyright (C) 2009 John Wiley & Sons, Ltd.

A Low-Complexity, Full-Rate, Full-Diversity 2 x 2 STBC with Golden Code's Coding Gain

This paper presents a low-ML-decoding-complexity, full-rate, full-diversity space-time block code (STBC) for a 2 transmit antenna, 2 receive antenna multiple-input multiple-output (MIMO) system, with coding gain equal to that of the best and well known Golden code for any QAM constellation. Recently, two codes have been proposed (by Paredes, Gershman and Alkhansari and by Sezginer and Sari), which enjoy a lower decoding complexity relative to the Golden code, but have lesser coding gain. The 2 x 2 STBC presented in this paper has lesser decoding complexity for non-square QAM constellations, compared with that of the Golden code, while having the same decoding complexity for square QAM constellations. Compared with the Paredes-Gershman-Alkhansari and Sezginer-Sari codes, the proposed code has the same decoding complexity for non-rectangular QAM constellations. Simulation results, which compare the codeword error rate (CER) performance, are presented.

On the improvement of diversity-multiplexing gain tradeoff in a training based TDD-simo system

This paper investigates the diversity-multiplexing gain tradeoff (DMT) of a time-division duplex (TDD) single-input multiple-output (SIMO) system with perfect channel state information (CSI) at the receiver (CSIR) and partial CSI at the transmitter (CSIT). The partial CSIT is acquired through a training sequence from the receiver to the transmitter. The training sequence is chosen in an intelligent manner based on the CSIR, to reduce the training length by a factor of r, the number of receive antennas. We show that, for the proposed training scheme and a given channel coherence time, the diversity order increases linearly with r for nonzero multiplexing gain. This is a significant improvement over conventional orthogonal training schemes.