Profiling hospitals based on emergency readmission: a multilevel transition modelling approach

Emergency readmission is seen as an important part of the United Kingdom government policy to improve the quality of care that patients receive. In this context, patients and the public have the right to know how well different health organizations are performing. Most methods for profiling estimate the expected numbers of adverse outcomes (e.g. readmission, mortality) for each organization. A number of statistical concerns have been raised, such as the differences in hospital sizes and the unavailability of relevant data for risk adjustment. Having recognized these statistical concerns, a new framework known as the multilevel transition model is developed. Hospital specific propensities of the first, second and further readmissions are considered to be measures of performance, where these measures are used to define a new performance index. During the period 1997 and 2004, the national (English) hospital episodes statistics dataset comprise more than 5 million patient readmissions. Implementing a multilevel model using the complete population dataset could possibly take weeks to estimate the parameters. To resolve the problem, we extract 1000 random samples from the original data, where each random sample is likely to lead to differing hospital performance measures. For computational efficiency a Grid implementation of the model is developed. Analysing the output from the full 1000 sample, we noticed that 4 out of the 5 worst performing hospitals treating cancer patients were in London. These hospitals are known to be the leading NHS Trusts in England, providing diverse range of services to complex patients, and therefore it is inevitable to expect higher numbers of emergency readmissions.     

Model‐based code generation for HLA federates

This paper addresses the problem of automated code generation for a High Level Architecture compliant federate application given its behavior model. The behavior model is a part of the architectural model of a federation that the federate can participate in. The federate behavior model is based on Live Sequence Charts, adopted as the behavioral specification formalism in the Federation Architecture Metamodel (FAMM). FAMM serves as a formal language for describing federation architectures. An objective is to help the testing of federation architecture by means of its prototype implementation early in the development lifecycle. A further objective is to help developers construct complete federate applications that are well modularized. The approach to achieve these objectives is aspect‐oriented in that the generated code, which handles the federate's interactions with a federation execution, serves as the base code, where the computation logic is to be weaved as an aspect. Copyright © 2009 John Wiley & Sons, Ltd.     

A modified genetic algorithm for forecasting fuzzy time series

Fuzzy time series approaches are used when observations of time series contain uncertainty. Moreover, these approaches do not require the assumptions needed for traditional time series approaches. Generally, fuzzy time series methods consist of three stages, namely, fuzzification, determination of fuzzy relations, and defuzzification. Artificial intelligence algorithms are frequently used in these stages with genetic algorithms being the most popular of these algorithms owing to their rich operators and good performance. However, the mutation operator of a GA may cause some negative results in the solution set. Thus, we propose a modified genetic algorithm to find optimal interval lengths and control the effects of the mutation operator. The results of applying our new approach to real datasets show superior forecasting performance when compared with those obtained by other techniques.     

Metamodeling live sequence charts for code generation

This article presents a metamodeling study for Live Sequence Charts (LSCs) and Message Sequence Charts (MSCs) with an emphasis on code generation. The article discusses specifically the following points: the approach to building a metamodel for MSCs and LSCs, a metamodel extension from MSC to LSC, support for model-based code generation, and finally action model and domain-specific data model integration. The metamodel is formulated in metaGME, the metamodel language for the Generic Modeling Environment.

Effects of gamma irradiation on aflatoxins

Summary The effects of gamma irradiation on a mixture of aflatoxins B₁, B₂, G₁, G₂ were studied. Standard solutions of A and B were irradiated at 5, 10, and 20 kGy in a solution of water/DMSO (9+1, v/ v) by using a¹³⁷Cs source. The control (0 kGy) and irradiated samples were subjected to RP-HPLC analyses with methanol/water (4+5, v/v) as the mobile phase. Aflatoxin B₁ (AFB₁) was the most radio-sensitive of the four compounds. The radiosensitivity of the other aflatoxins, was in increasing order: G₂, B₂, G₁. Only about 5% of AFB₁ remained after irradiation of solution A at 5 kGy. When the concentration of solution B was increased two-fold, trace amounts of AFB₁ remained after irradiation doses of 10 and 20 kGy. Irradiation was found to be suitable for the destruction of aflatoxins in solution.

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Einfluß von Gammastrahlung auf die Aflatoxine

Zusammenfassung Der EinfluB von -Strahlen auf die Aflatoxinmischung B₁, B₂, G₁ und G₂ wurde untersucht. Standardlösungen A und B wurden mit -Strahlung von 5; 10; bzw. 20 kGy in der Lösung von Wasser/DMSO (9+1, v/v) unter Verwendung einer¹³⁷Cs-Quelle bestrahlt. Kontroll(0 kGy)-und bestrahlte Proben wurden der RP-HPLC Analyse unter Verwendung von Methanol/Wasser (4+5, v/v) als mobile Phase unterworfen. Aflatoxin B₁ (AFB₁) war die strahlenempfindlichste von den vier, die Strahlenempfindlichkeit der anderen Aflatoxine nahm bei 5 kGy in der Reihenfolge: G₂, B₂, G₁ zu. Nur ca. 5% von AFB₁ ist nach der Bestrahlung üibriggeblie-ben. Wenn sich die Konzentration zweifach erhöht (Lösung B), ist von AFB₁ nur eine Spur nach der 10 kGy- und 20 kGy-Bestrahlung übriggeblieben. Es wurde gefunden, daß die Bestrahlung zur Zerstörung der Aflatoxine in der Lösung geeignet ist.

     

Synthesis, photophysical and photochemical properties of crown ether substituted zinc phthalocyanines

The photophysical and photochemical properties of the tetra- and octa-12-crown-4-substituted zinc (II) phthalocyanines are reported for the first time in the scope of this work. The new compounds have been characterized by elemental analysis, IR, ¹H and ¹³C NMR spectroscopy, electronic spectroscopy and mass spectra. General trends are described for photodegradation, singlet oxygen and fluorescence quantum yields, and fluorescence lifetimes of these compounds in dimethylsulphoxide (DMSO). Photophysical and photochemical properties of phthalocyanine complexes are very useful for photodynamic therapy (PDT) applications. The effects of the substituents on the photophysical and photochemical parameters of the zinc (II) phthalocyanines (5, 6 and 7) are also reported. The singlet oxygen quantum yields (Φ_Δ) ranged from 0.48 to 0.78 are indicating the potential of the complexes as photosensitizers in applications of PDT. The fluorescences of the substituted ZnPc complexes are effectively quenched by benzoquinone (BQ).     

Multi-machine earliness and tardiness scheduling problem: an interconnected neural network approach

This paper addresses the problem of scheduling a set of independent jobs with sequence-dependent setups and distinct due dates on non-uniform multi-machines to minimize the total weighted earliness and tardiness, and explores the use of artificial neural networks as a valid alternative to the traditional scheduling approaches. The objective is to propose a dynamical gradient neural network, which employs a penalty function approach with time varying coefficients for the solution of the problem which is known to be NP-hard. After the appropriate energy function was constructed, the dynamics are defined by steepest gradient descent on the energy function. The proposed neural network system is composed of two maximum neural networks, three piecewise linear and one log-sigmoid network all of which interact with each other. The motivation for using maximum networks is to reduce the network complexity and to obtain a simplified energy function. To overcome the tradeoff problem encountered in using the penalty function approach, a time varying penalty coefficient methodology is proposed to be used during simulation experiments. Simulation results of the proposed approach on a scheduling problem indicate that the proposed coupled network yields an optimal solution which makes it attractive for applications of larger sized problems.     

Synthesis and electrophoretic deposition of hydrothermally synthesized multilayer TiO2 nanotubes on conductive filters

TiO₂ nanotubes were synthesized by the decomposition of titanium isopropoxide in water and the calcination at 450 °C for 2 h to form TiO₂ nanoparticles. The synthesized TiO₂ in anatase form nanoparticles were processed hydrothermally in 10 M NaOH solution at 130 °C for 24 h to obtain multilayer TiO₂ nanotubes. TEM analysis revealed that the diameters of the tubes were around 10 nm and they are in the length of 100 nm. Subsequently, colloidal suspensions containing 1% wt. Of TiO2 nanotubes were prepared with TEA and butanol and electrophoretic deposition (EPD) experiments were conducted in order to obtain coatings on Ni and carbon filters using a deposition time of 10 min. and an applied voltage of 65 V. It is also shown that multilayer TiO₂ nanotubes having outer diameter around 10 nm and inner diameters of 4.3 nm can be produced using the described technique. EPD is also shown to be an effective technique to coat three dimensional components, such as Ni and C filters for various applications including water and air purification systems.     

Laser damage thresholds of ITER mirror materials and first results on in situ laser cleaning of stainless steel mirrors

A laser ablation system has been constructed and used to determine the damage threshold of stainless steel, rhodium and single-, poly- and nanocrystalline molybdenum in vacuum, at a number of wavelengths between 220 nm and 1064 nm using 5 ns pulses. All materials show an increase of the damage threshold with decreasing wavelength below 400 nm. Tests in a nitrogen atmosphere showed a decrease of the damage threshold by a factor of 2–3. Cleaning tests have been performed in vacuum on stainless steel samples after applying mixed Al/W/C/D coatings using magnetron sputtering. In situ XPS analysis during the cleaning process as well ex situ reflectivity measurements demonstrate near complete removal of the coating and a substantial recovery of the reflectivity. The first results also show that the reflectivity obtained through cleaning at 532 nm may be further increased by additional exposure to UV light, in this case 230 nm, an effect which is attributed to the removal of tungsten dust from the surface.