Length of stay prediction for clinical treatment process using temporal similarity

In clinical treatment processes, inpatient length of stay (LOS) is not only a readily available indicator of hospital activity, but also a reasonable proxy of resource consumption. Accurate inpatient LOS prediction has strong implications for health service delivery. Major techniques proposed (statistical approaches or artificial neuronal networks) consider a priori knowledge, such as demographics or patient physical factors, providing accurate methods to estimate LOS at early stages of the patient (admission). However, unexpected scenarios and variations are commonplaces of clinical treatment processes that have a dramatical impact on the LOS. Therefore, these predictors should deal with adaptability, considering the temporal evolution of the patient. In this paper, we propose an inpatient LOS prediction approach across various stages of clinical treatment processes. This proposal relies on a kind of regularity assumption demanding that patient traces of the specific treatment process with similar medical behaviors have similar LOS. Therefore, this approach follows a Case-based Reasoning methodology since it predicts an inpatient LOS of a partial patient trace by referring to the past traces of clinical treatment processes that have similar medical behaviors with the current one. The proposal is evaluated using 284 patient traces from the pulmonary infection CTPs, extracted from Zhejiang Huzhou Central Hospital of China.     

Oral Absorption and Disposition of alpha‐Linolenic,Rumenic and Vaccenic Acids After Administration as a Naturally Enriched Goat Dairy Fat to Rats

Although there is extensive information describing the positive biological effects of conjugated linoleic acid and its main isomer rumenic acid (RA; C18:2 cis 9, trans 11), and alpha‐linolenic acid (ALA) and vaccenic acid (TVA), data about their bioavailability are not available. In this work, we investigated the oral absorption and disposition of these fatty acids in Wistar rats. A naturally enriched goat dairy fat (EDF) was obtained by supplementing ruminant diets with oils or oilseeds rich in polyunsaturated fatty acids (PUFA). The EDF was administered orally (single dose of 3000 mg EDF/kg body weight equivalent to 153 mg TVA/kg body weight, 46 mg RA/kg body weight and 31 mg ALA/kg body weight), and serial blood and liver samples were collected and TVA, RA and ALA concentrations determined by GC/MS. The fatty acids TVA, RA and ALA were rapidly absorbed (t_1/2a, 0.36, 0.66 and 0.76 h, respectively, for plasma) and slowly eliminated (t_1/2β, 17.04, 18.40 and 16.52 h, respectively, for plasma). The maximum concentration (C_max) was detected in liver > plasma > erythrocyte. Our study shows that when orally administered EDF, its components TVA, RA and ALA were rapidly absorbed and distributed throughout the body by the blood circulation to exert systemic effects.     

Influence of NaCl,Na2SO4 and O2 on power generation from microbial fuel cells with non-catalyzed carbon electrodes and natural inocula

Microbial fuel cells (MFCs) are facing several technological challenges before they can be considered as reliable energy sources. Although several feasible inocula, materials and catalysts have been employed to produce energy, the design of a MFC should be done under realistic conditions: abundant and economic feedstock. In this study, two different MFC designs (parallel plate and tank reactors) are tested with non-catalyzed carbon electrodes and natural inocula. In both approaches cathodic oxygen reduction is performed on two different non-catalyzed carbon materials: carbon fabric and reticulate vitreous carbon. This study shows that power and current densities can be boosted by systematically decreasing the catholyte resistance (by additions of NaCl or Na₂SO₄) and dissolved oxygen concentration. In the parallel plate cell configuration, a mixed culture coming from sludge wastewater was used and power outputs up to 73 mW m^?2 (2867 mW m^?3) coupled to 187 mA m^?2 (anode surface area), were achieved. In the Sediment MFC cell configuration, lagoon sediment was used as both organic source of energy and natural supply of bacteria. Under this approach, the concentration of the organic matter is limited but it is demonstrated that bacteria can be adapted to degrade acetate. Power outputs up to 3.9 mW m^?2 normalized to the anodic electrode footprint area, coupled to 13 mA m^?2 were achieved.     

Optical sensing by transforming chromophoric silver clusters in DNA nanoreactors

Bifunctional DNA oligonucleotides serve as templates for chromophoric silver clusters and as recognition sites for target DNA strands, and communication between these two components is the basis of an oligonucleotide sensor. Few-atom silver clusters exhibit distinct electronic spectra spanning the visible and near-infrared region, and they are selectively synthesized by varying the base sequence of the DNA template. In these studies, a 16-base cluster template is adjoined with a 12-base sequence complementary to the target analyte, and hybridization induces structural changes in the composite sensor that direct the conversion between two spectrally and stoichiometrically distinct clusters. Without its complement, the sensor strand selectively harbors ~7 Ag atoms that absorb at 400 nm and fold the DNA host. Upon association of the target with its recognition site, the sensor strand opens to expose the cluster template that has the binding site for ~11 Ag atoms, and absorption at 720 nm with relatively strong emission develops in lieu of the violet absorption. Variations in the length and composition of the recognition site and the cluster template indicate that these types of dual-component sensors provide a general platform for near-infrared-based detection of oligonucleotides in challenging biological environments.     

Autonomic cardiovascular control following transient arousal from sleep: a time-varying closed-loop model

Recent studies suggest that exposure to repetitive episodes of hypoxia and transient arousal can lead to increased risk for cardiovascular disease in patients with obstructive sleep apnea syndrome (OSAS). To obtain an improved understanding of and to quantitatively characterize the autonomic effects of arousal from sleep, a time-varying closed-loop model was used to determine the interrelationships among respiration, heart rate and blood pressure in 8 normal adults. A recursive least squares algorithm was used in combination with the Laguerre expansion technique to estimate the time-varying impulse responses of the 4 model components. We found that during arousal: 1) respiratory-cardiac coupling gain increases in nonrapid-eye movement (NREM) but not in REM sleep; 2) in both NREM and REM sleep, baroreflex gain shows an initial increase, but this is followed by a more sustained decrease below pre-arousal baseline levels, allowing sympathetic tone to be elevated over a relatively long duration; 3) the gains of other model components show increases with arousal that are consistent with the increased sympathetic modulation of systemic vascular resistance and contractility of the heart. These findings establish a normative database against which further measurements of cardiovascular arousal responses in OSAS may be compared.     

Supervised classification of remotely sensed data with ongoing learning capability

A methodology to implement an automatic system for classifying remotely sensed data with an ongoing learning capability is introduced. The Nearest Neighbour (NN) rule is employed as the central classifier and several techniques are added to cope with the increase in computational load and with the risk of incorporating noisy data into the training sample. Experimental results confirm the enhancement in classification accuracy.     

Thin-Layer Drying of Mate Leaves (Ilex paraguariensis) in a Conveyor-Belt Dryer: A Semi-Automatic Control Strategy Based on a Dynamic Model

A feedback strategy of drying control of mate leaves in a thin-layer conveyor-belt dryer was experimentally evaluated. Moisture content in the discharge of the continuous dryer was controlled by manually adjusting the speed of the moving belt between 3.7 × 10^?4 and 15.2 × 10^?4 m s^?1 for approximately 7200 s in 120 s time steps. The sets of PID controller parameters and manipulated conveyor velocities were computed with a dynamic drying model at conditions identical to those found in the closed-loop experiments. The model is represented by a system of two partial differential equations built by energy and solute mass balances in the solid phase of the dryer. A large set of experimental drying curves and temperature of mate leaves as a function of drying time, in the temperature range from 55 to 130°C, confirmed the reliability of the considered model. Experimental closed-loop responses of discharge moisture content in the presence of disturbances in the feed moisture content (≈ 0.5 ? 1.7 dry basis) and variations in set-point (≈ 0.1 ? 1.0 dry basis) validated the suggested control scheme.     

Photoelectrochemical study of the layered compound In23Pse3

The layered compound $\text{In}{}_{\mathrm{<mtext>2</mtext><mtext>3</mtext>}}\text{PSe}{}_3$ is studied by photoelectrochemical technique. Two modes of transition, indirect ～ 1.55 eV, and direct ～ 1.80 eV are evidenced. An estimation of the hole diffusion length is given through the use of Gärtner model ($\text{L}\text{? 4 μ}\text{m}$). The flat band positions of the junction $\text{In}{}_{\mathrm{<mtext>2</mtext><mtext>3</mtext>}}\text{PSe}{}_3\text{-}\text{electrolyte}$ at different pH values are determined in an electrochemical scale.     

Households contaminated by environmental tobacco smoke: sources of infant exposures

Objectives: To examine (1) whether dust and surfaces in households of smokers are contaminated with environmental tobacco smoke (ETS); (2) whether smoking parents can protect their infants by smoking outside and away from the infant; and (3) whether contaminated dust, surfaces, and air contribute to ETS exposure in infants.

Design: Quasi-experiment comparing three types of households with infants: (1) non-smokers who believe they have protected their children from ETS; (2) smokers who believe they have protected their children from ETS; (3) smokers who expose their children to ETS.

Setting: Homes of smokers and non-smokers.

Participants: Smoking and non-smoking mothers and their infants 1 year.

Main outcome measures: ETS contamination as measured by nicotine in household dust, indoor air, and household surfaces. ETS exposure as measured by cotinine levels in infant urine.

Results: ETS contamination and ETS exposure were 5–7 times higher in households of smokers trying to protect their infants by smoking outdoors than in households of non-smokers. ETS contamination and exposure were 3–8 times higher in households of smokers who exposed their infants to ETS by smoking indoors than in households of smokers trying to protect their children by smoking outdoors.

Conclusions: Dust and surfaces in homes of smokers are contaminated with ETS. Infants of smokers are at risk of ETS exposure in their homes through dust, surfaces, and air. Smoking outside the home and away from the infant reduces but does not completely protect a smoker's home from ETS contamination and a smoker's infant from ETS exposure.