Attention, the intersection of cost and quality in health care

A method for assessing health care technology that models the demand on the clinician's attention exerted by patients' data (diagnostic and therapeutic) can provide a means for simultaneously reducing the cost and improving the quality of health care. The attentional demand exerted by patients' data can be measured by the amount of uncertainty in the data. Uncertainty can be expressed mathematically by the concept of entropy in information theory.     

An alternating digital tree (ADT) algorithm for 3D geometric searching and intersection problems

A searching algorithm is presented for determining which members of a set of n points in an N dimensional space lie inside a prescribed space subregion. The algorithm is then extended to handle finite size objects as well as points. In this form it is capable of solving problems such as that of finding the objects from a given set which intersect with a prescribed object. The suitability of the algorithm is demonstrated for the problem of three dimensional unstructured mesh generation using the advancing front method.     

Optimal management of logistic activities in multi-site environments

The new emerging area of Enterprise Wide Optimization (EWO) has focused the attention in effectively solving the combined production/distribution scheduling problem. The importance of logistic activities performed in multi-site environments comes from the relative magnitude of the associated transportation costs and the good chance of getting large savings on such expenses. This paper first develops an exact MILP mathematical formulation for the multiple vehicle time-window-constrained pickup and delivery (MVPDPTW) problem. The approach is able to account for many-to-many transportation requests, pure pickup and delivery tasks, heterogeneous vehicles and multiple depots. Optimal solutions for a variety of benchmark problems with cluster/random distributions of pickup and delivery locations and limited sizes in terms of customer requests and vehicles have been discovered. However, the computational cost exponentially grows with the number of requests. For large-scale m-PDPTW problems, a local search improvement algorithm steadily providing a better solution through two evolutionary steps is also presented. A neighborhood structure around the starting solution is generated by first allowing multiple request exchanges among nearby trips and then permitting the reordering of nodes on every individual route. If a better set of routes is found, both steps are repeated until no improved solution is discovered. Compact MILP mathematical formulations for both sub-problems have been developed and solved through an efficient branch-and-bound algorithm. A significant number of large-scale m-PDPTW benchmark problems, some of them including up to 100 transportation requests, were successfully solved in reasonable CPU times.     

2,4,6‐Trichlorophenol and phenol removal in methanogenic and partially‐aerated methanogenic conditions in a fluidized bed bioreactor

A fluidized bed bioreactor (FBBR) was operated for more than 575 days to remove 2,4,6‐trichlorophenol (TCP) and phenol (Phe) from a synthetic toxic wastewater containing 80 mg L^?1 of TCP and 20 mg L^?1 of Phe under two regimes: Methanogenic (M) and Partially‐Aerated Methanogenic (PAM). The mesophilic, laboratory‐scale FBBR consisted of a glass column (3 L capacity) loaded with 1 L of 1 mm diameter granular activated carbon colonized by an anaerobic consortium. Sucrose (1 g COD L^?1) was used as co‐substrate in the two conditions. The hydraulic residence time was kept constant at 1 day. Both conditions showed similar TCP and Phe removal (99.9 + %); nevertheless, in the Methanogenic regime, the accumulation of 4‐chlorophenol (4CP) up to 16 mg L^?1 and phenol up to 4 mg L^?1 was observed, whereas in PAM conditions 4CP and other intermediates were not detected. The specific methanogenic activity of biomass decreased from 1.01 ± 0.14 in M conditions to 0.19 ± 0.06 mmolCH₄ h^?1 gTKN^?1 in PAM conditions whereas the specific oxygen uptake rate increased from 0.039 ± 0.008 in M conditions to 0.054 ± 0.012 mmolO₂ h^?1 gTKN^?1, which suggested the co‐existence of both methanogenic archaea and aerobic bacteria in the undefined consortium. The advantage of the PAM condition over the M regime is that it provides for the thorough removal of less‐substituted chlorophenols produced by the reductive dehalogenation of TCP rather than the removal of the parent compound itself. Copyright © 2005 Society of Chemical Industry     

Study of 18-cm long single-sided AC-coupled silicon microstripdetectors

The SSC GEM silicon Central Tracker design incorporated 18-cm long single-sided AC-coupled silicon microstrip ladders. Compared to the 12-cm long ladders considered in the preliminary stages of the tracker design, the 18-cm long ladders have the advantage of reduced cost, channel count and overall power consumption, and led to a simplified tracker assembly. However, such long ships also present the challenge of maintaining satisfactory performance. The increased capacitance and series resistance contribute to lower signal-to-noise ratios, longer time walk, higher power consumption per channel and increased probability of crosstalk to neighboring channels. In this paper, an accurate method to calculate the geometric capacitance of the AC-coupled microstrips is presented and the calculated results are compared with measurements, SPICE simulations are performed to predict the noise, the extent of interstrip capacitive coupling and the dispersion of the detector signal due to the finite series resistance of the metal strips and the long length of the detector. The influence of the preamplifier current and the shaping time on the signal and noise levels is also presented. The study concludes that the 18-cm long ladders can successfully satisfy the performance goals of the GEM silicon Central Tracker     

Combination cytotoxic effects of cis-diamminedichloroplatinum(II) and 5-fluorouracil with and without leucovorin against human non-small cell lung cancer cell lines

Both cisplatin (CDDP) and leucovorin (LV) have been shown to enhance cytotoxicity of 5-fluorouracil (FUra) against murine and human neoplasms by increasing intracellular reduced folate concentrations. We were interested in their use in a combination to inhibit non-small cell lung cancer (NSCLC) cell growth and therefore conducted an in vitro study to investigate the cytotoxic activities of combinations of CDDP plus FUra, with and without LV (20 microM), against seven NSCLC cell lines. A tetrazolium assay with application of the classical isobole method was used to test drug combinations. We found that LV enhanced FUra but not CDDP cytotoxicity and that the degree of enhancement was negatively correlated with the effect of FUra. There was an overall additive combination effect of CDDP plus FUra, although there may be synergy at higher effect levels. There was synergy to a combination of CDDP, FUra, and LV, presumably primarily related to the synergistic effects of adding LV to FUra. In summary, LV and CDDP enhanced FUra cytotoxicity in a complementary fashion and there was clear synergy of a combination of CDDP, FUra, and LV against a panel of NSCLC cell lines. Our in vitro results provide a rationale for controlled clinical studies of this three-drug regimen in patients with NSCLC.     

Early detection and trellis splicing: reduced-complexity iterativedecoding

The bit-error rate (BER) performance of new iterative decoding algorithms (e,g,, turbodecoding) is achieved at the expense of a computationally burdensome decoding procedure. We present a method called early detection that can be used to reduce the computational complexity of a variety of iterative decoders. Using a confidence criterion, some information symbols, state variables, and codeword symbols are detected early on during decoding. In this way, the computational complexity of further processing is reduced with a controllable increase in the BER. We present an easily implemented instance of this algorithm, called trellis splicing, that can be used with turbodecoding. For a simulated system of this type, we obtain a reduction in the computational complexity of up to a factor of four, relative to a turbodecoder that obtains the same increase in the BER by performing fewer iterations