A survey of health care models that encompass multiple departments

In this survey we review quantitative health care models to illustrate the extent to which they encompass multiple hospital departments. The paper provides general overviews of the relationships that exists between major hospital departments and describes how these relationships are accounted for by researchers. We find the atomistic view of hospitals often taken by researchers is partially due to the ambiguity of patient care trajectories. To this end clinical pathways literature is reviewed to illustrate its potential for clarifying patient flows and for providing a holistic hospital perspective

A comparison of techniques for learning and using mathematics and a study of their relationship to logical principles

Various techniques exist for learning mathematical concepts, like experimentation and exploration, respectively using mathematics, like modelling and simulation. For a clear application of such techniques in mathematics education, there should be a clear distinction between these techniques. A recently developed theory of fuzzy concepts can be applied to analyse the four mentioned concepts. For all four techniques one can pose the question of their relationship to deduction, induction and abduction as logical principles. An empirical study was conducted with 12-13 aged students, aiming at checking the three reasoning processes

Robust fractional order PI control for cardiac output stabilisation

Drug regulatory paradigms are dependent on the hemodynamic system as it serves to distribute and clear the drug in/from the body. While focusing on the objective of the drug paradigm at hand, it is important to maintain stable hemodynamic variables. In this work, a biomedical application requiring robust control properties has been used to illustrate the potential of an autotuning method, referred to as the fractional order robust autotuner. The method is an extension of a previously presented autotuning principle and produces controllers which are robust to system gain variations. The feature of automatic tuning of controller parameters can be of great use for data-driven adaptation during intra-patient variability conditions. Fractional order PI/PD controllers are generalizations of the well-known PI/PD controllers that exhibit an extra parameter usually used to enhance the robustness of the closed loop system. (C) 2019, IFAC (International Federation of Automatic Control) Hosting by Elsevier Ltd. All rights reserved

Preparation of chemotherapy drugs: planning policy for reduced waiting times

This study investigates the impact of pharmacy policies on patient waiting time in the Chemotherapy Day Unit of the Netherland Cancer Institute - Antoni van Leeuwenhoek hospital (NKI-AVL). The project evaluated whether a reduction in waiting time resulting from medication orders being prepared in advance of patient appointments was justified, given that medications prepared in advance risked being wasted if patients arrived too sick for treatment. Within this context, we derive explicit expressions to approximate patient waiting times and wastage costs allowing management to see the tradeoff between these two metrics for different policies. Using a case study and a simulation model, the approximations are evaluated. The explicit expressions allow the analysis to be easily repeated when medication costs change or when new medications/protocols are introduced. In the same vein, other hospitals with different patient case mixes can easily complete the analysis in their setting. Finally, the outcome from this study resulted in a new policy at the cancer centre which is expected to decrease the waiting time by half while only increasing pharmacy’s costs by 1-2%

Formal verification of an autonomous personal robotic assistant

Human–robot teams are likely to be used in a variety of situations wherever humans require the assistance of robotic systems. Obvious examples include healthcare and manufacturing, in which people need the assistance of machines to perform key tasks. It is essential for robots working in close proximity to people to be both safe and trustworthy. In this paper we examine formal verification of a high-level planner/scheduler for autonomous personal robotic assistants such as Care-O-bot ™ . We describe how a model of Care-O-bot and its environment was developed using Brahms, a multiagent workflow language. Formal verification was then carried out by translating this to the input language of an existing model checker. Finally we present some formal verification results and describe how these could be complemented by simulation-based testing and realworld end-user validation in order to increase the practical and perceived safety and trustworthiness of robotic assistants

Synthetic Observational Health Data with GANs: from slow adoption to a boom in medical research and ultimately digital twins?

After being collected for patient care, Observational Health Data (OHD) can further benefit patient well-being by sustaining the development of health informatics and medical research. Vast potential is unexploited because of the fiercely private nature of patient-related data and regulations to protect it. Generative Adversarial Networks (GANs) have recently emerged as a groundbreaking way to learn generative models that produce realistic synthetic data. They have revolutionized practices in multiple domains such as self-driving cars, fraud detection, digital twin simulations in industrial sectors, and medical imaging. The digital twin concept could readily apply to modelling and quantifying disease progression. In addition, GANs posses many capabilities relevant to common problems in healthcare: lack of data, class imbalance, rare diseases, and preserving privacy. Unlocking open access to privacy-preserving OHD could be transformative for scientific research. In the midst of COVID-19, the healthcare system is facing unprecedented challenges, many of which of are data related for the reasons stated above. Considering these facts, publications concerning GAN applied to OHD seemed to be severely lacking. To uncover the reasons for this slow adoption, we broadly reviewed the published literature on the subject. Our findings show that the properties of OHD were initially challenging for the existing GAN algorithms (unlike medical imaging, for which state-of-the-art model were directly transferable) and the evaluation synthetic data lacked clear metrics. We find more publications on the subject than expected, starting slowly in 2017, and since then at an increasing rate. The difficulties of OHD remain, and we discuss issues relating to evaluation, consistency, benchmarking, data modelling, and reproducibility.Comment: 31 pages (10 in previous version), not including references and glossary, 51 in total. Inclusion of a large number of recent publications and expansion of the discussion accordingl

Higher physical fitness levels are associated with less language decline in healthy ageing

Healthy ageing is associated with decline in cognitive abilities such as language. Aerobic fitness has been shown to ameliorate decline in some cognitive domains, but the potential benefits for language have not been examined. In a cross-sectional sample, we investigated the relationship between aerobic fitness and tip-of-the-tongue states. These are among the most frequent cognitive failures in healthy older adults and occur when a speaker knows a word but is unable to produce it. We found that healthy older adults indeed experience more tip-of-the-tongue states than young adults. Importantly, higher aerobic fitness levels decrease the probability of experiencing tip-of-the-tongue states in healthy older adults. Fitness-related differences in word finding abilities are observed over and above effects of age. This is the first demonstration of a link between aerobic fitness and language functioning in healthy older adults

A Spatio-Temporal Bayesian Network Classifier for Understanding Visual Field Deterioration

Progressive loss of the field of vision is characteristic of a number of eye diseases such as glaucoma which is a leading cause of irreversible blindness in the world. Recently, there has been an explosion in the amount of data being stored on patients who suffer from visual deterioration including field test data, retinal image data and patient demographic data. However, there has been relatively little work in modelling the spatial and temporal relationships common to such data. In this paper we introduce a novel method for classifying Visual Field (VF) data that explicitly models these spatial and temporal relationships. We carry out an analysis of this method and compare it to a number of classifiers from the machine learning and statistical communities. Results are very encouraging showing that our classifiers are comparable to existing statistical models whilst also facilitating the understanding of underlying spatial and temporal relationships within VF data. The results reveal the potential of using such models for knowledge discovery within ophthalmic databases, such as networks reflecting the ‘nasal step’, an early indicator of the onset of glaucoma. The results outlined in this paper pave the way for a substantial program of study involving many other spatial and temporal datasets, including retinal image and clinical data

Learning robot policies using a high-level abstraction persona-behaviour simulator

2019 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting /republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other worksCollecting data in Human-Robot Interaction for training learning agents might be a hard task to accomplish. This is especially true when the target users are older adults with dementia since this usually requires hours of interactions and puts quite a lot of workload on the user. This paper addresses the problem of importing the Personas technique from HRI to create fictional patients’ profiles. We propose a Persona-Behaviour Simulator tool that provides, with high-level abstraction, user’s actions during an HRI task, and we apply it to cognitive training exercises for older adults with dementia. It consists of a Persona Definition that characterizes a patient along four dimensions and a Task Engine that provides information regarding the task complexity. We build a simulated environment where the high-level user’s actions are provided by the simulator and the robot initial policy is learned using a Q-learning algorithm. The results show that the current simulator provides a reasonable initial policy for a defined Persona profile. Moreover, the learned robot assistance has proved to be robust to potential changes in the user’s behaviour. In this way, we can speed up the fine-tuning of the rough policy during the real interactions to tailor the assistance to the given user. We believe the presented approach can be easily extended to account for other types of HRI tasks; for example, when input data is required to train a learning algorithm, but data collection is very expensive or unfeasible. We advocate that simulation is a convenient tool in these cases.Peer ReviewedPostprint (author's final draft