Building Data-Driven Pathways From Routinely Collected Hospital Data:A Case Study on Prostate Cancer

Background: Routinely collected data in hospitals is complex, typically heterogeneous, and scattered across multiple Hospital Information Systems (HIS). This big data, created as a byproduct of health care activities, has the potential to provide a better understanding of diseases, unearth hidden patterns, and improve services and cost. The extent and uses of such data rely on its quality, which is not consistently checked, nor fully understood. Nevertheless, using routine data for the construction of data-driven clinical pathways, describing processes and trends, is a key topic receiving increasing attention in the literature. Traditional algorithms do not cope well with unstructured processes or data, and do not produce clinically meaningful visualizations. Supporting systems that provide additional information, context, and quality assurance inspection are needed. Objective: The objective of the study is to explore how routine hospital data can be used to develop data-driven pathways that describe the journeys that patients take through care, and their potential uses in biomedical research; it proposes a framework for the construction, quality assessment, and visualization of patient pathways for clinical studies and decision support using a case study on prostate cancer. Methods: Data pertaining to prostate cancer patients were extracted from a large UK hospital from eight different HIS, validated, and complemented with information from the local cancer registry. Data-driven pathways were built for each of the 1904 patients and an expert knowledge base, containing rules on the prostate cancer biomarker, was used to assess the completeness and utility of the pathways for a specific clinical study. Software components were built to provide meaningful visualizations for the constructed pathways. Results: The proposed framework and pathway formalism enable the summarization, visualization, and querying of complex patient-centric clinical information, as well as the computation of quality indicators and dimensions. A novel graphical representation of the pathways allows the synthesis of such information. Conclusions: Clinical pathways built from routinely collected hospital data can unearth information about patients and diseases that may otherwise be unavailable or overlooked in hospitals. Data-driven clinical pathways allow for heterogeneous data (ie, semistructured and unstructured data) to be collated over a unified data model and for data quality dimensions to be assessed. This work has enabled further research on prostate cancer and its biomarkers, and on the development and application of methods to mine, compare, analyze, and visualize pathways constructed from routine data. This is an important development for the reuse of big data in hospitals

Sinuous breakdown in a flat plate boundary layer exposed to free-stream turbulence

In a flat plate boundary layer, perturbed with streaks, breakdown occurs due to a secondary instability acting on the streaks. An experimental study using a water channel with static turbulence grid, revealed the presence of a sinuous secondary instability mode in the bypass transition process. Five sinuous instabilities are investigated in detail in the horizontal plane. The streamwise length scale of the sinuous instability is around $40\delta^*_{300}$ and the spanwise scale equals around $\delta^*_{300}$. Four main features are found in the underlying streak configuration and developing streak-streak interactions. Firstly, all instabilities arise in a streak configuration where two low speed streaks are located at a small spanwise distance from each other. Patches of low speed fluid (forming a discontinuity in the streak pattern) are present in the high speed streaks surrounding the unstable low speed streak. As a consequence of the streak-streak interactions at the discontinuities vortices arise in a staggered configuration. Finally, the vortices develop into three-dimensional structures after which the flow falls apart into smaller three-dimensional flow regions

Art. XII.—Case of Death from Inhaling Chemical Fumes in a Sulphuric Acid Chamber.:

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Morfologi dan sintaksis bahasa Kemak

Buku Morjologi dan Sintaksis Bahasa Kemak ini merupakan salah satu hasil Bagian Proyek Pembinaan Bahasa dan Sastra Indonesia dan Daerah Nusa Tenggara Timur tahun 1995/1996. Atas dasar pertanyaan umum di atas, penelitian ini bertujuan untuk memperoleh deskripsi yang jelas tentang struktur morfologi dan sintaksis bahasa Kemak . Deskripsi ini mencakup sistem fonologi yang meliputi identifikasi jenis dan distribusi fonem segmental dan pola suku kata, sistem morfologi bahasa Kemak yang mencakup jenis morfem dan proses morfologis serta jenis kata, dan sistem sintaksis yangmeliputi frase , klausa, struktur, tipe, dan pola kalimat

On the Feasibility of Maintenance Algorithms in Dynamic Graphs

Near ubiquitous mobile computing has led to intense interest in dynamic graph theory. This provides a new and challenging setting for algorithmics and complexity theory. For any graph-based problem, the rapid evolution of a (possibly disconnected) graph over time naturally leads to the important complexity question: is it better to calculate a new solution from scratch or to adapt the known solution on the prior graph to quickly provide a solution of guaranteed quality for the changed graph? In this paper, we demonstrate that the former is the best approach in some cases, but that there are cases where the latter is feasible. We prove that, under certain conditions, hard problems cannot even be approximated in any reasonable complexity bound --- i.e., even with a large amount of time, having a solution to a very similar graph does not help in computing a solution to the current graph. To achieve this, we formalize the idea as a maintenance algorithm. Using r-Regular Subgraph as the primary example we show that W[1]-hardness for the parameterized approximation problem implies the non-existence of a maintenance algorithm for the given approximation ratio. Conversely we show that Vertex Cover, which is fixed-parameter tractable, has a 2-approximate maintenance algorithm. The implications of NP-hardness and NPO-hardness are also explored

Dyslexia: A case study

Dyslexia is a diagnosis commonly used to categorize many of the learning disabilities a child may have. Tests including the Wechsler Adult Intelligent Scale-Revised (WAIS-R), Woodcock-Johnson Psychoeducational Battery-Revised (the WJ-R), Dyslexia Determination Test and the Dyslexia Screener are used to isolate those thought to have dyslexia. Although a treatment for dyslexia is not available, optometrists can use vision therapy to increase the efficiency and stamina of the visual system. The goal of vision therapy is to refine those skills a patient does have to better compensate for the problems associated with dyslexia