Approximate Queueing Network Analysis of Patient Treatment Times

We develop an approximate generating function analysis (AGFA) technique which approximates the Laplace transform of the probability density function of customer response time in networks of queues with class-based priorities. From the approximated Laplace transform, we derive the first two moments of customer response time. This technique is applied to a model of a large hospitals Accident and Emergency department for which we obtain the mean and standard deviation of total patient service time. We experiment with different patient-handling priority schemes and compare the AGFA moments with the results from a discrete event simulation. Copyright 2007 ICST

A comparison of four functional test in discriminating fallers from non-fallers in older people

Purpose : Which functional tests on mobility and balance can better screen older people at risk of falls is unclear. This study aims to compare the Berg Balance Scale (BBS), Tinetti Mobility Score (TMS), Elderly Mobility Scale (EMS) and Timed Up and Go test (TUG) in discriminating fallers from non-fallers in older people. Method : This was a case-control study involving one rater who conducted a mobility and balance assessment on subjects using the four functional tests in random sequence. Subjects recruited included 17 and 22 older people with a history of single and multiple falls respectively from a public Falls Clinic, and 39 community-dwellers without fall history and whose age, sex and BMI matched those of the fallers. All subjects underwent the mobility and balance assessment within one day. Results : Single fallers performed better than multiple fallers in all four functional tests but were worse than non-fallers in the BBS, TMS and TUG. The BBS demonstrated the best discriminating ability, with high sensitivity and specificity. The BBS item \u27pick up an object from the floor\u27 was the best at screening fallers. Conclusion : BBS was the most powerful functional test of the four in discriminating fallers from non-faller

With others and for others: accounting for decisions about genetic testing in the Clinic

Poster PresentationWhile there are various factors influencing clients' decisions about genetic testing; testing for the sake of others is not uncommon. This paper focuses on decisions about testing (DOT) when a genetic mutation is identified in a Sudden Arrhythmia Death Syndromes (SADS) patient and it is unclear whether the mutation is the cause of the disease. Family members are then asked to consider genetic testing to ascertain the client’s genetic status and future risk. The paper examines, at the interactional level, how genetic counselors, clients and family members negotiate decisionmaking involving others. The data consists of 23 video-recorded consultations obtained from a Hong Kong hospital. Episodes of decisionmaking about testing are identified and extracted from the transcribed data. By using theme-oriented discourse analysis, the analysis focuses on the discourse strategies that participants employ to foreground the possible benefits when other family members undergo the genetic test. Preliminary findings show a disjuncture of perspectives between genetic counselors and family members in terms of the benefits of testing. While genetic counselors see testing as a means of confirming the diagnosis and managing risk, family members voice concerns about the usefulness of the test for a client's treatment. To mitigate these different perspectives on DOT, participants use a range of discourse strategies, such as contrast, foregrounding, self-and-other construction as a way of emphasizing future scenarios. This study, in sum, elucidates how other-oriented decisions are made in the clinical setting.published_or_final_versio

The Effect of the Disorder on the Longitudinal Resistance of a Graphene p-n Junction in Quantum Hall Regime

The longitudinal resistances of a six-terminal graphene p-n junction under a perpendicular magnetic field are investigated. Because of the chirality of the Hall edge states, the longitudinal resistances on top and bottom edges of the graphene ribbon are not equal. In the presence of suitable disorder, the top-edge and bottom-edge resistances well show the plateau structures in the both unipolar and bipolar regimes and the plateau values are determined by the Landau filling factors only. These plateau structures are in excellent agreement with the recent experiment. For the unipolar junction, the resistance plateaus emerge in the absence of impurity and they are destroyed by strong disorder. But for the bipolar junction, the resistances are very large without the plateau structures in the clean junction. The disorder can strongly reduce the resistances and leads the formation of the resistance plateaus, due to the mixture of the Hall edge states in virtue of the disorder. In addition, the size effect of the junction on the resistances is studied and some extra resistance plateaus are found in the long graphene junction case. This is explained by the fact that only part of the edge states participate in the full mixing.Comment: 7 pages, 5 figure

Multi-layered Gestalt in Real-time Interaction

In his PhD proposal, now published as Seeing Sociological, Garfinkel [2006] formulated action in terms of a mutually constitutive structure—the Noesis-Noema Structures. This structure can be traced to Aaron Gurwitsch’s gestalt psychology and Law of Good Gestalt which theorises how participants prioritise functional Gestalts over other possible meanings of what is perceivable in their surroundings. While Gurwitsch illustrated his theory using images, in this paper we revisit Gurwitsch’s theory in light of the advances in recording real-time interaction to consider Gestalt in spatio-temporality of real-time interaction. We consider the Law of Good Gestalt in terms of the dimensions of time and space, and postulate two analytical principles—the Principle of Good Momentary Gestalt and the Principle of Good Temporal Gestalt—for analysing a multi-angle video segment of a monologue taken from a training event. The analysis examines how the monologue was embedded in a multi-layer projection structure, so that during the time of the monologue, the trainer and trainees can be seen as achieving a transition between one activity to another while sustaining the frame of the training event. Through this, the analysis highlights the multi-layered structure of participants’ field of perception that constitutes their experience of the social activity, and explores a “method” to reconstruct such a structured field of perception through re-coupling meanings to the assemblages of multimodal resources recoverable on video

Disconnect Between Genes Associated With Ischemic Heart Disease and Targets of Ischemic Heart Disease Treatments

Background: Development of pharmacological treatments to mitigate ischemic heart disease (IHD) has encompassed disappointing results and expensive failures, which has discouraged investment in new approaches to prevention and control.Newtreatments aremost likely to be successful if they act on genetically validated targets. We assessed whether existing pharmacological treatments for IHD reduction are acting on genetically validated targets and whether all such targets for IHD are currently being exploited. Methods: Genes associatedwith IHDwere obtained fromthe loci of single nucleotide polymorphisms reported in either of two recent genome wide association studies supplemented by a gene-based analysis (accounting for linkage disequilibrium) of CARDIoGRAMplusC4D 1000 Genomes, a large IHD case (n = 60,801)-control (n = 123,504) study. Treatments targeting the products of these IHD genes and genes with products targeted by current IHD treatments were obtained from Kyoto Encyclopedia of Genes and Genomes and Drugbank. Cohen\u27s kappa was used to assess agreement. Results:Weidentified 173 autosomal genes associatedwith IHDand 236 autosomal genes with products targeted by current IHD treatments, only 8 genes (PCSK9, EDNRA, PLG, LPL, CXCL12, LRP1, CETP and ADORA2A) overlapped, i.e. were both associated with IHD and had products targeted by current IHD treatments. The Cohen\u27s kappa was 0.03. Interventions related to another 29 IHD genes exist, including dietary factors, environmental exposures and existing treatments for other indications. Conclusions: Closer alignment of IHD treatments with genetically validated physiological targets may represent a major opportunity for combating a leading cause of globalmorbidity andmortality through repurposing existing interventions

Dynamic combinatorial chemistry at the phospholipid bilayer interface

Abstract Background Molecular recognition at the environment provided by the phospholipid bilayer interface plays an important role in biology and is subject of intense investigation. Dynamic combinatorial chemistry is a powerful approach for exploring molecular recognition, but has thus far not been adapted for use in this special microenvironment. Results Thioester exchange was found to be a suitable reversible reaction to achieve rapid equilibration of dynamic combinatorial libraries at the egg phosphatidyl choline bilayer interface. Competing thioester hydrolysis can be minimised by judicial choice of the structure of the thioesters and the experimental conditions. Comparison of the library compositions in bulk solution with those in the presence of egg PC revealed that the latter show a bias towards the formation of library members rich in membrane-bound building blocks. This leads to a shift away from macrocyclic towards linear library members. Conclusions The methodology to perform dynamic combinatorial chemistry at the phospholipid bilayer interface has been developed. The spatial confinement of building blocks to the membrane interface can shift the ring-chain equilibrium in favour of chain-like compounds. These results imply that interfaces may be used as a platform to direct systems to the formation of (informational) polymers under conditions where small macrocycles would dominate in the absence of interfacial confinement. RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Are Preoperative Kattan and Stephenson Nomograms Predicting Biochemical Recurrence after Radical Prostatectomy Applicable in the Chinese Population?

Purpose. Kattan and Stephenson nomograms are based on the outcomes of patients with prostate cancer recruited in the USA, but their applicability to Chinese patients is yet to be validated. We aim at studying the predictive accuracy of these nomograms in the Chinese population. Patients and Methods. A total of 408 patients who underwent laparoscopic or open radical resection of prostate from 1995 to 2009 were recruited. The preoperative clinical parameters of these patients were collected, and they were followed up regularly with PSA monitored. Biochemical recurrence was defined as two or more consecutive PSA levels >0.4 ng/mL after radical resection of prostate or secondary cancer treatment. Results. The overall observed 5-year and 10-year biochemical recurrence-free survival rates were 68.3% and 59.8%, which was similar to the predicted values by the Kattan and Stephenson nomograms, respectively. The results of our study achieved a good concordance with both nomograms (Kattan: 5-years, 0.64; Stephenson: 5-years, 0.62, 10-years, 0.71). Conclusions. The incidence of prostate cancer in Hong Kong is increasing together with the patients’ awareness of this disease. Despite the fact that Kattan nomograms were derived from the western population, it has been validated in our study to be useful in Chinese patients as well

SCRIBBLE is required for pregnancy-induced alveologenesis in the adult mammary gland

The cell polarity protein SCRIB is a critical regulator of polarization, cell migration and tumourigenesis. Whereas SCRIB is known to regulate early stages of mouse mammary gland development, its function in the adult gland is not known. Using an inducible RNAi mouse model for downregulating SCRIB expression, we report an unexpected role for SCRIB as a positive regulator of cell proliferation during pregnancy associated mammary alveologenesis. SCRIB was required in the epithelial cell compartment of the mammary gland. Lack of SCRIB attenuated prolactin-induced activation of the JAK2/STAT5 signaling pathway. In addition, loss of SCRIB resulted in the downregulation of PRLR at cell surface and accumulation in intracellular structures that express markers of the Golgi apparatus and the recycling endosome. Unlike its role in virgin gland as a negative regulator cell proliferation, SCRIB is a positive regulator of mammary epithelial cell proliferation during pregnancy

Overexpression of Mechano-Growth Factor Modulates Inflammatory Cytokine Expression and Macrophage Resolution in Skeletal Muscle Injury

In muscle regeneration, infiltrating myeloid cells, such as macrophages mediate muscle inflammation by releasing key soluble factors. One such factor, insulin-like growth factor 1 (IGF-1), suppresses inflammatory cytokine expression and mediates macrophage polarization to anti-inflammatory phenotype during muscle injury. Previously the IGF-1Ea isoform was shown to be anti-inflammatory. Another isoform of IGF-1, mechano-growth factor (MGF), is structurally and functionally distinct from IGF-1Ea, but its role in muscle inflammation has not yet been characterized. In this study, we hypothesized that MGF expression in muscle injury modulates muscle inflammation. We first investigated changes of transcription and expression of MGF in response to skeletal muscle injury induced by cardiotoxin (CTX) in vivo. At 1–2 days post-injury, Mgf expression was significantly upregulated and positively correlated with that of inflammatory cytokines. Immunostaining revealed that infiltration of neutrophils and macrophages coincided with Mgf upregulation. Furthermore, infiltrating neutrophils and macrophages expressed Mgf, suggesting their contribution to MGF upregulation in muscle injury. Macrophages seem to be the predominant source of MGF in muscle injury, whereas neutrophil depletion did not affect muscle Mgf expression. Given the association of MGF and macrophages, we then studied whether MGF could affect macrophage infiltration and polarization. To test this, we overexpressed MGF in CTX-injured muscles and evaluated inflammatory marker expression, macrophage populations, and muscle regeneration outcomes. MGF overexpression delayed the resolution of macrophages, particularly the pro-inflammatory phenotype. This coincided with upregulation of inflammatory markers. Annexin V-based flow cytometry revealed that MGF overexpression likely delays macrophage resolution by limiting macrophage apoptosis. Although MGF overexpression did not obviously affect muscle regeneration outcomes, the findings are novel and provide insights on the physiological roles of MGF in muscle regeneration