An audit of acute oncology services: patient experiences of admission procedures and staff utilisation of a new telephone triage system.

OBJECTIVES: In 2010, St. James Institute of Oncology (Leeds, UK) created a new acute oncology service (AOS) consisting of a new admissions unit with a nurse-led telephone triage (TT) system. This audit cycle (March 2011 and June 2013) evaluated patient experiences of the reconfigured AOS and staff use of the TT system. METHODS: Patient views were elicited via a questionnaire and semi-structured interviews. The TT forms were analysed descriptively evaluating completion and data quality, reported symptoms and their severity and advice given (including admission rates). RESULTS: Patients (n = 40) reported high satisfaction with the new AOS. However, 56 % of patients delayed 2 days or more before contacting the unit. In 2011, 26 % of all the admitted patients were triaged via the TT system; 133 TT forms were completed. In June 2013, 49 % of the admitted patients were triaged; 264 forms were completed. The most commonly reported symptoms on the TT forms were pain, pyrexia/rigors/infection, diarrhoea, vomiting and dyspnoea. Half of the patients using the TT system were admitted (52 % in 2011, 49 % in 2013). CONCLUSIONS: Our audit provided evidence of successful implementation of the TT system with the number of TT forms doubling from 2011 to 2013. The new AOS was endorsed by patients, with the majority satisfied with the care they received

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Data Engineering

Chimera is a novel database language jointly designed by researchers at Politecnico di Milano, Bonn University, and ECRC of Munich in the context of the Esprit Project P6333, IDEA. Chimera integrates an object-oriented data model, a declarative query language based on deductive rules, and an active rule language for reactive processing. In this paper, we present the authors&apos; proposal for constraint management in Chimera, which relies on the declarative specification of passive constraints as deductive rules and on their transformation into different types of active rules. 1 Introduction Constraints are declarative specifications of properties that must be satisfied in any database instance. In OODBs constraints are typically used to restrict the admissible extension of a class, to impose restrictions on the state of individual objects, or to specify general laws that must be obeyed by sets of objects possibly belonging to different classes. To face violations of a constraint by an u..

Monitoring CO2 Storage Sites Onshore and Offshore using InSAR Data and Strain Sensing Fibre Optics Cables

A key requirement for geological CO2 storage is site integrity management and monitoring during operation through to the post decommissioning period. This paper focuses on monitoring deformation of the ground surface and seabed as a proxy for overall deformation in the reservoir and surrounding layers. The objective is to inform, based on deformation data, on how the reservoir is responding to CO2 injection and to ensure any issues with regard to storage integrity are rapidly detected. The magnitude and pattern of deformation at the surface reveals geomechanical/hydromechanical processes that occur in reservoir due to CO2 injection. We acquired deformation data from the In Salah CO2 injection site and from four additional study cases during the course of this study; one in the onshore UK, the other a combined campaign onshore Norway and offshore Germany, and the third in onshore Japan. Significant developments in measurement techniques, processing tools and interpretation algorithms were developed through this project. Models were then developed to simulate the observed data and to couple surface deformation to displacement in the subsurface. The results show millimeter-scale deformations in the subsurface have a signature at the surface that can be captured by the tools and workflows developed in this project. These deformations, particularly the patterns, are important factors to consider when monitoring a CO2 storage site

Monitoring CO₂ storage sites onshore and offshore using InSAR data and strain sensing fibre optics cables

A key requirement for geological CO2 storage is site integrity management and monitoring during operation through to the post decommissioning period. This paper focuses on monitoring deformation of the ground surface and seabed as a proxy for overall deformation in the reservoir and surrounding layers. The objective is to inform, based on deformation data, on how the reservoir is responding to CO2 injection and to ensure any issues with regard to storage integrity are rapidly detected. The magnitude and pattern of deformation at the surface reveals geomechanical/hydromechanical processes that occur in reservoir due to CO2 injection. We acquired deformation data from the In Salah CO2 injection site and from four additional study cases during the course of this study; one in the onshore UK, the other a combined campaign onshore Norway and offshore Germany, and the third in onshore Japan. Significant developments in measurement techniques, processing tools and interpretation algorithms were developedthrough this project. Models were then developed to simulate the observed data and to couple surface deformation to displacement in the subsurface. The results show millimeter-scale deformations in the subsurface have a signature at the surface that can be captured by the tools and workflows developed in this project. These deformations, particularly the patterns, are important factors to consider when monitoring a CO2 storage site

Serge Abiteboul, Rakesh Agrawal, Phil Bernstein, Mike Carey, Stefano Ceri, Bruce Croft, David DeWitt, Mike Franklin,

This report summarizes the discussion and conclusions of the sixth ad-hoc meeting held May 4-6, 2003 in Lowell, Mass. It observes that information management continues to be a critical component of most complex software systems. It recommends that database researchers increase focus on: integration of text, data, code, and streams; fusion of information from heterogeneous data sources; reasoning about uncertain data; unsupervised data mining for interesting correlations; information privacy; and self-adaptation and repai