8,329 research outputs found
Necessary and sufficient conditions of solution uniqueness in minimization
This paper shows that the solutions to various convex minimization
problems are \emph{unique} if and only if a common set of conditions are
satisfied. This result applies broadly to the basis pursuit model, basis
pursuit denoising model, Lasso model, as well as other models that
either minimize or impose the constraint , where
is a strictly convex function. For these models, this paper proves that,
given a solution and defining I=\supp(x^*) and s=\sign(x^*_I),
is the unique solution if and only if has full column rank and there
exists such that and for . This
condition is previously known to be sufficient for the basis pursuit model to
have a unique solution supported on . Indeed, it is also necessary, and
applies to a variety of other models. The paper also discusses ways to
recognize unique solutions and verify the uniqueness conditions numerically.Comment: 6 pages; revised version; submitte
Travel risk, malaria importation and malaria transmission in Zanzibar
The prevalence of Plasmodium falciparum malaria in Zanzibar has reached historic lows. Improving control requires quantifying malaria importation rates, identifying high-risk travelers, and assessing onwards transmission
Impacts of Co-Solvent Flushing on Microbial Populations Capable of Degrading Trichloroethylene
With increased application of co-solvent flushing technologies for removal of nonaqueous phase liquids from groundwater aquifers, concern over the effects of the solvent on native microorganisms and their ability to degrade residual contaminant has also arisen. This study assessed the impact of ethanol flushing on the numbers and activity potentials of trichloroethylene (TCE)-degrading microbial populations present in aquifer soils taken immediately after and 2 years after ethanol flushing of a former dry cleaners site. Polymerase chain reaction analysis revealed soluble methane monooxygenase genes in methanotrophic enrichments, and 16S rRNA analysis identified Methylocystis parvus with 98% similarity, further indicating the presence of a type II methanotroph. Dissimilatory sulfite reductase genes in sulfate-reducing enrichments prepared were also observed. Ethanol flushing was simulated in columns packed with uncontaminated soils from the dry cleaners site that were dosed with TCE at concentrations observed in the field; after flushing, the columns were subjected to a continuous flow of 500 pore volumes of groundwater per week. Total acridine orange direct cell counts of the flushed and nonflushed soils decreased over the 15-week testing period, but after 5 weeks, the flushed soils maintained higher cell counts than the nonflushed soils. Inhibition of methanogenesis by sulfate reduction was observed in all column soils, as was increasing removal of total methane by soils incubated under methanotrophic conditions. These results showed that impacts of ethanol were not as severe as anticipated and imply that ethanol may mitigate the toxicity of TCE to the microorganisms
Do adults with high functioning autism or Asperger Syndrome differ in empathy and emotion recognition?
The present study examined whether adults with high functioning autism (HFA) showed greater difficulties in (i) their self-reported ability to empathise with others and/or (ii) their ability to read mental states in others’ eyes than adults with Asperger syndrome (AS). The Empathy Quotient (EQ) and ‘Reading the Mind in the Eyes’ Test (Eyes Test) were compared in 43 adults with AS and 43 adults with HFA. No significant difference was observed on EQ score between groups, while adults with AS performed significantly better on the Eyes Test than those with HFA. This suggests that adults with HFA may need more support, particularly in mentalizing and complex emotion recognition, and raises questions about the existence of subgroups within autism spectrum conditions
Developing public health clinical decision support systems (CDSS) for the outpatient community in New York City: our experience
<p>Abstract</p> <p>Background</p> <p>Developing a clinically relevant set of quality measures that can be effectively used by an electronic health record (EHR) is difficult. Whether it is achieving internal consensus on relevant priority quality measures, communicating to EHR vendors' whose programmers generally lack clinical contextual knowledge, or encouraging implementation of EHR that meaningfully impacts health outcomes, the path is challenging. However, greater transparency of population health, better accountability, and ultimately improved health outcomes is the goal and EHRs afford us a realistic chance of reaching it in a scalable way.</p> <p>Method</p> <p>In this article, we summarize our experience as a public health government agency with developing measures for a public health oriented EHR in New York City in partnership with a commercial EHR vendor.</p> <p>Results</p> <p>From our experience, there are six key lessons that we share in this article that we believe will dramatically increase the chance of success. First, define the scope and build consensus. Second, get support from executive leadership. Third, find an enthusiastic and competent software partner. Fourth, implement a transparent operational strategy. Fifth, create and test the EHR system with real life scenarios. Last, seek help when you need it.</p> <p>Conclusions</p> <p>Despite the challenges, we encourage public health agencies looking to build a similarly focused public health EHR to create one both for improved individual patient as well as the larger population health.</p
The OPERA trial : a protocol for the process evaluation of a randomised trial of an exercise intervention for older people in residential and nursing accommodation
Background: The OPERA trial is large cluster randomised trial testing a physical activity intervention to address
depression amongst people living in nursing and residential homes for older people. A process evaluation was
commissioned alongside the trial and we report the protocol for this process evaluation. Challenges included the
cognitive and physical ability of the participants, the need to respect the privacy of all home residents, including
study non-participants, and the physical structure of the homes. Evaluation activity had to be organised around the
structured timetable of homes, leaving limited opportunities for data collection. The aims of this process evaluation
are to provide findings that will assist in the interpretation of the clinical trial results, and to inform potential
implementation of the physical activity intervention on a wider scale.
Methods/design: Quantitative data on recruitment of homes and individuals is being collected. For homes in the
intervention arm, data on dose and fidelity of the intervention delivered; including individual rates of participation
in exercise classes are collected. In the control homes, uptake and delivery of depression awareness training is
monitored. These data will be combined with qualitative data from an in-depth study of a purposive sample of
eight homes (six intervention and two control).
Discussion: Although process evaluations are increasingly funded alongside trials, it is still rare to see the findings
published, and even rarer to see the protocol for such an evaluation published. Process evaluations have the
potential to assist in interpreting and understanding trial results as well as informing future roll-outs of
interventions. If such evaluations are funded they should also be reported and reviewed in a similar way to the
trial outcome evaluation
Persistent Intersection Homology for the Analysis of Discrete Data
Topological data analysis is becoming increasingly relevant to support the
analysis of unstructured data sets. A common assumption in data analysis is
that the data set is a sample---not necessarily a uniform one---of some
high-dimensional manifold. In such cases, persistent homology can be
successfully employed to extract features, remove noise, and compare data sets.
The underlying problems in some application domains, however, turn out to
represent multiple manifolds with different dimensions. Algebraic topology
typically analyzes such problems using intersection homology, an extension of
homology that is capable of handling configurations with singularities. In this
paper, we describe how the persistent variant of intersection homology can be
used to assist data analysis in visualization. We point out potential pitfalls
in approximating data sets with singularities and give strategies for resolving
them.Comment: Topology-based Methods in Visualization 201
Temporal variations in quality of acute stroke care and outcomes in London hyperacute stroke units: a mixed-methods study
This is the final version. Available from the NIHR Journals Library via the DOI in this recordBackground
Seven-day working in hospitals is a current priority of international health research and policy. Previous research has shown variability in delivering evidence-based clinical interventions across different times of the day and week. We aimed to identify factors influencing such variations in London hyperacute stroke units.
Objectives
To investigate variations in quality of acute stroke care and outcomes by day and time of admission in London hyperacute stroke units, and to identify factors influencing such variations.
Design
This was a prospective cohort study using anonymised patient-level data from the Sentinel Stroke National Audit Programme. Factors influencing variations in care and outcomes were studied through interview and observation data.
Setting
The setting was acute stroke services in London hyperacute stroke units.
Participants
A total of 7094 patients with a primary diagnosis of stroke took part. We interviewed hyperacute stroke unit staff (n = 76), including doctors, nurses, therapists and administrators, and 31 patients and carers. We also conducted non-participant observations of delivery of care at different times of the day and week (n = 45, ≈102 hours).
Intervention
Hub-and-spoke model for care of suspected acute stroke patients in London with performance standards was designed to deliver uniform access to high-quality hyperacute stroke unit care across the week.
Main outcome measures
Indicators of quality of acute stroke care, mortality at 3 days after admission, disability at the end of the inpatient spell and length of stay.
Data sources
Sentinel Stroke National Audit Programme data for all patients in London hyperacute stroke units with a primary diagnosis of stroke between 1 January and 31 December 2014, and nurse staffing data for all eight London hyperacute stroke units for the same period.
Results
We found no variation in quality of care by day and time of admission across the week in terms of stroke nursing assessment, brain scanning and thrombolysis in London hyperacute stroke units, nor in 3-day mortality nor disability at hospital discharge. Other quality-of-care measures significantly varied by day and time of admission. Quality of care was better if the nurse in charge was at a higher band and/or there were more nurses on duty. Staff deliver ‘front-door’ interventions consistently by taking on additional responsibilities out of hours, creating continuities between day and night, building trusting relationships and prioritising ‘front-door’ interventions.
Limitations
We were unable to measure long-term outcomes as our request to the Sentinel Stroke National Audit Programme, the Healthcare Quality Improvement Partnership and NHS Digital for Sentinel Stroke National Audit Programme data linked with patient mortality status was not fulfilled.
Conclusions
Organisational factors influence 24 hours a day, 7 days a week (24/7), provision of stroke care, creating temporal patterns of provision reflected in patient outcomes, including mortality, length of stay and functional independence.
Future work
Further research would help to explore 24/7 stroke systems in other contexts. We need a clearer understanding of variations by looking at absolute time intervals, rather than achievement of targets. Research is needed with longer-term mortality and modified Rankin Scale data, and a more meaningful range of outcomes.National Institute for Health Research (NIHR
Recovery of renal function in dialysis patients
BACKGROUND: Although recovery of renal functions in dialysis dependent patients is estimated to be greater than 1%, there are no indicators that actually suggest such revival of renal function. Residual renal function in dialysis patients is unreliable and seldom followed. Therefore renal recovery (RR) in dialysis dependent patients may remain unnoticed. We present a group of dialysis dependent patients who regained their renal functions. The aim of this project is to determine any indicators that may identify the recovery of renal functions in dialysis dependent patients. METHODS: All the discharges from the chronic dialysis facilities were identified. Among these discharges deaths, transplants, voluntary withdrawals and transfers either to another modality or another dialysis facility were excluded in order to isolate the patients with RR. The dialysis flow sheets and medical records of these patients were subsequently reviewed. RESULTS: Eight patients with a mean age of 53.8 ± 6.7 years (± SEM) were found to have RR. Dialysis was initiated due to uremic symptoms in 6 patients and fluid overload in the remaining two. The patients remained dialysis dependent for 11.1 ± 4.2 months. All these patients had good urine output and 7 had symptoms related to dialysis. Their mean pre-initiation creatinine and BUN levels were 5.21 ± 0.6 mg/dl and 72.12 ± 11.12 mg/dl, respectively. Upon discontinuation, they remained dialysis free for 19.75 ± 5.97 months. The mean creatinine and BUN levels after cessation of dialysis were 2.85 ± 0.57 mg/dl and 29.62 ± 5.26 mg/dl, respectively, while the mean creatinine clearance calculated by 24-hour urine collection was 29.75 ± 4.78 ml/min. One patient died due to HIV complications. One patient resumed dialysis after nine months. Remaining continue to enjoy a dialysis free life. CONCLUSION: RR must be considered in patients with good urine output and unresolved acute renal failure. Dialysis intolerance may be an indicator of RR among such patients
Double-Mode Stellar Pulsations
The status of the hydrodynamical modelling of nonlinear multi-mode stellar
pulsations is discussed. The hydrodynamical modelling of steady double-mode
(DM) pulsations has been a long-standing quest that is finally being concluded.
Recent progress has been made thanks to the introduction of turbulent
convection in the numerical hydrodynamical codes which provide detailed results
for individual models. An overview of the modal selection problem in the HR
diagram can be obtained in the form of bifurcation diagrams with the help of
simple nonresonant amplitude equations that capture the DM phenomenon.Comment: 34 pages, to appear as a chapter in Nonlinear Stellar Pulsation in
the Astrophysics and Space Science Library (ASSL), Editors: M. Takeuti & D.
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