Prediction of potentially avoidable readmission risk in a division of general internal medicine.

The 30-day post-discharge readmission rate is a quality indicator that may reflect suboptimal care. The computerised algorithm SQLape® can retrospectively identify a potentially avoidable readmission (PARA) with high sensitivity and specificity. We retrospectively analysed the hospital stays of patients readmitted to the Department of Internal Medicine of the CHUV (Centre Hospitalier Universitaire Vaudois) in order to quantify the proportion of PARAs and derive a risk prediction model. All hospitalisations between January 2009 and December 2011 in our division of general internal medicine were analysed. Readmissions within 30 days of discharge were categorised using SQLape®. The impact on PARAs was tested for various clinical and nonclinical factors. The performance of the developed model was compared with the well-validated LACE and HOSPITAL scores. From a total of 11 074 hospital stays, 777 (7%) were followed with PARA within 30 days. By analysing a group of 6729 eligible stays, defined in particular by the patients' returning to their place of residence (home or residential care centre), we identified the following risk factors: ≥1 hospitalisation in the year preceding index admission, Charlson score >1, active cancer, hyponatraemia, length of stay >11 days, prescription of ≥15 different medications during the stay. These variables were used to derive a risk prediction model for PARA with a good discriminatory power (C-statistic 0.70) and calibration (p = 0.69). Patients were then classified as low (16.4%), intermediate (49.4%) or high (34.2%) risk of PARA. The estimated risk of PARA for each category was 3.5%, 8.7% and 19.6%, respectively. The LACE and the HOSPITAL scores were significantly correlated with the PARA risk. The discriminatory power of the LACE (C-statistic 0.61) and the HOSPITAL (C-statistic 0.54) were lower than our model. Our model identifies patients at high risk of 30-day PARA with a good performance. It could be used to target transition of care interventions. Nevertheless, this model should be validated on more data and could be improved with additional parameters. Our results highlight the difficulty to generalise one model in the context of different healthcare systems

Form Factors for B -> pi l nu-bar_l and B -> K* gamma Decays on the Lattice

We present a unified method for analysing form factors in B -> pi l nu-bar_l and B -> K* gamma decays. The analysis provides consistency checks on the q^2 and 1/M extrapolations necessary to obtain the physical decay rates. For the first time the q^2 dependence of the form factors is obtained at the B scale. In the B -> pi l nu-bar_l case, we show that pole fits to f^+ may not be consistent with the q^2 behaviour of f^0, leading to a possible factor of two uncertainty in the decay rate and hence in the value of |V_{ub}|^2 deduced from it. For B -> K* gamma, from the combined analysis of form factors T_1 and T_2, we find the hadronisation ratio R_{K^*} of the exclusive B -> K* gamma to the inclusive b -> s gamma rates is of order 35% or 15% for constant and pole-type behaviour of T_2 respectively.Comment: 13 pages, uuencoded compressed postscript file (including five figures). Also available from http://wwwhep.phys.soton.ac.uk/hepwww/papers/shep9509

Transmitter-side wireless information- and power-transfer in massive MIMO systems

Both time-switching (TS) and power splitting has been used at the receiver for wireless information and power transfer in the downlink of massive multiple-input-multiple-output systems. By contrast, this correspondence adopts the transmit-TS approach, where the energy and information are transferred over different fractions of a time slot. Our goal is to jointly optimize the transmit-TS factor and power allocation coefficients during energy and information transfer for maximizing the users’ minimum throughput subject to transmit power and minimum harvested energy constraints. This nonconvex problem is solved by our path following algorithm. Our simulation results demonstrate the benefits of the proposed transmit-TS algorithm, which easily doubles the throughput compared to that of the existing techniques.<br/

Improper Gaussian signaling for computationally tractable energy and information beamforming

The transmit time-switching (transmit-TS) approach, under which the energy and information are transferred over different fractions of a time slot has proved its supremacy over the power splitting (PS) approach of simultaneous wirelessinformation and power transfer, where PS splits the power of the received signal for energy harvesting and information decoding. For integrating data and energy transfer, this paper develops new classes of beamforming that are suitable for improper Gaussian signaling which is capable of network throughput improvements while maintaining high computational efficiency in its design

From free to forced adaptation: A political ecology of the ‘state‐society‐flood’ nexus in the Vietnamese Mekong Delta

10.1111/apv.12241Asia Pacific Viewpoin