Process Completing Sequences for Resource Allocation Systems with Synchronization

This paper considers the problem of establishing live resource allocation in workflows with synchronization stages. Establishing live resource allocation in this class of systems is challenging since deciding whether a given level of resource capacities is sufficient to complete a single process is NP-complete. In this paper, we develop two necessary conditions and one sufficient condition that provide quickly computable tests for the existence of process completing sequences. The necessary conditions are based on the sequence of completions of subprocesses that merge together at a synchronization. Although the worst case complexity is O(2), we expect the number of subprocesses combined at any synchronization will be sufficiently small so that total computation time remains manageable. The sufficient condition uses a reduction scheme that computes a sufficient capacity level of each resource type to complete and merge all subprocesses. The worst case complexity is O(⋅), where is the number of synchronizations. Finally, the paper develops capacity bounds and polynomial methods for generating feasible resource allocation sequences for merging systems with single unit allocation. This method is based on single step look-ahead for deadly marked siphons and is O(2). Throughout the paper, we use a class of Petri nets called Generalized Augmented Marked Graphs to represent our resource allocation systems

No-Shows to Primary Care Appointments: Subsequent Acute Care Utilization among Diabetic Patients

Background Patients who no-show to primary care appointments interrupt clinicians’ efforts to provide continuity of care. Prior literature reveals no-shows among diabetic patients are common. The purpose of this study is to assess whether no-shows to primary care appointments are associated with increased risk of future emergency department (ED) visits or hospital admissions among diabetics. Methods A prospective cohort study was conducted using data from 8,787 adult diabetic patients attending outpatient clinics associated with a medical center in Indiana. The outcomes examined were hospital admissions or ED visits in the 6 months (182 days) following the patient’s last scheduled primary care appointment. The Andersen-Gill extension of the Cox proportional hazard model was used to assess risk separately for hospital admissions and ED visits. Adjustment was made for variables associated with no-show status and acute care utilization such as gender, age, race, insurance and co-morbid status. The interaction between utilization of the acute care service in the six months prior to the appointment and no-show was computed for each model. Results The six-month rate of hospital admissions following the last scheduled primary care appointment was 0.22 (s.d. = 0.83) for no-shows and 0.14 (s.d. = 0.63) for those who attended (p \u3c 0.0001). No-show was associated with greater risk for hospitalization only among diabetics with a hospital admission in the prior six months. Among diabetic patients with a prior hospital admission, those who no-showed were at 60% greater risk for subsequent hospital admission (HR = 1.60, CI = 1.17–2.18) than those who attended their appointment. The six-month rate of ED visits following the last scheduled primary care appointment was 0.56 (s.d. = 1.48) for no-shows and 0.38 (s.d. = 1.05) for those who attended (p \u3c 0.0001); after adjustment for covariates, no-show status was not significantly related to subsequent ED utilization

A Wearable, Low-cost Hand Tremor Sensor for Detecting Hypoglycemic Events in Diabetic Patients

Severe hypoglycemia leverages complication in diabetes patients: e.g., it increases death rate by a six-fold. Therefore, early detection and prediction of hypoglycemic events are of utmost importance. This publication presents a prototype of a wearable hand-tremor system that detects the onset of hypoglycemic events. The results show the prototype is capable of simulating anticipated frequency and amplitude of the tremor relevant for hypoglycemic events. The initial functional performance-tests demonstrate a maximum error of 4.75% in the detecting the tremor frequency

Features of Physiologic Tremor in Diabetic Patients

In this paper, we estimate the effect of fatigue on physiological tremors in adults suffering from diabetes. We used a simple, wearable accelerometer to collect the acceleration data from 5 diabetic subjects with varying physical activity levels. Fatigue was induced via an intermittent submaximal isometric handgrip protocol, normalized for individual grip strength, until voluntary exhaustion. The overall results presented here show that the physiologic tremors in the range of 10-14 Hz are most noticeable under fatigue

The Mouse Gastrointestinal Bacteria Catalogue enables translation between the mouse and human gut microbiotas via functional mapping.

Funder: Royal SocietyHuman health and disease have increasingly been shown to be impacted by the gut microbiota, and mouse models are essential for investigating these effects. However, the compositions of human and mouse gut microbiotas are distinct, limiting translation of microbiota research between these hosts. To address this, we constructed the Mouse Gastrointestinal Bacteria Catalogue (MGBC), a repository of 26,640 high-quality mouse microbiota-derived bacterial genomes. This catalog enables species-level analyses for mapping functions of interest and identifying functionally equivalent taxa between the microbiotas of humans and mice. We have complemented this with a publicly deposited collection of 223 bacterial isolates, including 62 previously uncultured species, to facilitate experimental investigation of individual commensal bacteria functions in vitro and in vivo. Together, these resources provide the ability to identify and test functionally equivalent members of the host-specific gut microbiotas of humans and mice and support the informed use of mouse models in human microbiota research.Sir Henry Dale Fellowship jointly funded by Wellcome Trust and Royal Society [206245/Z/17/Z]. Rosetrees Trust [A2194]. Wellcome Trust [098051]

A publicly accessible database for Clostridioides difficile genome sequences supports tracing of transmission chains and epidemics

Clostridioides difficile is the primary infectious cause of antibiotic-associated diarrhea. Local transmissions and international outbreaks of this pathogen have been previously elucidated by bacterial whole-genome sequencing, but comparative genomic analyses at the global scale were hampered by the lack of specific bioinformatic tools. Here we introduce a publicly accessible database within EnteroBase (http://enterobase.warwick.ac.uk) that automatically retrieves and assembles C. difficile short-reads from the public domain, and calls alleles for core-genome multilocus sequence typing (cgMLST). We demonstrate that comparable levels of resolution and precision are attained by EnteroBase cgMLST and single-nucleotide polymorphism analysis. EnteroBase currently contains 18 254 quality-controlled C. difficile genomes, which have been assigned to hierarchical sets of single-linkage clusters by cgMLST distances. This hierarchical clustering is used to identify and name populations of C. difficile at all epidemiological levels, from recent transmission chains through to epidemic and endemic strains. Moreover, it puts newly collected isolates into phylogenetic and epidemiological context by identifying related strains among all previously published genome data. For example, HC2 clusters (i.e. chains of genomes with pairwise distances of up to two cgMLST alleles) were statistically associated with specific hospitals (P<10−4) or single wards (P=0.01) within hospitals, indicating they represented local transmission clusters. We also detected several HC2 clusters spanning more than one hospital that by retrospective epidemiological analysis were confirmed to be associated with inter-hospital patient transfers. In contrast, clustering at level HC150 correlated with k-mer-based classification and was largely compatible with PCR ribotyping, thus enabling comparisons to earlier surveillance data. EnteroBase enables contextual interpretation of a growing collection of assembled, quality-controlled C. difficile genome sequences and their associated metadata. Hierarchical clustering rapidly identifies database entries that are related at multiple levels of genetic distance, facilitating communication among researchers, clinicians and public-health officials who are combatting disease caused by C. difficile

Distinct microbial and immune niches of the human colon.

Gastrointestinal microbiota and immune cells interact closely and display regional specificity; however, little is known about how these communities differ with location. Here, we simultaneously assess microbiota and single immune cells across the healthy, adult human colon, with paired characterization of immune cells in the mesenteric lymph nodes, to delineate colonic immune niches at steady state. We describe distinct helper T cell activation and migration profiles along the colon and characterize the transcriptional adaptation trajectory of regulatory T cells between lymphoid tissue and colon. Finally, we show increasing B cell accumulation, clonal expansion and mutational frequency from the cecum to the sigmoid colon and link this to the increasing number of reactive bacterial species

Residual Life Distributions from Component Degradation Signals: A Bayesian Approach

Received and accepted Real-time condition monitoring is becoming an important tool in maintenance decision-making. Condition monitoring is the process of collecting real-time sensor information from a functioning device in order to reason about the health of the device. To make effective use of condition information, it is useful to characterize a device degradation signal, a quantity computed from condition information that captures the current state of the device and provides information on how that condition is likely to evolve in the future. If properly modeled, the degradation signal can be used to compute a residual-life distribution for the device being monitored, which can the

Genomic attributes of airway commensal bacteria and mucosa

Microbial communities at the airway mucosal barrier are conserved and highly ordered, in likelihood reflecting co-evolution with human host factors. Freed of selection to digest nutrients, the airway microbiome underpins cognate management of mucosal immunity and pathogen resistance. We show here the initial results of systematic culture and whole-genome sequencing of the thoracic airway bacteria, identifying 52 novel species amongst 126 organisms that constitute 75% of commensals typically present in heathy individuals. Clinically relevant genes encode antimicrobial synthesis, adhesion and biofilm formation, immune modulation, iron utilisation, nitrous oxide (NO) metabolism and sphingolipid signalling. Using whole-genome content we identify dysbiotic features that may influence asthma and chronic obstructive pulmonary disease. We match isolate gene content to transcripts and metabolites expressed late in airway epithelial differentiation, identifying pathways to sustain host interactions with microbiota. Our results provide a systematic basis for decrypting interactions between commensals, pathogens, and mucosa in lung diseases of global significance