2,163 research outputs found
A novel intelligent system for securing cash levels using Markov random fields
Financial support from the Spanish Ministry of Universities "Disruptive group decision making systems in fuzzy context: Applications in smart energy and people analytics" (PID2019-103880RB-I00), and Junta de Andalucia (SEJ340) is gratefully acknowledged.The maintenance of cash levels under certain security thresholds is key for the health of the banking sector. In this paper, the monitoring process of branch network cash levels is performed using a single intelligent system which should provide an alert when there are cash shortages at any point of the network. Such an integral solution would provide a unified insight that guarantees that branches with similar cash features are secured as a whole. That is to say, a triggered alarm at a specific branch would indicate that attention must also be paid to similar (in-cash-feature) branches. The system also incorporates a (complementary) specific treatment for individual branches. The Early Warning System for securing cash levels presented in this paper (cash level EWS) is deliberately free of local demographic specifications, thereby overcoming the current lack of worldwide definitions for local demographics. This aspect would be particularly valuable for banking institutions with branch networks all over the world. A further benefit is the cost reductions that are a result of replacing several approaches with a single global one. Instead of local demographic parameters, a solid theoretical model based on Markov random fields (MRFs) has been developed. The use of MRFs means a reduction in the amount of information required. This would mean a higher processing speed as well as a significant reduction in the amount of storage capacity required. To the best of the author's knowledge, this is the first time that MRFs have been applied to cash monitoring.Spanish Ministry of Universities
PID2019-103880RB-I00Junta de Andalucia
SEJ34
Towards a Classification of Rough Set Bireducts
Size reduction mechanisms are very important in several mathematical fields. In rough set theory, bireducts arose to reduce simultaneously the set of attributes and the set of objects of the considered dataset, providing subsystems with the minimal sets of attributes that connect the maximum number of objects preserving the information of the original dataset. This paper presents the main properties of bireducts and how they can be used for removing inconsistencies. © 2020, Springer Nature Switzerland AG
DESCRIPCIÓN Y ANÁLISIS DEL GRADO DE APLICACIÓN DEL PROGRAMA INFORMÁTICO DE CUIDADOS, AZAHAR, EN EL HOSPITAL UNIVERSITARIO REINA SOFÍA DE CÓRDOBA. PLANTEAMIENTO DE NUEVAS LÍNEAS DE ACTUACIÓN
To provide qualitative nursing care starting from a jointly unity criteria was one of the objectives to register and manage the nursing care process through a computer program at the Hospital of Reina Sofia in Cordoba. We present a first assessment on its application.Prestar cuidados enfermeros de calidad a partir de una unidad consensuada de criterio fue uno de los objetivos para registrar y gestionar el Proceso de Atención de Enfermería a través de un programa informático, en el Hospital Reina Sofía de Córdoba. Se presenta una primera evaluación de su grado de aplicació
Four distinct trajectories of tau deposition identified in Alzheimer's disease
Alzheimer’s disease (AD) is characterized by the spread of tau pathology throughout the cerebral cortex. This spreading pattern was thought to be fairly consistent across individuals, although recent work has demonstrated substantial variability in the population with AD. Using tau-positron emission tomography scans from 1,612 individuals, we identified 4 distinct spatiotemporal trajectories of tau pathology, ranging in prevalence from 18 to 33%. We replicated previously described limbic-predominant and medial temporal lobe-sparing patterns, while also discovering posterior and lateral temporal patterns resembling atypical clinical variants of AD. These ‘subtypes’ were stable during longitudinal follow-up and were replicated in a separate sample using a different radiotracer. The subtypes presented with distinct demographic and cognitive profiles and differing longitudinal outcomes. Additionally, network diffusion models implied that pathology originates and spreads through distinct corticolimbic networks in the different subtypes. Together, our results suggest that variation in tau pathology is common and systematic, perhaps warranting a re-examination of the notion of ‘typical AD’ and a revisiting of tau pathological staging
Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds
Please cite the published version which is available via the DOI link in this record.Western industrialised nations face a large increase in the number of older people. People over the age of 60 years account for almost half of the 16.8 million hospital admissions in England from 2009 to 2010. During 2009-10, respiratory infections accounted for approximately 1 in 30 hospital admissions and 1 in 20 of the 51.5 million bed-days.HTA ProgrammeNational Institute for Health Research (NIHR
CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults
Background: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls.
Methods: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021.
Results: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis.
Conclusions: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies
Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths
Background: Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquired pneumonia (CAP), but underlying mechanisms are unknown. Persistence of the prothrombotic state that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activated during CAP persist at hospital discharge, when patients appear to have recovered clinically, and are associated with higher mortality, particularly due to cardiovascular causes. Methods: In a cohort of survivors of CAP hospitalization from 28 US sites, we measured D-Dimer, thrombin-antithrombin complexes [TAT], Factor IX, antithrombin, and plasminogen activator inhibitor-1 at hospital discharge, and determined 1-year all-cause and cardiovascular mortality. Results: Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis) and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinically recovered. D-dimer and TAT levels were elevated at discharge in 78.8% and 30.1% of all subjects, and in 51.3% and 25.3% of those without severe sepsis. Higher D-dimer and TAT levels were associated with higher risk of all-cause mortality (range of hazard ratios were 1.66-1.17, p = 0.0001 and 1.46-1.04, p = 0.001 after adjusting for demographics and comorbid illnesses) and cardiovascular mortality (p = 0.009 and 0.003 in competing risk analyses). Conclusions: Elevations of TAT and D-dimer levels are common at hospital discharge in patients who appeared to have recovered clinically from pneumonia and are associated with higher risk of subsequent deaths, particularly due to cardiovascular disease. © 2011 Yende et al
Cardiac Complications in Patients with Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Observational Studies
Vicente Corrales-Medina and colleagues report estimates of the risk of cardiac complications among patients with community-acquired pneumonia from a systematic review and meta-analysis
Cross-cultural adaptation of children´s environmental health questionnaires for English nursing students
Objectives: Children are among the most vulnerable population groups with regard to environmental risks. Nursing students must be fully educated on children’s environmental health as they are in a key position to prevent and reduce the effects of environmental hazards. The main objective of this study was to adapt and validate an English language version of two questionnaires about children’s health and the environment, to assess the knowledge and skills of student nurses in England. Design: Observational cross-sectional study. Setting: A university in Southern England. Method: The study involves translating, adapting and validating the Children’s Environmental Health Knowledge Questionnaire (ChEHK-Q) and the Children’s Environmental Health Skills Questionnaire (ChEHS-Q) with nursing students in England (N = 232). Results: The psychometric characteristics of both questionnaires were strong. Infit and outfit values were close to 1. The reliability values for the items and people were 0.96 and 0.79 for ChEHK-Q and 0.98 and 0.89 for ChEHS-Q, respectively. Only 52 (22.41%) and 77 (33.62%) participants had at least good knowledge and skills, respectively. Higher knowledge and skills were found with respect to the vulnerability of children and identification of environmental risks in the home. Lower levels of knowledge and skills were found with respect to the effects of pesticides and the assessment of neoplastic pollutants. Conclusion: Findings demonstrate deficiencies in nursing competencies related to children’s environmental health. The use of these questionnaires will facilitate improvement in both knowledge and skills related to children’s environmental health among future nurses
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