Direct to consumer advertising via the Internet, a study of hip resurfacing

With increased use of the internet for health information and direct to consumer advertising from medical companies, there is a concern about the quality of the information available for patients. The aim of this study was to examine the quality of health information on the internet for hip resurfacing. An assessment tool was designed to measure quality of information. Websites were measured on credibility of source; usability; currentness of the information; content relevance; content accuracy/completeness and disclosure/bias. Each website assessed was given a total score, based on number of scores achieved from the above categories websites were further analysed on author, geographical origin and possession of an independent credibility check. There was positive correlation between the overall score for the website and the score of each website in each assessment category. Websites by implant companies, doctors and hospitals scored poorly. Websites with an independent credibility check such as Health on the Net (HoN) scored twice the total scores of websites without. Like other internet health websites, the quality of information on hip resurfacing websites is variable. This study highlights methods by which to assess the quality of health information on the internet and advocates that patients should look for a statement of an "independent credibility check" when searching for information on hip resurfacing

Using routine blood test results to predict the risk of death for emergency medical admissions to hospital: an external model validation study

YesBackground The Biochemistry and Haematology Outcome Model (BHOM) relies on the results from routine index blood tests to predict the patient risk of death. We aimed to externally validate the BHOM model. Method We considered all emergency adult medical patients who were discharged from Northern Lincolnshire and Goole (NLAG) hospital in 2014. We compared patient characteristics between NLAG (the validation sample) and the hospital where BHOM was developed. We evaluated the predictive performance, according to discriminative ability (with a concordance statistic, c), and calibration (agreement between observed and predicted risk). Result There were 29 834 emergency discharges of which 24 696 (83%) had complete data. In comparison with the development sample, the NLAG sample was similar in age, blood test results, but experienced a lower mortality (4.7% vs 8.7%). When applied to NLAG, the BHOM model had good discrimination (c-statistic 0.83 [95% CI 0.823 - 0.842]). Calibration was good overall, although the BHOM model overpredicted for lowest (<5%, observed = 229,predicted =286) and highest (≥50%, observed = 31, predicted = 49) risk groups, even after recalibrating for the differences in baseline risk of death. Conclusion Differences in patient case-mix profile and baseline risk of death need to be considered before the BHOM model can be used in another hospital. After re-calibrating for the baseline difference in risk the BHOM model had good discrimination but less adequate calibration

Geometric shape of invariant manifolds for a class of stochastic partial differential equations

Invariant manifolds play an important role in the study of the qualitative dynamical behaviors for nonlinear stochastic partial differential equations. However, the geometric shape of these manifolds is largely unclear. The purpose of the present paper is to try to describe the geometric shape of invariant manifolds for a class of stochastic partial differential equations with multiplicative white noises. The local geometric shape of invariant manifolds is approximated, which holds with significant likelihood. Furthermore, the result is compared with that for the corresponding deterministic partial differential equations

Performance of externally validated enhanced computer-aided versions of the National Early Warning Score in predicting mortality following an emergency admission to hospital in England: a cross-sectional study

YesOBJECTIVES: In the English National Health Service, the patient's vital signs are monitored and summarised into a National Early Warning Score (NEWS) to support clinical decision making, but it does not provide an estimate of the patient's risk of death. We examine the extent to which the accuracy of NEWS for predicting mortality could be improved by enhanced computer versions of NEWS (cNEWS). DESIGN: Logistic regression model development and external validation study. SETTING: Two acute hospitals (YH-York Hospital for model development; NH-Northern Lincolnshire and Goole Hospital for external model validation). PARTICIPANTS: Adult (≥16 years) medical admissions discharged over a 24-month period with electronic NEWS (eNEWS) recorded on admission are used to predict mortality at four time points (in-hospital, 24 hours, 48 hours and 72 hours) using the first electronically recorded NEWS (model M0) versus a cNEWS model which included age+sex (model M1) +subcomponents of NEWS (including diastolic blood pressure) (model M2). RESULTS: The risk of dying in-hospital following emergency medical admission was 5.8% (YH: 2080/35 807) and 5.4% (NH: 1900/35 161). The c-statistics for model M2 in YH for predicting mortality (in-hospital=0.82, 24 hours=0.91, 48 hours=0.88 and 72 hours=0.88) was higher than model M0 (in-hospital=0.74, 24 hours=0.89, 48 hours=0.86 and 72 hours=0.85) with higher Positive Predictive Value (PPVs) for in-hospital mortality (M2 19.3% and M0 16.6%). Similar findings were seen in NH. Model M2 performed better than M0 in almost all major disease subgroups. CONCLUSIONS: An externally validated enhanced computer-aided NEWS model (cNEWS) incrementally improves on the performance of a NEWS only model. Since cNEWS places no additional data collection burden on clinicians and is readily automated, it may now be carefully introduced and evaluated to determine if it can improve care in hospitals that have eNEWS systems.This research was supported by the Health Foundation. The Health Foundation is an independent charity working to improve the quality of healthcare in the UK. This research was also supported by the National Institute for Health Research (NIHR) Yorkshire and Humberside Patient Safety Translational Research Centre (YHPSTRC)

Comment on ‘Tumour-infiltrating inflammation and prognosis in colorectal cancer: systematic review and meta-analysis’

No abstract available

Computational studies on the effect of geometric parameters on the performance of a solar chimney power plant

A solar chimney power plant (SCPP) is a renewable-energy power plant that transforms solar energy into electricity. The SCPP consists of three essential elements – solar air collector, chimney tower, and wind turbine(s). The present work is aimed at optimizing the geometry of the major components of the SCPP using a computational fluid dynamics (CFD) software ANSYS-CFX to study and improve the flow characteristics inside the SCPP. The overall chimney height and the collector diameter of the SCPP were kept constant at 10 m and 8 m respectively. The collector inlet opening was varied from 0.05 m to 0.2 m. The collector outlet diameter was also varied from 0.6 m to 1 m. These modified collectors were tested with chimneys of different divergence angles (0�–3�) and also different chimney inlet openings of 0.6 m to 1 m. The diameter of the chimney was also varied from 0.25 m to 0.3 m. Based on the CFX computational results, the best configuration was achieved using the chimney with a divergence angle of 2� and chimney diameter of 0.25 m together with the collector opening of 0.05 m and collector outlet diameter of 1 m. The temperature inside the collector is higher for the lower opening resulting in a higher flow rate and power

Survey of the physico-chemical quality of the wastewaters of Biskra city rejected in Chabat Roba, Messdour and Wadi Z'ommor (Algeria)

The wastewaters of the agglomeration of Biskra (Southeast Algeria) are poured without treatment in three main dismissals that are Chabat Roba (1st site), Messdour (2nd site) and Wadi Z'ommor (3rd site). The pollution charge determined in the 1st site is the order of 157.76 ± 34.14 mg/L of O2 for the BOD5 (Biochemical Oxygen Demand in 5 days) of 457 ± 73.59 mg/L of O2 for the COD (Chemical Oxygen Demand) and 1109 ± 110.56 mg/L for the TSS (Total suspended Solids). In the 2nd site, the polluting charge is in average of 156 ± 29.72 mg/L of 'O2 for the BOD5, 430.76 ± 29.81 mg/L of O2 for the COD and 1157.92 ± 76 mg/L of O2 for the TSS. The 3rd site, the polluting charge is represented by 152.92 ± 27.76 mg/L of O2 of BOD5, 381.69 ± 70.03 mg/L of O2 of COD and by 1039 ±106.65 mg/L of O2 of TSS. The follow-up of these parameters in the three sites puts in evidence instability of the organic charge during seasons. The COD/BOD5 report equal 3 for the 1st site, this elevated value, watch that these waters are characterized by an inorganic pollution probably due to the industrial origin. With regard to the 2nd and 3rd sites, the COD/BOD5 report is between 3 and 2.5 for the first and between 2 and 2.50 for the second. The results defined the urban nature of the rejection poured in these sites.Key words: Wastewaters, Biskra, COD/BOD5 report, pollution charge, TSS

Magnetism of Two Coupled Harmonic Oscillators

The thermodynamical properties of a system of two coupled harmonic oscillators in the presence of an uniform magnetic field B are investigated. Using an unitary transformation, we show that the system can be diagonalized in simple way and then obtain the energy spectrum solutions. These will be used to determine the thermodynamical potential in terms of different physical parameters like the coupling parameter \alpha. This allows us to give a generalization of already significant published work and obtain different results, those could be used to discuss the magnetism of the system. Different limiting cases, in terms of \alpha and B, have been discussed. In fact, quantum corrections to the Landau diamagnetism and orbital paramagnetism are found.Comment: 25 page