A novel framework for predicting patients at risk of readmission

Uncertainty in decision-making for patients’ risk of re-admission arises due to non-uniform data and lack of knowledge in health system variables. The knowledge of the impact of risk factors will provide clinicians better decision-making and in reducing the number of patients admitted to the hospital. Traditional approaches are not capable to account for the uncertain nature of risk of hospital re-admissions. More problems arise due to large amount of uncertain information. Patients can be at high, medium or low risk of re-admission, and these strata have ill-defined boundaries. We believe that our model that adapts fuzzy regression method will start a novel approach to handle uncertain data, uncertain relationships between health system variables and the risk of re-admission. Because of nature of ill-defined boundaries of risk bands, this approach does allow the clinicians to target individuals at boundaries. Targeting individuals at boundaries and providing them proper care may provide some ability to move patients from high risk to low risk band. In developing this algorithm, we aimed to help potential users to assess the patients for various risk score thresholds and avoid readmission of high risk patients with proper interventions. A model for predicting patients at high risk of re-admission will enable interventions to be targeted before costs have been incurred and health status have deteriorated. A risk score cut off level would flag patients and result in net savings where intervention costs are much higher per patient. Preventing hospital re-admissions is important for patients, and our algorithm may also impact hospital income

Degree Optimization and Stability Condition for the Min-Sum Decoder

The min-sum (MS) algorithm is arguably the second most fundamental algorithm in the realm of message passing due to its optimality (for a tree code) with respect to the {\em block error} probability \cite{Wiberg}. There also seems to be a fundamental relationship of MS decoding with the linear programming decoder \cite{Koetter}. Despite its importance, its fundamental properties have not nearly been studied as well as those of the sum-product (also known as BP) algorithm. We address two questions related to the MS rule. First, we characterize the stability condition under MS decoding. It turns out to be essentially the same condition as under BP decoding. Second, we perform a degree distribution optimization. Contrary to the case of BP decoding, under MS decoding the thresholds of the best degree distributions for standard irregular LDPC ensembles are significantly bounded away from the Shannon threshold. More precisely, on the AWGN channel, for the best codes that we find, the gap to capacity is 1dB for a rate 0.3 code and it is 0.4dB when the rate is 0.9 (the gap decreases monotonically as we increase the rate). We also used the optimization procedure to design codes for modified MS algorithm where the output of the check node is scaled by a constant $1/\alpha$. For $\alpha = 1.25$, we observed that the gap to capacity was lesser for the modified MS algorithm when compared with the MS algorithm. However, it was still quite large, varying from 0.75 dB to 0.2 dB for rates between 0.3 and 0.9. We conclude by posing what we consider to be the most important open questions related to the MS algorithm.Comment: submitted to ITW 0

Malaysia : Feeding China's Expanding Demand for Wood Pulp

Malaysia has a total capacity pulp and paper production at over 1 million T/year. The country is a net importer of pulp, paper, and paper board, and progressively tends to decrease its dependency. However, the self-sufficiency is growing at a slow rate. All the paper mills of the country are small by the world industry standards, none producing more than 300 000 T/Year. The Malaysian government has identified this particular industry sector as one of the priority areas for investment in the second industrial master plan (IMP2). The strategy is to achieve a state of self sufficiency, to reduce import, and to encourage foreign capital inflow. The industry was one of the industries to survive the economic downturn resulting from the “Asian crisis” in 1997, as much as the softening of the economy following the September 11th, 2001 event. No paper mill was closed down or taken over by larger companies at these occasions. The paper mills survived by remaining small but efficient, while cutting the cost of production at the same time. The industry also managed to remain buoyant by focusing on niche markets at the national scale. The Malaysian pulp and paper industry is heavily dependant on imported fibre, particularly virgin pulp, and is also facing the need to find a new source of fibre to strengthen and retain the quality of secondary fibres as the use of recycled paper is growing in Malaysia. As for the other wood-based Malaysian industries, further development of integration of downstream activities is highly promoted. The utilisation of wood waste is promoted through the emphasis on R&D and technology improvements. Meanwhile, more forest plantation projects are planned to ensure a sufficient and steady source of fibre supply in the long run. Other sources of supply are non-wood materials, such as oil palm residues; Kenaf (Hibiscus cannabinus) are also presented as alternatives to wood fibre.forest; tropical forest; pulp; paper; economy; Malaysia; trade; network; globalisation; China

Vietnam : Feeding China's Expanding Demand for Wood Pulp

Regarding the forest sector, in a context of substantial areas of denuded and bare lands (initially around 25% of Vietnam area), forestry rehabilitation and development plans have been continuously on the focus in Vietnam since the end of the war. The first projects were planned under an existing broader program, the United Nations World Food program (1975-200). These projects essentially concerned agro-forestry and demonstrations trials. Vietnam started its economic renovation policy (known as “Doi Moi”) in 1986 with a series of major economic programs and industrial development plans1. Among them, the program 327 (1993-1998) was initially planning substantial effort to rehabilitate forest degraded lands. It soon shifted to focus on forest protection in critical zones. Finally, the program 661 (1998-2010), also known as “Five million hectares reforestation program” (5MHRP), really put the emphasis on a substantial increment of the nation's forest areas. By the end of this program, the national forests are expected to cover more than 14 million hectares. The program includes both protection of existing forests and reforestation. Initially, Most of the production plantations were planned to be established with fast growing exogenous species (i.e. eucalyptus). Now, the government is promoting the development of indigenous species as much as possible.forest; tropical forest; pulp; paper; economy; Vietnam; trade; network; globalisation; China