Building Data-Driven Pathways From Routinely Collected Hospital Data:A Case Study on Prostate Cancer

Background: Routinely collected data in hospitals is complex, typically heterogeneous, and scattered across multiple Hospital Information Systems (HIS). This big data, created as a byproduct of health care activities, has the potential to provide a better understanding of diseases, unearth hidden patterns, and improve services and cost. The extent and uses of such data rely on its quality, which is not consistently checked, nor fully understood. Nevertheless, using routine data for the construction of data-driven clinical pathways, describing processes and trends, is a key topic receiving increasing attention in the literature. Traditional algorithms do not cope well with unstructured processes or data, and do not produce clinically meaningful visualizations. Supporting systems that provide additional information, context, and quality assurance inspection are needed. Objective: The objective of the study is to explore how routine hospital data can be used to develop data-driven pathways that describe the journeys that patients take through care, and their potential uses in biomedical research; it proposes a framework for the construction, quality assessment, and visualization of patient pathways for clinical studies and decision support using a case study on prostate cancer. Methods: Data pertaining to prostate cancer patients were extracted from a large UK hospital from eight different HIS, validated, and complemented with information from the local cancer registry. Data-driven pathways were built for each of the 1904 patients and an expert knowledge base, containing rules on the prostate cancer biomarker, was used to assess the completeness and utility of the pathways for a specific clinical study. Software components were built to provide meaningful visualizations for the constructed pathways. Results: The proposed framework and pathway formalism enable the summarization, visualization, and querying of complex patient-centric clinical information, as well as the computation of quality indicators and dimensions. A novel graphical representation of the pathways allows the synthesis of such information. Conclusions: Clinical pathways built from routinely collected hospital data can unearth information about patients and diseases that may otherwise be unavailable or overlooked in hospitals. Data-driven clinical pathways allow for heterogeneous data (ie, semistructured and unstructured data) to be collated over a unified data model and for data quality dimensions to be assessed. This work has enabled further research on prostate cancer and its biomarkers, and on the development and application of methods to mine, compare, analyze, and visualize pathways constructed from routine data. This is an important development for the reuse of big data in hospitals

Irreversibility in response to forces acting on graphene sheets

The amount of rippling in graphene sheets is related to the interactions with the substrate or with the suspending structure. Here, we report on an irreversibility in the response to forces that act on suspended graphene sheets. This may explain why one always observes a ripple structure on suspended graphene. We show that a compression-relaxation mechanism produces static ripples on graphene sheets and determine a peculiar temperature $T_c$, such that for $T<T_c$ the free-energy of the rippled graphene is smaller than that of roughened graphene. We also show that $T_c$ depends on the structural parameters and increases with increasing sample size.Comment: 4 pages, 4 Figure

Solvent-free coarse-grained lipid model for large-scale simulations

A coarse-grained molecular model, which consists of a spherical particle and an orientation vector, is proposed to simulate lipid membrane on a large length scale. The solvent is implicitly represented by an effective attractive interaction between particles. A bilayer structure is formed by orientation-dependent (tilt and bending) potentials. In this model, the membrane properties (bending rigidity, line tension of membrane edge, area compression modulus, lateral diffusion coefficient, and flip-flop rate) can be varied over broad ranges. The stability of the bilayer membrane is investigated via droplet-vesicle transition. The rupture of the bilayer and worm-like micelle formation can be induced by an increase in the spontaneous curvature of the monolayer membrane.Comment: 13 pages, 19 figure

The lamellar-to-isotropic transition in ternary amphiphilic systems

We study the dependence of the phase behavior of ternary amphiphilic systems on composition and temperature. Our analysis is based on a curvature elastic model of the surfactant film with sufficiently large spontaneous curvature and sufficiently negative saddle-splay modulus that the stable phases are the lamellar phase and a droplet microemulsion. In addition to the curvature energy, we consider the contributions to the free energy of the long-ranged van der Waals interaction and of the undulation modes. We find that for bending rigidities of order k_B T, the lamellar phase extends further and further into the water apex of the phase diagram as the phase inversion temperature is approached, in good agreement with experimental results.Comment: LaTeX2e, 11 pages with references and 2 eps figures included, submitted to Europhys. Let

The isotropic-nematic interface in suspensions of hard rods: Mean-field properties and capillary waves

We present a study of the isotropic-nematic interface in a system of hard spherocylinders. First we compare results from Monte Carlo simulations and Onsager density functional theory for the interfacial profiles of the orientational order parameter and the density. Those interfacial properties that are not affected by capillary waves are in good agreement, despite the fact that Onsager theory overestimates the coexistence densities. Then we show results of a Monte Carlo study of the capillary waves of the interface. In agreement with recent theoretical investigations (Eur.Phys.J. E {\bf 18} 407 (2005)) we find a strongly anistropic capillary wave spectrum. For the wave-numbers accessed in our simulations, the spectrum is quadratic, i.e.elasticity does not play a role. We conjecture that this effect is due to the strong bending rigidity of the director field in suspensions of spherocylinders.Comment: 8 pages, 10 figure

Shape of a liquid front upon dewetting

We examine the profile of a liquid front of a film that is dewetting a solid substrate. Since volume is conserved, the material that once covered the substrate is accumulated in a rim close to the three phase contact line. Theoretically, such a profile of a Newtonian liquid resembles an exponentially decaying harmonic oscillation that relaxes into the prepared film thickness. For the first time, we were able to observe this behavior experimentally. A non-Newtonian liquid - a polymer melt - however, behaves differently. Here, viscoelastic properties come into play. We will demonstrate that by analyzing the shape of the rim profile. On a nm scale, we gain access to the rheology of a non-Newtonian liquid.Comment: 4 pages, 4 figure

Liquid drops on a surface: using density functional theory to calculate the binding potential and drop profiles and comparing with results from mesoscopic modelling

The contribution to the free energy for a film of liquid of thickness $h$ on a solid surface, due to the interactions between the solid-liquid and liquid-gas interfaces is given by the binding potential, $g(h)$. The precise form of $g(h)$ determines whether or not the liquid wets the surface. Note that differentiating $g(h)$ gives the Derjaguin or disjoining pressure. We develop a microscopic density functional theory (DFT) based method for calculating $g(h)$, allowing us to relate the form of $g(h)$ to the nature of the molecular interactions in the system. We present results based on using a simple lattice gas model, to demonstrate the procedure. In order to describe the static and dynamic behaviour of non-uniform liquid films and drops on surfaces, a mesoscopic free energy based on $g(h)$ is often used. We calculate such equilibrium film height profiles and also directly calculate using DFT the corresponding density profiles for liquid drops on surfaces. Comparing quantities such as the contact angle and also the shape of the drops, we find good agreement between the two methods. We also study in detail the effect on $g(h)$ of truncating the range of the dispersion forces, both those between the fluid molecules and those between the fluid and wall. We find that truncating can have a significant effect on $g(h)$ and the associated wetting behaviour of the fluid.Comment: 16 pages, 13 fig

Zero-range processes with saturated condensation: the steady state and dynamics

We study a class of zero-range processes in which the real-space condensation phenomenon does not occur and is replaced by a saturated condensation: that is, an extensive number of finite-size "condensates" in the steady state. We determine the conditions under which this occurs, and investigate the dynamics of relaxation to the steady state. We identify two stages: a rapid initial growth of condensates followed by a slow process of activated evaporation and condensation. We analyze these nonequilibrium dynamics with a combination of meanfield approximations, first-passage time calculations and a fluctuation-dissipation type approach.Comment: 21 pages, 12 figure

Universal reduction of pressure between charged surfaces by long-wavelength surface charge modulation

We predict theoretically that long-wavelength surface charge modulations universally reduce the pressure between the charged surfaces with counterions compared with the case of uniformly charged surfaces with the same average surface charge density. The physical origin of this effect is the fact that surface charge modulations always lead to enhanced counterion localization near the surfaces, and hence, fewer charges at the midplane. We confirm the last prediction with Monte Carlo simulations.Comment: 8 pages 1 figure, Europhys. Lett., in pres

Capillary Waves in a Colloid-Polymer Interface

The structure and the statistical fluctuations of interfaces between coexisting phases in the Asakura-Oosawa (AO) model for a colloid--polymer mixture are analyzed by extensive Monte Carlo simulations. We make use of a recently developed grand canonical cluster move with an additional constraint stabilizing the existence of two interfaces in the (rectangular) box that is simulated. Choosing very large systems, of size LxLxD with L=60 and D=120, measured in units of the colloid radius, the spectrum of capillary wave-type interfacial excitations is analyzed in detail. The local position of the interface is defined in terms of a (local) Gibbs surface concept. For small wavevectors capillary wave theory is verified quantitatively, while for larger wavevectors pronounced deviations show up. For wavevectors that correspond to the typical distance between colloids in the colloid-rich phase, the interfacial fluctuations exhibit the same structure as observed in the bulk structure factor. When one analyzes the data in terms of the concept of a wavevector-dependent interfacial tension, a monotonous decrease of this quantity with increasing wavevector is found. Limitations of our analysis are critically discussed.Comment: 12 pages, 15 figure