Improving Runtime Overheads for detectEr

We design monitor optimisations for detectEr, a runtime-verification tool synthesising systems of concurrent monitors from correctness properties for Erlang programs. We implement these optimisations as part of the existing tool and show that they yield considerably lower runtime overheads when compared to the unoptimised monitor synthesis.Comment: In Proceedings FESCA 2015, arXiv:1503.0437

Are routine investigations in acute paediatric admissions justified?

Aim: To assess the appropriateness of investigations and their impact on management of acute paediatric admissions. Method: All investigations performed within the first six hours in all consecutive paediatric admissions (n=138) over a 6 week period, in a teaching general hospital, were recorded retrospectively and the results were analysed for normality/ abnormality and effect on patient management. Results: Out of a total of 480 emergency investigations performed on 89 patients, the complete blood count, electrolytes and chest X-rays were the three investigations most likely to be deranged and influenced management in 5% (n=3), 25% (n=8) and 46% (n=6) of subjects with an abnormal result, respectively. Impact on management was more evident on analysing a subgroup admitted with mild gastroenteritis, in whom serum electrolytes were abnormal in 50% (n=19), and 42% (n=8) of these needed a change in their management. Conclusion: Rationalising the number of investigations in acute paediatric admissions would result in less discomfort to children and in a significant cost benefit.peer-reviewe

Is 24 hour observation in hospital after stopping intravenous antibiotics in neonates justified?

Background: Antibiotics are given empirically for suspected sepsis in up to 75% of neonates on the Neonatal and Paediatric Intensive Care Unit (NPICU), after completion of a septic screen. Treatment is discontinued on day 3 if cultures remain negative or after 7-14 days with proven sepsis and, until recently, these neonates are then observed for an additional period of 24 hours before being discharged from hospital. Aim: To assess whether the 24 hour observation period after stopping antibiotics is clinically justified and, if not, whether neonates can be discharged safely on the same day when antibiotics are stopped. Methods: A consecutive sample of 95 babies admitted to NPICU, and who received antibiotics, from December 2006 to January 2008 were analysed prospectively. Their clinical presentation, predisposing risk factors for neonatal sepsis, investigations, antibiotic details and medical management including respiratory support were recorded, and correlated with all events that may have occurred during the observation period after stopping antibiotics. Results: No adverse events were documented in the 24 hour period after antibiotics in all 95 neonates in this study and, therefore, there was no association with any potential predisposing risk factors. Conclusion: The need to observe neonates for a period prior to discharge after stopping antibiotics is not supported on clinical grounds and, as a result of this study, has been discontinued. Neonates can be discharged from hospital safely and immediately on stopping antibiotics, thus reducing hospital stay and an estimated cost saving of approximately €18,000 to the service provider per annum.peer-reviewe

Overview of the blood transfusion policy in preterms on the Neonatal Intensive Care Unit

Preterm infants on the Neonatal Intensive Care Unit receive a greater number of red cell transfusions than any other hospitalised group. Over the past twenty years research has focused on setting standards to determine when it is necessary to transfuse packed cells in this cohort, whilst exploring the use of red cell growth factors and other substrates judiciously in order to reduce and/or avoid red cell transfusions and limit donor exposure. One hundred and eighty-one blood transfusions were administered to 106 preterms less than 35 weeks gestation on the NICU during 2009 in Malta. The median (range) volume of blood used from each bag supplied by the Blood Transfusion Department was 25.8mls (10-50mls), the rest of which was discarded. Risk factors for transfusion included Extremely Low Birth Weight (less than 1kg) and a gestation of less than 30 weeks. The blood transfusion guidelines presently in use on the local NICU were reviewed and compared with more restrictive guidelines on other units and suggestions made to reduce transfusions in line with these guidelines. A reduction in transfusion aliquots provided for neonates to just 50mls from the customary 250mls in a dedicated single-donor programme will safeguard limited health resources and minimise donor exposure.peer-reviewe

Gaussian distributions on Riemannian symmetric spaces, random matrices, and planar Feynman diagrams

Gaussian distributions can be generalized from Euclidean space to a wide class of Riemannian manifolds. Gaussian distributions on manifolds are harder to make use of in applications since the normalisation factors, which we will refer to as partition functions, are complicated, intractable integrals in general that depend in a highly non-linear way on the mean of the given distribution. Nonetheless, on Riemannian symmetric spaces, the partition functions are independent of the mean and reduce to integrals over finite dimensional vector spaces. These are generally still hard to compute numerically when the dimension (more precisely the rank $N$) of the underlying symmetric space gets large. On the space of positive definite Hermitian matrices, it is possible to compute these integrals exactly using methods from random matrix theory and the so-called Stieltjes-Wigert polynomials. In other cases of interest to applications, such as the space of symmetric positive definite (SPD) matrices or the Siegel domain (related to block-Toeplitz covariance matrices), these methods seem not to work quite as well. Nonetheless, it remains possible to compute leading order terms in a large $N$ limit, which provide increasingly accurate approximations as $N$ grows. This limit is inspired by realizing a given partition function as the partition function of a zero-dimensional quantum field theory or even Chern-Simons theory. From this point of view the large $N$ limit arises naturally and saddle-point methods, Feynman diagrams, and certain universalities that relate different spaces emerge

The Containment Scouts: First Insights into an Initiative to Increase the Public Health Workforce for Contact Tracing during the COVID-19 Pandemic in Germany

The COVID-19 pandemic in Germany has demanded a substantially larger public health workforce to perform contact tracing and contact management of COVID-19 cases, in line with recommendations of the World Health Organization (WHO). In response, the Robert Koch Institute (RKI) established the national “Containment Scout Initiative” (CSI) to support the local health authorities with a short-term workforce solution. It is part of a range of measures for strengthening the public health system in order to limit the spread of SARS-CoV-2 in Germany. The CSI is an example of how solutions to address critical health system capacity issues can be implemented quickly. It also demonstrates that medical or health-related backgrounds may not be necessary to support health authorities with pandemic-specific tasks and fulfil accurate contact tracing. However, it is a short-term solution and cannot compensate for the lack of existing qualified staff as well as other deficits that exist within the public health sector in Germany. This article describes the structure and process of the first phase of this initiative in order to support health policymakers, public health practitioners, and researchers considering innovative and flexible approaches for addressing urgent workforce capacity issues.Peer Reviewe

Practical recommendations for hyperspectral and thermal proximal disease sensing in potato and leek fields

Thermal and hyperspectral proximal disease sensing are valuable tools towards increasing pesticide use efficiency. However, some practical aspects of the implementation of these sensors remain poorly understood. We studied an optimal measurement setup combining both sensors for disease detection in leek and potato. This was achieved by optimising the signal-to-noise ratio (SNR) based on the height of measurement above the crop canopy, off-zenith camera angle and exposure time (ET) of the sensor. Our results indicated a clear increase in SNR with increasing ET for potato. Taking into account practical constraints, the suggested setup for a hyperspectral sensor in our experiment involves (for both leek and potato) an off-zenith angle of 17 degrees, height of 30 cm above crop canopy and ET of 1 ms, which differs from the optimal setup of the same sensor for wheat. Artificial light proved important to counteract the effect of cloud cover on hyperspectral measurements. The interference of these lamps with thermal measurements was minimal for a young leek crop but increased in older leek and after long exposure. These results indicate the importance of optimising the setup before measurements, for each type of crop