Modelling polio data using the first order non-negative integer-valued autoregressive INAR(1) model.

Time series data may consists of counts, such as the number of road accidents, the number of patients in a certain hospital, the number of customers waiting for service at a certain time and etc. When the value of the observations are large it is usual to use Gaussian Autoregressive Moving Average (ARMA) process to model the time series. However if the observed counts are small, it is not appropriate to use ARMA process to model the observed phenomenon. In such cases we need to model the time series data by using Non-Negative Integer valued Autoregressive (INAR) process. The modeling of counts data is based on the binomial thinning operator. In this paper we illustrate the modeling of counts data using the monthly number of Poliomyelitis data in United States between January 1970 until December 1983. We applied the AR(1), Poisson regression model and INAR(1) model and the suitability of these models were assessed by using the Index of Agreement(I.A.). We found that INAR(1) model is more appropriate in the sense it had a better I.A. and it is natural since the data are counts

Safety of switching from brand-name to generic levetiracetam in patients with epilepsy

Purpose: The approach to the use of generic antiepileptic drugs has recently evolved from major concern to general acceptance, but the evidence related specifically to the safety of switching from brand-name to generic levetiracetam (LEV) is scarce. The aim of the study was to assess the risk of increased frequency of seizures or other adverse events after replacement of a brand-name LEV with a generic one. Patients and methods: This retrospective analysis included 159 patients treated with LEV in a tertiary outpatient epilepsy clinic. We included all patients diagnosed with epilepsy who were treated with LEV as at March 1, 2013. Most patients were forced to switch to the generic LEV because of the sudden rise in cost of the branded LEV. We recorded data on age, sex, age at onset of epilepsy, type of epilepsy, and its treatment. We analyzed data from one visit before potential switching and from two visits after the potential switching. The interval between visits was typically 3 months. We registered an increase in the frequency of seizures and in the occurrence of adverse events. Results: Among 151 subjects who switched to generic LEV after March 1, 2013, increased frequency of seizures was noted in 9 patients (6%) during the first follow-up visit. Patients with increased frequency of seizures did not differ from other patients regarding sex, age, age at the onset of epilepsy, and the median dose of LEV before switching or the median duration of treatment with LEV before switching. Two patients returned to brand-name LEV. Adverse events were noted in six other patients (4%) and included somnolence, irritability, or dizziness. Conclusion: Switching from brand-name to generic LEV is generally safe

Hybrid AC/DC Transmission Expansion Planning Considering HVAC to HVDC Conversion Under Renewable Penetration

In this paper, a dynamic (i.e. multi-year) hybrid model is presented for Transmission Expansion Planning (TEP) utilizing the High Voltage Alternating Current (HVAC) and multiterminal Voltage Sourced Converter (VSC)-based High Voltage Direct Current (HVDC) alternatives. In addition to new HVAC and HVDC lines, the possibility of converting existing HVAC transmission lines to HVDC lines is considered in the proposed model. High shares of renewable resources are integrated into the proposed hybrid AC/DC TEP model. Due to the intermittency of renewable resources, the planning of large-scale Energy Storage (ES) devices is considered. In order to accurately estimate the total TEP costs and hence capturing the scenarios of load and renewable generation uncertainty, using a clustering approach, each year of the planning horizon is replaced with four representative days. The proposed model is formulated as a Mixed-Integer Linear Programming (MILP) problem. Using Benders Decomposition (BD) algorithm, the proposed model is decomposed into a Master investment problem to handle the decision variables, and Sub-problems to check the feasibility of master problem solution and optimize the operation and ES investment cost. Three test systems are used as case studies to demonstrate the effectiveness of the proposed hybrid AC/DC TEP model

Uraz wielonarządowy - udział Lotniczego Pogotowia Ratunkowego w akcji ratowniczej

Obrażenia ciała spowodowane urazem są jedną z wiodących przyczyn umieralności na świecie. Są pierwszą przyczyną zgonów w grupie wiekowej 10-45 lat. Postępowanie przedszpitalne z pacjentem może okazać się nie lada wyzwaniem dla zespołu ratownictwa medycznego. Dedykowanym protokołem postępowania z pacjentem w fazie przedszpitalnej jest protokół ITLS (International Trauma Life Support) lub TCCC (Tactical Combat Casualty Care) w zależności od specyfikacji miejsca zdarzenia. W postępowaniu szpitalnym dobrze jest zwrócić uwagę na protokoły ETC (European Trauma Course) oraz SDC (Surgery Damage Control). Ostatni z wymienionych ma związek z medycyną pola walki i coraz częściej docenia się jego skuteczność w doświadczeniach cywilnych. Bez względu na to jaki protokół postępowania zostanie wykorzystany priorytetem dla każdego medyka, na każdym etapie jest walka o życie pacjenta i maksymalne skrócenie czasu od momentu zdarzenia do wdrożenia właściwego leczenia. Jedną z możliwości skrócenia czasu jest wykorzystanie zespołu HEMS (Helicopter Emergency Medical Service) celem szybkiego transportu pacjenta do właściwego zakładu opieki zdrowotnej. Niniejsza praca opisuje epidemiologię, postępowanie oraz element transportu z uwzględnieniem drogi lotniczej u pacjentów z mnogimi obrażeniami ciała