A system for patient management based discrete-event simulation and hierarchical clustering

Hospital Accident and Emergency (A&E) departments in England have a 4 hour target to treat 98% of patients from arrival to discharge, admission or transfer. Managing resources to meet the target and deliver care across the range of A&E services is a huge challenge for A&E managers. This paper develops an intelligent patient management tool to help managers and clinicians better understand patient length of stay and resources within an A&E area. The developed discrete-event simulation model gives a highlevel representation of ambulance arrivals into A&E. The model facilitates analysis in the following ways: visually interactive software showing patient length of stay in the A&E area; patient activity broken down into sub-groups so that intelligence might be gathered on how sub-groups affect the overall length of stay; understanding the number of patient treatment places and nurse resources required. To support ease of inputs for scenario and sensitivity testing, data is entered into the simulation model (Simul8) via Excel spreadsheets. The model discussed in this paper used patient length of stay grouped by A&E diagnosis codes and was limited to ambulance arrivals. The analysis was derived from A&E attendance in 2004 from an English hospital

Trophodynamics of krill and its potential role in blue whale feeding in the Perth Canyon, south-east Indian Ocean

Migrating blue whales along the Western Australian coast exhibit feeding behaviour within the Perth Canyon, which is an area of high krill abundance, particularly for Euphausia recurva. The importance of krill in marine food webs has led to a number of trophodynamic studies investigating their fatty acid and stable isotope compositions. In the south-east Indian Ocean, the suppression of upwelling by the dominant Leeuwin Current results in relatively oligotrophic waters, particularly during autumn and winter. Oligotrophic waters tend to be dominated by small autotrophic flagellates (i. e. dinoflagellates) and cyanobacteria. We relate biochemical data obtained for E. recurva, as well as Stylocheiron carinatum and Pseudeuphausia latifrons with their potential food source, phytoplankton, and one of their potential predators, the endangered pygmy blue whale (Balaenoptera musculus brevicauda) sampled in the Perth Canyon. Fatty acids of all three krill species were dominated by polyunsaturated fatty acids (PUFA; ~50%) largely comprised of omega-3 PUFA, which is typical for krill. The high docosahexaenoic acid (DHA) to eicosapentaenoic acid (EPA) ratio reflects a dinoflagellate, rather than a diatom diet, and the high oleic acid (18: 1 9) to vaccenic acid (18: 1 7) ratio is indicative of an omnivorous diet. Stable isotope analysis positions E. recurva as a first, possibly second order consumer (5. 8 - 8. 4 15N)and phytoplankton as the likely source of carbon (-18 to -24 13C) .The fatty acid composition of krill did not match that of the surface phytoplankton sampled, which was low in PUFA and more reflective of degraded and detrital material. This suggests that krill are not feeding at the surface, and may feed closer to the deep chlorophyll maximum. The outer blubber layer sampled from the pygmy blue whale was high in monounsaturated fatty acids (MUFA, 58%) rather than PUFA, and did not reflect the krill fatty acid composition. However, the high DHA to EPA ratio in the blubber indicated a diet originating from dinoflagellates, as found for krill. Stratification of fatty acids across blubber layers is common for marine mammals and the outer blubber layer for some species has been found to not accurately reflect the diet of the animal

Observation of single collisionally cooled trapped ions in a buffer gas

Individual Ba ions are trapped in a gas-filled linear ion trap and observed with a high signal-to-noise ratio by resonance fluorescence. Single-ion storage times of ~5 min (~1 min) are achieved using He (Ar) as a buffer gas at pressures in the range 8e-5 - 4e-3 torr. Trap dynamics in buffer gases are experimentally studied in the simple case of single ions. In particular, the cooling effects of light gases such as He and Ar and the destabilizing properties of heavier gases such as Xe are studied. A simple model is offered to explain the observed phenomenology.Comment: 5 pages, 4 figures, accepted for publication in Phys. Rev. A. Minor text and figure change

Polarized photons in radiative muon capture

We discuss the measurement of polarized photons arising from radiative muon capture. The spectrum of left circularly polarized photons or equivalently the circular polarization of the photons emitted in radiative muon capture on hydrogen is quite sensitive to the strength of the induced pseudoscalar coupling constant $g_P$. A measurement of either of these quantities, although very difficult, might be sufficient to resolve the present puzzle resulting from the disagreement between the theoretical prediction for $g_P$ and the results of a recent experiment. This sensitivity results from the absence of left-handed radiation from the muon line and from the fact that the leading parts of the radiation from the hadronic lines, as determined from the chiral power counting rules of heavy-baryon chiral perturbation theory, all contain pion poles.Comment: 10 pages, 6 figure

A linear RFQ ion trap for the Enriched Xenon Observatory

The design, construction, and performance of a linear radio-frequency ion trap (RFQ) intended for use in the Enriched Xenon Observatory (EXO) are described. EXO aims to detect the neutrinoless double-beta decay of $^{136}$Xe to $^{136}$Ba. To suppress possible backgrounds EXO will complement the measurement of decay energy and, to some extent, topology of candidate events in a Xe filled detector with the identification of the daughter nucleus ($^{136}$Ba). The ion trap described here is capable of accepting, cooling, and confining individual Ba ions extracted from the site of the candidate double-beta decay event. A single trapped ion can then be identified, with a large signal-to-noise ratio, via laser spectroscopy.Comment: 18 pages, pdflatex, submitted to NIM