Performance comparison of the exact run-length distribution between the run sum X and EWMA X charts

The run sum (RS) X and exponentially weighted moving average (EWMA) X charts are very effective in detecting small and moderate process mean shifts. The design of the RS X and EWMA X charts based on the average run length (ARL) alone, can be misleading and confusing. This is due to the fact that the run-length distribution of a control chart is highly right-skewed when the process is in-control or slightly out-of-control; while that for the out-ofcontrol cases, the run-length distribution is almost symmetric. On the other hand, the percentiles of the run-length distribution provide the probability of getting a signal by a certain number of samples. This will benefit practitioners as the percentiles of the run-length distribution give comprehensive information regarding the behaviour of a control chart. Accordingly, this paper provides a thorough study of the run-length properties (ARL, standard deviation of the run length and percentiles of the run-length distribution) for the RS X and EWMA X charts. Comparative studies show that the EWMA X chart outperforms the RS X charts for detecting small mean shifts when all the control charts are optimized with respect to a small shift size. However, the RS X charts surpass the EWMA X chart for all sizes of mean shifts when all the control charts are optimized with respect to a large shift size

Benefits and limitations of implementing Chronic Care Model (CCM) in primary care programs: a systematic review

Background: Chronic Care Model (CCM) has been developed to improve patients' health care by restructuring health systems in a multidimensional manner. This systematic review aims to summarize and analyse programs specifically designed and conducted for the fulfilment of multiple CCM components. We have focused on programs targeting diabetes mellitus, hypertension and cardiovascular disease. Method and results: This review was based on a comprehensive literature search of articles in the PubMed database that reported clinical outcomes. We included a total of 25 eligible articles. Evidence of improvement in medical outcomes and the compliance of patients with medical treatment were reported in 18 and 14 studies, respectively. Two studies demonstrated a reduction of the medical burden in terms of health service utilization, and another two studies reported the effectiveness of the programs in reducing the risk of heart failure and other cardiovascular diseases. However, CCMs were still restricted by limited academic robustness and social constraints when they were implemented in primary care. Higher professional recognition, tighter system collaborations and increased financial support may be necessary to overcome the limitations of, and barriers to CCM implementation. Conclusion: This review has identified the benefits of implementing CCM, and recommended suggestions for the future development of CCM

Surveillance of emerging drugs of abuse in Hong Kong: Validation of an analytical tool

© 2015, Hong Kong Academy of Medicine Press. All rights reserved. Objective: To validate a locally developed chromatography-based method to monitor emerging drugs of abuse whilst performing regular drug testing in abusers. Design: Cross-sectional study. Setting: Eleven regional hospitals, seven social service units, and a tertiary level clinical toxicology laboratory in Hong Kong. Participants: A total of 972 drug abusers and high-risk individuals were recruited from acute, rehabilitation, and high-risk settings between 1 November 2011 and 31 July 2013. A subset of the participants was of South Asian ethnicity. In total, 2000 urine or hair specimens were collected. Main outcome measures: Proof of concept that surveillance of emerging drugs of abuse can be performed whilst conducting routine drug of abuse testing in patients. Results: The method was successfully applied to 2000 samples with three emerging drugs of abuse detected in five samples: PMMA (paramethoxymethamphetamine), TFMPP [1-(3-trifluoromethylphenyl)piperazine], and methcathinone. The method also detected conventional drugs of abuse, with codeine, methadone, heroin, methamphetamine, and ketamine being the most frequently detected drugs. Other findings included the observation that South Asians had significantly higher rates of using opiates such as heroin, methadone, and codeine; and that ketamine and cocaine had significantly higher detection rates in acute subjects compared with the rehabilitation population. Conclusions: This locally developed analytical method is a valid tool for simultaneous surveillance of emerging drugs of abuse and routine drug monitoring of patients at minimal additional cost and effort. Continued, proactive surveillance and early identification of emerging drugs will facilitate prompt clinical, social, and legislative management.Link_to_subscribed_fulltex

Special Libraries, April 1933

Volume 24, Issue 3https://scholarworks.sjsu.edu/sla_sl_1933/1002/thumbnail.jp

Highly-parallelized simulation of a pixelated LArTPC on a GPU

The rapid development of general-purpose computing on graphics processing units (GPGPU) is allowing the implementation of highly-parallelized Monte Carlo simulation chains for particle physics experiments. This technique is particularly suitable for the simulation of a pixelated charge readout for time projection chambers, given the large number of channels that this technology employs. Here we present the first implementation of a full microphysical simulator of a liquid argon time projection chamber (LArTPC) equipped with light readout and pixelated charge readout, developed for the DUNE Near Detector. The software is implemented with an end-to-end set of GPU-optimized algorithms. The algorithms have been written in Python and translated into CUDA kernels using Numba, a just-in-time compiler for a subset of Python and NumPy instructions. The GPU implementation achieves a speed up of four orders of magnitude compared with the equivalent CPU version. The simulation of the current induced on 10^3 pixels takes around 1 ms on the GPU, compared with approximately 10 s on the CPU. The results of the simulation are compared against data from a pixel-readout LArTPC prototype

The bulbocavernosus reflex in the assessment of neurogenic impotence in diabetic and non-diabetic men

Annals of the Academy of Medicine Singapore254558-561AAMS

Use of sedation in dentistry.

Singapore dental journal231 Suppl14-1