Modelling of errors in databases

A lot of time and energy are expended assembling national databases containing information about health care processes and outcomes. Unfortunately, given the complexity of the data gathering procedures involved, errors occur. This inevitably leads to problems when it comes to the analysis of data from such sources. Indeed, sometimes it is very much a matter of faith that summary statistics represent a true reflection of the facts. On the assumption that one knows the rates at which different forms of errors occur, mathematical modelling methods can be used to obtain estimates of the effects of such errors on the estimates that would be derived for summary statistics associated with an erroneous data base

Can the Heinrich ratio be used to predict harm from medication errors?

The purpose of this study was to establish whether, for medication errors, there exists a fixed Heinrich ratio between the number of incidents which did not result in harm, the number that caused minor harm, and the number that caused serious harm. If this were the case then it would be very useful in estimating any changes in harm following an intervention. Serious harm resulting from medication errors is relatively rare, so it can take a great deal of time and resource to detect a significant change. If the Heinrich ratio exists for medication errors, then it would be possible, and far easier, to measure the much more frequent number of incidents that did not result in harm and the extent to which they changed following an intervention; any reduction in harm could be extrapolated from this

Preliminary basic performance analysis of the Cedar multiprocessor memory system

Some preliminary basic results on the performance of the Cedar multiprocessor memory system are presented. Empirical results are presented and used to calibrate a memory system simulator which is then used to discuss the scalability of the system

Incidence and viral aetiologies of acute respiratory illnesses (ARIs) in the United States: a population-based study.

We conducted prospective, community-wide surveillance for acute respiratory illnesses (ARIs) in Rochester, NY and Marshfield, WI during a 3-month period in winter 2011. We estimated the incidence of ARIs in each community, tested for viruses, and determined the proportion of ARIs associated with healthcare visits. We used a rolling cross-sectional design to sample participants, conducted telephone interviews to assess ARI symptoms (defined as a current illness with feverishness or cough within the past 7 days), collected nasal/throat swabs to identify viruses, and extracted healthcare utilization from outpatient/inpatient records. Of 6492 individuals, 321 reported an ARI within 7 days (4·9% total, 5·7% in Rochester, 4·4% in Marshfield); swabs were collected from 208 subjects. The cumulative ARI incidence for the entire 3-month period was 52% in Rochester [95% confidence interval (CI) 42-63] and 35% in Marshfield (95% CI 28-42). A specific virus was identified in 39% of specimens: human coronavirus (13% of samples), rhinovirus (12%), RSV (7%), influenza virus (4%), human metapneumovirus (4%), and adenovirus (1%). Only 39/200 (20%) had a healthcare visit (2/9 individuals with influenza). ARI incidence was ~5% per week during winter

Planning Ahead: Object-Directed Sequential Actions Decoded from Human Frontoparietal and Occipitotemporal Networks.

Object-manipulation tasks (e.g., drinking from a cup) typically involve sequencing together a series of distinct motor acts (e.g., reaching toward, grasping, lifting, and transporting the cup) in order to accomplish some overarching goal (e.g., quenching thirst). Although several studies in humans have investigated the neural mechanisms supporting the planning of visually guided movements directed toward objects (such as reaching or pointing), only a handful have examined how manipulatory sequences of actions-those that occur after an object has been grasped-are planned and represented in the brain. Here, using event-related functional MRI and pattern decoding methods, we investigated the neural basis of real-object manipulation using a delayed-movement task in which participants first prepared and then executed different object-directed action sequences that varied either in their complexity or final spatial goals. Consistent with previous reports of preparatory brain activity in non-human primates, we found that activity patterns in several frontoparietal areas reliably predicted entire action sequences in advance of movement. Notably, we found that similar sequence-related information could also be decoded from pre-movement signals in object- and body-selective occipitotemporal cortex (OTC). These findings suggest that both frontoparietal and occipitotemporal circuits are engaged in transforming object-related information into complex, goal-directed movements

Interpolatory methods for H∞\mathcal{H}_\infty model reduction of multi-input/multi-output systems

We develop here a computationally effective approach for producing high-quality $\mathcal{H}_\infty$-approximations to large scale linear dynamical systems having multiple inputs and multiple outputs (MIMO). We extend an approach for $\mathcal{H}_\infty$ model reduction introduced by Flagg, Beattie, and Gugercin for the single-input/single-output (SISO) setting, which combined ideas originating in interpolatory $\mathcal{H}_2$-optimal model reduction with complex Chebyshev approximation. Retaining this framework, our approach to the MIMO problem has its principal computational cost dominated by (sparse) linear solves, and so it can remain an effective strategy in many large-scale settings. We are able to avoid computationally demanding $\mathcal{H}_\infty$ norm calculations that are normally required to monitor progress within each optimization cycle through the use of "data-driven" rational approximations that are built upon previously computed function samples. Numerical examples are included that illustrate our approach. We produce high fidelity reduced models having consistently better $\mathcal{H}_\infty$ performance than models produced via balanced truncation; these models often are as good as (and occasionally better than) models produced using optimal Hankel norm approximation as well. In all cases considered, the method described here produces reduced models at far lower cost than is possible with either balanced truncation or optimal Hankel norm approximation

Neural representation of geometry and surface properties in object and scene perception

Multiple cortical regions are crucial for perceiving the visual world, yet the processes shaping representations in these regions are unclear. To address this issue, we must elucidate how perceptual features shape representations of the environment. Here, we explore how the weighting of different visual features affects neural representations of objects and scenes, focusing on the scene-selective parahippocampal place area (PPA), but additionally including the retrosplenial complex (RSC), occipital place area (OPA), lateral occipital (LO) area, fusiform face area (FFA) and occipital face area (OFA). Across three experiments, we examined functional magnetic resonance imaging (fMRI) activity while human observers viewed scenes and objects that varied in geometry (shape/layout) and surface properties (texture/material). Interestingly, we found equal sensitivity in the PPA for these properties within a scene, revealing that spatial-selectivity alone does not drive activation within this cortical region. We also observed sensitivity to object texture in PPA, but not to the same degree as scene texture, and representations in PPA varied when objects were placed within scenes. We conclude that PPA may process surface properties in a domain-specific manner, and that the processing of scene texture and geometry is equally-weighted in PPA and may be mediated by similar underlying neuronal mechanisms

The Quantized O(1,2)/O(2)×Z2O(1,2)/O(2)\times Z_2 Sigma Model Has No Continuum Limit in Four Dimensions. I. Theoretical Framework

The nonlinear sigma model for which the field takes its values in the coset space $O(1,2)/O(2)\times Z_2$ is similar to quantum gravity in being perturbatively nonrenormalizable and having a noncompact curved configuration space. It is therefore a good model for testing nonperturbative methods that may be useful in quantum gravity, especially methods based on lattice field theory. In this paper we develop the theoretical framework necessary for recognizing and studying a consistent nonperturbative quantum field theory of the $O(1,2)/O(2)\times Z_2$ model. We describe the action, the geometry of the configuration space, the conserved Noether currents, and the current algebra, and we construct a version of the Ward-Slavnov identity that makes it easy to switch from a given field to a nonlinearly related one. Renormalization of the model is defined via the effective action and via current algebra. The two definitions are shown to be equivalent. In a companion paper we develop a lattice formulation of the theory that is particularly well suited to the sigma model, and we report the results of Monte Carlo simulations of this lattice model. These simulations indicate that as the lattice cutoff is removed the theory becomes that of a pair of massless free fields. Because the geometry and symmetries of these fields differ from those of the original model we conclude that a continuum limit of the $O(1,2)/O(2)\times Z_2$ model which preserves these properties does not exist.Comment: 25 pages, no figure

High Salinity Relay as a Postharvest Processing Strategy To Reduce Vibrio vulnificus Levels in Chesapeake Bay Oysters (Crassostrea virginica)

In 2009 the U.S. Food and Drug Administration (FDA) announced its intention to implement postharvest processing (PHP) methods to eliminate Vibrio vulnificus from oysters intended for the raw, half-shell market that are harvested from the Gulf of Mexico during warmer months. FDA-approved PHP methods can be expensive and may be associated with unfavorable responses from some consumers. A relatively unexplored PHP method that uses relaying to high salinity waters could be an alternative strategy, considering that high salinities appear to negatively affect the survival of V. vulnificus. During relay, however, oysters may be exposed to rapid and large salinity increases that could cause increased mortality. In this study, the effectiveness of high salinity relay to reduce V. vulnificus to (MPN) per g and the impact on oyster mortality were assessed in the lower Chesapeake Bay. Two relay experiments were performed during the summer and fall of 2010. Oysters collected from three grow-out sites, a low salinity site (14 to 15 practical salinity units [psu]) and two moderate salinity sites (22 to 25 psu), were relayed directly to a high salinity site (≥30 psu) on Virginia\u27s Eastern Shore. Oysters were assayed for V. vulnificus and Vibrio parahaemolyticus (another Vibrio species of concern) densities at time 0 prior to relay and after 7 and 14 days of relay, using the FDA MPN enrichment method combined with detection by real-time PCR. After 14 days, both V. vulnificus and V. parahaemolyticus densities were ≤0.8 MPN/g, and decreases of 2 to 3 log in V. vulnificus densities were observed. Oyster mortalities were low (

“Turning Point”: Evaluating the Impact of a Three-Month UK-Based Clinical Education Training Programme for Physicians from a Chinese Medical School

Purpose: Transnational faculty development programmes are increasingly popular in medicine, although evaluation of such activities rarely considers longer-term outcomes or the impact of language training. This study attempts to fill this gap by evaluating the lasting impacts of a three-month clinical education and English language training programme at University College London Medical School, UK, for medical educators from Ningbo University, China. Methods: In-depth, semi-structured interviews were conducted in China with 41 participants who had completed the programme between 2013 and 2018. Interview data were analysed using an inductive thematic analysis, and themes were categorised using the four primary components of the faculty development model outlined by Irby and O’Sullivan (2011) – context, facilitator, programme, and participant. Results: Contextual impacts included the importance of participants learning in the familiar environment of their own clinical discipline, the cultural enrichment gained by spending time overseas, reflecting on differences in health-care systems, and attempts to implement and disseminate learning on return to China. Facilitator-related factors included new insights into the student–educator relationship and valuing the support of programme mentors. Programme-related factors included exposure to new teaching methods and technical presentation skills, the challenges of navigating observership placements, spoken English language and pronunciation issues, and establishing a peer network of medical educators. Participant-related factors included improved confidence and self-reflection, adjusting educational approaches for different student groups, and career development in medical education. Conclusion: Participants gained teaching confidence from their engagement in the programme and many described it as a turning point in their careers as educators. Although in the period after attending, individuals changed their own practices and influenced colleagues within their organisation, often through taking on senior roles, and systematic education changes were generally not implemented. Dedicated English language classes and clinical placements were considered the most positive features of the programme