Towards a fairer reimbursement system for burn patients using cost-sensitive classification

The adoption of the Prospective Payment System (PPS) in the UK National Health Service (NHS) has led to the creation of patient groups called Health Resource Groups (HRG). HRGs aim to identify groups of clinically similar patients that share similar resource usage for reimbursement purposes. These groups are predominantly identified based on expert advice, with homogeneity checked using the length of stay (LOS). However, for complex patients such as those encountered in burn care, LOS is not a perfect proxy of resource usage, leading to incomplete homogeneity checks. To improve homogeneity in resource usage and severity, we propose a data-driven model and the inclusion of patient-level costing. We investigate whether a data-driven approach that considers additional measures of resource usage can lead to a more comprehensive model. In particular, a cost-sensitive decision tree model is adopted to identify features of importance and rules that allow for a focused segmentation on resource usage (LOS and patient-level cost) and clinical similarity (severity of burn). The proposed approach identified groups with increased homogeneity compared to the current HRG groups, allowing for a more equitable reimbursement of hospital care costs if adopted.Comment: Joint KDD 2021 Health Day and 2021 KDD Workshop on Applied Data Science for Healthcare: State of XAI and trustworthiness in Healt

Normal and Reverse Faulting Driven by the Subduction Zone Earthquake Cycle in the Northern Chilean Forearc

Despite its location in a convergent tectonic setting, the Coastal Cordillera of northern Chile between 21°S and 25°S is dominated by structures demonstrating extension in the direction of plate convergence. In some locations, however, normal faults have been reactivated as reverse faults, complicating the interpretation of long-term strain. In order to place these new observations in a tectonic context, we model stress changes induced on these faults by the subduction earthquake cycle. Our simulations predict that interseismic locking on the plate boundary encourages normal slip on fore-arc faults, which may result from elastic rebound due to interplate earthquakes or from seismic or aseismic motion that takes place within the interseismic period. Conversely, stress generated by strong subduction zone earthquakes, such as the 1995 Mw = 8.1 Antofagasta event, provides a mechanism for the reverse reactivation we document here. Upper plate fault slip in response to the low-magnitude stress changes induced by the subduction earthquake cycle suggests that the absolute level of stress on these faults is very low. Furthermore, seismic hazard analysis for northern Chile requires consideration of not only the plate boundary earthquake cycle but also the cycle on fore-arc faults that may or may not coincide with the interplate pattern. Though the relationships between permanent strain and deformation calculated using elastic models remain unclear, the compatibility of modeled stress fields with the distribution of fore-arc faulting suggests that interseismic strain accumulation and coseismic deformation on the subduction megathrust both play significant roles in shaping structural behavior in the upper plate

Slip Distribution of the 2014 Mw=8.1 Pisagua, Northern Chile, Earthquake Sequence Estimated From Coseismic Fore-Arc Surface Cracks

The 2014 Mw = 8.1 Iquique (Pisagua), Chile, earthquake sequence ruptured a segment of the Nazca-South America subduction zone that last hosted a great earthquake in 1877. The sequence opened \u3e3700 surface cracks in the fore arc of decameter-scale length and millimeter-to centimeter-scale aperture. We use the strikes of measured cracks, inferred to be perpendicular to coseismically applied tension, to estimate the slip distribution of the main shock and largest aftershock. The slip estimates are compatible with those based on seismic, geodetic, and tsunami data, indicating that geologic observations can also place quantitative constraints on rupture properties. The earthquake sequence ruptured between two asperities inferred from a regional-scale distribution of surface cracks, interpreted to represent a modal or most common rupture scenario for the northern Chile subduction zone. We suggest that past events, including the 1877 earthquake, broke the 2014 Pisagua source area together with adjacent sections in a throughgoing rupture

Surface Cracks Record Long-Term Seismic Segmentation of the Andean Margin

Understanding the long-term patterns of great earthquake rupture along a subduction zone provides a framework for assessing modern seismic hazard. However, evidence that can be used to infer the size and location of past earthquakes is typically erased by erosion after a few thousand years. Meter-scale cracks that cut the surface of coastal areas in northern Chile and southern Peru preserve a record of earthquakes spanning several hundred thousand years owing to the hyperarid climate of the region. These cracks have been observed to form during and/or shortly after strong subduction earthquakes, are preserved for long time periods throughout the Atacama Desert, demonstrate evidence for multiple episodes of reactivation, and show changes in orientation over spatial scales similar to the size of earthquake segments. Our observations and models show that crack orientations are consistent with dynamic and static stress fields generated by recent earthquakes. While localized structural and topographic processes influence some cracks, the strong preferred orientation over large regions indicates that cracks are primarily formed by plate boundary–scale stresses, namely repeated earthquakes. We invert the crack-based strain data for slip along the well-known Iquique seismic gap segment of the margin and find consistency with gravity anomaly–based inferences of long-term earthquake slip patterns, as well as the magnitude and location of the November 2007 Tocopilla earthquake. We suggest that the meter-scale cracks can be used to map characteristic earthquake rupture segments that persist over many seismic cycles, which encourages future study of cracks and other small-scale structures to better constrain the persistence of asperities in other arid, tectonically active regions

Is the Sevier Desert Reflection of West-Central Utah a Normal Fault?: Comment and Reply

Forum discussion on an article originally by Anders et al. Allmendinger and Royse critique Anders et al.'s argument, to which Anders et al. responds. Critique abstract: The continuing discussion of the Sevier Desert region, almost 20 years after MacDonald’s (1976) classic paper, provides a measure of the significance of the region as well as the non-uniqueness of seismic reflection data interpretation. The article by Anders and Christie-Blick (1994) and the nearly simultaneous publication of similar ideas by Hamilton (1994) raise important questions. The interpretation of a Sevier Desert detachment has always been a hypothesis to be tested rather than a fact. In our opinion, however, Anders and Christie-Blick and Hamilton have ignored a variety of basic geologic data requiring the presence of a major low-angle normal fault on the east side of the Sevier Desert basin. Response abstract: We concur with Allmendinger and Royse’s assessment of the detachment interpretation for the Sevier Desert reflection as a ‘‘hypothesis to be tested.’’ We reported on an attempt to do just that: to look for evidence for fault-related deformation in samples from two boreholes that intersect this feature. The absence of evidence for cataclasis in the inferred hanging-wall block or ductile deformation in the footwall naturally raises some interesting issues for the tectonic interpretation of the Sevier Desert. In drawing attention to these issues, we have not ‘‘ignored’’ any basic geologic data, nor are we aware of any data that ‘‘require’’ the presence of a major low-angle normal fault

Measurement and Interpretation of Fermion-Pair Production at LEP energies above the Z Resonance

This paper presents DELPHI measurements and interpretations of cross-sections, forward-backward asymmetries, and angular distributions, for the e+e- -> ffbar process for centre-of-mass energies above the Z resonance, from sqrt(s) ~ 130 - 207 GeV at the LEP collider. The measurements are consistent with the predictions of the Standard Model and are used to study a variety of models including the S-Matrix ansatz for e+e- -> ffbar scattering and several models which include physics beyond the Standard Model: the exchange of Z' bosons, contact interactions between fermions, the exchange of gravitons in large extra dimensions and the exchange of sneutrino in R-parity violating supersymmetry.Comment: 79 pages, 16 figures, Accepted by Eur. Phys. J.

Evidence for an Excess of Soft Photons in Hadronic Decays of Z^0

Soft photons inside hadronic jets converted in front of the DELPHI main tracker (TPC) in events of qqbar disintegrations of the Z^0 were studied in the kinematic range 0.2 < E_gamma < 1 GeV and transverse momentum with respect to the closest jet direction p_T < 80 MeV/c. A clear excess of photons in the experimental data as compared to the Monte Carlo predictions is observed. This excess (uncorrected for the photon detection efficiency) is (1.17 +/- 0.06 +/- 0.27) x 10^{-3} gamma/jet in the specified kinematic region, while the expected level of the inner hadronic bremsstrahlung (which is not included in the Monte Carlo) is (0.340 +/- 0.001 +/- 0.038) x 10^{-3} gamma/jet. The ratio of the excess to the predicted bremsstrahlung rate is then (3.4 +/- 0.2 +/- 0.8), which is similar in strength to the anomalous soft photon signal observed in fixed target experiments with hadronic beams.Comment: 37 pages, 9 figures, Accepted by Eur. Phys. J.

A Determination of the Centre-of-Mass Energy at LEP2 using Radiative 2-fermion Events

Using e+e- -> mu+mu-(gamma) and e+e- -> qqbar(gamma) events radiative to the Z pole, DELPHI has determined the centre-of-mass energy, sqrt{s}, using energy and momentum constraint methods. The results are expressed as deviations from the nominal LEP centre-of-mass energy, measured using other techniques. The results are found to be compatible with the LEP Energy Working Group estimates for a combination of the 1997 to 2000 data sets.Comment: 20 pages, 6 figures, Accepted by Eur. Phys. J.

Determination of the b quark mass at the M_Z scale with the DELPHI detector at LEP

An experimental study of the normalized three-jet rate of b quark events with respect to light quarks events (light= \ell \equiv u,d,s) has been performed using the CAMBRIDGE and DURHAM jet algorithms. The data used were collected by the DELPHI experiment at LEP on the Z peak from 1994 to 2000. The results are found to agree with theoretical predictions treating mass corrections at next-to-leading order. Measurements of the b quark mass have also been performed for both the b pole mass: M_b and the b running mass: m_b(M_Z). Data are found to be better described when using the running mass. The measurement yields: m_b(M_Z) = 2.85 +/- 0.18 (stat) +/- 0.13 (exp) +/- 0.19 (had) +/- 0.12 (theo) GeV/c^2 for the CAMBRIDGE algorithm. This result is the most precise measurement of the b mass derived from a high energy process. When compared to other b mass determinations by experiments at lower energy scales, this value agrees with the prediction of Quantum Chromodynamics for the energy evolution of the running mass. The mass measurement is equivalent to a test of the flavour independence of the strong coupling constant with an accuracy of 7 permil.Comment: 24 pages, 10 figures, Accepted by Eur. Phys. J.