Healthcare in continuum for an ageing population: national self monitoring or remote offshore monitoring for Australia?

Australia is a country, similar to other developed nations, confronting an ageing population with complex demographics. Ensuring continued healthcare for the ageing, while providing sufficient support for the already aged population requiring assistance, is at the forefront of the national agenda. Varied initiatives are with foci to leverage the advantages of lCTs leading to e-Health provisioning and assisted technologies. While these initiatives increasingly put budgetary constraints on local and federal governments, there is also a case for offshore resourcing of non-critical health services, to support, streamline and enhance the continuum of care, as the nation faces acute shortages of medical practitioners and nurses. However, privacy and confidentiality concerns in this context are a significant issue in Australia. In this paper, we take the position that if the National and state electronic health records system initiatives, are fully implemented, offshore resourcing can be a feasible complementary option resulting in a win-win situation of cutting costs and enabling the continuum of healthcare.<br /

Persistence in q-state Potts model: A Mean-Field approach

We study the Persistence properties of the T=0 coarsening dynamics of one dimensional $q$-state Potts model using a modified mean-field approximation (MMFA). In this approximation, the spatial correlations between the interfaces separating spins with different Potts states is ignored, but the correct time dependence of the mean density $P(t)$ of persistent spins is imposed. For this model, it is known that $P(t)$ follows a power-law decay with time, $P(t)\sim t^{-\theta(q)}$ where $\theta(q)$ is the $q$-dependent persistence exponent. We study the spatial structure of the persistent region within the MMFA. We show that the persistent site pair correlation function $P_{2}(r,t)$ has the scaling form $P_{2}(r,t)=P(t)^{2}f(r/t^{{1/2}})$ for all values of the persistence exponent $\theta(q)$. The scaling function has the limiting behaviour $f(x)\sim x^{-2\theta}$ ($x\ll 1$) and $f(x)\to 1$ ($x\gg 1$). We then show within the Independent Interval Approximation (IIA) that the distribution $n(k,t)$ of separation $k$ between two consecutive persistent spins at time $t$ has the asymptotic scaling form $n(k,t)=t^{-2\phi}g(t,\frac{k}{t^{\phi}})$ where the dynamical exponent has the form $\phi$=max(${1/2},\theta$). The behaviour of the scaling function for large and small values of the arguments is found analytically. We find that for small separations $k\ll t^{\phi}, n(k,t)\sim P(t)k^{-\tau}$ where $\tau$=max($2(1-\theta),2\theta$), while for large separations $k\gg t^{\phi}$, $g(t,x)$ decays exponentially with $x$. The unusual dynamical scaling form and the behaviour of the scaling function is supported by numerical simulations.Comment: 11 pages in RevTeX, 10 figures, submitted to Phys. Rev.

Spatial distribution of persistent sites

We study the distribution of persistent sites (sites unvisited by particles $A$) in one dimensional $A+A\to\emptyset$ reaction-diffusion model. We define the {\it empty intervals} as the separations between adjacent persistent sites, and study their size distribution $n(k,t)$ as a function of interval length $k$ and time $t$. The decay of persistence is the process of irreversible coalescence of these empty intervals, which we study analytically under the Independent Interval Approximation (IIA). Physical considerations suggest that the asymptotic solution is given by the dynamic scaling form $n(k,t)=s^{-2}f(k/s)$ with the average interval size $s\sim t^{1/2}$. We show under the IIA that the scaling function $f(x)\sim x^{-\tau}$ as $x\to 0$ and decays exponentially at large $x$. The exponent $\tau$ is related to the persistence exponent $\theta$ through the scaling relation $\tau=2(1-\theta)$. We compare these predictions with the results of numerical simulations. We determine the two-point correlation function $C(r,t)$ under the IIA. We find that for $r\ll s$, $C(r,t)\sim r^{-\alpha}$ where $\alpha=2-\tau$, in agreement with our earlier numerical results.Comment: 15 pages in RevTeX, 5 postscript figure

Exact Results for a Three-Body Reaction-Diffusion System

A system of particles hopping on a line, singly or as merged pairs, and annihilating in groups of three on encounters, is solved exactly for certain symmetrical initial conditions. The functional form of the density is nearly identical to that found in two-body annihilation, and both systems show non-mean-field, ~1/t**(1/2) instead of ~1/t, decrease of particle density for large times.Comment: 10 page

Exponents appearing in heterogeneous reaction-diffusion models in one dimension

We study the following 1D two-species reaction diffusion model : there is a small concentration of B-particles with diffusion constant $D_B$ in an homogenous background of W-particles with diffusion constant $D_W$; two W-particles of the majority species either coagulate ($W+W \longrightarrow W$) or annihilate ($W+W \longrightarrow \emptyset$) with the respective probabilities $p_c=(q-2)/(q-1)$ and $p_a=1/(q-1)$; a B-particle and a W-particle annihilate ($W+B \longrightarrow \emptyset$) with probability 1. The exponent $\theta(q,\lambda=D_B/D_W)$ describing the asymptotic time decay of the minority B-species concentration can be viewed as a generalization of the exponent of persistent spins in the zero-temperature Glauber dynamics of the 1D $q$-state Potts model starting from a random initial condition : the W-particles represent domain walls, and the exponent $\theta(q,\lambda)$ characterizes the time decay of the probability that a diffusive "spectator" does not meet a domain wall up to time $t$. We extend the methods introduced by Derrida, Hakim and Pasquier ({\em Phys. Rev. Lett.} {\bf 75} 751 (1995); Saclay preprint T96/013, to appear in {\em J. Stat. Phys.} (1996)) for the problem of persistent spins, to compute the exponent $\theta(q,\lambda)$ in perturbation at first order in $(q-1)$ for arbitrary $\lambda$ and at first order in $\lambda$ for arbitrary $q$.Comment: 29 pages. The three figures are not included, but are available upon reques

Model of Cluster Growth and Phase Separation: Exact Results in One Dimension

We present exact results for a lattice model of cluster growth in 1D. The growth mechanism involves interface hopping and pairwise annihilation supplemented by spontaneous creation of the stable-phase, +1, regions by overturning the unstable-phase, -1, spins with probability p. For cluster coarsening at phase coexistence, p=0, the conventional structure-factor scaling applies. In this limit our model falls in the class of diffusion-limited reactions A+A->inert. The +1 cluster size grows diffusively, ~t**(1/2), and the two-point correlation function obeys scaling. However, for p>0, i.e., for the dynamics of formation of stable phase from unstable phase, we find that structure-factor scaling breaks down; the length scale associated with the size of the growing +1 clusters reflects only the short-distance properties of the two-point correlations.Comment: 12 page

Coherent State path-integral simulation of many particle systems

The coherent state path integral formulation of certain many particle systems allows for their non perturbative study by the techniques of lattice field theory. In this paper we exploit this strategy by simulating the explicit example of the diffusion controlled reaction $A+A\to 0$. Our results are consistent with some renormalization group-based predictions thus clarifying the continuum limit of the action of the problem.Comment: 20 pages, 4 figures. Minor corrections. Acknowledgement and reference correcte

Predicting complicated appendicitis based on clinical findings: the role of Alvarado and appendicitis inflammatory response scores

PURPOSE: The pre-interventional differentiation between complicated and uncomplicated appendicitis is decisive for treatment. In the context of conservative therapy, the definitive diagnosis of uncomplicated appendicitis is mandatory. This study investigates the ability of clinical scoring systems and imaging to differentiate between the two entities. METHODS: This is a retrospective analysis of two cohorts from two tertiary referral centers in Switzerland and Germany. All consecutive patients underwent appendectomy between January 2008 and April 2013 (in the first cohort) or between January 2017 and June 2019 (the second cohort). Exclusion criteria did not apply as all patients found by the database search and received an appendectomy were included. Diagnostic testing and calculation of a receiver operating curve were performed to identify a cutoff for clinical scores that resulted in a minimum sensitivity of 90% to detect complicated appendicitis. The cutoff was combined with additional diagnostic imaging criteria to see if diagnostic properties could be improved. RESULTS: Nine hundred fifty-six patients were included in the analysis. Two hundred twenty patients (23%) had complicated appendicitis, and 736 patients (77%) had uncomplicated appendicitis or no inflammation. The complicated appendicitis cohort had a mean Alvarado score of 7.03 and a mean AIR of 5.21. This compared to a mean Alvarado of 6.53 and a mean AIR of 4.07 for the uncomplicated appendicitis cohort. The highest Alvarado score with a sensitivity of > 90% to detect complicated appendicitis was >== 5 (sensitivity = 95%, specificity 8.99%). The highest AIR score with a sensitivity of > 90% to detect complicated appendicitis was >== 3 (sensitivity 91.82%, specificity 18.53). The analysis showed that additional CT information did not improve the sensitivity of the proposed cut-offs. CONCLUSION: AIR and Alvarado scores showed limited capability to distinguish between complicated and uncomplicated appendicitis even with additional imaging in this retrospective cohort. As conservative management of appendicitis needs to exclude patients with complicated disease reliably, appendectomy seems until now to remain the safest option to prevent undertreatment of this mostly benign disease

Reaction Kinetics of Clustered Impurities

We study the density of clustered immobile reactants in the diffusion-controlled single species annihilation. An initial state in which these impurities occupy a subspace of codimension d' leads to a substantial enhancement of their survival probability. The Smoluchowski rate theory suggests that the codimensionality plays a crucial role in determining the long time behavior. The system undergoes a transition at d'=2. For d'<2, a finite fraction of the impurities survive: ni(t) ~ ni(infinity)+const x log(t)/t^{1/2} for d=2 and ni(t) ~ ni(infinity)+const/t^{1/2} for d>2. Above this critical codimension, d'>=2, the subspace decays indefinitely. At the critical codimension, inverse logarithmic decay occurs, ni(t) ~ log(t)^{-a(d,d')}. Above the critical codimension, the decay is algebraic ni(t) ~ t^{-a(d,d')}. In general, the exponents governing the long time behavior depend on the dimension as well as the codimension.Comment: 10 pages, late

Three-Species Diffusion-Limited Reaction with Continuous Density-Decay Exponents

We introduce a model of three-species two-particle diffusion-limited reactions A+B -> A or B, B+C -> B or C, and C+A -> C or A, with three persistence parameters (survival probabilities in reaction) of the hopping particle. We consider isotropic and anisotropic diffusion (hopping with a drift) in 1d. We find that the particle density decays as a power-law for certain choices of the persistence parameter values. In the anisotropic case, on one symmetric line in the parameter space, the decay exponent is monotonically varying between the values close to 1/3 and 1/2. On another, less symmetric line, the exponent is constant. For most parameter values, the density does not follow a power-law. We also calculated various characteristic exponents for the distance of nearest particles and domain structure. Our results support the recently proposed possibility that 1d diffusion-limited reactions with a drift do not fall within a limited number of distinct universality classes.Comment: 12 pages in plain LaTeX and four Postscript files with figure