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Discrete event simulation

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https://www.readbyqxmd.com/read/27906775/improving-liver-allocation-using-optimized-neighborhoods
#1
Vikram Kilambi, Sanjay Mehrotra
BACKGROUND: Geographic disparities persist in access to liver transplantation. Candidates with similar urgency experience varying opportunities for transplants across the US. Policymakers are poised to act and 1 proposal entails reorganizing the current OPTN of 11 regions into 8 districts. However, redistricting has the shortcomings that OPOs are disconnected from their immediate neighbors by district borders and that it is not easily responsive to uncertainty resulting from variability in donor and listing rates...
October 7, 2016: Transplantation
https://www.readbyqxmd.com/read/27902491/the-adaptation-rate-of-a-quantitative-trait-in-an-environmental-gradient
#2
R Hermsen
The spatial range of a species habitat is generally determined by the ability of the species to cope with biotic and abiotic variables that vary in space. Therefore, the species range is itself an evolvable property. Indeed, environmental gradients permit a mode of evolution in which range expansion and adaptation go hand in hand. This process can contribute to rapid evolution of drug resistant bacteria and viruses, because drug concentrations in humans and livestock treated with antibiotics are far from uniform...
November 30, 2016: Physical Biology
https://www.readbyqxmd.com/read/27893803/performance-evaluation-model-for-application-layer-firewalls
#3
Shichang Xuan, Wu Yang, Hui Dong, Jiangchuan Zhang
Application layer firewalls protect the trusted area network against information security risks. However, firewall performance may affect user experience. Therefore, performance analysis plays a significant role in the evaluation of application layer firewalls. This paper presents an analytic model of the application layer firewall, based on a system analysis to evaluate the capability of the firewall. In order to enable users to improve the performance of the application layer firewall with limited resources, resource allocation was evaluated to obtain the optimal resource allocation scheme in terms of throughput, delay, and packet loss rate...
2016: PloS One
https://www.readbyqxmd.com/read/27885884/about-the-advantages-and-disadvantages-of-discrete-event-simulation-for-health-economic-analyses
#4
Mondher Toumi, Ekkehard Beck, Steve Sherman, Leyla Mohseninejad, Samuel Aballéa
No abstract text is available yet for this article.
December 2016: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/27875546/evaluation-of-control-strategies-for-porcine-reproductive-and-respiratory-syndrome-prrs-in-swine-breeding-herds-using-a-discrete-event-agent-based-model
#5
Andréia Gonçalves Arruda, Robert Friendship, Jane Carpenter, Amy Greer, Zvonimir Poljak
The objective of this study was to develop a discrete event agent-based stochastic model to explore the likelihood of the occurrence of porcine reproductive and respiratory syndrome (PRRS) outbreaks in swine herds with different PRRS control measures in place. The control measures evaluated included vaccination with a modified-live attenuated vaccine and live-virus inoculation of gilts, and both were compared to a baseline scenario where no control measures were in place. A typical North American 1,000-sow farrow-to-wean swine herd was used as a model, with production and disease parameters estimated from the literature and expert opinion...
2016: PloS One
https://www.readbyqxmd.com/read/27870130/estimating-hazard-ratios-in-cohort-data-with-missing-disease-information-due-to-death
#6
Nadine Binder, Anne-Sophie Herrnböck, Martin Schumacher
In clinical and epidemiological studies information on the primary outcome of interest, that is, the disease status, is usually collected at a limited number of follow-up visits. The disease status can often only be retrieved retrospectively in individuals who are alive at follow-up, but will be missing for those who died before. Right-censoring the death cases at the last visit (ad-hoc analysis) yields biased hazard ratio estimates of a potential risk factor, and the bias can be substantial and occur in either direction...
November 21, 2016: Biometrical Journal. Biometrische Zeitschrift
https://www.readbyqxmd.com/read/27853739/efficiency-of-endoscopy-units-can-be-improved-with-use-of-discrete-event-simulation-modeling
#7
Bryan G Sauer, Kanwar P Singh, Barry L Wagner, Matthew S Vanden Hoek, Katherine Twilley, Steven M Cohn, Vanessa M Shami, Andrew Y Wang
Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27852231/a-discrete-event-simulation-model-of-clinical-and-operating-room-efficiency-outcomes-of-sugammadex-versus-neostigmine-for-neuromuscular-block-reversal-in-canada
#8
Ralph P Insinga, Cédric Joyal, Alexandra Goyette, André Galarneau
BACKGROUND: The objective of this analysis is to explore potential impact on operating room (OR) efficiency and incidence of residual neuromuscular blockade (RNMB) with use of sugammadex (Bridion™, Merck & Co., Inc., Kenilworth, NJ USA) versus neostigmine for neuromuscular block reversal in Canada. METHODS: A discrete event simulation (DES) model was developed to compare ORs using either neostigmine or sugammadex for NMB reversal over one month. Selected inputs included OR procedure and turnover times, hospital policies for paid staff overtime and procedural cancellations due to OR time over-run, and reductions in RNMB and associated complications with sugammadex use...
November 16, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27831819/reply-letter-to-the-editor-about-the-advantages-and-disadvantages-of-discrete-event-simulation-for-health-economic-analyses
#9
Jamie Caro
No abstract text is available yet for this article.
November 10, 2016: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/27821671/cost-effectiveness-of-case-finding-strategies-for-primary-prevention-of-cardiovascular-disease-a-modelling-study
#10
Catriona Crossan, Joanne Lord, Ronan Ryan, Leo Nherera, Tom Marshall
BACKGROUND: Policies of active case finding for cardiovascular disease (CVD) prevention in healthy adults are common, but economic evaluation has not investigated targeting such strategies at those who are most likely to benefit. AIM: To assess the cost effectiveness of targeted case finding for CVD prevention. DESIGN AND SETTING: Cost-effectiveness modelling in an English primary care population. METHOD: A cohort of 10 000 individuals aged 30-74 years and without existing CVD or diabetes was sampled from The Health Improvement Network database, a large primary care database...
November 7, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27801641/a-systematic-review-and-economic-evaluation-of-bisphosphonates-for-the-prevention-of-fragility-fractures
#11
Sarah Davis, Marrissa Martyn-St James, Jean Sanderson, John Stevens, Edward Goka, Andrew Rawdin, Susi Sadler, Ruth Wong, Fiona Campbell, Matt Stevenson, Mark Strong, Peter Selby, Neil Gittoes
BACKGROUND: Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. OBJECTIVES: To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax(®) and Fosamax(®) Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel(®) and Actonel Once a Week(®), Warner Chilcott UK Ltd), ibandronic acid (Bonviva(®), Roche Products Ltd) and zoledronic acid (Aclasta(®), Novartis Pharmaceuticals UK Ltd)] for the prevention of fragility fracture and to assess their cost-effectiveness at varying levels of fracture risk...
October 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27797995/changes-to-physician-processing-times-in-response-to-clinic-congestion-and-patient-punctuality-a-retrospective-study
#12
Chester G Chambers, Maqbool Dada, Shereef Elnahal, Stephanie Terezakis, Theodore DeWeese, Joseph Herman, Kayode A Williams
OBJECTIVES: We examine interactions among 3 factors that affect patient waits and use of overtime in outpatient clinics: clinic congestion, patient punctuality and physician processing rates. We hypothesise that the first 2 factors affect physician processing rates, and this adaptive physician behaviour serves to reduce waiting times and the use of overtime. SETTING: 2 urban academic clinics and an affiliated suburban clinic in metropolitan Baltimore, Maryland, USA...
October 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27785772/a-systematic-review-of-cardiovascular-outcomes-based-cost-effectiveness-analyses-of-lipid-lowering-therapies
#13
REVIEW
Ching-Yun Wei, Ruben G W Quek, Guillermo Villa, Shravanthi R Gandra, Carol A Forbes, Steve Ryder, Nigel Armstrong, Sohan Deshpande, Steven Duffy, Jos Kleijnen, Peter Lindgren
BACKGROUND: Previous reviews have evaluated economic analyses of lipid-lowering therapies using lipid levels as surrogate markers for cardiovascular disease. However, drug approval and health technology assessment agencies have stressed that surrogates should only be used in the absence of clinical endpoints. OBJECTIVE: The aim of this systematic review was to identify and summarise the methodologies, weaknesses and strengths of economic models based on atherosclerotic cardiovascular disease event rates...
October 27, 2016: PharmacoEconomics
https://www.readbyqxmd.com/read/27785081/cost-effectiveness-of-eplerenone-in-nyha-class-ii-chronic-heart-failure-patients-with-reduced-lvef-an-analysis-for-greece
#14
Kostas Athanasakis, Aikaterini Bilitou, Dawn Lee, Eleftheria Karampli, Apostolos Karavidas, John Parissis, Georgia Sykara, John Kyriopoulos
OBJECTIVES: The aim of the study was to evaluate the cost-effectiveness (CE) of treatment with eplerenone versus standard care in adult patients with New York Heart Association class II chronic heart failure and reduced left ventricular ejection fraction from the perspective of the Greek national health care payer. METHODS: A discrete-event model simulating the clinical course and respective outcomes of eplerenone as an add-on to standard therapy versus standard therapy alone based on the pivotal Eplerenone in Mild Patients Hospitalization and SurvIval Study in Heart Failure (EMPHASIS-HF) trial was locally adapted for the Greek setting...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27785046/simulation-analysis-of-resource-flexibility-on-healthcare-processes
#15
Yusta W Simwita, Berit I Helgheim
PURPOSE: This paper uses discrete event simulation to explore the best resource flexibility scenario and examine the effect of implementing resource flexibility on different stages of patient treatment process. Specifically we investigate the effect of resource flexibility on patient waiting time and throughput in an orthopedic care process. We further seek to explore on how implementation of resource flexibility on patient treatment processes affects patient access to healthcare services...
2016: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/27780572/determining-nurse-aide-staffing-requirements-to-provide-care-based-on-resident-workload-a-discrete-event-simulation-model
#16
John F Schnelle, L Dale Schroyer, Avantika A Saraf, Sandra F Simmons
BACKGROUND: Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs...
November 1, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27777983/shewanella-baltica-ecotypes-have-wide-transcriptional-variation-under-the-same-growth-conditions
#17
W S Hambright, Jie Deng, James M Tiedje, Ingrid Brettar, Jorge L M Rodrigues
In bacterial populations, subtle expressional differences may promote ecological specialization through the formation of distinct ecotypes. In a barrier-free habitat, this process most likely precedes population divergence and may predict speciation events. To examine this, we used four sequenced strains of the bacterium Shewanella baltica, OS155, OS185, OS195, and OS223, as models to assess transcriptional variation and ecotype formation within a prokaryotic population. All strains were isolated from different depths throughout a water column of the Baltic Sea, occupying different ecological niches characterized by various abiotic parameters...
September 2016: MSphere
https://www.readbyqxmd.com/read/27769228/quantifying-the-effect-of-complications-on-patient-flow-costs-and-surgical-throughputs
#18
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27768683/intrinsic-noise-profoundly-alters-the-dynamics-and-steady-state-of-morphogen-controlled-bistable-genetic-switches
#19
Ruben Perez-Carrasco, Pilar Guerrero, James Briscoe, Karen M Page
During tissue development, patterns of gene expression determine the spatial arrangement of cell types. In many cases, gradients of secreted signalling molecules-morphogens-guide this process by controlling downstream transcriptional networks. A mechanism commonly used in these networks to convert the continuous information provided by the gradient into discrete transitions between adjacent cell types is the genetic toggle switch, composed of cross-repressing transcriptional determinants. Previous analyses have emphasised the steady state output of these mechanisms...
October 2016: PLoS Computational Biology
https://www.readbyqxmd.com/read/27761104/accurate-chemical-master-equation-solution-using-multi-finite-buffers
#20
Youfang Cao, Anna Terebus, Jie Liang
The discrete chemical master equation (dCME) provides a fundamental framework for studying stochasticity in mesoscopic networks. Because of the multi-scale nature of many networks where reaction rates have large disparity, directly solving dCMEs is intractable due to the exploding size of the state space. It is important to truncate the state space effectively with quantified errors, so accurate solutions can be computed. It is also important to know if all major probabilistic peaks have been computed. Here we introduce the Accurate CME (ACME) algorithm for obtaining direct solutions to dCMEs...
2016: Multiscale Modeling & Simulation: a SIAM Interdisciplinary Journal
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