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Discrete event simulation

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https://www.readbyqxmd.com/read/28516345/performance-and-cost-evaluation-of-health-information-systems-using-micro-costing-and-discrete-event-simulation
#1
Olfa Rejeb, Claire Pilet, Sabri Hamana, Xiaolan Xie, Thierry Durand, Saber Aloui, Anne Doly, Pierre Biron, Lionel Perrier, Vincent Augusto
Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach...
May 17, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28508958/modeling-the-critical-care-pathway-for-cardiothoracic-surgery
#2
Nicolas Bahou, Claire Fenwick, Gillian Anderson, Robert van der Meer, Tony Vassalos
The west of Scotland heart and lung center based at the Golden Jubilee National Hospital houses all adult cardiothoracic surgery for the region. Increased demand for scheduled patients and fluctuations in emergency referrals resulted in increasing waiting times and patient cancellations. The main issue was limited resources, which was aggravated by the stochastic nature of the length of stay (LOS) and arrival of patients. Discrete event simulation (DES) was used to assess if an enhanced schedule was sufficient, or more radical changes, such as capacity or other resource reallocations should be considered in order to solve the problem...
May 16, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28507994/a-step-by-step-framework-on-discrete-events-simulation-in-emergency-department-a-systematic-review
#3
REVIEW
Mahsa Dehghani, Nazila Moftian, Peyman Rezaei-Hachesu, Taha Samad-Soltani
OBJECTIVE: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department. METHODS: For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28502247/assessing-the-costs-and-benefits-of-insuring-psychological-services-as-part-of-medicare-for-depression-in-canada
#4
Helen-Maria Vasiliadis, Anne Dezetter, Eric Latimer, Martin Drapeau, Alain Lesage
OBJECTIVE: The study estimated costs and effects associated with increasing access to publicly funded psychological services for depression in a public health care system. METHODS: Discrete event simulation modeled clinical events (relapse, recovery, hospitalizations, suicide attempts, and suicide), health service use, and cost outcomes over 40 years in a population with incident depression. Parameters included epidemiologic and economic data from the literature and data from a secondary analysis of the 2012 Canadian Community Health Survey on mental health...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28498849/percutaneous-coronary-intervention-with-second-generation-drug-eluting-stent-versus-bare-metal-stent-systematic-review-and-cost-benefit-analysis
#5
Thomas G Poder, Jihane Erraji, Lucien P Coulibaly, Kouamé Koffi
BACKGROUND: Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries...
2017: PloS One
https://www.readbyqxmd.com/read/28494999/modeling-and-control-of-operator-functional-state-in-a-unified-framework-of-fuzzy-inference-petri-nets
#6
Jian-Hua Zhang, Jia-Jun Xia, Jonathan M Garibaldi, Petros P Groumpos, Ru-Bin Wang
BACKGROUND AND OBJECTIVE: In human-machine (HM) hybrid control systems, human operator and machine cooperate to achieve the control objectives. To enhance the overall HM system performance, the discrete manual control task-load by the operator must be dynamically allocated in accordance with continuous-time fluctuation of psychophysiological functional status of the operator, so-called operator functional state (OFS). The behavior of the HM system is hybrid in nature due to the co-existence of discrete task-load (control) variable and continuous operator performance (system output) variable...
June 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28487459/patient-flow-within-uk-emergency-departments-a-systematic-review-of-the-use-of-computer-simulation-modelling-methods
#7
Syed Mohiuddin, John Busby, Jelena Savović, Alison Richards, Kate Northstone, William Hollingworth, Jenny L Donovan, Christos Vasilakis
OBJECTIVES: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28480535/integrated-continuous-bioprocessing-economic-operational-and-environmental-feasibility-for-clinical-and-commercial-antibody-manufacture
#8
James Pollock, Jon Coffman, Sa V Ho, Suzanne S Farid
This paper presents a systems approach to evaluating the potential of integrated continuous bioprocessing for monoclonal antibody (mAb) manufacture across a product's lifecycle from pre-clinical to commercial manufacture. The economic, operational and environmental feasibility of alternative continuous manufacturing strategies were evaluated holistically using a prototype UCL decisional tool that integrated process economics, discrete-event simulation, environmental impact analysis, operational risk analysis and multi-attribute decision-making...
May 8, 2017: Biotechnology Progress
https://www.readbyqxmd.com/read/28472324/cost-effectiveness-of-palbociclib-in-hormone-receptor-positive-advanced-breast-cancer
#9
H Mamiya, R K Tahara, S M Tolaney, N Choudhry, M Najafzadeh
BACKGROUND: Palbociclib, a novel small-molecule inhibitor of cyclin-dependent kinases 4 and 6 for the treatment of advanced breast cancer, has demonstrated significant efficacy in prolonging progression-free survival when added to existing therapies. Considering the high cost of palbociclib, we assessed cost-effectiveness of adding palbociclib to usual care in treatment of advanced breast cancer. METHODS: We developed a discrete event simulation model to simulate time to cancer progression and to compare life time clinical benefit and cost of alternative treatment strategies for patients with metastatic disease from societal perspective...
May 2, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28463022/friendship-dissolution-within-social-networks-modeled-through-multilevel-event-history-analysis
#10
Danielle O Dean, Daniel J Bauer, Mitchell J Prinstein
A social network perspective can bring important insight into the processes that shape human behavior. Longitudinal social network data, measuring relations between individuals over time, has become increasingly common-as have the methods available to analyze such data. A friendship duration model utilizing discrete-time multilevel survival analysis with a multiple membership random effect structure is developed and applied here to study the processes leading to undirected friendship dissolution within a larger social network...
May 2, 2017: Multivariate Behavioral Research
https://www.readbyqxmd.com/read/28450140/effect-of-confounding-variables-on-hemodynamic-response-function-estimation-using-averaging-and-deconvolution-analysis-an-event-related-nirs-study
#11
Ardalan Aarabi, Victoria Osharina, Fabrice Wallois
Slow and rapid event-related designs are used in fMRI and functional near-infrared spectroscopy (fNIRS) experiments to temporally characterize the brain hemodynamic response to discrete events. Conventional averaging (CA) and the deconvolution method (DM) are the two techniques commonly used to estimate the Hemodynamic Response Function (HRF) profile in event-related designs. In this study, we conducted a series of simulations using synthetic and real NIRS data to examine the effect of the main confounding factors, including event sequence timing parameters, different types of noise, signal-to-noise ratio (SNR), temporal autocorrelation and temporal filtering on the performance of these techniques in slow and rapid event-related designs...
April 25, 2017: NeuroImage
https://www.readbyqxmd.com/read/28445398/consensus-based-cooperative-control-based-on-pollution-sensing-and-traffic-information-for-urban-traffic-networks
#12
Antonio Artuñedo, Raúl M Del Toro, Rodolfo E Haber
Nowadays many studies are being conducted to develop solutions for improving the performance of urban traffic networks. One of the main challenges is the necessary cooperation among different entities such as vehicles or infrastructure systems and how to exploit the information available through networks of sensors deployed as infrastructures for smart cities. In this work an algorithm for cooperative control of urban subsystems is proposed to provide a solution for mobility problems in cities. The interconnected traffic lights controller (TLC) network adapts traffic lights cycles, based on traffic and air pollution sensory information, in order to improve the performance of urban traffic networks...
April 26, 2017: Sensors
https://www.readbyqxmd.com/read/28422648/fast-and-stable-signal-deconvolution-via-compressible-state-space-models
#13
Abbas Kazemipour, Ji Liu, Krystyna Solarana, Daniel Nagode, Patrick Kanold, Min Wu, Behtash Babadi
OBJECTIVE: Common biological measurements are in the form of noisy convolutions of signals of interest with possibly unknown and transient blurring kernels. Examples include EEG and calcium imaging data. Thus, signal deconvolution of these measurements is crucial in understanding the underlying biological processes. The objective of this paper is to develop fast and stable solutions for signal deconvolution from noisy, blurred and undersampled data, where the signals are in the form of discrete events distributed in time and space...
April 13, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28389485/operational-strategies-to-manage-non-elective-orthopaedic-surgical-flows-a-simulation-modelling-study
#14
Marie Persson, Helena Hvitfeldt-Forsberg, Maria Unbeck, Olof Gustaf Sköldenberg, Andreas Stark, Paula Kelly-Pettersson, Pamela Mazzocato
OBJECTIVES: To explore the value of simulation modelling in evaluating the effects of strategies to plan and schedule operating room (OR) resources aimed at reducing time to surgery for non-elective orthopaedic inpatients at a Swedish hospital. METHODS: We applied discrete-event simulation modelling. The model was populated with real world data from a university hospital with a strong focus on reducing waiting time to surgery for patients with hip fracture. The system modelled concerned two patient groups that share the same OR resources: hip-fracture and other non-elective orthopaedic patients in need of surgical treatment...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28384413/comparative-effectiveness-of-tacrolimus-based-steroid-sparing-versus-steroid-maintenance-regimens-in-kidney-transplantation-results-from-discrete-event-simulation
#15
Vibha C A Desai, Yann Ferrand, Teresa M Cavanaugh, Christina M L Kelton, J Jaime Caro, Jens Goebel, Pamela C Heaton
BACKGROUND: Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. OBJECTIVES: To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28368834/asynchronous-state-estimation-for-discrete-time-switched-complex-networks-with-communication-constraints
#16
Dan Zhang, Qing-Guo Wang, Dipti Srinivasan, Hongyi Li, Li Yu
This paper is concerned with the asynchronous state estimation for a class of discrete-time switched complex networks with communication constraints. An asynchronous estimator is designed to overcome the difficulty that each node cannot access to the topology/coupling information. Also, the event-based communication, signal quantization, and the random packet dropout problems are studied due to the limited communication resource. With the help of switched system theory and by resorting to some stochastic system analysis method, a sufficient condition is proposed to guarantee the exponential stability of estimation error system in the mean-square sense and a prescribed $H∞ performance level is also ensured...
March 29, 2017: IEEE Transactions on Neural Networks and Learning Systems
https://www.readbyqxmd.com/read/28366005/evaluation-of-dissolution-in-the-lower-intestine-and-its-impact-on-the-absorption-process-of-high-dose-low-solubility-drugs
#17
Danai Georgaka, James Butler, Filippos Kesisoglou, Christos Reppas, Maria Vertzoni
PURPOSE: First, to optimize a recently proposed two-stage single-compartment in vitro test for the evaluation of dissolution in the lower intestine with the mini-paddle apparatus in the fasted and fed state using two model high dose, low solubility drugs [sulfasalazine (Azulfidine®) and micronized aprepitant] and one mesalamine colon targeting product (Asacol, 400mg/tablet). Second, to evaluate the impact of passive absorption from the lower intestine on the overall absorption process using three model high dose, low solubility drugs [micronized aprepitant, SB705498, and albendazole (Zentel®)]...
April 1, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28361346/redesigning-the-diagnostic-pathway-for-chest-pain-patients-in-emergency-departments
#18
Sebastian Rachuba, Andrew Salmon, Zhivko Zhelev, Martin Pitt
Patients presenting with chest pain at an emergency department in the United Kingdom receive troponin tests to assess the likelihood of an acute myocardial infarction (AMI). Until recently, serial testing with two blood samples separated by at least six hours was necessary in order to analyse the change in troponin levels over time. New high-sensitivity troponin tests, however, allow the inter-test time to be shortened from six to three hours. Recent evidence also suggests that the new generation of troponin tests can be used to rule out AMI on the basis of a single test if patients at low risk of AMI present with very low cardiac troponin levels more than three hours after onset of worst pain...
March 30, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28349405/quantitative-modeling-and-automated-analysis-of-meiotic-recombination
#19
Martin A White, Shunxin Wang, Liangran Zhang, Nancy Kleckner
Many morphological features, in both physical and biological systems, exhibit spatial patterns that are specifically characterized by a tendency to occur with even spacing (in one, two, or three dimensions). The positions of crossover (CO) recombination events along meiotic chromosomes provide an interesting biological example of such an effect. In general, mechanisms that explain such patterns may (a) be mechanically based, (b) occur by a reaction-diffusion mechanism in which macroscopic mechanical effects are irrelevant, or (c) involve a combination of both types of effects...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#20
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
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