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Performance Modelling of Patient Flow Scheduling Through a Formal Method

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Journal of Shanghai Jiaotong university(Science) 2017年第1期22卷 66-71页

作者：陈潇 thomas nigel 丁杰 School of Computer Science and Communication Engineering Jiangsu University School of Computing Science Newcastle University School of Information Engineering Yangzhou University

Smart environment is being used in many areas to deliver more services to individuals in a physical space, such as a hospital. In the UK, the National Health Service(NHS) provides free and high quality healthcare service for all residents. Smart hospital environment is able to support NHS and provide more convenience. Patient flow scheduling is a crucial section in a smart hospital environment. Smart hospital environment aims to provide a smart environment in the hospital to facilitate individual experience and improve the quality of healthcare *** of all, this paper investigates a real world patient flow scenario of a hospital in the UK and models a general scheduling scheme based on the scenario using a compositional formal approach, i.e. performance evaluation process algebra(PEPA). This scheduling scheme uses an easy-implemented solution(the grouping scheme) to reduce the waiting queue in the hospital. Secondly, fluid flow analysis is used for the performance analysis by generating a set of ordinary differential equations(ODEs) in terms of the PEPA model.

关键词： scheduling performance valuation patient flow performance evaluation process algebra (PEPA) ordinary differential equations (ODEs) TP 302 TP 391 A

Late recurrence after surgery for cholangiocarcinoma:implications for follow-up?

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Hepatobiliary & Pancreatic Diseases International 2008年第5期7卷 544-546页

作者： Harun thomas nigel David Heaton Institute of Liver Studies Kings College Hospital Denmark HillLondonSE5 9RSUK

BACKGROUND:Biliary tract cancer is uncommon,but has a high rate of early recurrence and a poor prognosis. There is only limited information on patients surviving more than 5 years after resection. METHODS:We report a patient who developed recurrence 8 years after resection of *** of late recurrence after excision of cholangiocarcinoma are reviewed. RESULTS:Few long-term survivors with biliary tract cancer have been *** survivors tend to have well differentiated or papillary *** present case had no recurrence for 8 years despite poor prognostic factors including poor differentiation,invasion through the muscle wall and perineural *** has been suggested that tumor cells left after the first operation grow and present as late *** is a need to differentiate a new primary and field change from recurrence of the previous tumor. CONCLUSIONS:Long-term follow-up after resection of cholangiocarcinoma is needed because late recurrence after 5 years *** mortality rate between 5 and 10 years after resection of cholangiocarcinoma ranges from 6%to 43%in different *** detection of local recurrence may give an opportunity for further surgical resection.

关键词： cholangiocarcinoma late recurrence long-term survivors

Cystic dystrophy in heterotopic pancreas:a rare indication for pancreaticoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2009年第2期8卷 215-217页

作者： Harun thomas Paul Marriott Bernard Portmann nigel Heaton Mohamed Rela Institute of Liver Studies Kings College School of Medicine at Denmark Hill

BACKGROUND:Cystic dystrophy in heterotopic pancreas (CDHP)is a rare benign condition characterized by the presence of cysts in the wall of the digestive tract associated with inflammation and fibrosis,intermingled with heterotopic pancreatic *** options for CDHP are poorly defined. METHOD:We report a case of CDHP,and review the literature focusing on the diagnosis and management. RESULTS:CDHP is mainly encountered in men in the fifth decade of life in association with chronic pancreatitis secondary to alcohol *** and mechanical obstruction of heterotopic pancreatic ducts have been implicated in its *** presentation is varied and current imaging provides the diagnosis. Treatment options include somatostatin analogue injections, endoscopic cyst fenestration and surgical resection (pancreaticoduodenectomy or gastrointestinal bypass). CONCLUSION:CDHP is rare and presents a diagnostic and therapeutic *** long term efficacy and indications for different treatment options need to be refined.

关键词： pancreas diseases duodenum cysts heterotopia

Liver transplantation for acute intermittent porphyria:a viable treatment?

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 93-96页

作者： Faisal S Dar Koji Asai Ali Raza Haque thomas Cherian Mohamed Rela nigel Heaton Kings College London School of Medicine at King's College Hospital Institute of Liver StudiesKing's College Hospital

BACKGROUND:Acute intermittent porphyria (AIP) is the most common hepatic *** clinical presentation includes severe disabling and life-threatening neurovisceral symptoms and acute psychiatric *** symptoms result from the overproduction and accumulation of porphyrin precursors,5-aminoleuvulinic acid (ALA) and porphobilinogen (PBG).The effect of medical treatment is transient and is not effective once irreversible neurological damage has *** transplantation (LT) replaces hepatic enzymes and can restore normal excretion of ALA and PBG and prevent acute ***:Two cases of LT for AIP were identified retrospectively from a prospectively maintained LT ***:LT was successful with resolution of AIP in two patients who suffered from repeated acute ***:LT can correct the underlying metabolic abnormality in AIP and improves quality of life significantly.

关键词： liver transplantation acute intermittent porphyria erythropoietic porphyria metabolic liver diseases acute liver failure porphyrias

Harrogate consensus agreement:Cycling-specific sport-related concussion

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Sports Medicine and Health Science 2021年第2期3卷 110-114页

作者： Jeroen Swart Xavier Bigard thomas Fladischer Roger Palfreeman Helge Riepenhof nigel Jones Neil Heron Division of Exercise&Sports Medicine University of Cape TownFIMS Scientific CommissionUAE Tem EmiratesWorld Tour Professional Cycling TeamUnited Arab Emirates Medical Director International Cycling UnionAigleSwitzerland LKH Hochsteiermark Orthopedics&Traumatology Bruck/MurAustria Team Mitchelton Scott Australia Department of Sports and Rehabilitation Medicine BG Trauma Hospital of HamburgGermany Head of Medical British CyclingUK School of Medicine Dentistry and Biomedical Sciences Queen's UniversityBelfast.Team IneosWorld Tour Professional Cycling TeamUK

Sport-related concussion(SRC)is a common and increasingly recognised sport-related injury and accounts for between 1%and 9%of all cycling-specific *** has been drawn to the difficulty in managing suspected SRC in a fast-paced sport such as road cycling,particularly the lack of an effective and time-efficient assessment protocol.A meeting on cycling SRC was convened in Harrogate,United Kingdom,in an attempt to resolve this *** aim was to agree on standard terminology,definitions,diagnostic protocols and return to play protocols for the various differing codes of cycle *** experts in the field of cycling medicine were invited to participate by the International Cycling Union and are the authors of this *** panel recognised that the sport of cycling consists of varied disciplines,some of which provide a setting in which a sideline assessment is possible which is in line with the Berlin Consensus ***,other disciplines provide challenging circumstances where health care providers have limited access to participants and where participants are unable to discontinue participation and participate in sideline ***-based discipline-specific protocols and guidelines which recognise the limitations posed by these circumstances,but nevertheless,improve on the current situation specific to the sport of cycling are presented as a potential solution to the unique chal-lenges posed by these cycling disciplines.

关键词： Sport-related concussion Cycling

Sensitivity of diagnosis of spontaneous bacterial peritonitis is higher with the automated cell count method

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World Journal of Hepatology 2024年第11期16卷 1265-1281页

作者： Juan G Acevedo-Haro Waddah Mohamed Prebashan Moodley Oliver Bendall Kris Bennett nigel Keelty Sally Chan Sam Waddy Joanne Hosking Wayne thomas Robert Tilley South West Liver Unit University Hospitals Plymouth NHS TrustPlymouth PL68DHUnited Kingdom Medical School University of PlymouthPlymouth PL68DHUnited Kingdom Intensive Care Unit University Hospitals Plymouth NHS TrustPlymouth PL68DHUnited Kingdom Medical Statistics Group Peninsula Clinical Trials UnitUniversity of PlymouthPlymouth PL68DHUnited Kingdom Haematology Service University Hospitals Plymouth NHS TrustPlymouth PL68DHUnited Kingdom Microbiology Service University Hospitals Plymouth NHS TrustPlymouth PL68DHUnited Kingdom

BACKGROUND Spontaneous bacterial peritonitis(SBP)is one of the most important complications of patients with liver cirrhosis entailing high morbidity and *** an accurate early diagnosis of this infection is key in the outcome of these *** current definition of SBP is based on studies performed more than 40 years ago using a manual technique to count the number of polymorphs in ascitic fluid(AF).There is a lack of data comparing the traditional cell count method with a current automated cell ***,current international guidelines do not mention the type of cell count method to be employed and around half of the centers still rely on the traditional manual *** To compare the accuracy of polymorph count on AF to diagnose SBP between the traditional manual cell count method and a modern automated cell counter against SBP cases fulfilling gold standard criteria:Positive AF culture and signs/symptoms of *** Retrospective analysis including two cohorts:Cross-sectional(cohort 1)and case-control(cohort 2),of patients with decompensated cirrhosis and *** cell count methods were conducted *** SBP cases had a pathogenic bacteria isolated on AF and signs/symptoms of *** A total of 137 cases with 5 positive-SBP,and 85 cases with 33 positive-SBP were included in cohort 1 and 2,***-SBP cases had worse liver function in both *** automated method showed higher sensitivity than the manual cell count:80%vs 52%,P=0.02,in cohort *** methods showed very good specificity(>95%).The best cutoff using the automated cell counter was polymorph≥0.2 cells×10^(9)/L(equivalent to 200 cells/mm^(3))in AF as it has the higher sensitivity keeping a good *** The automated cell count method should be preferred over the manual method to diagnose SBP because of its higher *** definition,using the automated method,as polymorph cell count≥0.2 cells×1

关键词： Spontaneous bacterial peritonitis Diagnosis Cirrhosis Bacterial infection Automated cell count method Manual cell count method Ascitic fluid

Does Pre-Operative Tranexamic Acid Increase the Incidence of Thromboembolism in Primary Lower Limb Arthroplasty?

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Open Journal of Orthopedics 2013年第6期3卷 249-252页

作者： Veenesh Selvaratnam James R. Fountain nigel J. Donnachie thomas G. thomas Fintan A. Carroll Wirral University Teaching Hospital NHS Foundation Trust Wirral UK Wirral University Teaching Hospital NHS Foundation Trust Wirral UK.

Introduction: Tranexamic Acid (TA) has been shown to decrease peri-operative bleeding in primary lower limb arthroplasty surgery. There are still concerns with regards to the increased risk of thromboembolic events with the use of TA. The aim of this study was to assess whether the use of pre-operative TA increased the incidence of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) in Total Hip Replacement (THR) and Total Knee Replacement (TKR). Methods: Patients who underwent primary THR or TKR between August 2007 and August 2009 were identified from the databases of three surgeons within the lower limb arthroplasty unit. A retrospective case notes analysis was performed. DVT was diagnosed on Duplex Ultrasound Scan and PE on CT Pulmonary Angiogram. A positive result was a diagnosis of DVT or PE within 3 months of surgery. Results: 701 patients underwent primary THR and TKR over the 2-year period. 320 patients (189 THR, 131 TKR) received TA pre-operatively. 381 patients (190 THR, 191 TKR) did not receive TA prior to surgery. A total of 8 (2.5%) patients who received TA were diagnosed with either a DVT (4) or PE (4) post operatively. In those patients not receiving TA, 6 had a DVT and 4 had a PE, a total of 10 (2.6%). Conclusion: Pre-operative use of Tranexamic Acid in primary THR and TKR does not increase the incidence of DVT and PE.

关键词： Tranexamic Acid DVT PE TKR THR

国际自行车联合会哈罗盖特共识:自行车运动中的脑震荡

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成都体育学院学报 2021年第5期47卷 140-142页

作者： Jeroen Swart Xavier Bigard thomas Fladischer Roger Palfreeman Helge Riepenhof nigel Jones Neil Heron 开普敦大学运动医学部开普敦南非7725 国际自行车联盟艾格勒瑞士1860 霍赫施泰尔马克州立医院骨伤科穆尔河畔布鲁克奥地利8600 米切尔顿-斯科特车队澳大利亚 BG汉堡创伤医院运动与康复医学科汉堡德国21033 英国自行车协会英国贝尔法斯特女王大学医学牙医及生物医用科学学院贝尔法斯特英国BT97BL

运动相关脑震荡(Sport-related concussion,SRC)是一种常见且逐渐被大家重视的运动相关损伤,大约占自行车全部运动损伤的1%~9%。在快节奏的运动(如公路自行车项目)中如何管理SRC已经得到关注,特别是在缺少省时有效检测方案的情况下。近... 详细信息

运动相关脑震荡(Sport-related concussion,SRC)是一种常见且逐渐被大家重视的运动相关损伤,大约占自行车全部运动损伤的1%~9%。在快节奏的运动(如公路自行车项目)中如何管理SRC已经得到关注,特别是在缺少省时有效检测方案的情况下。近期在英国哈罗盖特召开的自行车运动SRC专家会议正努力解决该问题。该会议旨在将不同自行车项目下的标准术语、定义、诊断方案以及重返赛场标准达成一致。国际自行车联盟邀请了7位自行车医学专家(即本文作者)出席了本次会议。专家组认为,自行车运动涵盖了不同的项目,其中的一些项目具备场边评估的环境条件,符合柏林共识。然而,其他项目的场地环境受限于医疗保障人员与参赛者之间的接触困难,或参赛者不能够中止运动以进行场边评估,使得场边评估具有一定难度。基于共识的项目特异性方案和指南提出了现状的局限。尽管如此,此指南仍为当前不同自行车运动项目带来的独特挑战提供了潜在的解决方案,以改善自行车运动的现状。

关键词：运动相关脑震荡自行车运动国际自行车联合会

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Call for emergency action to limit global temperature increases,restore biodiversity and protect health

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Stroke & Vascular Neurology 2021年第3期6卷 321-323页

作者： Lukoye Atwoli Abdullah H Baqui thomas Benfield Raffaella Bosurgi Fiona Godlee Stephen Hancocks Richard Horton Laurie Laybourn-Langton Carlos Augusto Monteiro Ian Norman Kirsten Patrick nigel Praities Marcel GM Olde Rikkert Eric J Rubin Peush Sahni Richard Smith Nicholas J Talley Sue Turale Damián Vázquez East African Medical Journal NairobiKenya Journal of Health Population and NutritionBaltimoreMarylandUSA Danish Medical Journal CopenhagenDenmark PLOS Medicine CambridgeUK The BMJ LondonUK British Dental Journal LondonUK The Lancet LondonUK UK Health Alliance on Climate Change LondonUK Revista de Saúde Pública S鉶PauloBrazil International Journal of Nursing Studies LondonUK CMAJ OttawaOntarioCanada Pharmaceutical Journal LondonUK Dutch Journal of Medicine NijmegenThe Netherlands NEJM BostonMassachusettsUSA National Medical Journal of India New DelhiIndia Medical Journal of Australia NewcastleNew South WalesAustralia International Nursing Review GenevaSwitzerland Pan American Journal of Public Health WashingtonDCUSA

Wealthy nations must do much more,much *** United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental *** will meet again at the biodiversity summit in Kunming,China,and the climate conference(Conference of the Parties(COP)26)in Glasgow,*** of these pivotal meetings,we-the editors of health journals worldwide-call for urgent action to keep average global temperature increases below 1.5℃,halt the destruction of nature and protect health.

关键词： action collective faster