Waiting Times and Length of Stay of Trauma Patients in a Botswana Referral Hospital Emergency Department

Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswana. The aim of this study was to determine the Emergency Department (ED) waiting times and LOS of trauma patients at Princess Marina Hospital in Gaborone, Botswana. Methods: This was a retrospective medical records review of waiting times (time from triage to review by ED medical officer) and LOS (time from triage to disposition from the emergency department). The waiting times for the different assigned acuities were assessed against the South African Triage System (SATS) standards. All trauma patients seen from 19/11/2018 to 18/12/2018 were included in the study. Prolonged length of stay was defined as duration > 6 hours. Categorical data was summarized with frequencies while numeric data was summarized with medians and interquartile ranges. Results: A total of 187 trauma patients’ files were analyzed. Of these, 72 (38.5%) were females. The median waiting time was 3.8 hours and the maximum was 19.2 hours. The median length of stay (LOS) was 8.8 hours with a maximum of 37.2 hours. Only 53 (28.3%) of the participants had a LOS of less than 6 hours. None of the emergent patients were seen immediately. Only 5 (4.0%) of the very urgent patients were seen within the target of 10 minutes. Finally, only 10 (20.4%) of urgent patients were seen within the target time of 1 hour. Conclusion: The waiting times and length of stay in Princess Marina Hospital were mostly above the recommended standards. Urgent interventions are needed to reduce waiting times and length of stay for trauma patients. More studies are needed to explore the sources of delay and investigate possible solutions to this public health challenge.

Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital

Introduction: Emergency medicine is a critical component of quality public health service. In fact length of stay and waiting times in the Emergency department are key indicators of quality. The aim of this study was to determine waiting times and determinants of prolonged length of stay (LOS) in the Princess Marina Hospital Emergency Department. Methods: This was a retrospective observational study. It was done at Princess Marina, a referral hospital in Gaborone, Botswana. Triage forms of patients who presented between 19/11/ 2018 and 18/12/2018 were reviewed. Data from patient files was used to determine time duration from triage to being reviewed by a doctor, time duration from review by emergency doctor to patients’ disposition and the time duration from patient’s triage to disposition (length of stay). Prolonged length of stay was defined as duration > 6 hours. Results: A total of 1052 files repre- senting patients seen over a 1-month period were reviewed. 72.5% of the patients had a prolonged length of stay. The median emergency doctor waiting time was 4.5 hours (IQR 1.6 - 8.3 hours) and the maximum was 27.1 hours. The median length of stay in the emergency department was 9.6 hours (IQR 5.8 - 14.6 hours) and the maximum was 45.9 hours. Patient’s age (AOR 1.01), mental status (AOR 0.61), admission to internal medicine service (AOR 5.12) and pediatrics admissions (AOR 0.11) were significant predictors of prolonged length of stay in the emergency department. Conclusion: Princess Marina Hospital emergency department waiting times and length of stay are long. Age, normal mental status and internal medicine admission were independent predictors of prolonged stay (>6 hours). Admission to the pediatrics service was associated with shorter length of stay. There is a need for interventions to address the long waiting times and length of stay. Interventions should particularly focus on the identified predictors.

Dynamics of solitons in Bose-Einstein condensate with time-dependent atomic scattering length

The evolution of solitons in Bose-Einstein condensates （BECs） with time-dependent atomic scattering length in an expulsive parabolic potential is studied. Based on the extended hyperbolic function method, we successfully obtain the bright and dark soliton solutions. In addition, some new soliton solutions in this model are found. The results in this paper include some in the literature （Phys. Rev. Lett. 94（2005）050402 and Chin. Phys. Lett. 22（2005） 1855）.

Reaction Subdiffusion with Random Waiting Time Depending on the Preceding Jump Length

To describe the energy-dependent characteristics of the reaction-subdiffusion process, we analyze the simple reaction A--→B under subdiffsion with waiting time depending on the preceding jump length, and derive the corresponding master equations in the Fourier Laplace space for the distribution of A and B particles in a continuous time random walk scheme. Moreover, the generalizations of the reaction-diffusion equation for the Gaussian jump length with the probability density function of waiting time being quadratically dependent on the preceding jump length are obtained by applying the derived master equations.

Region-time-length algorithm and its application to the study of intermediate-short term earthquake precursor in North China

The Region-Time-Length Algorithm (RTL algorithm) is introduced and improved in the paper. Compared with the original definition, the influence of rupture length on RTL function is emphasized and the weights of epicentral distance function, time function, and rupture length function are ensured to be equal. The retrospective examinations of RTL algorithm in North China have indicated that the anomalies obtained by the improved RTL algorithm show the short or intermediate-short term precursory features in most cases. There are two types of RTL anomalous patterns before the main shock. For the I-type, the variation pattern of the VRTL, numerical values of the VRTL(x, y, z, t) function, is complete and most of them have shown the changing pattern of rising from 0 turning dropping or dropping from 0 turning rising. For the II-type, the variation pattern of VRTL is not complete, which increases or decreases quickly from 0 and there is no evident turning, the main shock generally occurs in the short period around the peak VRTL. The rising of VRTL indicates an increase of seismic activity relative to the background level, which means the enhancement of seismic activity, while the dropping of VRTL indicates the decrease of seismic activity relative to the background level, which represents the seismic quiescence to a certain extent. According to statistical examination results of RTL algorithm in North China, the methods to distinguish the intermediate and short-term anomalies and to estimate the occurrence time of the coming main shock are given in the paper. For both I and II-type RTL anomalies, the R-value, i.e., the forecasting score, is about 0.6 and 0.3 for the 3 months forecasting period and about 0.7 and 0.4 for the 6 months forecasting period. The preliminary discussion is also made for the influences of characteristic time-span t0, characteristic distance r0, and threshold magnitude M0 on computation of VRTL, as well as some other significant problems in application.

God Time = Planck Time: Finally Detected! And Its Relation to Hubble Time

Newton already mentioned indivisible time in Principia. In 1899, Max Planck derived a unique time period from three universal constants: G, c, and ħ, and today this is known as the Planck time. The Planck time is of the order of about 10−44 seconds while the best atomic clocks are down to 10−19 seconds. An approach has recently been outlined that puts an upper limit on the quantization of time to 10−33 seconds;this is, however, still far away from the Planck time. We demonstrate that the Planck time can easily be measured without any knowledge of any other physical constants. This is remarkable as this means we have demonstrated that the Planck time and therefore the Planck scale is real and detectable. It has taken more than 100 years to understand this. The reason for the breakthrough in Planck scale physics in recent years comes from understanding that G is a composite constant and that the true matter wavelength is the Compton wavelength rather than the de Broglie wavelength. When this is understood, the mysteries of the Planck scale can be uncovered. In this paper, we also demonstrate how to measure the number of Planck events in a gravitational mass without relying on any constants. This directly relates to a new and simple method for quantizing general relativity theory that we also will shortly discuss.

Recognition of Bragg Wavelength Disturbed by Time Delay of Fiber Length in Prepositive Tunable Filter

The wavelength shift in fiber Bragg grating does not depend directly on the total light levels, losses in the connecting fibers and couplers, or source power. However, if the tunable Fabry-Perot filter is place on the end of incident fiber, the detected time delay of modulation light is occurred due to the unmatch between the scanning time and light transmission time in the transmission fiber. Consequently, the detected peak wavelength shifts with the length of transmission fiber. Thus, the peak wavelength shift effect of Bragg reflective light transmitted in fiber with different fiber length can be obvious in the demodulator with a prepositive tunable Fabry-Perot filter. The experiment indicates the shift rates of 0.109 - 0.126 nm/km increase approximately linearly with the original peak wavelength of 1532.917 - 1560.300 nm at the fiber length of 0 - 6 km. To certify the consistency of measurement data, the criterion correction is introduced. By using the differential method of two fiber Bragg gratings with an optical path, the differential worth is compensated from the disturbance modulated by the time delay of fiber length.

基于单片机的MIDI文件中delta-time的实现

在单片机与某些MIDI模块进行通信时,由单片机将MIDI文件发送给MIDI模块时,MIDI模块仅能执行MIDI命令,不能识别和执行MIDI文件中的delta-time,而delta-time又是MIDI文件中非常重要的部分,在这种情况下单片机就要根据delta-time的特征,完成识别并执行delta-time的任务。

应用Unity Real Time软件建立血细胞分析个性化质控规则的探讨

目的对血细胞分析项目进行六西格玛性能评价,选择个性化质控规则,提出改进方向,为提高检测质量奠定基础。方法根据血细胞分析项目的不精密度[变异系数(CV)]、不正确度[偏移(Bias)]和允许总误差(TEa),应用Unity Real Time质控软件(简称URT)Westgard Advisor功能,得到分析项目西格玛(σ)值、σ度量图和个性化规则等信息。对σ值未能达到6的项目,通过质量目标指数(QGI)查找导致方法性能不佳的主要原因,并根据分析批长度Westgard西格玛规则流程图,确定分析项目分析批长度。结果不同血细胞分析项目性能特征和建议质控规则并不相同,各项目从单独1个规则到多规则均选择了个性化质控规则。对σ值未达到6的分析项目,根据QGI提示,除血红蛋白项目需优先改进正确度外,其他项目均需优先改进精密度;实验室在用检测系统经综合评估后,确定分析批长度为200份,与实际系统每日检测样本量一致。结论应用URT对血细胞分析等定量分析项目进行六西格玛性能评价,可根据性能特征选择个性化质控规则,并根据QGI进行持续改进;根据分析批长度Westgard西格玛规则流程图确定合适的分析批长度,可确保检测质量。

The Coherence Cube Computing Method with Self-adaptive Time Window Based on Wavelet Transform

The coherence cube technology has become an important technology for the seismic attribute interpretation, which extracts the discontinuities of the events through analyzing the similarities of adjacent seismic channels to identify the fault form. The coherence cube technology which uses constant time window lengths can not balance the shallow layers and the deep layers, because the frequency band of seismic data varies with time. When analyzing the shallow layers, the time window will crossover a lot of events, which will lead to weak focusing ability and failure to delineate the details. While the time window will not be long enough for analyzing deep layers, which will lead to low accuracy because the coherences near the zero points of the events are heavily influenced by noise. For solving the problem, we should make a research on the coherence cube technology with self-adaptive time window. This paper determines the sample points＆#39; time window lengths in real time by computing the instantaneous frequency bands with Wavelet Transformation, which gives a coherence computing method with the self-adaptive time window lengths. The result shows that the coherence cube technology with self-adaptive time window based on Wavelet Transformation improves the accuracy of fault identification, and supresses the noise effectively. The method combines the advantages of long time window method and short time window method.

Euclidean Model of Space and Time

The aim of this work is to show that the currently widely accepted geometrical model of space and time based on the works of Einstein and Minkowski is not unique. The work presents an alternative geometrical model of space and time, a model which, unlike the current one, is based solely on Euclidean geometry. In the new model, the pseudo-Euclidean spacetime is replaced with a specific subset of four-dimensional Euclidean space. The work shows that four-dimensional Euclidean space allows explanation of known relativistic effects that are now explained in pseudo-Euclidean spacetime by Einstein’s Special Theory of Relativity (STR). It also shows simple geometric-kinematical nature of known relativistic phenomena and among others explains why we cannot travel backward in time. The new solution is named the Euclidean Model of Space and Time (EMST).

Using a Grandfather Pendulum Clock to Measure the World’s Shortest Time Interval, the Planck Time (With Zero Knowledge of <i>G</i>)

Haug has recently introduced a new theory of unified quantum gravity coined “Collision Space-Time”. From this new and deeper understanding of mass, we can also understand how a grandfather pendulum clock can be used to measure the world’s shortest time interval, namely the Planck time, indirectly, without any knowledge of G. Therefore, such a clock can also be used to measure the diameter of an indivisible particle indirectly. Further, such a clock can easily measure the Schwarzschild radius of the gravity object and what we will call “Schwarzschild time”. These facts basically prove that the Newton gravitational constant is not needed to find the Planck length or the Planck time;it is also not needed to find the Schwarzschild radius. Unfortunately, there is significant inertia towards new ideas that could significantly alter our perspective on the fundamentals in the current physics establishment. However, this situation is not new in the history of science. Still, the idea that the Planck time can be measured totally independently of any knowledge of Newton’s gravitational constant could be very important for moving forward in physics. Interestingly, an old instrument that today is often thought of as primitive instrument can measure the world’s shortest possible time interval. No atomic clock or optical clock is even close to be able to do this.

Analysis of Hops Length in Wireless Sensor Networks

Wireless sensor networks are provided with a limited source of power. The lifetime of such networks is an overwhelming matter in most network applications. This lifetime depends strongly on how efficiently such energy is distributed over the nodes especially during transmitting and receiving data. Each node may route messages to destination nodes either through short hops or long hops. Optimizing the length of these hops may save energy, and therefore extend the lifetime of WSNs. In this paper, we propose a theorem to optimize the hop’s length so to make WSN power consumption minimal. The theorem establishes a simple condition on hop’s length range. Computer simulation when performing such condition on Mica2 sensors and Mica2dot sensors reveals good performance regarding WSNs energy consumption.

Spacetime Discreteness: Shedding Light on Two of the Simplest Observations in Physics

Loop quantum gravity is considered to be one of the two major candidates for a theory of quantum gravity. The most appealing aspect about this theory is it predicts that spacetime is not continuous;both space and time have a discrete nature. Simply, space is not infinitely divisible, but it has a granular structure, and time does not flow continuously like a smooth river. This paper demonstrates a review for two missed (unnoted) observations that support the discreteness of the spacetime. The content of this paper does not validate the specific model of quantized geometry of the spacetime which is predicted by the theory itself. Instead, it proves that time does not flow continuously. But it flows in certain, discrete steps, like a ticking of a clock, due to a simple observation which is absence of any possible value of time that can exist between the present and the future. Regarding space, it validates the spatial discreteness, and the existence of spatial granules (space quanta) due to a simple observation which is the existence of the origin position in a coordinates system. All of this is achieved by reviewing the concept of discreteness itself, and applied directly to the observations.

A Solution to the Cosmological Constant Problem in Two Time Dimensions

For the last hundred years, the existence and the value of the cosmological constant Λ has been a great enigma. So far, any theoretical model has failed to predict the value of Λ by several orders of magnitude. We here offer a solution to the cosmological constant problem by extending the Einstein-Friedmann equations by one additional time dimension. Solving these equations, we find that the Universe is flat on a global scale and that the cosmological constant lies between 10-90 m-2 and 10-51 m-2 which is in range observed by experiments. It also proposes a mean to explain the Planck length and to mitigate the singularity at the Big Bang.

X-band deflecting cavity design for ultra-short bunch length measurement of SXFEL at SINAP

For developing the X-ray Free Electron Lasers test facility(SXFEL) at Shanghai Institute of Applied Physics,Chinese Academy of Sciences(SINAP), ultra-short bunch is the crucial requirement for excellent lasing performance. It is a big challenge for deflecting cavity to measure the length of ultra-short bunch, and higher deflecting gradient is required for higher measurement resolution. X-band travelling wave deflecting structure has features of higher deflecting voltage and compact structure, which has good performance at ultra-short bunch length measurement. In this paper, a new X-band deflecting structure is designed to operate in HEM11-2π/3 mode.For suppressing the polarization of deflecting plane of the HEM11 mode, two symmetrical caves are added on the cavity wall to separate two polarized modes.

Real Time Power Monitoring Detection Based on Sequence Time Domain Reflectometry Approach

Sequence Time Domain Reflectometry (STDR) have been demonstrated to be a powerful technique for detecting the length of cable or length of open circuit or short circuit cables. Using this method along with using smart meter on the main electrical panel board to monitor consumption if load at each circuit, enable user to monitor power consumption at each node (power outlet) only by operating a smart digital meter and an STDR circuitry on each circuit at the main electrical panel board. This paper introduces this method and examines it on dead-wire and energized wire with a load connected across it. Experimental results are demonstrated for both types. Test result show the potential application of this approach to provide consumption information and potential cost saving via feedback for users.

Reality of Space and Time

In Newton’s classical physics, space and time are treated as absolute, independent quantities and can be discussed separately. In Special Relativity, Einstein proved that space and time are relative and dependent and therefore must not be treated separately. Minkowski adopted four-dimensional space-time frames (4-d s-t frames), which indirectly revealed the dependency of space and time with the addition of a constraint for an event interval. We are not able to visualize 4-d s-t frames. Since space and time are inseparable, three-dimensional space-time frames (3-d s-t frames) can be constructed by embedding time into space to directly show the interdependency of space and time. Time contraction and length contraction can also be depicted graphically using 3-d s-t frames. We have much better understanding reality of space and time in 3-d s-t frames. This will lead to Contextual Reality for better understanding the universe.

Analysis of Waiting Time in Emergency Department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia

Emergency Department (ED) in Alnoor Hospital is considered the pulsating unit in the hospital by facing a daily challenge through a huge exposure to number of patients round between 500 - 700 per day in average. With this busy service in ED, our study emerges to measure the quality of provided services to patients in term of measuring the total length of stay time (LOS) in ED and its influencing factors. This is a prospective study aiming to estimate the average time patients spend in ED of Alnoor Hospital during the month of January (2013). In addition, it inspects factors influencing the LOS. The questionnaire which conducted and filled by emergency team over all patients was consisted of the following data: arrival time to ED, initial time of assessment by nurse, initial time of assessment by doctor, time of arrival to specific area, consultation time, arrival time of consulted specialty, time of laboratory investigation, time of radiological investigation, time of final disposition and time of physical disposition. For the 7604 patient visits analyzed, mean ED LOS was 3.02 hour (SD = 5.03 hour). About half of the patients spent less than 59 minutes (44%), 32.6% spent 1 to 3:59 hour, 15.2% spent 4 to 7:59 hour, and 8.2% of the patients spent more than 8 hours. A priceless such study will offer an opportunity to evaluate the recent ED performance and assist to adapt future optimization strategies to improve the quality of services provided to the patient.

狭义相对论时空观的图像解译

狭义相对论的时空观之所以抽象且难以理解,一方面是因为狭义相对论所涉及的时空效应,如同时性的相对性、长度收缩和时间延缓等,在实际中都很难被观测到;另一方面是因为我们很难将这些时空效应同时直观形象地描述出来,并且给出不同参考系各自观测到的时空效应之间的对应关系。本文针对这一问题,利用图示法将两个参考系在不同时刻观测到的时空图像表示出来,并结合具体数值对他们间的对应关系进行讨论。在图示法中同时考虑了同时性的相对性、长度收缩和时间延缓这三个狭义相对论重要的时空效应,这样可直观形象地看到在一个参考系中得到的观测结果会被另一个参考系所认同,正是这些彼此认同的观测结果构成了狭义相对论的时空观。通过对不同参考系中观察到的时空图像及其相互联系的讨论,可以加深学生对狭义相对论时空效应及洛伦兹变换的物理意义的理解。