Comparison of different approaches to determining the mean delay time in a queuing system H2/M/1

Author(s):  
Veniamin Tarasov ◽  
Nadezhda Bakhareva ◽  
Igor Kartashevskiy ◽  
Liudmila Lipilina
1997 ◽  
Vol 22 (3) ◽  
pp. 346-352 ◽  
Author(s):  
N. S. MOIEMEN ◽  
D. ELLIOT

This study investigated the outcome of composite graft replacement of 50 amputated digital tips in 50 children over a period of 3 years and 6 months. Eleven of 18 tips (61%) which were replaced within 5 hours survived completely while none of 32 digital tips replaced after 5 hours survived completely. This difference was highly significant. The mean delay time between amputation and replacement in the successful group was 3.9 hours and in the others was 7.2 hours. This difference was also statistically significant. The implications of the findings of this series to the use of this treatment are discussed.


2005 ◽  
Vol 192 ◽  
pp. 561-565
Author(s):  
D. Maoz ◽  
A. Gal-Yam

SummaryThe iron mass in galaxy clusters is about 6 times larger than could have been produced by core-collapse SNe, assuming the stars in cluster galaxies formed with a standard IMF. Type-Ia SNe have been proposed as the alternative dominant iron source. We use our HST measurements of the cluster SN-Ia rate at high redshift to study the cluster iron enrichment scenario. The measurements can constrain the star-formation epoch and the SN-Ia progenitor models via the mean delay time between the formation of a stellar population and the explosion of some of its members as SNe-Ia. The low observed rate of cluster SNe-Ia at z ~ 1 pushes back the star-formation epoch in clusters to z > 2, and implies a short delay time. We also show a related analysis for high-z field SNe which implies, under some conditions, a long SN-Ia delay time. Thus, cluster enrichment by core-collapse SNe from a top-heavy IMF may remain the only viable option.


1993 ◽  
Vol 18 (1) ◽  
pp. 115-118 ◽  
Author(s):  
J. STEVENSON ◽  
I. W. R. ANDERSON

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.


Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 39-47
Author(s):  
Connor Zale ◽  
Joshua Hansen ◽  
Paul Ryan

Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.


Author(s):  
Orimoloye Segun Michael

The queuing theory is the mathematical approach to the analysis of waiting lines in any setting where arrivals rate of the subject is faster than the system can handle. It is applicable to the health care setting where the systems have excess capacity to accommodate random variation. Therefore, the purpose of this study was to determine the waiting, arrival and service times of patients at AAUA Health- setting and to model a suitable queuing system by using simulation technique to validate the model. This study was conducted at AAUA Health- Centre Akungba Akoko. It employed analytical and simulation methods to develop a suitable model. The collection of waiting time for this study was based on the arrival rate and service rate of patients at the Outpatient Centre. The data was calculated and analyzed using Microsoft Excel. Based on the analyzed data, the queuing system of the patient current situation was modelled and simulated using the PYTHON software. The result obtained from the simulation model showed that the mean arrival rate of patients on Friday week1 was lesser than the mean service rate of patients (i.e. 5.33> 5.625 (λ > µ). What this means is that the waiting line would be formed which would increase indefinitely; the service facility would always be busy. The analysis of the entire system of the AAUA health centre showed that queue length increases when the system is very busy. This work therefore evaluated and predicted the system performance of AAUA Health-Centre in terms of service delivery and propose solutions on needed resources to improve the quality of service offered to the patients visiting this health centre.


2021 ◽  
Vol 103-B (6) ◽  
pp. 1127-1132
Author(s):  
Julia Gray ◽  
Matthew Welck ◽  
Nicholas P. Cullen ◽  
Dishan Singh

Aims To assess the characteristic clinical features, management, and outcome of patients who present to orthopaedic surgeons with functional dystonia affecting the foot and ankle. Methods We carried out a retrospective search of our records from 2000 to 2019 of patients seen in our adult tertiary referral foot and ankle unit with a diagnosis of functional dystonia. Results A total of 29 patients were seen. A majority were female (n = 25) and the mean age of onset of symptoms was 35.3 years (13 to 71). The mean delay between onset and diagnosis was 7.1 years (0.5 to 25.0). Onset was acute in 25 patients and insidious in four. Of the 29 patients, 26 had a fixed dystonia and three had a spasmodic dystonia. Pain was a major symptom in all patients, with a coexisting diagnosis of chronic regional pain syndrome (CRPS) made in nine patients. Of 20 patients treated with Botox, only one had a good response. None of the 12 patients who underwent a surgical intervention at our unit or elsewhere reported a subjective overall improvement. After a mean follow-up of 3.2 years (1 to 12), four patients had improved, 17 had remained the same, and eight reported a deterioration in their condition. Conclusion Patients with functional dystonia typically presented with a rapid onset of fixed deformity after a minor injury/event and pain out of proportion to the deformity. Referral to a neurologist to rule out neurological pathology is advocated, and further management should be carried out in a movement disorder clinic. Response to treatment (including Botulinum toxin (Botox) injections) is generally poor. Surgery in this group of patients is not recommended and may worsen the condition. The overall prognosis remains poor. Cite this article: Bone Joint J 2021;103-B(6):1127–1132.


2017 ◽  
Vol 41 (4) ◽  
pp. 187-191 ◽  
Author(s):  
Sukhmeet Singh ◽  
Paul Scouller ◽  
Daniel J. Smith

Aims and methodThe mean delay for bipolar disorder diagnosis is 10 years. Identification of patients with previous hypomania is challenging, sometimes resulting in misdiagnosis. The aims of this study were: (a) to estimate the proportion of primary care patients with depression currently taking antidepressants who have undiagnosed bipolar disorder and (b) to compare a brief 3-item manic features questionnaire with the Hypomania Checklist (HCL-13). The sample comprised patients with a recorded diagnosis of depression, either on long-term antidepressant therapy or with previous multiple courses of antidepressants.ResultsOf 149 participants assessed, 24 (16.1%) satisfied criteria for bipolar disorder. Areas under the curve (AUC) for the 3-item questionnaire and the HCL-13 were similar (0.79 and 0.72, respectively) but positive predictive values (PPV) were low.Clinical implicationsBipolar disorder may be underdiagnosed in primary care. A 3-item questionnaire could be used by general practitioners to screen for bipolar disorder in their patients with depression.


1974 ◽  
Vol 22 (3) ◽  
pp. 277 ◽  
Author(s):  
WE Poole ◽  
PC Catling

Eastern grey kangaroos, M. giganteus, and the western grey kangaroos M. f. fuliginosus, M.J melanops and M. f, ocydromus were bred in enclosures over a period of 10 y. Testis biopsies indicated sexual maturity in males, as follows: in both species, changes in the tubules from age 15 months; some spermatozoa seen by 20 months; active spermatogenesis with sperm free in the lumen by 31 (some western greys) or 48 months (eastern greys). In females, onset of sexual maturation, indicated by eversion of the teats, was from 14 and 18 months in western and eastern greys respectively; initial mating at c. 16.4 and 19 months with births not less than 1 month later. Crosses occurred only between western males and eastern females. Male hybrids were sterile; females were fertile, invariably mated with western males but also twice with eastern males. Smears taken from the anterior urogenital sinus showed that in both species and in their hybrids oestrus was accompanied by a marked increase in long narrow epithelial cells ('long cells'). The cycle was 34.85+-4.42 days in western females, 38.06h+-3.51 days in hybrids and 45.58+-19.82 days in eastern females. Variation in cycle length between and within females in each species was not significant, although variation between fuliginosus and melanops was significant at the 5% level. Oestrus occurred in all months of the year but least often in winter when some females entered anoestrus. Variance ratios for cycle length in relation to month of year were not significant for eastern or hybrid females but were, at the 5 % level, for western females. On loss or removal of pouch young the mean delay in return to oestrus was 10.92f 4.78 days in eastern and 8.2515.84 days in western females, significantly different at the 5% level. Females which retain their young may return to oestrus by 150 days after the birth and may mate at any or all of up to nine oestruses before conceiving again. Differences between eastern and western females were not significant, but those between western subspecies were, particularly between fuliginosus and melanops at the 0.1 % level. Embryonic diapause was observed seven times, all in eastern females, and followed matings not less than 160 days after the birth of a current pouch young.


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