Modelling the episodes of care for iron deficiency anemia patients in a secondary-care center using continuous-time multistate Markov chain

Multi-objective prediction for denitration systems in cement: an approach combining process analysis and bi-directional long short-term memory network

Selective Non-Catalytic Reduction (SNCR) can improve the denitration process and reduce NOx emissions by accurizing prediction of NOx concentration and ammonia escape. However, there are inevitable time delays and nonlinearity problems in the prediction of NOx emission. To reduce NOx concentration quickly in SNCR, excessive ammonia spraying often causes a large amount of ammonia to escape, resulting in secondary pollution. Therefore, it is particularly important to monitor ammonia escape. To solve the above problems, this paper proposes a framework by specifically analyzing the cement denitration process and combining a multi-objective time series bi-directional long short-term memory network (MT-BiLSTM). Among them, the model achieves multi-objective prediction of NOx emission concentration and ammonia escape simultaneously. In addition, time series containing delay information are introduced in the input layer to eliminate the influence of delay. Based on the bi-directional LSTM model, the dropout strategy is adopted to improve the generalization of the model and the Adam optimizer is applied to improve the network performance. Besides, through the multi-step prediction of NOx emission at 3 time points, the dynamic nature of the data is preserved, which provides dynamic information support for realizing the automation of denitration system. The prediction performance of the MT-BiLSTM model is experimentally validated, and the results demonstrate that it can reliably predict both NOx and ammonia escape. The model achieves more accurate and reliable results for the prediction of flue gas concentrations compared with other methods such as SVR, DTR and LSTM. Therefore, the MT-BiLSTM model provides a basis for achieving NOx emission reduction and accurate ammonia injection.

Broad external validation of a multivariable risk prediction model for gastrointestinal malignancy in iron deficiency anaemia

BACKGROUND

Using two large datasets from Dorset, we previously reported an internally validated multivariable risk model for predicting the risk of GI malignancy in IDA-the IDIOM score. The aim of this retrospective observational study was to validate the IDIOM model using two independent external datasets.

METHODS

The external validation datasets were collected, in a secondary care setting, by different investigators from cohorts in Oxford and Sheffield derived under different circumstances, comprising 1117 and 474 patients with confirmed IDA respectively. The data were anonymised prior to analysis. The predictive performance of the original model was evaluated by estimating measures of calibration, discrimination and clinical utility using the validation datasets.

RESULTS

The discrimination of the original model using the external validation data was 70% (95% CI 65, 75) for the Oxford dataset and 70% (95% CI 61, 79) for the Sheffield dataset. The analysis of mean, weak, flexible and across the risk groups' calibration showed no tendency for under or over-estimated risks in the combined validation data. Decision curve analysis demonstrated the clinical value of the IDIOM model with a net benefit that is higher than 'investigate all' and 'investigate no-one' strategies up to a threshold of 18% in the combined validation data, using a risk cut-off of around 1.2% to categorise patients into the very low risk group showed that none of the patients stratified in this risk group proved to have GI cancer on investigation in the validation datasets.

CONCLUSION

This external validation exercise has shown promising results for the IDIOM model in predicting the risk of underlying GI malignancy in independent IDA datasets collected in different clinical settings.