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The study of sampling proposals for diffusion processes has been tackled numerous times in the literature. In practice, these are used to impute paths for a target diffusion process given a startin...

Summary Introduction Despite the perception that meticillin-resistant Staphylococcus aureus (MRSA) is now under control in high-income countries, global prevalence remains high, even increasing in some regions. Universal admission screening and decolonization has been instituted in some hospitals to attempt control but the practice remains controversial. Methods In 2014, Mater Dei Hospital in Malta introduced a universal admission screening policy, utilizing a novel, centralized and customized approach to achieve high compliance and low cost. Admissions are screened nasally by designated staff using chromogenic media, irrespective of risk factors. Carriers are decolonized without concurrent isolation or contact precautions. In this study, longitudinal, quasi-experimental evaluation was undertaken using time series analysis to analyse the impact of the intervention on the proportion of MRSA among clinical S. aureus isolates (%MRSA) and incidence per 1000 bed-days. A cost–utility analysis was also attempted to identify approximate quality-adjusted life years (QALYs) gained. Results A transfer function model approach concluded that the intervention had a significant effect on both %MRSA and incidence. Six years following its introduction, the screening programme had led to an overall 43% long-term reduction in %MRSA from pre-screening levels [R2=0.687; Bayesian information criterion (BIC)=4.063], translating to a decrease in incidence of approximately 0.56 cases/1000 bed-days (R2=0.633, BIC=-3.063). No correlation was identified with consumption of antibiotics or alcohol hand rub. The annual cost–benefit of the programme was calculated at €1058 per QALY gain per year. Conclusion The universal admission screening and decolonization intervention was successful and cost-effective in this high-endemicity setting. It facilitated improvement in the prevalence of MRSA, achieving reduction levels rarely reported by Mediterranean hospitals.

We implement hidden Markov models (HMMs) and hidden semi-Markov models (HSMMs) on Bitcoin/US dollar (BTC/USD) with the aim of market phase detection. We make analogous comparisons to Standard and Poor&rsquo, s 500 (S and P 500), a benchmark traditional stock index and a protagonist of several studies in finance. Popular labels given to market phases are &ldquo, bull&rdquo, &ldquo, bear&rdquo, correction&rdquo, and &ldquo, rally&rdquo, In the first part, we fit HMMs and HSMMs and look at the evolution of hidden state parameters and state persistence parameters over time to ensure that states are correctly classified in terms of market phase labels. We conclude that our modelling approaches yield positive results in both BTC/USD and the S and P 500, and both are best modelled via four-state HSMMs. However, the two assets show different regime volatility and persistence patterns&mdash, BTC/USD has volatile bull and bear states and generally weak state persistence, while the S and P 500 shows lower volatility on the bull states and stronger state persistence. In the second part, we put our models to the test of detecting different market phases by devising investment strategies that aim to be more profitable on unseen data in comparison to a buy-and-hold approach. In both cases, for select investment strategies, four-state HSMMs are also the most profitable and significantly outperform the buy-and-hold strategy.

Intervention analysis is an important method for analysing temporary or long-lasting effects of sudden events on time series data. We use monthly data of the National Statistics Office’s Tourstat survey covering the years 2003 up to 2012. This contains a number of time series regarding tourist demographics, the type of tourism, and other variables of economic relevance. We apply intervention analysis to determine the impact of the introduction of budget airline routes to Maltese tourism related time series. We consider two main interventions. The first is the introduction of Italy and UK bound routes in October 2006. The second is the introduction of a considerable number of routes in March 2010, in particular the Marseille route. In addition to the standard types of intervention introduced by Box and Tiao (1975), the step and the pulse intervention, we also use a periodic pulse intervention which allows us to cater for any seasonality in the intervention effect, with the corresponding transfer function possibilities. We conclude with a critique of this method for this data.

There are currently 15,000 junior doctors in the foundation programme (FP). The programme's purpose is to bridge medical school and specialty training, and it replaced the Pre-Registration House Officer year (PRHO) and the first Senior House Officer (SHO) year: it is made up of three-to six-month placements in primary and secondary care specialities that will allow trainees to experience a wide range of specialities, allow greater general experience and form a clear career direction. This two-year internship programme was introduced in 2005, as part of the process of modernising postgraduate medical training in the United Kingdom. This was in response to the problems identified in the consultation document entitled the "Unfinished Business" There were problems highlighted in the old SHO training which included lack of supervision, career direction and an ever-increasing workload., peer-reviewed

Objective. We investigated the impact of bed occupancy, particularly overcrowding, on the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in general ward settings., Methods. We performed a time-series and mixed-model analysis of variance of monthly incidence of MRSA infection and corresponding bed occupancy rates, over 65 months, in the medicine and surgical wards within St. Luke's Hospital, a 900-bed tertiary care facility in Malta., Results. In the medicine wards, significant periodic fluctuations in bed demand were evident during the study period, with peaks of occupancy greater than 120% during the winter months. Cross-correlation analysis between the rate of bed occupancy and the rate of MRSA infection displayed an oscillatory configuration, with a periodicity of 12, similar to the periodicity evident in the autocorrelation bed-occupancy pattern. Further statistical analysis by means of analysis of variance confirmed that the months with excessive overcrowding tended to coincide with a significant increase in the rate of MRSA infection, occurring after a lag of approximately 2 months. Identical analysis of equivalent data from the surgical wards also revealed significant fluctuation in the rate of bed occupancy; however, occupancy never exceeded 100%. No cross-correlational relationship with MRSA infection incidence was present., Conclusion. The study data suggest that, in our setting, simple fluctuations in the rate of bed occupancy did not have a direct impact on the incidence of MRSA infection as long as the rate of bed occupancy was within designated levels. Rather, it was episodes of significant overcrowding, with occupancy levels in excess of designated numbers, that triggered increases in infection incidence rates., peer-reviewed