Effectiveness, costs, and cost-effectiveness of recruitment strategies for a mammographic screening program to detect breast cancer

BACKGROUND AND PURPOSE: Since effective and affordable recruitment methods are essential for the widespread implementation of mammographic screening for detection of breast cancer, we studied the effectiveness, the costs, and the cost-effectiveness of various recruitment strategies in the population targeted by a pilot Australian program that offered free mammography screening between 1988 and 1990. METHODS: We evaluated three public recruitment strategies--local newspaper articles, community promotion, and promotion to physicians--and five personal strategies--invitation letters with or without specified appointment times, either alone or with a follow-up letter, or telephone call to nonattenders. The effectiveness of public recruitment strategies was estimated from monthly attendance rates by Poisson regression analysis, while the probability of attendance in response to personal strategies was calculated using logistic regression analysis. Costs were determined by resource usage studies. The cost-effectiveness ratios for personal strategies were determined using decision analysis. RESULTS: The costs in 1988-1989 Australian dollars per woman recruited were $22 for local newspaper articles and $106 for community promotion. No detectable increase in attendance resulted from promotion to physicians. When the cost of reserving an appointment was considered, the most cost-effective personal recruitment strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders. This strategy recruited 35.6% of women in the sample targeted and cost $10.52 per attendee. In comparison, the most effective personal recruitment strategy was a letter with a specified appointment time followed by a second letter to nonattenders, which recruited 44.1% of women at an average cost of $19.99 and a marginal cost of $59.71 per additional attendee. CONCLUSIONS: Personal recruitment strategies were more cost-effective than public strategies. The most cost-effective personal strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders.

Cost-effective authentic and anonymous data sharing with forward security

Data sharing has never been easier with the advances of cloud computing, and an accurate analysis on the shared data provides an array of benefits to both the society and individuals. Data sharing with a large number of participants must take into account several issues, including efficiency, data integrity and privacy of data owner. Ring signature is a promising candidate to construct an anonymous and authentic data sharing system. It allows a data owner to anonymously authenticate his data which can be put into the cloud for storage or analysis purpose. Yet the costly certificate verification in the traditional public key infrastructure (PKI) setting becomes a bottleneck for this solution to be scalable. Identity-based (ID-based) ring signature, which eliminates the process of certificate verification, can be used instead. In this paper, we further enhance the security of ID-based ring signature by providing forward security: If a secret key of any user has been compromised, all previous generated signatures that include this user still remain valid. This property is especially important to any large scale data sharing system, as it is impossible to ask all data owners to re-authenticate their data even if a secret key of one single user has been compromised. We provide a concrete and efficient instantiation of our scheme, prove its security and provide an implementation to show its practicality.

Low cost BIST techniques for linear and non-linear analog circuits

With the ever increasing demands for high complexity consumer electronic products, market pressures demand faster product development and lower cost. SoCbased design can provide the required design flexibility and speed by allowing the use of IP cores. However, testing costs in the SoC environment can reach a substantial percent of the total production cost. Analog testing costs may dominate the total test cost, as testing of analog circuits usually require functional verification of the circuit and special testing procedures. For RF analog circuits commonly used in wireless applications, testing is further complicated because of the high frequencies involved. In summary, reducing analog test cost is of major importance in the electronic industry today. BIST techniques for analog circuits, though potentially able to solve the analog test cost problem, have some limitations. Some techniques are circuit dependent, requiring reconfiguration of the circuit being tested, and are generally not usable in RF circuits. In the SoC environment, as processing and memory resources are available, they could be used in the test. However, the overhead for adding additional AD and DA converters may be too costly for most systems, and analog routing of signals may not be feasible and may introduce signal distortion. In this work a simple and low cost digitizer is used instead of an ADC in order to enable analog testing strategies to be implemented in a SoC environment. Thanks to the low analog area overhead of the converter, multiple analog test points can be observed and specific analog test strategies can be enabled. As the digitizer is always connected to the analog test point, it is not necessary to include muxes and switches that would degrade the signal path. For RF analog circuits, this is specially useful, as the circuit impedance is fixed and the influence of the digitizer can be accounted for in the design phase. Thanks to the simplicity of the converter, it is able to reach higher frequencies, and enables the implementation of low cost RF test strategies. The digitizer has been applied successfully in the testing of both low frequency and RF analog circuits. Also, as testing is based on frequency-domain characteristics, nonlinear characteristics like intermodulation products can also be evaluated. Specifically, practical results were obtained for prototyped base band filters and a 100MHz mixer. The application of the converter for noise figure evaluation was also addressed, and experimental results for low frequency amplifiers using conventional opamps were obtained. The proposed method is able to enhance the testability of current mixed-signal designs, being suitable for the SoC environment used in many industrial products nowadays.

Low cost non-intrusive home energy monitoring

This thesis presents a low cost non-intrusive home energy monitor built on top of Non-Intrusive Load Monitoring (NILM) concepts and techniques. NILM solutions are already considered low cost alternatives to the big majority of existing commercial energy monitors but the goal here is to make its cost even lower by using a mini netbook as a whole in one solution. The mini netbook is installed in the homes main circuit breaker and computes power consumption by reading current and voltage from the built-in sound card. At the same time, feedback to the users is provided using the 11’’ LCD screen as well as other built-in I/O modules. Our meter is also capable of detecting changes in power and tries to find out which appliance lead to that change and it is being used as part of an eco-feedback platform that was build to study the long terms of energy eco-feedback in individuals. In this thesis the steps that were taken to come up with such a system are presented, from the basics of AC power measurements to the implementation of an event detector and classifier that was used to disaggregate the power load. In the last chapter results from some validation tests that have been performed are presented in order to validate the experiment. It is believed that such a system will not only be important as an energy monitor, but also as an open system than can be easily changed to accommodate and test new or existing nonintrusive load monitoring techniques.

Proportional controllers: Direct method for stability analysis and MATLAB implementation

In most cases, the cost of a control system increases based on its complexity. Proportional (P) controller is the simplest and most intuitive structure for the implementation of linear control systems. The difficulty to find the stability range of feedback systems with P controllers, using the Routh-Hurwitz criterion, increases with the order of the plant. For high order plants, the stability range cannot be easily obtained from the investigation of the coefficient signs in the first column of the Routh's array. A direct method for the determination of the stability range is presented. The method is easy to understand, to compute, and to offer the students a better comprehension on this subject. A program in MATLAB language, based on the proposed method, design examples, and class assessments, is provided in order to help the pedagogical issues. The method and the program enable the user to specify a decay rate and also extend to proportional-integral (PI), proportional-derivative (PD), and proportional-integral-derivative (PID) controllers.

Energy efficiency potential in Jamaica: challenges, opportunities and strategies for implementation

Incluye Bibliografía

Implementation of DNA markers to produce genomically - Enhanced EPDs in nellore cattle

Background: The sequencing and publication of the cattle genome and the identification of single nucleotide polymorphism (SNP) molecular markers have provided new tools for animal genetic evaluation and genomic-enhanced selection. These new tools aim to increase the accuracy and scope of selection while decreasing generation interval. The objective of this study was to evaluate the enhancement of accuracy caused by the use of genomic information (Clarifide® - Pfizer) on genetic evaluation of Brazilian Nellore cattle. Review: The application of genome-wide association studies (GWAS) is recognized as one of the most practical approaches to modern genetic improvement. Genomic selection is perhaps most suited to the improvement of traits with low heritability in zebu cattle. The primary interest in livestock genomics has been to estimate the effects of all the markers on the chip, conduct cross-validation to determine accuracy, and apply the resulting information in GWAS either alone [9] or in combination with bull test and pedigree-based genetic evaluation data. The cost of SNP50K genotyping however limits the commercial application of GWAS based on all the SNPs on the chip. However, reasonable predictability and accuracy can be achieved in GWAS by using an assay that contains an optimally selected predictive subset of markers, as opposed to all the SNPs on the chip. The best way to integrate genomic information into genetic improvement programs is to have it included in traditional genetic evaluations. This approach combines traditional expected progeny differences based on phenotype and pedigree with the genomic breeding values based on the markers. Including the different sources of information into a multiple trait genetic evaluation model, for within breed dairy cattle selection, is working with excellent results. However, given the wide genetic diversity of zebu breeds, the high-density panel used for genomic selection in dairy cattle (Ilumina Bovine SNP50 array) appears insufficient for across-breed genomic predictions and selection in beef cattle. Today there is only one breed-specific targeted SNP panel and genomic predictions developed using animals across the entire population of the Nellore breed (www.pfizersaudeanimal.com), which enables genomically - enhanced selection. Genomic profiles are a way to enhance our current selection tools to achieve more accurate predictions for younger animals. Material and Methods: We analyzed the age at first calving (AFC), accumulated productivity (ACP), stayability (STAY) and heifer pregnancy at 30 months (HP30) in Nellore cattle fitting two different animal models; 1) a traditional single trait model, and 2) a two-trait model where the genomic breeding value or molecular value prediction (MVP) was included as a correlated trait. All mixed model analyses were performed using the statistical software ASREML 3.0. Results: Genetic correlation estimates between AFC, ACP, STAY, HP30 and respective MVPs ranged from 0.29 to 0.46. Results also showed an increase of 56%, 36%, 62% and 19% in estimated accuracy of AFC, ACP, STAY and HP30 when MVP information was included in the animal model. Conclusion: Depending upon the trait, integration of MVP information into genetic evaluation resulted in increased accuracy of 19% to 62% as compared to accuracy from traditional genetic evaluation. GE-EPD will be an effective tool to enable faster genetic improvement through more dependable selection of young animals.

The need of subsidy for the implementation of photovoltaic solar energy as supporting of decentralized electrical power generation in Brazil

The growing demand for electrical power and the limited capital invested to provide this power is forcing countries like Brazil to search for new alternatives for electrical power generation. The purpose of this paper is to present a technical and economic study on a 15 kW solar plant installed in an isolated community, highlighting the importance of the need for financial subsidy from the government. It evaluates the importance of parameters such as the annual interest rate, specific investment, the marginal cost of expanding the electrical power supply and the government subsidy on amortization time of capital invested. © 2012 Elsevier Ltd All rights reserved.

Implementation of convective heating in Companhia Siderúrgica Nacional Blast Furnace runners

This paper describes the main characteristics and advantages of convective heating system for refractory lining, compared with conventional heating systems. In addition the main results obtained are presented with its implementation in CSN Blast Furnace #2 and 3 Runners, in terms of cost and equipment availability, as well as the need for ceramic coating to protect the lining against oxidation, arising from excessive air combustion. © 2012 Elsevier Ltd. All rights reserved.

Implementation strategy for poverty eradication in Belize

Summary This document identifies the component of the implementation strategy. These include: the attainment of productive employment and sustainable livelihood; social protection and reduced vulnerability; health; education; the environment; management and resources for social development programmes; institutional mechanisms; measurement and monitoring instruments; and foreign affairs. In this tabular presentation, the issues associated with each component are identified, priority actions outlined, and time frame, cost, source of funds and institutional responsibility included.

Report on the implementation of the ECLAC work programme subregional activities for the Caribbean 2006-2007 biennium [Covering the period 1 Janurary 2006- 31 December 2007]

The focus of the activities of the Economic Commission for Latin America and the Caribbean/Caribbean Development and Cooperation Committee (ECLAC/CDCC) secretariat during the 2006-2007 biennium continued to be on assistance to member governments of the subregion with policy-making and development strategies, especially on issues relevant to the promotion of the economic, social, and environmental dimensions of development in the Caribbean. The Subregional Headquarters for the Caribbean worked closely with member countries of the CDCC in an effort to ensure the relevance of outputs which would inform policy options. This involved the strengthening of partnerships with both regional and subregional institutions and relevant agencies of the United Nations system working in the Caribbean. A major decision was taken to refocus the operational aspects of the secretariat to ensure that they were relevant to the development goals of its members. This involved the introduction of a thematic approach to the work of the office. One of the changes resulting from this was the restructuring and renaming of the Caribbean Documentation Centre. The Caribbean Knowledge Management Centre (CKMC), as it is now known, has changed its emphasis from organizing and disseminating documents, and is now a more proactive partner in the research undertaken by staff and other users of the service. The CKMC manages the ECLAC website, the public face of the organization. Newsletters and all other documents, including Information and Communications Technology (ICT) profiles of selected countries, prepared by the secretariat, are now available online at the ECLAC/CDCC website www.eclacpos.org . The Caribbean Knowledge Management Portal was launched at a meeting of information specialists in St. Vincent and the Grenadines in 2007. In addition to reaching a wider public, this measure was introduced as a means of reducing the cost of printing or disseminating publications. In spite of the unusually high vacancy rate, at both the international and local levels, during the biennium, the subregional headquarters accomplished 98 per cent of the 119 outputs earmarked for the period. Using vacant positions to carry out the assignments was not an easy task, given the complexity in recruiting qualified and experienced persons for short periods. Nevertheless, consultancy services and short-term replacement staff greatly aided the delivery of these outputs. All the same, 35 work months remained unused during the biennium, leaving 301 work months to complete the outputs. In addition to the unoccupied positions, the work of the subprogramme was severely affected by the rising cost of regional and subregional travel which limited the ability of staff to network and interact with colleagues of member countries. This also hampered the outreach programme carried out mainly through ad hoc expert group meetings. In spite of these shortcomings, the period proved to be successful for the subprogramme as it engaged the attention of member countries in its work either through direct or indirect participation. Staff members completed 36 technical papers plus the reports of the meetings and workshops. A total of 523 persons, representing member countries, participated in the 18 intergovernmental and expert meetings convened by the secretariat in the 24-month period. In its effort to build technical capacity, the subprogramme convened 15 workshops/seminars which offered training for 446 persons.

The benefits of soft sensor and multi-rate control for the implementation of wireless networked control systems

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil

Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40-69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn't done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.

Results obtained with a low cost software-based audiometer for hearing screening

Introduction: The implementation of hearing screening programs can be facilitated by reducing operating costs, including the cost of equipment. The Telessaúde (TS) audiometer is a low-cost, software-based, and easy-to-use piece of equipment for conducting audiometric screening. Aim: To evaluate the TS audiometer for conducting audiometric screening. Methods: A prospective randomized study was performed. Sixty subjects, divided into those who did not have (group A, n = 30) and those who had otologic complaints (group B, n = 30), underwent audiometric screening with conventional and TS audiometers in a randomized order. Pure tones at 25 dB HL were presented at frequencies of 500, 1000, 2000, and 4000 Hz. A "fail" result was considered when the individual failed to respond to at least one of the stimuli. Pure-tone audiometry was also performed on all participants. The concordance of the results of screening with both audiometers was evaluated. The sensitivity, specificity, and positive and negative predictive values of screening with the TS audiometer were calculated. Results: For group A, 100% of the ears tested passed the screening. For group B, "pass" results were obtained in 34.2% (TS) and 38.3% (conventional) of the ears tested. The agreement between procedures (TS vs. conventional) ranged from 93% to 98%. For group B, screening with the TS audiometer showed 95.5% sensitivity, 90.4% sensitivity, and positive and negative predictive values equal to 94.9% and 91.5%, respectively. Conclusions: The results of the TS audiometer were similar to those obtained with the conventional audiometer, indicating that the TS audiometer can be used for audiometric screening.

Implementation of a robust optical flow method for color images

We analyse the influence of colour information in optical flow methods. Typically, most of these techniques compute their solutions using grayscale intensities due to its simplicity and faster processing, ignoring the colour features. However, the current processing systems have minimized their computational cost and, on the other hand, it is reasonable to assume that a colour image offers more details from the scene which should facilitate finding better flow fields. The aim of this work is to determine if a multi-channel approach supposes a quite enough improvement to justify its use. In order to address this evaluation, we use a multi-channel implementation of a well-known TV-L1 method. Furthermore, we review the state-of-the-art in colour optical flow methods. In the experiments, we study various solutions using grayscale and RGB images from recent evaluation datasets to verify the colour benefits in motion estimation.