Performance tiers: Implementing comparative effectiveness analysis in the health care setting through operations research and spatial methods

This dissertation develops and tests a comparative effectiveness methodology utilizing a novel approach to the application of Data Envelopment Analysis (DEA) in health studies. The concept of performance tiers (PerT) is introduced as terminology to express a relative risk class for individuals within a peer group and the PerT calculation is implemented with operations research (DEA) and spatial algorithms. The analysis results in the discrimination of the individual data observations into a relative risk classification by the DEA-PerT methodology. The performance of two distance measures, kNN (k-nearest neighbor) and Mahalanobis, was subsequently tested to classify new entrants into the appropriate tier. The methods were applied to subject data for the 14 year old cohort in the Project HeartBeat! study.^ The concepts presented herein represent a paradigm shift in the potential for public health applications to identify and respond to individual health status. The resultant classification scheme provides descriptive, and potentially prescriptive, guidance to assess and implement treatments and strategies to improve the delivery and performance of health systems. ^

SOCIO-ENVIRONMENTAL FACTORS ASSOCIATED WITH THE DISTRIBUTION OF DRACUNCULUS MEDINENSIS (GUINEA WORM DISEASE) AND SUGGESTED METHODS FOR CONTROL, IBARAPA, NIGERIA, 1982 (AFRICA)

A population-based cross-sectional survey of socio-environmental factors associated with the prevalence of Dracunculus medinensis (guinea worm disease) was conducted in Idere, a rural agricultural community in Ibarapa, Oyo state, Nigeria, during 1982.^ The epidemiologic data were collected by household interview of all 501 households. The environmental data were collected by analysis of water samples collected from all domestic water sources and rainfall records.^ The specific objectives of this research were to: (a) Describe the prevalence of guinea worm disease in Idere during 1982 by age, sex, area of residence, drinking water source, religion and weekly amount of money spent by the household to collect potable drinking water. (b) Compare the characteristics of cases with non-cases of guinea worm in order to identify factors associated with high risk of infection. (c) Investigate domestic water sources for the distribution of Cyclops. (d) Determine the extent of potable water shortage with a view to identifying factors responsible for such shortage in the community. (e) Describe the effects of guinea worm on school attendance during 1980/1982 school years by class and location of school from piped water supply.^ The findings of this research indicate that during 1982, 31.8 percent of Idere's 6,527 residents experienced guinea worm infection, with higher prevalence of infection recorded in males in their most productive years and females in their teenage years. The role of sex and age to risk of higher infection rate was explained in the context of water related exposure and water intake due to dehydration from physical occupational actitives of subgroups.^ Potable water available to residents was considerably below the minimum recommended by WHO for tropical climates, with sixty-eight percent of water needs of the residents coming from unprotected surface water which harbour Cyclops, the obligatory intermediate host of Dracunculus medinensis. An association was found between periods of relative high density of Cyclops in domestic water and rainfall.^ Impact of guinea worm infection on educational activities was considerable and its implications were discussed, including the implications of the research findings in relation to control of guinea worm disease in Ibarapa. ^

Comparison of machine learning approaches and statistical methods for estimation of airborne chemical exposures

Accurate quantitative estimation of exposure using retrospective data has been one of the most challenging tasks in the exposure assessment field. To improve these estimates, some models have been developed using published exposure databases with their corresponding exposure determinants. These models are designed to be applied to reported exposure determinants obtained from study subjects or exposure levels assigned by an industrial hygienist, so quantitative exposure estimates can be obtained. ^ In an effort to improve the prediction accuracy and generalizability of these models, and taking into account that the limitations encountered in previous studies might be due to limitations in the applicability of traditional statistical methods and concepts, the use of computer science- derived data analysis methods, predominantly machine learning approaches, were proposed and explored in this study. ^ The goal of this study was to develop a set of models using decision trees/ensemble and neural networks methods to predict occupational outcomes based on literature-derived databases, and compare, using cross-validation and data splitting techniques, the resulting prediction capacity to that of traditional regression models. Two cases were addressed: the categorical case, where the exposure level was measured as an exposure rating following the American Industrial Hygiene Association guidelines and the continuous case, where the result of the exposure is expressed as a concentration value. Previously developed literature-based exposure databases for 1,1,1 trichloroethane, methylene dichloride and, trichloroethylene were used. ^ When compared to regression estimations, results showed better accuracy of decision trees/ensemble techniques for the categorical case while neural networks were better for estimation of continuous exposure values. Overrepresentation of classes and overfitting were the main causes for poor neural network performance and accuracy. Estimations based on literature-based databases using machine learning techniques might provide an advantage when they are applied to other methodologies that combine `expert inputs' with current exposure measurements, like the Bayesian Decision Analysis tool. The use of machine learning techniques to more accurately estimate exposures from literature-based exposure databases might represent the starting point for the independence from the expert judgment.^

Phosphorus and Potassium Rates and Placement Methods for Corn and Soybean Managed with No-till or Tillage

No-till management for corn and soybean results in little or no incorporation of crop residues and fertilizer with soil. Subsurface banding phosphorus (P) and potassium (K) fertilizers with planter attachments could be more effective than broadcast fertilization, because in no-till with broadcast fertilizer, both nutrients accumulate at or near the soil surface. A long-term study was initiated in 1994 at the ISU Northwest Research Farm to evaluate P and K fertilizer placement for corn and soybean managed with no-till and chiselplow tillage.

An environmental magnetic study, sedimentological and numerical methods around Tauranga Harbour, New Zealand

Magnetic iron minerals are widespread and indicative sediment constituents in estuarine, coastal and shelf systems. We combine environmental magnetic, sedimentological and numerical methods to identify magnetite-enriched placer-like zones in a complex coastal system and delineate their formation mechanisms. Magnetic susceptibility and remanence measurements on 245 surficial sediment samples collected in and around Tauranga Harbour, the largest barrier-enclosed tidal estuary of New Zealand, reveal several discrete enrichment zones controlled by local hydrodynamic conditions. Active magnetite enrichment takes place in tidal channels, which feed into two coast-parallel nearshore magnetite-enriched belts centered at water depths of 6-10 m and 10-20 m. A close correlation between magnetite content and magnetic grain size was found, where higher susceptibility values are associated within coarser magnetic crystal sizes. Two key mechanisms for magnetite enrichment are identified. First, tide-induced residual currents primarily enable magnetite enrichment within the estuarine channel network. A coast-parallel, fine sand magnetite enrichment belt in water depths of less than 10 m along the barrier island has a strong decrease in magnetite content away from the southern tidal inlet and is apparently related to active coast-parallel transport combined with mobilizing surf zone processes. A second, less pronounced, but more uniform magnetite enrichment belt at 10-20 m water depth is composed of non-mobile, medium-coarse-grained relict sands, which have been reworked during post-glacial sea level transgression. We demonstrate the potential of magnetic methods to reveal and differentiate coastal magnetite enrichment patterns and investigate their formative mechanisms.

Neurological Disease Detection and Monitoring from Voice Production

The dramatic impact of neurological degenerative pathologies in life quality is a growing concern. It is well known that many neurological diseases leave a fingerprint in voice and speech production. Many techniques have been designed for the detection, diagnose and monitoring the neurological disease. Most of them are costly or difficult to extend to primary attention medical services. Through the present paper it will be shown how some neurological diseases can be traced at the level of phonation. The detection procedure would be based on a simple voice test. The availability of advanced tools and methodologies to monitor the organic pathology of voice would facilitate the implantation of these tests. The paper hypothesizes that some of the underlying mechanisms affecting the production of voice produce measurable correlates in vocal fold biomechanics. A general description of the methodological foundations for the voice analysis system which can estimate correlates to the neurological disease is shown. Some study cases will be presented to illustrate the possibilities of the methodology to monitor neurological diseases by voice

The CDG, UDG, and MEL methods for automatic compile-time parallelization of logic programs for independent and-parallelism

There has been significant interest in parallel execution models for logic programs which exploit Independent And-Parallelism (IAP). In these models, it is necessary to determine which goals are independent and therefore eligible for parallel execution and which goals have to wait for which others during execution. Although this can be done at run-time, it can imply a very heavy overhead. In this paper, we present three algorithms for automatic compiletime parallelization of logic programs using IAP. This is done by converting a clause into a graph-based computational form and then transforming this graph into linear expressions based on &-Prolog, a language for IAP. We also present an algorithm which, given a clause, determines if there is any loss of parallelism due to linearization, for the case in which only unconditional parallelism is desired. Finally, the performance of these annotation algorithms is discussed for some benchmark programs.

Complete and efficient methods for supporting side effects in independent/restricted and-parallelism

It has been shown that it is possible to exploit Independent/Restricted And-parallelism in logic programs while retaining the conventional "don't know" semantics of such programs. In particular, it is possible to parallelize pure Prolog programs while maintaining the semantics of the language. However, when builtin side-effects (such as write or assert) appear in the program, if an identical observable behaviour to that of sequential Prolog implementations is to be preserved, such side-effects have to be properly sequenced. Previously proposed solutions to this problem are either incomplete (lacking, for example, backtracking semantics) or they force sequentialization of significant portions of the execution graph which could otherwise run in parallel. In this paper a series of side-effect synchronization methods are proposed which incur lower overhead and allow more parallelism than those previously proposed. Most importantly, and unlike previous proposals, they have well-defined backward execution behaviour and require only a small modification to a given (And-parallel) Prolog implementation.

Integration of research advances in modelling and monitoring in support of WFD river basin management planning in the context of climate change

The integration of scientific knowledge about possible climate change impacts on water resources has a direct implication on the way water policies are being implemented and evolving. This is particularly true regarding various technical steps embedded into the EU Water Framework Directive river basin management planning, such as risk characterisation, monitoring, design and implementation of action programmes and evaluation of the "good status" objective achievements (in 2015). The need to incorporate climate change considerations into the implementation of EU water policy is currently discussed with a wide range of experts and stakeholders at EU level. Research trends are also on-going, striving to support policy developments and examining how scientific findings and recommendations could be best taken on board by policy-makers and water managers within the forthcoming years. This paper provides a snapshot of policy discussions about climate change in the context of the WFD river basin management planning and specific advancements of related EU-funded research projects. Perspectives for strengthening links among the scientific and policy-making communities in this area are also highlighted.

Multiprotocol Android Application for Smart Control and Monitoring in Buildings

This paper presents a multiprotocol mobile application for building automation which supports and enables the integration of the most representative control technologies such as KNX, LonWorks and X-10. The application includes a real-time monitoring service. Finally, advanced control functionalities based on gestures recognition and predefined scenes have been implemented. This application has been developed and tested in the Energy Efficiency Research Facility located at CeDInt-UPM, where electrical loads, blinds and HVAC and lighting systems can be controlled.

The road to e-services: online and mobile games as enablers

Institute for Prospective Technological Studies Mission: - to provide customer-driven support to the EU policymaking process - by developing science based responses to policy challenges - having both socio-economic and scientific /technological dimension.

The application of inverse-dispersion and gradient methods to estimate ammonia emissions from a penguin colony.

Penguin colonies represent some of the most concentrated sources of ammonia emissions to the atmosphere in the world. The ammonia emitted into the atmosphere can have a large influence on the nitrogen cycling of ecosystems near the colonies. However, despite the ecological importance of the emissions, no measurements of ammonia emissions from penguin colonies have been made. The objective of this work was to determine the ammonia emission rate of a penguin colony using inverse-dispersion modelling and gradient methods. We measured meteorological variables and mean atmospheric concentrations of ammonia at seven locations near a colony of Adélie penguins in Antarctica to provide input data for inverse-dispersion modelling. Three different atmospheric dispersion models (ADMS, LADD and a Lagrangian stochastic model) were used to provide a robust emission estimate. The Lagrangian stochastic model was applied both in ‘forwards’ and ‘backwards’ mode to compare the difference between the two approaches. In addition, the aerodynamic gradient method was applied using vertical profiles of mean ammonia concentrations measured near the centre of the colony. The emission estimates derived from the simulations of the three dispersion models and the aerodynamic gradient method agreed quite well, giving a mean emission of 1.1 g ammonia per breeding pair per day (95% confidence interval: 0.4–2.5 g ammonia per breeding pair per day). This emission rate represents a volatilisation of 1.9% of the estimated nitrogen excretion of the penguins, which agrees well with that estimated from a temperature-dependent bioenergetics model. We found that, in this study, the Lagrangian stochastic model seemed to give more reliable emission estimates in ‘forwards’ mode than in ‘backwards’ mode due to the assumptions made.

High speed railroad bridges. Conception, bases of design, typological possibilities and construction methods

Diseño conceptual de puentes de alta velocidad ferroviarios. Railroad bridges, in general, and those for high speed railways, in particular, demand very special conditions. The traffic loads are much higher than for road bridges. Loads due to braking and acceleration determine, due to their magnitude, the structural layout. Because of the speed of the vehicles there are specific dynamic effects which need to be considered. In order to ensure passenger comfort, compatible with speeds of up to 350 km/h, it is necessary to meet very demanding conditions with respect to stiffness, displacements and dynamic behavior. In this paper these conditions are briefly described and different typological possibilities to satisfy them are presented as well as the main construction methods applicable to this kind of bridges.

A comparative analysis between FEM and Boundary Methods in bending of Plates

Two different methods of analysis of plate bending, FEM and BM are discussed in this paper. The plate behaviour is assumed to be represented by using the linear thin plate theory where the Poisson-Kirchoff assumption holds. The BM based in a weighted mean square error technique produced good results for the problem of plate bending. The computational effort demanded in the BM is smaller than the one needed in a FEM analysis for the same level of accuracy. The general application of the FEM cannot be matched by the BM. Particularly, different types of geometry (plates of arbitrary geometry) need a similar but not identical treatment in the BM. However, this loss of generality is counterbalanced by the computational efficiency gained in the BM in the solution achievement