Analytics and optimization for emergency healthcare processes

This thesis deals with the analysis and management of emergency healthcare processes through the use of advanced analytics and optimization approaches. Emergency processes are among the most complex within healthcare. This is due to their non-elective nature and their high variability. This thesis is divided into two topics. The first one concerns the core of emergency healthcare processes, the emergency department (ED). In the second chapter, we describe the ED that is the case study. This is a real case study with data derived from a large ED located in northern Italy. In the next two chapters, we introduce two tools for supporting ED activities. The first one is a new type of analytics model. Its aim is to overcome the traditional methods of analyzing the activities provided in the ED by means of an algorithm that analyses the ED pathway (organized as event log) as a whole. The second tool is a decision-support system, which integrates a deep neural network for the prediction of patient pathways, and an online simulator to evaluate the evolution of the ED over time. Its purpose is to provide a set of solutions to prevent and solve the problem of the ED overcrowding. The second part of the thesis focuses on the COVID-19 pandemic emergency. In the fifth chapter, we describe a tool that was used by the Bologna local health authority in the first part of the pandemic. Its purpose is to analyze the clinical pathway of a patient and from this automatically assign them a state. Physicians used the state for routing the patients to the correct clinical pathways. The last chapter is dedicated to the description of a MIP model, which was used for the organization of the COVID-19 vaccination campaign in the city of Bologna, Italy.

Adapting fruit production to climate change: how to increase intrinsic fruit quality and save water through deficit irrigation scheduling.

Fruit crops are an important resource for food security, since more than being nutrient they are also a source of natural antioxidant compounds, such as polyphenols and vitamins. However, fruit crops are also among the cultivations threatened by the harmful effects of climate change This study had the objective of investigating the physiological effects of deficit irrigation on apple (2020-2021), sour cherry (2020-2021-2022) and apricot (2021-2022) trees, with a special focus on fruit nutraceutical quality. On each trial, the main physiological parameters were monitored along the growing season: i) stem and leaf water potentials; ii) leaf gas exchanges; iii) fruit and shoot growth. At harvest, fruit quality was evaluated especially in terms of fruit size, flesh firmness and soluble solids content. Moreover, it was performed: i) total phenolic content determination; ii) anthocyanidin concentration evaluation; and iii) untargeted metabolomic study. Irrigation scheduling in apricot, apple and sour cherry is surely overestimated by the decision support system available in Emilia-Romagna region. The water stress imposed on different fruit crops, each during two years of study, showed as a general conclusion that the decrease in the irrigation water did not show a straightforward decrease in plant physiological performance. This can be due to the miscalculation of the real water needs of the considered fruit crops. For this reason, there is the need to improve this important tool for an appropriate water irrigation management. Furthermore, there is also the need to study the behaviour of fruit crops under more severe deficit irrigations. In fact, it is likely that the application of lower water amounts will enhance the synthesis of specialized metabolites, with positive repercussion on human health. These hypotheses must be verified.

A flexible consensus scheme for multicriteria group decision making under linguistic assessments

The present paper proposes a flexible consensus scheme for group decision making, which allows one to obtain a consistent collective opinion, from information provided by each expert in terms of multigranular fuzzy estimates. It is based on a linguistic hierarchical model with multigranular sets of linguistic terms, and the choice of the most suitable set is a prerogative of each expert. From the human viewpoint, using such model is advantageous, since it permits each expert to utilize linguistic terms that reflect more adequately the level of uncertainty intrinsic to his evaluation. From the operational viewpoint, the advantage of using such model lies in the fact that it allows one to express the linguistic information in a unique domain, without losses of information, during the discussion process. The proposed consensus scheme supposes that the moderator can interfere in the discussion process in different ways. The intervention can be a request to any expert to update his opinion or can be the adjustment of the weight of each expert`s opinion. An optimal adjustment can be achieved through the execution of an optimization procedure that searches for the weights that maximize a corresponding soft consensus index. In order to demonstrate the usefulness of the presented consensus scheme, a technique for multicriteria analysis, based on fuzzy preference relation modeling, is utilized for solving a hypothetical enterprise strategy planning problem, generated with the use of the Balanced Scorecard methodology. (C) 2009 Elsevier Inc. All rights reserved.

Decision making in fuzzy environment and multicriteria power engineering problems

This paper presents results of research into the use of the Bellman-Zadeh approach to decision making in a fuzzy environment for solving multicriteria power engineering problems. The application of the approach conforms to the principle of guaranteed result and provides constructive lines in computationally effective obtaining harmonious solutions on the basis of solving associated maxmin problems. The presented results are universally applicable and are already being used to solve diverse classes of power engineering problems. It is illustrated by considering problems of power and energy shortage allocation, power system operation, optimization of network configuration in distribution systems, and energetically effective voltage control in distribution systems. (c) 2011 Elsevier Ltd. All rights reserved.

Classification-Based Method of Linear Multicriteria Optimization

The paper describes a classification-based learning-oriented interactive method for solving linear multicriteria optimization problems. The method allows the decision makers describe their preferences with greater flexibility, accuracy and reliability. The method is realized in an experimental software system supporting the solution of multicriteria optimization problems.

Information systems to support decision-making in *construction owner organizations: A data warehousing approach

Construction organizations typically deal with large volumes of project data containing valuable information. It is found that these organizations do not use these data effectively for planning and decision-making. There are two reasons. First, the information systems in construction organizations are designed to support day-to-day construction operations. The data stored in these systems are often non-validated, non-integrated and are available in a format that makes it difficult for decision makers to use in order to make timely decisions. Second, the organizational structure and the IT infrastructure are often not compatible with the information systems thereby resulting in higher operational costs and lower productivity. These two issues have been investigated in this research with the objective of developing systems that are structured for effective decision-making. ^ A framework was developed to guide storage and retrieval of validated and integrated data for timely decision-making and to enable construction organizations to redesign their organizational structure and IT infrastructure matched with information system capabilities. The research was focused on construction owner organizations that were continuously involved in multiple construction projects. Action research and Data warehousing techniques were used to develop the framework. ^ One hundred and sixty-three construction owner organizations were surveyed in order to assess their data needs, data management practices and extent of use of information systems in planning and decision-making. For in-depth analysis, Miami-Dade Transit (MDT) was selected which is in-charge of all transportation-related construction projects in the Miami-Dade county. A functional model and a prototype system were developed to test the framework. The results revealed significant improvements in data management and decision-support operations that were examined through various qualitative (ease in data access, data quality, response time, productivity improvement, etc.) and quantitative (time savings and operational cost savings) measures. The research results were first validated by MDT and then by a representative group of twenty construction owner organizations involved in various types of construction projects. ^

Information systems to support decision-making in construction owner organizations : a data warehousing approach

Construction organizations typically deal with large volumes of project data containing valuable information. It is found that these organizations do not use these data effectively for planning and decision-making. There are two reasons. First, the information systems in construction organizations are designed to support day-to-day construction operations. The data stored in these systems are often non-validated, nonintegrated and are available in a format that makes it difficult for decision makers to use in order to make timely decisions. Second, the organizational structure and the IT infrastructure are often not compatible with the information systems thereby resulting in higher operational costs and lower productivity. These two issues have been investigated in this research with the objective of developing systems that are structured for effective decision-making. A framework was developed to guide storage and retrieval of validated and integrated data for timely decision-making and to enable construction organizations to redesign their organizational structure and IT infrastructure matched with information system capabilities. The research was focused on construction owner organizations that were continuously involved in multiple construction projects. Action research and Data warehousing techniques were used to develop the framework. One hundred and sixty-three construction owner organizations were surveyed in order to assess their data needs, data management practices and extent of use of information systems in planning and decision-making. For in-depth analysis, Miami-Dade Transit (MDT) was selected which is in-charge of all transportation-related construction projects in the Miami-Dade county. A functional model and a prototype system were developed to test the framework. The results revealed significant improvements in data management and decision-support operations that were examined through various qualitative (ease in data access, data quality, response time, productivity improvement, etc.) and quantitative (time savings and operational cost savings) measures. The research results were first validated by MDT and then by a representative group of twenty construction owner organizations involved in various types of construction projects.

DEVELOPMENT OF A DECISION/DEPLOYMENT SUPPORT TOOL FOR VARIABLE SPEED LIMITS IN RECURRENT CONGESTION

Traffic demand increases are pushing aging ground transportation infrastructures to their theoretical capacity. The result of this demand is traffic bottlenecks that are a major cause of delay on urban freeways. In addition, the queues associated with those bottlenecks increase the probability of a crash while adversely affecting environmental measures such as emissions and fuel consumption. With limited resources available for network expansion, traffic professionals have developed active traffic management systems (ATMS) in an attempt to mitigate the negative consequences of traffic bottlenecks. Among these ATMS strategies, variable speed limits (VSL) and ramp metering (RM) have been gaining international interests for their potential to improve safety, mobility, and environmental measures at freeway bottlenecks. Though previous studies have shown the tremendous potential of variable speed limit (VSL) and VSL paired with ramp metering (VSLRM) control, little guidance has been developed to assist decision makers in the planning phase of a congestion mitigation project that is considering VSL or VSLRM control. To address this need, this study has developed a comprehensive decision/deployment support tool for the application of VSL and VSLRM control in recurrently congested environments. The decision tool will assist practitioners in deciding the most appropriate control strategy at a candidate site, which candidate sites have the most potential to benefit from the suggested control strategy, and how to most effectively design the field deployment of the suggested control strategy at each implementation site. To do so, the tool is comprised of three key modules, (1) Decision Module, (2) Benefits Module, and (3) Deployment Guidelines Module. Each module uses commonly known traffic flow and geometric parameters as inputs to statistical models and empirically based procedures to provide guidance on the application of VSL and VSLRM at each candidate site. These models and procedures were developed from the outputs of simulated experiments, calibrated with field data. To demonstrate the application of the tool, a list of real-world candidate sites were selected from the Maryland State Highway Administration Mobility Report. Here, field data from each candidate site was input into the tool to illustrate the step-by-step process required for efficient planning of VSL or VSLRM control. The output of the tool includes the suggested control system at each site, a ranking of the sites based on the expected benefit-to-cost ratio, and guidelines on how to deploy the VSL signs, ramp meters, and detectors at the deployment site(s). This research has the potential to assist traffic engineers in the planning of VSL and VSLRM control, thus enhancing the procedure for allocating limited resources for mobility and safety improvements on highways plagued by recurrent congestion.

Multicriteria analysis in decision making under information uncertainty

This paper presents results of research related to multicriteria decision making under information uncertainty. The Bell-man-Zadeh approach to decision making in a fuzzy environment is utilized for analyzing multicriteria optimization models (< X, M > models) under deterministic information. Its application conforms to the principle of guaranteed result and provides constructive lines in obtaining harmonious solutions on the basis of analyzing associated maxmin problems. This circumstance permits one to generalize the classic approach to considering the uncertainty of quantitative information (based on constructing and analyzing payoff matrices reflecting effects which can be obtained for different combinations of solution alternatives and the so-called states of nature) in monocriteria decision making to multicriteria problems. Considering that the uncertainty of information can produce considerable decision uncertainty regions, the resolving capacity of this generalization does not always permit one to obtain unique solutions. Taking this into account, a proposed general scheme of multicriteria decision making under information uncertainty also includes the construction and analysis of the so-called < X, R > models (which contain fuzzy preference relations as criteria of optimality) as a means for the subsequent contraction of the decision uncertainty regions. The paper results are of a universal character and are illustrated by a simple example. (c) 2007 Elsevier Inc. All rights reserved.

DR-NEGOTIATE - A system for automated agent negotiation with defeasible logic-based strategies

This paper reports on a system for automated agent negotiation, based on a formal and executable approach to capture the behavior of parties involved in a negotiation. It uses the JADE agent framework, and its major distinctive feature is the use of declarative negotiation strategies. The negotiation strategies are expressed in a declarative rules language, defeasible logic, and are applied using the implemented system DR-DEVICE. The key ideas and the overall system architecture are described, and a particular negotiation case is presented in detail.

Utilização do método Multicritério AHP, na aquisição de um sistema ERP

The selection of an Enterprise Resource Planning (ERP) system is one of the most sensitive and highest impact processes in the area of information systems and technologies, because it supports and integrates the whole business of an organization. Hence the importance of deciding the best solution in order to contribute to the organization's competitiveness in a global and increasingly demanding market. Therefore, it is essential to provide tools to support decision making, turning complex and often intangible decisions into simple and quantifiable scenarios. This study addressed the adoption of the Analytical Hierarchy Process (AHP) multicriteria decision method to support the selection of an ERP system. The literature review was the source used to obtain the set of the most relevant criteria to be considered in this decision, which were subsequently validated through systematic application of various surveys of experts and people related to the field of ERP systems. To support the application of AHP, according to the model obtained in the study, it was developed a web application that will be available to the general public. The responsible for the acquisition of ERP systems can use it to easily apply the AHP method based on validated decision model. On the other hand, the web application can be used as a validation tool, allowing collecting data for future developments of the decision model.

Risk Aversion in a Mixed-Integer Nonlinear Approach to Support Decision-Making for a Hydro Power Producer

In this paper, a mixed-integer nonlinear approach is proposed to support decision-making for a hydro power producer, considering a head-dependent hydro chain. The aim is to maximize the profit of the hydro power producer from selling energy into the electric market. As a new contribution to earlier studies, a risk aversion criterion is taken into account, as well as head-dependency. The volatility of the expected profit is limited through the conditional value-at-risk (CVaR). The proposed approach has been applied successfully to solve a case study based on one of the main Portuguese cascaded hydro systems.

Metalearning in ALBidS: A Strategic Bidding System for electricity markets

Metalearning is a subfield of machine learning with special pro-pensity for dynamic and complex environments, from which it is difficult to extract predictable knowledge. The field of study of this work is the electricity market, which due to the restructuring that recently took place, became an especially complex and unpredictable environment, involving a large number of different entities, playing in a dynamic scene to obtain the best advantages and profits. This paper presents the development of a metalearner, applied to the decision support of electricity markets’ negotia-tion entities. The proposed metalearner takes advantage on several learning algorithms implemented in ALBidS, an adaptive learning system that pro-vides decision support to electricity markets’ participating players. Using the outputs of each different strategy as inputs, the metalearner creates its own output, considering each strategy with a different weight, depending on its individual quality of performance. The results of the proposed meth-od are studied and analyzed using MASCEM - a multi-agent electricity market simulator that models market players and simulates their operation in the market. This simulator provides the chance to test the metalearner in scenarios based on real electricity market´s data.

Intelligent power system

Artificial intelligence techniques are being widely used to face the new reality and to provide solutions that can make power systems undergo all the changes while assuring high quality power. In this way, the agents that act in the power industry are gaining access to a generation of more intelligent applications, making use of a wide set of AI techniques. Knowledge-based systems and decision-support systems have been applied in the power and energy industry. This article is intended to offer an updated overview of the application of artificial intelligence in power systems. This article paper is organized in a way so that readers can easily understand the problems and the adequacy of the proposed solutions. Because of space constraints, this approach can be neither complete nor sufficiently deep to satisfy all readers’ needs. As this is amultidisciplinary area, able to attract both software and computer engineering and power system people, this article tries to give an insight into themost important concepts involved in these applications. Complementary material can be found in the reference list, providing deeper and more specific approaches.

VirtualECare: group decision supported by idea generation and argumentation

In the last years there has been a considerable increase in the number of people in need of intensive care, especially among the elderly, a phenomenon that is related to population ageing (Brown 2003). However, this is not exclusive of the elderly, as diseases as obesity, diabetes, and blood pressure have been increasing among young adults (Ford and Capewell 2007). As a new fact, it has to be dealt with by the healthcare sector, and particularly by the public one. Thus, the importance of finding new and cost effective ways for healthcare delivery are of particular importance, especially when the patients are not to be detached from their environments (WHO 2004). Following this line of thinking, a VirtualECare Multiagent System is presented in section 2, being our efforts centered on its Group Decision modules (Costa, Neves et al. 2007) (Camarinha-Matos and Afsarmanesh 2001).On the other hand, there has been a growing interest in combining the technological advances in the information society - computing, telecommunications and knowledge – in order to create new methodologies for problem solving, namely those that convey on Group Decision Support Systems (GDSS), based on agent perception. Indeed, the new economy, along with increased competition in today’s complex business environments, takes the companies to seek complementarities, in order to increase competitiveness and reduce risks. Under these scenarios, planning takes a major role in a company life cycle. However, effective planning depends on the generation and analysis of ideas (innovative or not) and, as a result, the idea generation and management processes are crucial. Our objective is to apply the GDSS referred to above to a new area. We believe that the use of GDSS in the healthcare arena will allow professionals to achieve better results in the analysis of one’s Electronically Clinical Profile (ECP). This attainment is vital, regarding the incoming to the market of new drugs and medical practices, which compete in the use of limited resources.