Endemic tuberculosis, the homeless, and public transportation: A merging of geographical information systems surveillance and the Houston Tuberculosis Initiative Surveillance project

To reach the goals established by the Institute of Medicine (IOM) and the Centers for Disease Control's (CDC) STOP TB USA, measures must be taken to curtail a future peak in Tuberculosis (TB) incidence and speed the currently stagnant rate of TB elimination. Both efforts will require, at minimum, the consideration and understanding of the third dimension of TB transmission: the location-based spread of an airborne pathogen among persons known and unknown to each other. This consideration will require an elucidation of the areas within the U.S. that have endemic TB. The Houston Tuberculosis Initiative (HTI) was a population-based active surveillance of confirmed Houston/Harris County TB cases from 1995–2004. Strengths in this dataset include the molecular characterization of laboratory confirmed cases, the collection of geographic locations (including home addresses) frequented by cases, and the HTI time period that parallels a decline in TB incidence in the United States (U.S.). The HTI dataset was used in this secondary data analysis to implement a GIS analysis of TB cases, the locations frequented by cases, and their association with risk factors associated with TB transmission. ^ This study reports, for the first time, the incidence of TB among the homeless in Houston, Texas. The homeless are an at-risk population for TB disease, yet they are also a population whose TB incidence has been unknown and unreported due to their non-enumeration. The first section of this dissertation identifies local areas in Houston with endemic TB disease. Many Houston TB cases who reported living in these endemic areas also share the TB risk factor of current or recent homelessness. Merging the 2004–2005 Houston enumeration of the homeless with historical HTI surveillance data of TB cases in Houston enabled this first-time report of TB risk among the homeless in Houston. The homeless were more likely to be US-born, belong to a genotypic cluster, and belong to a cluster of a larger size. The calculated average incidence among homeless persons was 411/100,000, compared to 9.5/100,000 among housed. These alarming rates are not driven by a co-infection but by social determinants. The unsheltered persons were hospitalized more days and required more follow-up time by staff than those who reported a steady housing situation. The homeless are a specific example of the increased targeting of prevention dollars that could occur if TB rates were reported for specific areas with known health disparities rather than as a generalized rate normalized over a diverse population. ^ It has been estimated that 27% of Houstonians use public transportation. The city layout allows bus routes to run like veins connecting even the most diverse of populations within the metropolitan area. Secondary data analysis of frequent bus use (defined as riding a route weekly) among TB cases was assessed for its relationship with known TB risk factors. The spatial distribution of genotypic clusters associated with bus use was assessed, along with the reported routes and epidemiologic-links among cases belonging to the identified clusters. ^ TB cases who reported frequent bus use were more likely to have demographic and social risk factors associated with poverty, immune suppression and health disparities. An equal proportion of bus riders and non-bus riders were cultured for Mycobacterium tuberculosis, yet 75% of bus riders were genotypically clustered, indicating recent transmission, compared to 56% of non-bus riders (OR=2.4, 95%CI(2.0, 2.8), p<0.001). Bus riders had a mean cluster size of 50.14 vs. 28.9 (p<0.001). Second order spatial analysis of clustered fingerprint 2 (n=122), a Beijing family cluster, revealed geographic clustering among cases based on their report of bus use. Univariate and multivariate analysis of routes reported by cases belonging to these clusters found that 10 of the 14 clusters were associated with use. Individual Metro routes, including one route servicing the local hospitals, were found to be risk factors for belonging to a cluster shown to be endemic in Houston. The routes themselves geographically connect the census tracts previously identified as having endemic TB. 78% (15/23) of Houston Metro routes investigated had one or more print groups reporting frequent use for every HTI study year. We present data on three specific but clonally related print groups and show that bus-use is clustered in time by route and is the only known link between cases in one of the three prints: print 22. (Abstract shortened by UMI.)^

A simulation study using the hybrid statistic and the meta-analysis t-test for data with matched and unmatched subjects in the interim analysis of clinical trials

An interim analysis is usually applied in later phase II or phase III trials to find convincing evidence of a significant treatment difference that may lead to trial termination at an earlier point than planned at the beginning. This can result in the saving of patient resources and shortening of drug development and approval time. In addition, ethics and economics are also the reasons to stop a trial earlier. In clinical trials of eyes, ears, knees, arms, kidneys, lungs, and other clustered treatments, data may include distribution-free random variables with matched and unmatched subjects in one study. It is important to properly include both subjects in the interim and the final analyses so that the maximum efficiency of statistical and clinical inferences can be obtained at different stages of the trials. So far, no publication has applied a statistical method for distribution-free data with matched and unmatched subjects in the interim analysis of clinical trials. In this simulation study, the hybrid statistic was used to estimate the empirical powers and the empirical type I errors among the simulated datasets with different sample sizes, different effect sizes, different correlation coefficients for matched pairs, and different data distributions, respectively, in the interim and final analysis with 4 different group sequential methods. Empirical powers and empirical type I errors were also compared to those estimated by using the meta-analysis t-test among the same simulated datasets. Results from this simulation study show that, compared to the meta-analysis t-test commonly used for data with normally distributed observations, the hybrid statistic has a greater power for data observed from normally, log-normally, and multinomially distributed random variables with matched and unmatched subjects and with outliers. Powers rose with the increase in sample size, effect size, and correlation coefficient for the matched pairs. In addition, lower type I errors were observed estimated by using the hybrid statistic, which indicates that this test is also conservative for data with outliers in the interim analysis of clinical trials.^

Del fantástico al nonsense : Sobre la narrativa de Silvina Ocampo

El lugar común que identifica a la literatura de Silvina Ocampo como fantástica resulta un pretexto tranquilizador que de algún modo domestica su rareza. En las interpretaciones críticas actuales sigue funcionando esta idea reductora que, si para una coyuntura determinada resultaba explicativa, hoy se revela improcedente. Entiendo que, en sus momentos más característicos, los relatos de Ocampo se definen menos por los tópicos y procedimientos que involucran lo sobrenatural, lo anormal o lo irreal, que por una forma de la escritura cuyo desatino deja atónito al lector. Para leer esta literatura en nuevos términos, pienso en el nonsense como relato de la insensatez, un modo de uso de la locura como estética y como ética.

Del fantástico al nonsense : Sobre la narrativa de Silvina Ocampo

El lugar común que identifica a la literatura de Silvina Ocampo como fantástica resulta un pretexto tranquilizador que de algún modo domestica su rareza. En las interpretaciones críticas actuales sigue funcionando esta idea reductora que, si para una coyuntura determinada resultaba explicativa, hoy se revela improcedente. Entiendo que, en sus momentos más característicos, los relatos de Ocampo se definen menos por los tópicos y procedimientos que involucran lo sobrenatural, lo anormal o lo irreal, que por una forma de la escritura cuyo desatino deja atónito al lector. Para leer esta literatura en nuevos términos, pienso en el nonsense como relato de la insensatez, un modo de uso de la locura como estética y como ética.

Del fantástico al nonsense : Sobre la narrativa de Silvina Ocampo

El lugar común que identifica a la literatura de Silvina Ocampo como fantástica resulta un pretexto tranquilizador que de algún modo domestica su rareza. En las interpretaciones críticas actuales sigue funcionando esta idea reductora que, si para una coyuntura determinada resultaba explicativa, hoy se revela improcedente. Entiendo que, en sus momentos más característicos, los relatos de Ocampo se definen menos por los tópicos y procedimientos que involucran lo sobrenatural, lo anormal o lo irreal, que por una forma de la escritura cuyo desatino deja atónito al lector. Para leer esta literatura en nuevos términos, pienso en el nonsense como relato de la insensatez, un modo de uso de la locura como estética y como ética.

High-resolution paleomagnetic investigation in the Iceland Basin

Based on discrete samples, we report new high-resolution records of the ~185 kyr Iceland Basin (IB) geomagnetic excursion from Ocean Drilling Project (ODP) Site 1063 on the Bermuda Rise (sedimentation rate 32 cm/kyr) and from ODP Site 983 in the far North Atlantic (sedimentation rate 18 cm/kyr). Two records from Holes 1063A and 1063B are very consistent, and provide the highest resolution of the detailed field behaviour during the IB excursion obtained so far. Inclination records from Holes 983B and 983C in the far North Atlantic are also very consistent, whereas declination anomalies deviate more notably. The pseudo-Thellier (PT) technique was applied along with more conventional palaeointensity proxies (NRM/ARM and NRM/kappa) to recover relative palaeointensity (RPI) estimates from Hole 1063A and Hole 983B. As expected, these proxies indicate that the field intensity generally dropped at both sites during the IB excursion, but also that the history of RPI from the two sites is different. VGPs from Site 1063 indicate that the field at this location experienced some stop-and-go behaviour between patches of intense vertical flux over North America and the tip of South America, areas which coincide fairly well with patches of preferred transitional VGP clustering from reversals and zones of high seismic velocity in the lower mantle. Changes in RPI at this location were generally gradual, possibly due to the proximity of these flux patches, and the first period of VGP-clustering over North America was accompanied by a conspicuous increase in RPI. VGPs from Site 983 track along a different path, and the associated RPI changes are very abrupt and completely synchronous with the onset and termination of the excursion. The differing VGP paths from Sites 1063 and 983 indicate that the global field structure during the IB excursion was not dominated by a single dipole.

Responses of the tropical gorgonian coral Eunicea fusca to ocean acidification conditions

Ocean acidification can have negative repercussions from the organism to ecosystem levels. Octocorals deposit high-magnesium calcite in their skeletons, and according to different models, they could be more susceptible to the depletion of carbonate ions than either calcite or aragonite-depositing organisms. This study investigated the response of the gorgonian coral Eunicea fusca to a range of CO2 concentrations from 285 to 4,568 ppm (pH range 8.1-7.1) over a 4-week period. Gorgonian growth and calcification were measured at each level of CO2 as linear extension rate and percent change in buoyant weight and calcein incorporation in individual sclerites, respectively. There was a significant negative relationship for calcification and CO2 concentration that was well explained by a linear model regression analysis for both buoyant weight and calcein staining. In general, growth and calcification did not stop in any of the concentrations of pCO2; however, some of the octocoral fragments experienced negative calcification at undersaturated levels of calcium carbonate (>4,500 ppm) suggesting possible dissolution effects. These results highlight the susceptibility of the gorgonian coral E. fusca to elevated levels of carbon dioxide but suggest that E. fusca could still survive well in mid-term ocean acidification conditions expected by the end of this century, which provides important information on the effects of ocean acidification on the dynamics of coral reef communities. Gorgonian corals can be expected to diversify and thrive in the Atlantic-Eastern Pacific; as scleractinian corals decline, it is likely to expect a shift in these reef communities from scleractinian coral dominated to octocoral/soft coral dominated under a "business as usual" scenario of CO2 emissions.

Evaluation of the influence of toll systems on energy consumption and CO2 emissions: A case study of a Spanish highway

This paper studies the energy consumption and subsequent CO2 emissions of road highway transportation under three toll systems in Spain for four categories of vehicles: cars, vans, buses and articulated trucks. The influence of toll systems is tested for a section of AP-41 highway between Toledo and Madrid. One system is free flow, other is traditional stop and go and the last toll system operates with an electronic toll collection (ETC) technology. Energy consumption and CO2 emissions were found to be closely related to vehicle mass, wind exposure, engine efficiency and acceleration rate. These parameters affect, directly or indirectly, the external forces which determine the energy consumption. Reducing the magnitude of these forces through an appropriate toll management is an important way of improving the energy performance of vehicles. The type of toll system used can have a major influence on the energy efficiency of highway transportation and therefore it is necessary to consider free flow.

The ciao approach to the dynamic vs. static language dilemma. Proceedings for the international workshop on scripts to programs

Abstract is not available

A collaborative filtering approach to mitigate the new user cold start problem.

The new user cold start issue represents a serious problem in recommender systems as it can lead to the loss of new users who decide to stop using the system due to the lack of accuracy in the recommenda- tions received in that first stage in which they have not yet cast a significant number of votes with which to feed the recommender system?s collaborative filtering core. For this reason it is particularly important to design new similarity metrics which provide greater precision in the results offered to users who have cast few votes. This paper presents a new similarity measure perfected using optimization based on neu- ral learning, which exceeds the best results obtained with current metrics. The metric has been tested on the Netflix and Movielens databases, obtaining important improvements in the measures of accuracy, precision and recall when applied to new user cold start situations. The paper includes the mathematical formalization describing how to obtain the main quality measures of a recommender system using leave- one-out cross validation.

Challenges for the comprehensive management of cloud services in a PaaS framework

The 4CaaSt project aims at developing a PaaS framework that enables flexible definition, marketing, deployment and management of Cloud-based services and applications. The major innovations proposed by 4CaaSt are the blueprint and its lifecycle management, a one stop shop for Cloud services and a PaaS level resource management featuring elasticity. 4CaaSt also provides a portfolio of ready to use Cloud native services and Cloud-aware immigrant technologies.

Development of a methodology and tool to evaluate the impact of ICT measures on road transport emissions

The paper presents the main elements of a project entitled ICT-Emissions that aims at developing a novel methodology to evaluate the impact of ICT-related measures on mobility, vehicle energy consumption and CO2 emissions of vehicle fleets at the local scale, in order to promote the wider application of the most appropriate ICT measures. The proposed methodology combines traffic and emission modelling at micro and macro scales. These will be linked with interfaces and submodules which will be specifically designed and developed. A number of sources are available to the consortium to obtain the necessary input data. Also, experimental campaigns are offered to fill in gaps of information in traffic and emission patterns. The application of the methodology will be demonstrated using commercially available software. However, the methodology is developed in such a way as to enable its implementation by a variety of emission and traffic models. Particular emphasis is given to (a) the correct estimation of driver behaviour, as a result of traffic-related ICT measures, (b) the coverage of a large number of current vehicle technologies, including ICT systems, and (c) near future technologies such as hybrid, plug-in hybrids, and electric vehicles. The innovative combination of traffic, driver, and emission models produces a versatile toolbox that can simulate the impact on energy and CO2 of infrastructure measures (traffic management, dynamic traffic signs, etc.), driver assistance systems and ecosolutions (speed/cruise control, start/stop systems, etc.) or a combination of measures (cooperative systems).The methodology is validated by application in the Turin area and its capacity is further demonstrated by application in real world conditions in Madrid and Rome.

Comparing fuzzy and intelligent PI controllers in stop-and-go manoeuvres

The aim of this work was twofold: on the one hand, to describe a comparative study of two intelligent control techniques-fuzzy and intelligent proportional-integral (PI) control, and on the other, to try to provide an answer to an as yet unsolved topic in the automotive sector-stop-and-go control in urban environments at very low speeds. Commercial vehicles exhibit nonlinear behavior and therefore constitute an excellent platform on which to check the controllers. This paper describes the design, tuning, and evaluation of the controllers performing actions on the longitudinal control of a car-the throttle and brake pedals-to accomplish stop-and-go manoeuvres. They are tested in two steps. First, a simulation model is used to design and tune the controllers, and second, these controllers are implemented in the commercial vehicle-which has automatic driving capabilities-to check their behavior. A stop-and-go manoeuvre is implemented with the two control techniques using two cooperating vehicles.

O Botafumeiro: parametric pumping in the Middle Age

The pendular motion of a giant censer (O Botafumeiro) that hangs in the transept of the cathedral of Santiago de Compostela, and is cyclically pumped by men who pull at the supporting rope, is analyzed. Maximum angular amplitude attainable, and number of cycles and time needed to attain it, are calculated; the results agree with observed values (~ 82°, ~ 17 cycles, ~ 80 seconds) to the few percent accuracy of both the analysis and the observations and parameter measurements. The energy gain in a pumping cycle is obtained for an arbitrary pumping procedure to two orders in the small fractional change of pendular length; the relevance of the ratio (characteristic radial acceleration during pumping)/g to the gain is discussed- Effects due to rope mass, air drag on both Censer and rope, and the fact that the Censer is not a point mass, are considered. If the pumping cycle is inverted once the maximum amplitude has been attained, the Censer could be swiftly brought to rest, avoiding the usual violent stop. Historically recorded accidents, rope shape, and the influence of relevant parameters on the motion are discussed.

A theoretical study on the formation of iodine oxide aggregates and monohydrates

Biotic and abiotic emissions of molecular iodine and iodocarbons from the sea or the ice surface and the intertidal zone to the coastal/polar marine boundary layer lead to the formation of iodine oxides, which subsequently nucleate forming iodine oxide particles (IOPs). Although the link between coastal iodine emissions and ultrafine aerosol bursts is well established, the details of the nucleation mechanism have not yet been elucidated. In this paper, results of a theoretical study of a range of potentially relevant aggregation reactions of different iodine oxides, as well as complexation with water molecules, are reported. Thermochemical properties of these reactions are obtained from high level ab initio correlated calculations including spin–orbit corrections. The results show that the nucleation path most likely proceeds through dimerisation of I2O4. It is also shown that water can hinder gas-to-particle conversion to some extent, although complexation with key iodine oxides does not remove enough of these to stop IOP formation. A consistent picture of this process emerges from the theoretical study presented here and the findings of a new laboratory study reported in the accompanying paper (Gomez Martin et al., 2013).