Diabetes as a tracer condition in international benchmarking of health systems

OBJECTIVE - To assess the performance of health systems using diabetes as a tracer condition. RESEARCH DESIGN AND METHODS - We generated a measure of case-fatality among young people with diabetes Using the mortalily-to-incidence ratio (M/I ratio) for 29 industrialized countries using published data on diabetes incidence and mortality. Standardized incidence rates for ages 0-14 years were extracted from the World Health Organization DiaMond Study for the period 1990-1994; data on death from diabetes for ages 0-39 years were obtained from the World Health Organization Mortality database and converted into age-standardized death rates for the period 1994-1998, using the European standard population. RESULTS - The MA ratio varied > 10-fold. These relative differences appear similar to those observed in cohort studies of mortality among young people with type I diabetes in five countries. A sensitivity analysis showed that using plausible assumptions about potential overestimation of diabetes as a cause of death and underestimation of incidence rates in the U.S. yields an M/I ratio that would still be twice as high as in the U.K. or Canada. CONCLUSIONS - The M/I ratio for diabetes provides a means of differentiating countries on quality of care for people with diabetes. It is solely an indicator of potential problems, a basis for Stimulating more detailed assessments of whether such problems exist, and what can be done to address them.

Summarizing level-two topological relations in large spatial datasets

Summarizing topological relations is fundamental to many spatial applications including spatial query optimization. In this article, we present several novel techniques to effectively construct cell density based spatial histograms for range (window) summarizations restricted to the four most important level-two topological relations: contains, contained, overlap, and disjoint. We first present a novel framework to construct a multiscale Euler histogram in 2D space with the guarantee of the exact summarization results for aligned windows in constant time. To minimize the storage space in such a multiscale Euler histogram, an approximate algorithm with the approximate ratio 19/12 is presented, while the problem is shown NP-hard generally. To conform to a limited storage space where a multiscale histogram may be allowed to have only k Euler histograms, an effective algorithm is presented to construct multiscale histograms to achieve high accuracy in approximately summarizing aligned windows. Then, we present a new approximate algorithm to query an Euler histogram that cannot guarantee the exact answers; it runs in constant time. We also investigate the problem of nonaligned windows and the problem of effectively partitioning the data space to support nonaligned window queries. Finally, we extend our techniques to 3D space. Our extensive experiments against both synthetic and real world datasets demonstrate that the approximate multiscale histogram techniques may improve the accuracy of the existing techniques by several orders of magnitude while retaining the cost efficiency, and the exact multiscale histogram technique requires only a storage space linearly proportional to the number of cells for many popular real datasets.

Local edge detectors: A substrate for fine spatial vision at low temporal frequencies in rabbit retina

Visual acuity is limited by the size and density of the smallest retinal ganglion cells, which correspond to the midget ganglion cells in primate retina and the beta- ganglion cells in cat retina, both of which have concentric receptive fields that respond at either light- On or light- Off. In contrast, the smallest ganglion cells in the rabbit retina are the local edge detectors ( LEDs), which respond to spot illumination at both light- On and light- Off. However, the LEDs do not predominate in the rabbit retina and the question arises, what role do they play in fine spatial vision? We studied the morphology and physiology of LEDs in the isolated rabbit retina and examined how their response properties are shaped by the excitatory and inhibitory inputs. Although the LEDs comprise only similar to 15% of the ganglion cells, neighboring LEDs are separated by 30 - 40 mu m on the visual streak, which is sufficient to account for the grating acuity of the rabbit. The spatial and temporal receptive- field properties of LEDs are generated by distinct inhibitory mechanisms. The strong inhibitory surround acts presynaptically to suppress both the excitation and the inhibition elicited by center stimulation. The temporal properties, characterized by sluggish onset, sustained firing, and low bandwidth, are mediated by the temporal properties of the bipolar cells and by postsynaptic interactions between the excitatory and inhibitory inputs. We propose that the LEDs signal fine spatial detail during visual fixation, when high temporal frequencies are minimal.

Advanced computing for systems biology

Systems biology is based on computational modelling and simulation of large networks of interacting components. Models may be intended to capture processes, mechanisms, components and interactions at different levels of fidelity. Input data are often large and geographically disperse, and may require the computation to be moved to the data, not vice versa. In addition, complex system-level problems require collaboration across institutions and disciplines. Grid computing can offer robust, scaleable solutions for distributed data, compute and expertise. We illustrate some of the range of computational and data requirements in systems biology with three case studies: one requiring large computation but small data (orthologue mapping in comparative genomics), a second involving complex terabyte data (the Visible Cell project) and a third that is both computationally and data-intensive (simulations at multiple temporal and spatial scales). Authentication, authorisation and audit systems are currently not well scalable and may present bottlenecks for distributed collaboration particularly where outcomes may be commercialised. Challenges remain in providing lightweight standards to facilitate the penetration of robust, scalable grid-type computing into diverse user communities to meet the evolving demands of systems biology.

3D statistical shape models to embed spatial relationship information

This paper presents the creation of 3D statistical shape models of the knee bones and their use to embed information into a segmentation system for MRIs of the knee. We propose utilising the strong spatial relationship between the cartilages and the bones in the knee by embedding this information into the created models. This information can then be used to automate the initialisation of segmentation algorithms for the cartilages. The approach used to automatically generate the 3D statistical shape models of the bones is based on the point distribution model optimisation framework of Davies. Our implementation of this scheme uses a parameterized surface extraction algorithm, which is used as the basis for the optimisation scheme that automatically creates the 3D statistical shape models. The current approach is illustrated by generating 3D statistical shape models of the patella, tibia and femoral bones from a segmented database of the knee. The use of these models to embed spatial relationship information to aid in the automation of segmentation algorithms for the cartilages is then illustrated.

Spatial indexing for scalability in FCA

The paper provides evidence that spatial indexing structures offer faster resolution of Formal Concept Analysis queries than B-Tree/Hash methods. We show that many Formal Concept Analysis operations, computing the contingent and extent sizes as well as listing the matching objects, enjoy improved performance with the use of spatial indexing structures such as the RD-Tree. Speed improvements can vary up to eighty times faster depending on the data and query. The motivation for our study is the application of Formal Concept Analysis to Semantic File Systems. In such applications millions of formal objects must be dealt with. It has been found that spatial indexing also provides an effective indexing technique for more general purpose applications requiring scalability in Formal Concept Analysis systems. The coverage and benchmarking are presented with general applications in mind.

Using the Amazon metric to construct an image database based on what people do, not what they say

Current image database metadata schemas require users to adopt a specific text-based vocabulary. Text-based metadata is good for searching but not for browsing. Existing image-based search facilities, on the other hand, are highly specialised and so suffer similar problems. Wexelblat's semantic dimensional spatial visualisation schemas go some way towards addressing this problem by making both searching and browsing more accessible to the user in a single interface. But the question of how and what initial metadata to enter a database remains. Different people see different things in an image and will organise a collection in equally diverse ways. However, we can find some similarity across groups of users regardless of their reasoning. For example, a search on Amazon.com returns other products also, based on an averaging of how users navigate the database. In this paper, we report on applying this concept to a set of images for which we have visualised them using traditional methods and the Amazon.com method. We report on the findings of this comparative investigation in a case study setting involving a group of randomly selected participants. We conclude with the recommendation that in combination, the traditional and averaging methods would provide an enhancement to current database visualisation, searching, and browsing facilities.

The spatial pattern of child growth in Papua New Guinea

Child growth in PNG shows strong regional differences, with highlands children being generally shorter but stockier than those from lowland areas. Differences in diet, socioeconomic status and local subsistence agriculture were found to be important predictors of child growth. All variables indicating higher socioeconomic status were correlated with better growth, as was a high consumption of imported and local high quality foods such as cereals, legumes, tinned fish or meat and fresh fish. Differences in subsistence explained between 25% and 50% of the geographical variation in growth. Child growth was better in systems based on cassava and sweet potato, and worse in those where banana, sago and taro are staples. The cultivation of all major cash crops and sales of fish and food crops improved child growth. Birth weights show similar patterns to those observed in child growth. The implications of these findings for possible interventions are discussed.

Efficiently computing weighted proximity relationships in spatial databases

Spatial data mining recently emerges from a number of real applications, such as real-estate marketing, urban planning, weather forecasting, medical image analysis, road traffic accident analysis, etc. It demands for efficient solutions for many new, expensive, and complicated problems. In this paper, we investigate the problem of evaluating the top k distinguished “features” for a “cluster” based on weighted proximity relationships between the cluster and features. We measure proximity in an average fashion to address possible nonuniform data distribution in a cluster. Combining a standard multi-step paradigm with new lower and upper proximity bounds, we presented an efficient algorithm to solve the problem. The algorithm is implemented in several different modes. Our experiment results not only give a comparison among them but also illustrate the efficiency of the algorithm.

On aggregation issues in spatial data management

Large amounts of information can be overwhelming and costly to process, especially when transmitting data over a network. A typical modern Geographical Information System (GIS) brings all types of data together based on the geographic component of the data and provides simple point-and-click query capabilities as well as complex analysis tools. Querying a Geographical Information System, however, can be prohibitively expensive due to the large amounts of data which may need to be processed. Since the use of GIS technology has grown dramatically in the past few years, there is now a need more than ever, to provide users with the fastest and least expensive query capabilities, especially since an approximated 80 % of data stored in corporate databases has a geographical component. However, not every application requires the same, high quality data for its processing. In this paper we address the issues of reducing the cost and response time of GIS queries by preaggregating data by compromising the data accuracy and precision. We present computational issues in generation of multi-level resolutions of spatial data and show that the problem of finding the best approximation for the given region and a real value function on this region, under a predictable error, in general is "NP-complete.