Adaptive clinical trial design for targeted therapy development

The development of targeted therapy involve many challenges. Our study will address some of the key issues involved in biomarker identification and clinical trial design. In our study, we propose two biomarker selection methods, and then apply them in two different clinical trial designs for targeted therapy development. In particular, we propose a Bayesian two-step lasso procedure for biomarker selection in the proportional hazards model in Chapter 2. In the first step of this strategy, we use the Bayesian group lasso to identify the important marker groups, wherein each group contains the main effect of a single marker and its interactions with treatments. In the second step, we zoom in to select each individual marker and the interactions between markers and treatments in order to identify prognostic or predictive markers using the Bayesian adaptive lasso. In Chapter 3, we propose a Bayesian two-stage adaptive design for targeted therapy development while implementing the variable selection method given in Chapter 2. In Chapter 4, we proposed an alternate frequentist adaptive randomization strategy for situations where a large number of biomarkers need to be incorporated in the study design. We also propose a new adaptive randomization rule, which takes into account the variations associated with the point estimates of survival times. In all of our designs, we seek to identify the key markers that are either prognostic or predictive with respect to treatment. We are going to use extensive simulation to evaluate the operating characteristics of our methods.^

Modelling calving front dynamics using a level-set method: application to Jakobshavn Isbræ, West Greenland, links model results in MATLAB format

Calving is a major mechanism of ice discharge of the Antarctic and Greenland ice sheets, and a change in calving front position affects the entire stress regime of marine terminating glaciers. The representation of calving front dynamics in a 2-D or 3-D ice sheet model remains non-trivial. Here, we present the theoretical and technical framework for a level-set method, an implicit boundary tracking scheme, which we implement into the Ice Sheet System Model (ISSM). This scheme allows us to study the dynamic response of a drainage basin to user-defined calving rates. We apply the method to Jakobshavn Isbræ, a major marine terminating outlet glacier of the West Greenland Ice Sheet. The model robustly reproduces the high sensitivity of the glacier to calving, and we find that enhanced calving triggers significant acceleration of the ice stream. Upstream acceleration is sustained through a combination of mechanisms. However, both lateral stress and ice influx stabilize the ice stream. This study provides new insights into the ongoing changes occurring at Jakobshavn Isbræ and emphasizes that the incorporation of moving boundaries and dynamic lateral effects, not captured in flow-line models, is key for realistic model projections of sea level rise on centennial timescales.

Age model, stable isotopes, major element proportions and endmember unmixing results from four western tropical Atlantic cores

We investigate changes in the delivery and oceanic transport of Amazon sediments related to terrestrial climate variations over the last 250 ka. We present high-resolution geochemical records from four marine sediment cores located between 5 and 12° N along the northern South American margin. The Amazon River is the sole source of terrigenous material for sites at 5 and 9° N, while the core at 12° N receives a mixture of Amazon and Orinoco detrital particles. Using an endmember unmixing model, we estimated the relative proportions of Amazon Andean material ("%-Andes", at 5 and 9° N) and of Amazon material ("%-Amazon", at 12° N) within the terrigenous fraction. The %-Andes and %-Amazon records exhibit significant precessional variations over the last 250 ka that are more pronounced during interglacials in comparison to glacial periods. High %-Andes values observed during periods of high austral summer insolation reflect the increased delivery of suspended sediments by Andean tributaries and enhanced Amazonian precipitation, in agreement with western Amazonian speleothem records. Increased Amazonian rainfall reflects the intensification of the South American monsoon in response to enhanced land-ocean thermal gradient and moisture convergence. However, low %-Amazon values obtained at 12° N during the same periods seem to contradict the increased delivery of Amazon sediments. We propose that reorganizations in surface ocean currents modulate the northwestward transport of Amazon material. In agreement with published records, the seasonal North Brazil Current retroflection is intensified (or prolonged in duration) during cold substages of the last 250 ka (which correspond to intervals of high DJF or low JJA insolation) and deflects eastward the Amazon sediment and freshwater plume.

Prioritization of Policies: A Prototype Model of a Flowchart Method

This paper builds a prototype model of how to prioritize policies by using a flowchart. We presented the following six steps to decide priorities of policies: Step 1 is to attain the social subsistence level (primary education, health care, and food sufficiency); Step 2 is to attain macroeconomic stability; Step 3 is to liberalize the economy by structural adjustment programs; Step 4 is capacity building specific to a growth strategy by facilitating sufficient infrastructure (physical infrastructure and institutions); Step 5 is to initiate a growth strategy; and Step 6 is to narrow income inequalities. We illustrated the effectiveness of our "flowchart method" in case studies of Morocco, Laos, Vietnam, and China. The first priority of reforms in Morocco was given to social sectors of primary education and health care, particularly in the rural areas at Step 1. Laos should not put much emphasis on growth strategy before educational reform, attainment of macroeconomic stability, and institutional capacity building at Steps 1, 2, and 3. Vietnam can focus on reforming the state-run enterprises and developing the stock markets at Step 5 of growth strategies. We found that we should apply our flowchart method to China not nation-wide but province-wide.

Estimation Technique of International Input-Output Model by Non-survey Method

The Asian International Input-Output (IO) Table that is compiled by Institute of Developing Economies-JETRO (IDE), was constructed in Isard type form. Thus, it required a lot of time to publish. In order to avoid this time-lag problem and establish a more simple compilation technique, this paper concentrates on verifying the possibility of using the Chenery-Moses type estimation technique. If possible, applying the Chenery-Moses instead of the Isard type would be effective for both impact and linkage analysis (except for some countries such as Malaysia and Singapore and some primary sectors. Using Chenery-Moses estimation method, production of the Asian International IO table can be reduced by two years. And more, this method might have the possibilities to be applied for updating exercise of Asian IO table.

Uniformly reweighted belief propagation for distributed Bayesian hypothesis testing

Belief propagation (BP) is a technique for distributed inference in wireless networks and is often used even when the underlying graphical model contains cycles. In this paper, we propose a uniformly reweighted BP scheme that reduces the impact of cycles by weighting messages by a constant ?edge appearance probability? rho ? 1. We apply this algorithm to distributed binary hypothesis testing problems (e.g., distributed detection) in wireless networks with Markov random field models. We demonstrate that in the considered setting the proposed method outperforms standard BP, while maintaining similar complexity. We then show that the optimal ? can be approximated as a simple function of the average node degree, and can hence be computed in a distributed fashion through a consensus algorithm.

Multi-dimensional classification using Bayesian networks for stationary and evolving streaming data

Hoy en día, con la evolución continua y rápida de las tecnologías de la información y los dispositivos de computación, se recogen y almacenan continuamente grandes volúmenes de datos en distintos dominios y a través de diversas aplicaciones del mundo real. La extracción de conocimiento útil de una cantidad tan enorme de datos no se puede realizar habitualmente de forma manual, y requiere el uso de técnicas adecuadas de aprendizaje automático y de minería de datos. La clasificación es una de las técnicas más importantes que ha sido aplicada con éxito a varias áreas. En general, la clasificación se compone de dos pasos principales: en primer lugar, aprender un modelo de clasificación o clasificador a partir de un conjunto de datos de entrenamiento, y en segundo lugar, clasificar las nuevas instancias de datos utilizando el clasificador aprendido. La clasificación es supervisada cuando todas las etiquetas están presentes en los datos de entrenamiento (es decir, datos completamente etiquetados), semi-supervisada cuando sólo algunas etiquetas son conocidas (es decir, datos parcialmente etiquetados), y no supervisada cuando todas las etiquetas están ausentes en los datos de entrenamiento (es decir, datos no etiquetados). Además, aparte de esta taxonomía, el problema de clasificación se puede categorizar en unidimensional o multidimensional en función del número de variables clase, una o más, respectivamente; o también puede ser categorizado en estacionario o cambiante con el tiempo en función de las características de los datos y de la tasa de cambio subyacente. A lo largo de esta tesis, tratamos el problema de clasificación desde tres perspectivas diferentes, a saber, clasificación supervisada multidimensional estacionaria, clasificación semisupervisada unidimensional cambiante con el tiempo, y clasificación supervisada multidimensional cambiante con el tiempo. Para llevar a cabo esta tarea, hemos usado básicamente los clasificadores Bayesianos como modelos. La primera contribución, dirigiéndose al problema de clasificación supervisada multidimensional estacionaria, se compone de dos nuevos métodos de aprendizaje de clasificadores Bayesianos multidimensionales a partir de datos estacionarios. Los métodos se proponen desde dos puntos de vista diferentes. El primer método, denominado CB-MBC, se basa en una estrategia de envoltura de selección de variables que es voraz y hacia delante, mientras que el segundo, denominado MB-MBC, es una estrategia de filtrado de variables con una aproximación basada en restricciones y en el manto de Markov. Ambos métodos han sido aplicados a dos problemas reales importantes, a saber, la predicción de los inhibidores de la transcriptasa inversa y de la proteasa para el problema de infección por el virus de la inmunodeficiencia humana tipo 1 (HIV-1), y la predicción del European Quality of Life-5 Dimensions (EQ-5D) a partir de los cuestionarios de la enfermedad de Parkinson con 39 ítems (PDQ-39). El estudio experimental incluye comparaciones de CB-MBC y MB-MBC con los métodos del estado del arte de la clasificación multidimensional, así como con métodos comúnmente utilizados para resolver el problema de predicción de la enfermedad de Parkinson, a saber, la regresión logística multinomial, mínimos cuadrados ordinarios, y mínimas desviaciones absolutas censuradas. En ambas aplicaciones, los resultados han sido prometedores con respecto a la precisión de la clasificación, así como en relación al análisis de las estructuras gráficas que identifican interacciones conocidas y novedosas entre las variables. La segunda contribución, referida al problema de clasificación semi-supervisada unidimensional cambiante con el tiempo, consiste en un método nuevo (CPL-DS) para clasificar flujos de datos parcialmente etiquetados. Los flujos de datos difieren de los conjuntos de datos estacionarios en su proceso de generación muy rápido y en su aspecto de cambio de concepto. Es decir, los conceptos aprendidos y/o la distribución subyacente están probablemente cambiando y evolucionando en el tiempo, lo que hace que el modelo de clasificación actual sea obsoleto y deba ser actualizado. CPL-DS utiliza la divergencia de Kullback-Leibler y el método de bootstrapping para cuantificar y detectar tres tipos posibles de cambio: en las predictoras, en la a posteriori de la clase o en ambas. Después, si se detecta cualquier cambio, un nuevo modelo de clasificación se aprende usando el algoritmo EM; si no, el modelo de clasificación actual se mantiene sin modificaciones. CPL-DS es general, ya que puede ser aplicado a varios modelos de clasificación. Usando dos modelos diferentes, el clasificador naive Bayes y la regresión logística, CPL-DS se ha probado con flujos de datos sintéticos y también se ha aplicado al problema real de la detección de código malware, en el cual los nuevos ficheros recibidos deben ser continuamente clasificados en malware o goodware. Los resultados experimentales muestran que nuestro método es efectivo para la detección de diferentes tipos de cambio a partir de los flujos de datos parcialmente etiquetados y también tiene una buena precisión de la clasificación. Finalmente, la tercera contribución, sobre el problema de clasificación supervisada multidimensional cambiante con el tiempo, consiste en dos métodos adaptativos, a saber, Locally Adpative-MB-MBC (LA-MB-MBC) y Globally Adpative-MB-MBC (GA-MB-MBC). Ambos métodos monitorizan el cambio de concepto a lo largo del tiempo utilizando la log-verosimilitud media como métrica y el test de Page-Hinkley. Luego, si se detecta un cambio de concepto, LA-MB-MBC adapta el actual clasificador Bayesiano multidimensional localmente alrededor de cada nodo cambiado, mientras que GA-MB-MBC aprende un nuevo clasificador Bayesiano multidimensional. El estudio experimental realizado usando flujos de datos sintéticos multidimensionales indica los méritos de los métodos adaptativos propuestos. ABSTRACT Nowadays, with the ongoing and rapid evolution of information technology and computing devices, large volumes of data are continuously collected and stored in different domains and through various real-world applications. Extracting useful knowledge from such a huge amount of data usually cannot be performed manually, and requires the use of adequate machine learning and data mining techniques. Classification is one of the most important techniques that has been successfully applied to several areas. Roughly speaking, classification consists of two main steps: first, learn a classification model or classifier from an available training data, and secondly, classify the new incoming unseen data instances using the learned classifier. Classification is supervised when the whole class values are present in the training data (i.e., fully labeled data), semi-supervised when only some class values are known (i.e., partially labeled data), and unsupervised when the whole class values are missing in the training data (i.e., unlabeled data). In addition, besides this taxonomy, the classification problem can be categorized into uni-dimensional or multi-dimensional depending on the number of class variables, one or more, respectively; or can be also categorized into stationary or streaming depending on the characteristics of the data and the rate of change underlying it. Through this thesis, we deal with the classification problem under three different settings, namely, supervised multi-dimensional stationary classification, semi-supervised unidimensional streaming classification, and supervised multi-dimensional streaming classification. To accomplish this task, we basically used Bayesian network classifiers as models. The first contribution, addressing the supervised multi-dimensional stationary classification problem, consists of two new methods for learning multi-dimensional Bayesian network classifiers from stationary data. They are proposed from two different points of view. The first method, named CB-MBC, is based on a wrapper greedy forward selection approach, while the second one, named MB-MBC, is a filter constraint-based approach based on Markov blankets. Both methods are applied to two important real-world problems, namely, the prediction of the human immunodeficiency virus type 1 (HIV-1) reverse transcriptase and protease inhibitors, and the prediction of the European Quality of Life-5 Dimensions (EQ-5D) from 39-item Parkinson’s Disease Questionnaire (PDQ-39). The experimental study includes comparisons of CB-MBC and MB-MBC against state-of-the-art multi-dimensional classification methods, as well as against commonly used methods for solving the Parkinson’s disease prediction problem, namely, multinomial logistic regression, ordinary least squares, and censored least absolute deviations. For both considered case studies, results are promising in terms of classification accuracy as well as regarding the analysis of the learned MBC graphical structures identifying known and novel interactions among variables. The second contribution, addressing the semi-supervised uni-dimensional streaming classification problem, consists of a novel method (CPL-DS) for classifying partially labeled data streams. Data streams differ from the stationary data sets by their highly rapid generation process and their concept-drifting aspect. That is, the learned concepts and/or the underlying distribution are likely changing and evolving over time, which makes the current classification model out-of-date requiring to be updated. CPL-DS uses the Kullback-Leibler divergence and bootstrapping method to quantify and detect three possible kinds of drift: feature, conditional or dual. Then, if any occurs, a new classification model is learned using the expectation-maximization algorithm; otherwise, the current classification model is kept unchanged. CPL-DS is general as it can be applied to several classification models. Using two different models, namely, naive Bayes classifier and logistic regression, CPL-DS is tested with synthetic data streams and applied to the real-world problem of malware detection, where the new received files should be continuously classified into malware or goodware. Experimental results show that our approach is effective for detecting different kinds of drift from partially labeled data streams, as well as having a good classification performance. Finally, the third contribution, addressing the supervised multi-dimensional streaming classification problem, consists of two adaptive methods, namely, Locally Adaptive-MB-MBC (LA-MB-MBC) and Globally Adaptive-MB-MBC (GA-MB-MBC). Both methods monitor the concept drift over time using the average log-likelihood score and the Page-Hinkley test. Then, if a drift is detected, LA-MB-MBC adapts the current multi-dimensional Bayesian network classifier locally around each changed node, whereas GA-MB-MBC learns a new multi-dimensional Bayesian network classifier from scratch. Experimental study carried out using synthetic multi-dimensional data streams shows the merits of both proposed adaptive methods.

B2DI a bayesian BDI agent model with causal belief updating based on MSBN

In this paper, we introduce B2DI model that extends BDI model to perform Bayesian inference under uncertainty. For scalability and flexibility purposes, Multiply Sectioned Bayesian Network (MSBN) technology has been selected and adapted to BDI agent reasoning. A belief update mechanism has been defined for agents, whose belief models are connected by public shared beliefs, and the certainty of these beliefs is updated based on MSBN. The classical BDI agent architecture has been extended in order to manage uncertainty using Bayesian reasoning. The resulting extended model, so-called B2DI, proposes a new control loop. The proposed B2DI model has been evaluated in a network fault diagnosis scenario. The evaluation has compared this model with two previously developed agent models. The evaluation has been carried out with a real testbed diagnosis scenario using JADEX. As a result, the proposed model exhibits significant improvements in the cost and time required to carry out a reliable diagnosis.

MBIS: Multivariate Bayesian Image Segmentation Tool

We present MBIS (Multivariate Bayesian Image Segmentation tool), a clustering tool based on the mixture of multivariate normal distributions model. MBIS supports multi-channel bias field correction based on a B-spline model. A second methodological novelty is the inclusion of graph-cuts optimization for the stationary anisotropic hidden Markov random field model. Along with MBIS, we release an evaluation framework that contains three different experiments on multi-site data. We first validate the accuracy of segmentation and the estimated bias field for each channel. MBIS outperforms a widely used segmentation tool in a cross-comparison evaluation. The second experiment demonstrates the robustness of results on atlas-free segmentation of two image sets from scan-rescan protocols on 21 healthy subjects. Multivariate segmentation is more replicable than the monospectral counterpart on T1-weighted images. Finally, we provide a third experiment to illustrate how MBIS can be used in a large-scale study of tissue volume change with increasing age in 584 healthy subjects. This last result is meaningful as multivariate segmentation performs robustly without the need for prior knowledge.

A model to develop a platform for personalised health applications

Antecedentes Europa vive una situación insostenible. Desde el 2008 se han reducido los recursos de los gobiernos a raíz de la crisis económica. El continente Europeo envejece con ritmo constante al punto que se prevé que en 2050 habrá sólo dos trabajadores por jubilado [54]. A esta situación se le añade el aumento de la incidencia de las enfermedades crónicas, relacionadas con el envejecimiento, cuyo coste puede alcanzar el 7% del PIB de un país [51]. Es necesario un cambio de paradigma. Una nueva manera de cuidar de la salud de las personas: sustentable, eficaz y preventiva más que curativa. Algunos estudios abogan por el cuidado personalizado de la salud (pHealth). En este modelo las prácticas médicas son adaptadas e individualizadas al paciente, desde la detección de los factores de riesgo hasta la personalización de los tratamientos basada en la respuesta del individuo [81]. El cuidado personalizado de la salud está asociado a menudo al uso de las tecnologías de la información y comunicación (TICs) que, con su desarrollo exponencial, ofrecen oportunidades interesantes para la mejora de la salud. El cambio de paradigma hacia el pHealth está lentamente ocurriendo, tanto en el ámbito de la investigación como en la industria, pero todavía no de manera significativa. Existen todavía muchas barreras relacionadas a la economía, a la política y la cultura. También existen barreras puramente tecnológicas, como la falta de sistemas de información interoperables [199]. A pesar de que los aspectos de interoperabilidad están evolucionando, todavía hace falta un diseño de referencia especialmente direccionado a la implementación y el despliegue en gran escala de sistemas basados en pHealth. La presente Tesis representa un intento de organizar la disciplina de la aplicación de las TICs al cuidado personalizado de la salud en un modelo de referencia, que permita la creación de plataformas de desarrollo de software para simplificar tareas comunes de desarrollo en este dominio. Preguntas de investigación RQ1 >Es posible definir un modelo, basado en técnicas de ingeniería del software, que represente el dominio del cuidado personalizado de la salud de una forma abstracta y representativa? RQ2 >Es posible construir una plataforma de desarrollo basada en este modelo? RQ3 >Esta plataforma ayuda a los desarrolladores a crear sistemas pHealth complejos e integrados? Métodos Para la descripción del modelo se adoptó el estándar ISO/IEC/IEEE 42010por ser lo suficientemente general y abstracto para el amplio enfoque de esta tesis [25]. El modelo está definido en varias partes: un modelo conceptual, expresado a través de mapas conceptuales que representan las partes interesadas (stakeholders), los artefactos y la información compartida; y escenarios y casos de uso para la descripción de sus funcionalidades. El modelo fue desarrollado de acuerdo a la información obtenida del análisis de la literatura, incluyendo 7 informes industriales y científicos, 9 estándares, 10 artículos en conferencias, 37 artículos en revistas, 25 páginas web y 5 libros. Basándose en el modelo se definieron los requisitos para la creación de la plataforma de desarrollo, enriquecidos por otros requisitos recolectados a través de una encuesta realizada a 11 ingenieros con experiencia en la rama. Para el desarrollo de la plataforma, se adoptó la metodología de integración continua [74] que permitió ejecutar tests automáticos en un servidor y también desplegar aplicaciones en una página web. En cuanto a la metodología utilizada para la validación se adoptó un marco para la formulación de teorías en la ingeniería del software [181]. Esto requiere el desarrollo de modelos y proposiciones que han de ser validados dentro de un ámbito de investigación definido, y que sirvan para guiar al investigador en la búsqueda de la evidencia necesaria para justificarla. La validación del modelo fue desarrollada mediante una encuesta online en tres rondas con un número creciente de invitados. El cuestionario fue enviado a 134 contactos y distribuido en algunos canales públicos como listas de correo y redes sociales. El objetivo era evaluar la legibilidad del modelo, su nivel de cobertura del dominio y su potencial utilidad en el diseño de sistemas derivados. El cuestionario incluía preguntas cuantitativas de tipo Likert y campos para recolección de comentarios. La plataforma de desarrollo fue validada en dos etapas. En la primera etapa se utilizó la plataforma en un experimento a pequeña escala, que consistió en una sesión de entrenamiento de 12 horas en la que 4 desarrolladores tuvieron que desarrollar algunos casos de uso y reunirse en un grupo focal para discutir su uso. La segunda etapa se realizó durante los tests de un proyecto en gran escala llamado HeartCycle [160]. En este proyecto un equipo de diseñadores y programadores desarrollaron tres aplicaciones en el campo de las enfermedades cardio-vasculares. Una de estas aplicaciones fue testeada en un ensayo clínico con pacientes reales. Al analizar el proyecto, el equipo de desarrollo se reunió en un grupo focal para identificar las ventajas y desventajas de la plataforma y su utilidad. Resultados Por lo que concierne el modelo que describe el dominio del pHealth, la parte conceptual incluye una descripción de los roles principales y las preocupaciones de los participantes, un modelo de los artefactos TIC que se usan comúnmente y un modelo para representar los datos típicos que son necesarios formalizar e intercambiar entre sistemas basados en pHealth. El modelo funcional incluye un conjunto de 18 escenarios, repartidos en: punto de vista de la persona asistida, punto de vista del cuidador, punto de vista del desarrollador, punto de vista de los proveedores de tecnologías y punto de vista de las autoridades; y un conjunto de 52 casos de uso repartidos en 6 categorías: actividades de la persona asistida, reacciones del sistema, actividades del cuidador, \engagement" del usuario, actividades del desarrollador y actividades de despliegue. Como resultado del cuestionario de validación del modelo, un total de 65 personas revisó el modelo proporcionando su nivel de acuerdo con las dimensiones evaluadas y un total de 248 comentarios sobre cómo mejorar el modelo. Los conocimientos de los participantes variaban desde la ingeniería del software (70%) hasta las especialidades médicas (15%), con declarado interés en eHealth (24%), mHealth (16%), Ambient Assisted Living (21%), medicina personalizada (5%), sistemas basados en pHealth (15%), informática médica (10%) e ingeniería biomédica (8%) con una media de 7.25_4.99 años de experiencia en estas áreas. Los resultados de la encuesta muestran que los expertos contactados consideran el modelo fácil de leer (media de 1.89_0.79 siendo 1 el valor más favorable y 5 el peor), suficientemente abstracto (1.99_0.88) y formal (2.13_0.77), con una cobertura suficiente del dominio (2.26_0.95), útil para describir el dominio (2.02_0.7) y para generar sistemas más específicos (2_0.75). Los expertos también reportan un interés parcial en utilizar el modelo en su trabajo (2.48_0.91). Gracias a sus comentarios, el modelo fue mejorado y enriquecido con conceptos que faltaban, aunque no se pudo demonstrar su mejora en las dimensiones evaluadas, dada la composición diferente de personas en las tres rondas de evaluación. Desde el modelo, se generó una plataforma de desarrollo llamada \pHealth Patient Platform (pHPP)". La plataforma desarrollada incluye librerías, herramientas de programación y desarrollo, un tutorial y una aplicación de ejemplo. Se definieron cuatro módulos principales de la arquitectura: el Data Collection Engine, que permite abstraer las fuentes de datos como sensores o servicios externos, mapeando los datos a bases de datos u ontologías, y permitiendo interacción basada en eventos; el GUI Engine, que abstrae la interfaz de usuario en un modelo de interacción basado en mensajes; y el Rule Engine, que proporciona a los desarrolladores un medio simple para programar la lógica de la aplicación en forma de reglas \if-then". Después de que la plataforma pHPP fue utilizada durante 5 años en el proyecto HeartCycle, 5 desarrolladores fueron reunidos en un grupo de discusión para analizar y evaluar la plataforma. De estas evaluaciones se concluye que la plataforma fue diseñada para encajar las necesidades de los ingenieros que trabajan en la rama, permitiendo la separación de problemas entre las distintas especialidades, y simplificando algunas tareas de desarrollo como el manejo de datos y la interacción asíncrona. A pesar de ello, se encontraron algunos defectos a causa de la inmadurez de algunas tecnologías empleadas, y la ausencia de algunas herramientas específicas para el dominio como el procesado de datos o algunos protocolos de comunicación relacionados con la salud. Dentro del proyecto HeartCycle la plataforma fue utilizada para el desarrollo de la aplicación \Guided Exercise", un sistema TIC para la rehabilitación de pacientes que han sufrido un infarto del miocardio. El sistema fue testeado en un ensayo clínico randomizado en el cual a 55 pacientes se les dio el sistema para su uso por 21 semanas. De los resultados técnicos del ensayo se puede concluir que, a pesar de algunos errores menores prontamente corregidos durante el estudio, la plataforma es estable y fiable. Conclusiones La investigación llevada a cabo en esta Tesis y los resultados obtenidos proporcionan las respuestas a las tres preguntas de investigación que motivaron este trabajo: RQ1 Se ha desarrollado un modelo para representar el dominio de los sistemas personalizados de salud. La evaluación hecha por los expertos de la rama concluye que el modelo representa el dominio con precisión y con un balance apropiado entre abstracción y detalle. RQ2 Se ha desarrollado, con éxito, una plataforma de desarrollo basada en el modelo. RQ3 Se ha demostrado que la plataforma es capaz de ayudar a los desarrolladores en la creación de software pHealth complejos. Las ventajas de la plataforma han sido demostradas en el ámbito de un proyecto de gran escala, aunque el enfoque genérico adoptado indica que la plataforma podría ofrecer beneficios también en otros contextos. Los resultados de estas evaluaciones ofrecen indicios de que, ambos, el modelo y la plataforma serán buenos candidatos para poderse convertir en una referencia para futuros desarrollos de sistemas pHealth. ABSTRACT Background Europe is living in an unsustainable situation. The economic crisis has been reducing governments' economic resources since 2008 and threatening social and health systems, while the proportion of older people in the European population continues to increase so that it is foreseen that in 2050 there will be only two workers per retiree [54]. To this situation it should be added the rise, strongly related to age, of chronic diseases the burden of which has been estimated to be up to the 7% of a country's gross domestic product [51]. There is a need for a paradigm shift, the need for a new way of caring for people's health, shifting the focus from curing conditions that have arisen to a sustainable and effective approach with the emphasis on prevention. Some advocate the adoption of personalised health care (pHealth), a model where medical practices are tailored to the patient's unique life, from the detection of risk factors to the customization of treatments based on each individual's response [81]. Personalised health is often associated to the use of Information and Communications Technology (ICT), that, with its exponential development, offers interesting opportunities for improving healthcare. The shift towards pHealth is slowly taking place, both in research and in industry, but the change is not significant yet. Many barriers still exist related to economy, politics and culture, while others are purely technological, like the lack of interoperable information systems [199]. Though interoperability aspects are evolving, there is still the need of a reference design, especially tackling implementation and large scale deployment of pHealth systems. This thesis contributes to organizing the subject of ICT systems for personalised health into a reference model that allows for the creation of software development platforms to ease common development issues in the domain. Research questions RQ1 Is it possible to define a model, based on software engineering techniques, for representing the personalised health domain in an abstract and representative way? RQ2 Is it possible to build a development platform based on this model? RQ3 Does the development platform help developers create complex integrated pHealth systems? Methods As method for describing the model, the ISO/IEC/IEEE 42010 framework [25] is adopted for its generality and high level of abstraction. The model is specified in different parts: a conceptual model, which makes use of concept maps, for representing stakeholders, artefacts and shared information, and in scenarios and use cases for the representation of the functionalities of pHealth systems. The model was derived from literature analysis, including 7 industrial and scientific reports, 9 electronic standards, 10 conference proceedings papers, 37 journal papers, 25 websites and 5 books. Based on the reference model, requirements were drawn for building the development platform enriched with a set of requirements gathered in a survey run among 11 experienced engineers. For developing the platform, the continuous integration methodology [74] was adopted which allowed to perform automatic tests on a server and also to deploy packaged releases on a web site. As a validation methodology, a theory building framework for SW engineering was adopted from [181]. The framework, chosen as a guide to find evidence for justifying the research questions, imposed the creation of theories based on models and propositions to be validated within a scope. The validation of the model was conducted as an on-line survey in three validation rounds, encompassing a growing number of participants. The survey was submitted to 134 experts of the field and on some public channels like relevant mailing lists and social networks. Its objective was to assess the model's readability, its level of coverage of the domain and its potential usefulness in the design of actual, derived systems. The questionnaires included quantitative Likert scale questions and free text inputs for comments. The development platform was validated in two scopes. As a small-scale experiment, the platform was used in a 12 hours training session where 4 developers had to perform an exercise consisting in developing a set of typical pHealth use cases At the end of the session, a focus group was held to identify benefits and drawbacks of the platform. The second validation was held as a test-case study in a large scale research project called HeartCycle the aim of which was to develop a closed-loop disease management system for heart failure and coronary heart disease patients [160]. During this project three applications were developed by a team of programmers and designers. One of these applications was tested in a clinical trial with actual patients. At the end of the project, the team was interviewed in a focus group to assess the role the platform had within the project. Results For what regards the model that describes the pHealth domain, its conceptual part includes a description of the main roles and concerns of pHealth stakeholders, a model of the ICT artefacts that are commonly adopted and a model representing the typical data that need to be formalized among pHealth systems. The functional model includes a set of 18 scenarios, divided into assisted person's view, caregiver's view, developer's view, technology and services providers' view and authority's view, and a set of 52 Use Cases grouped in 6 categories: assisted person's activities, system reactions, caregiver's activities, user engagement, developer's activities and deployer's activities. For what concerns the validation of the model, a total of 65 people participated in the online survey providing their level of agreement in all the assessed dimensions and a total of 248 comments on how to improve and complete the model. Participants' background spanned from engineering and software development (70%) to medical specialities (15%), with declared interest in the fields of eHealth (24%), mHealth (16%), Ambient Assisted Living (21%), Personalized Medicine (5%), Personal Health Systems (15%), Medical Informatics (10%) and Biomedical Engineering (8%) with an average of 7.25_4.99 years of experience in these fields. From the analysis of the answers it is possible to observe that the contacted experts considered the model easily readable (average of 1.89_0.79 being 1 the most favourable scoring and 5 the worst), sufficiently abstract (1.99_0.88) and formal (2.13_0.77) for its purpose, with a sufficient coverage of the domain (2.26_0.95), useful for describing the domain (2.02_0.7) and for generating more specific systems (2_0.75) and they reported a partial interest in using the model in their job (2.48_0.91). Thanks to their comments, the model was improved and enriched with concepts that were missing at the beginning, nonetheless it was not possible to prove an improvement among the iterations, due to the diversity of the participants in the three rounds. From the model, a development platform for the pHealth domain was generated called pHealth Patient Platform (pHPP). The platform includes a set of libraries, programming and deployment tools, a tutorial and a sample application. The main four modules of the architecture are: the Data Collection Engine, which allows abstracting sources of information like sensors or external services, mapping data to databases and ontologies, and allowing event-based interaction and filtering, the GUI Engine, which abstracts the user interface in a message-like interaction model, the Workow Engine, which allows programming the application's user interaction ows with graphical workows, and the Rule Engine, which gives developers a simple means for programming the application's logic in the form of \if-then" rules. After the 5 years experience of HeartCycle, partially programmed with pHPP, 5 developers were joined in a focus group to discuss the advantages and drawbacks of the platform. The view that emerged from the training course and the focus group was that the platform is well-suited to the needs of the engineers working in the field, it allowed the separation of concerns among the different specialities and it simplified some common development tasks like data management and asynchronous interaction. Nevertheless, some deficiencies were pointed out in terms of a lack of maturity of some technological choices, and for the absence of some domain-specific tools, e.g. for data processing or for health-related communication protocols. Within HeartCycle, the platform was used to develop part of the Guided Exercise system, a composition of ICT tools for the physical rehabilitation of patients who suffered from myocardial infarction. The system developed using the platform was tested in a randomized controlled clinical trial, in which 55 patients used the system for 21 weeks. The technical results of this trial showed that the system was stable and reliable. Some minor bugs were detected, but these were promptly corrected using the platform. This shows that the platform, as well as facilitating the development task, can be successfully used to produce reliable software. Conclusions The research work carried out in developing this thesis provides responses to the three three research questions that were the motivation for the work. RQ1 A model was developed representing the domain of personalised health systems, and the assessment of experts in the field was that it represents the domain accurately, with an appropriate balance between abstraction and detail. RQ2 A development platform based on the model was successfully developed. RQ3 The platform has been shown to assist developers create complex pHealth software. This was demonstrated within the scope of one large-scale project, but the generic approach adopted provides indications that it would offer benefits more widely. The results of these evaluations provide indications that both the model and the platform are good candidates for being a reference for future pHealth developments.

Including functional usability features in a Model-Driven Development Method

The Software Engineering (SE) community has historically focused on working with models to represent functionality and persistence, pushing interaction modelling into the background, which has been covered by the Human Computer Interaction (HCI) community. Recently, adequately modelling interaction, and specifically usability, is being considered as a key factor for success in user acceptance, making the integration of the SE and HCI communities more necessary. If we focus on the Model-Driven Development (MDD) paradigm, we notice that there is a lack of proposals to deal with usability features from the very first steps of software development process. In general, usability features are manually implemented once the code has been generated from models. This contradicts the MDD paradigm, which claims that all the analysts? effort must be focused on building models, and the code generation is relegated to model to code transformations. Moreover, usability features related to functionality may involve important changes in the system architecture if they are not considered from the early steps. We state that these usability features related to functionality can be represented abstractly in a conceptual model, and their implementation can be carried out automatically.

Clustering basado en redes bayesianas con predictoras continuas: aplicaciones en neurociencia

Desentrañar el funcionamiento del cerebro es uno de los principales desafíos a los que se enfrenta la ciencia actual. Un área de estudio que ha despertado muchas expectativas e interés es el análisis de la estructura cortical desde el punto de vista morfológico, de manera que se cree una simulación del cerebro a nivel molecular. Con ello se espera poder profundizar en el estudio de numerosas enfermedades neurológicas y patológicas. Con el desarrollo de este proyecto se persigue el estudio del soma y de las espinas desde el punto de vista de la neuromorfología teórica. Es común en el estado del arte que en el análisis de las características morfológicas de una neurona en tres dimensiones el soma sea ignorado o, en el mejor de los casos, que sea sustituido por una simple esfera. De hecho, el concepto de soma resulta abstracto porque no se dispone de una dfinición estricta y robusta que especifique exactamente donde finaliza y comienzan las dendritas. En este proyecto se alcanza por primera vez una definición matemática de soma para determinar qué es el soma. Con el fin de simular somas se ahonda en los atributos utilizados en el estado del arte. Estas propiedades, de índole genérica, no especifican una morfología única. Es por ello que se propone un método que agrupe propiedades locales y globales de la morfología. En disposición de las características se procede con la categorización del cuerpo celular en distintas clases a partir de un nuevo subtipo de red bayesiana dinámica adaptada al espacio. Con ello se discute la existencia de distintas clases de somas y se descubren las diferencias entre los somas piramidales de distintas capas del cerebro. A partir del modelo matemático se simulan por primera vez somas virtuales. Algunas morfologías de espinas han sido atribuidas a ciertos comportamientos cognitivos. Por ello resulta de interés dictaminar las clases existentes y relacionarlas con funciones de la actividad cerebral. La clasificación más extendida (Peters y Kaiserman-Abramof, 1970) presenta una definición ambigua y subjetiva dependiente de la interpretación de cada individuo y por tanto discutible. Este estudio se sustenta en un conjunto de descriptores extraídos mediante una técnica de análisis topológico local para representaciones 3D. Sobre estos datos se trata de alcanzar el conjunto de clases más adecuado en el que agrupar las espinas así como de describir cada grupo mediante reglas unívocas. A partir de los resultados, se discute la existencia de un continuo de espinas y las propiedades que caracterizan a cada subtipo de espina. ---ABSTRACT---Unravel how the brain works is one of the main challenges faced by current science. A field of study which has aroused great expectations and interest is the analysis of the cortical structure from a morphological point of view, so that a molecular level simulation of the brain is achieved. This is expected to deepen the study of many neurological and pathological diseases. This project seeks the study of the soma and spines from the theoretical neuromorphology point of view. In the state of the art it is common that when it comes to analyze the morphological characteristics of a three dimension neuron the soma is ignored or, in the best case, it is replaced by a simple sphere. In fact, the concept of soma is abstract because there is not a robust and strict definition on exactly where it ends and dendrites begin. In this project a mathematical definition is reached for the first time to determine what a soma is. With the aim to simulate somas the atributes applied in the state of the art are studied. These properties, generic in nature, do not specify a unique morphology. It is why it was proposed a method to group local and global morphology properties. In arrangement of the characteristics it was proceed with the categorization of the celular body into diferent classes by using a new subtype of dynamic Bayesian network adapted to space. From the result the existance of different classes of somas and diferences among pyramidal somas from distinct brain layers are discovered. From the mathematical model virtual somas were simulated for the first time. Some morphologies of spines have been attributed to certain cognitive behaviours. For this reason it is interesting to rule the existent classes and to relate them with their functions in the brain activity. The most extended classification (Peters y Kaiserman-Abramof, 1970) presents an ambiguous and subjective definition that relies on the interpretation of each individual and consequently it is arguable. This study was based on the set of descriptors extracted from a local topological analysis technique for 3D representations. On these data it was tried to reach the most suitable set of classes to group the spines as well as to describe each cluster by unambiguous rules. From these results, the existance of a continuum of spines and the properties that characterize each spine subtype were discussed .

Bayesian model selection methodology for road safety

Road accidents are a very relevant issue in many countries and macroeconomic models are very frequently applied by academia and administrations to reduce their frequency and consequences. The selection of explanatory variables and response transformation parameter within the Bayesian framework for the selection of the set of explanatory variables a TIM and 3IM (two input and three input models) procedures are proposed. The procedure also uses the DIC and pseudo -R2 goodness of fit criteria. The model to which the methodology is applied is a dynamic regression model with Box-Cox transformation (BCT) for the explanatory variables and autorgressive (AR) structure for the response. The initial set of 22 explanatory variables are identified. The effects of these factors on the fatal accident frequency in Spain, during 2000-2012, are estimated. The dependent variable is constructed considering the stochastic trend component.

Bayesian model selection of structural explanatory models.

In this study we are proposing a Bayesian model selection methodology, where the best model from the list of candidate structural explanatory models is selected. The model structure is based on the Zellner's (1971)explanatory model with autoregressive errors. For the selection technique we are using a parsimonious model, where the model variables are transformed using Box and Cox (1964) class of transformations.

Bayesian model selection of structural explanatory models: Application to road accident data

Using the Bayesian approach as the model selection criteria, the main purpose in this study is to establish a practical road accident model that can provide a better interpretation and prediction performance. For this purpose we are using a structural explanatory model with autoregressive error term. The model estimation is carried out through Bayesian inference and the best model is selected based on the goodness of fit measures. To cross validate the model estimation further prediction analysis were done. As the road safety measures the number of fatal accidents in Spain, during 2000-2011 were employed. The results of the variable selection process show that the factors explaining fatal road accidents are mainly exposure, economic factors, and surveillance and legislative measures. The model selection shows that the impact of economic factors on fatal accidents during the period under study has been higher compared to surveillance and legislative measures.