Development of a risk model for adverse drug events in the elderly

The aim of this study was to develop a predictive model for adverse drug events (ADEs) in elderly patients. Socio-demographic and medical data were collected from chart reviews, computerised information and a patient interview, for a population of 929 elderly patients (aged greater than or equal to 65 years) whose admission to the Waveney/B raid Valley Hospital in Northern Ireland was not scheduled. A further 204 patients formed a validation group. An ADE score was assigned to each patient using a modified Naranjo algorithm scoring system. The ADE scores ranged from 0 to 8. For the purposes of developing a risk model, scores of 4 or more were considered to constitute a high risk of an ADE.

Global Quantum Correlation in the Ising model

We study quantum correlations in an isotropic Ising ring under the effects of a transverse magnetic field. After characterizing the behavior of two-spin quantum correlations, we extend our analysis to global properties of the ring, using a figure of merit for quantum correlations that shows enough sensitivity to reveal the drastic changes in the properties of the system at criticality. This opens up the possibility to relate statistical properties of quantum many-body systems to suitably tailored measures of quantum correlations that capture features going far beyond standard quantum entanglement.

FROM LINE-DRAWINGS TO IMPRESSIONS OF 3D OBJECTS - DEVELOPING A MODEL TO ACCOUNT FOR THE SHAPES THAT PEOPLE SEE

The interpretations people attach to line drawings reflect shape-related processes in human vision. Their divergences from expectations embodied in related machine vision traditions are summarized, and used to suggest how human vision decomposes the task of interpretation. A model called IO implements this idea. It first identifies geometrically regular, local fragments. Initial decisions fix edge orientations, and this information constrains decisions about other properties. Relations between fragments are explored, beginning with weak consistency checks and moving to fuller ones. IO's output captures multiple distinctive characteristics of human performance, and it suggests steady progress towards understanding shape-related visual processes is possible.

Animal foraging from an individual perspective: an object orientated model

A model system, HOOFS (Hierarchical Object Orientated Foraging Simulator), has been developed to study foraging by animals in a complex environment. The model is implemented using an individual-based object-orientated structure. Different species of animals inherit their general properties from a generic animal object which inherits from the basic dynamic object class. Each dynamic object is a separate program thread under the control of a central scheduler. The environment is described as a map of small hexagonal patches, each with their own level of resources and a patch-specific rate of resource replenishment. Each group of seven patches (0th order) is grouped into a Ist order super-patch with seven nth order super-patches making up a n + 1th order super-patch for n up to a specified value. At any time each animal is associated with a single patch. Patch choice is made by combining the information on the resources available within different order patches and super-patches along with information on the spatial location of other animals. The degree of sociality of an animal is defined in terms of optimal spacing from other animals and by the weighting of patch choice based on social factors relative to that based on food availability. Information, available to each animal, about patch resources diminishes with distance from that patch. The model has been used to demonstrate that social interactions can constrain patch choice and result in a short-term reduction of intake and a greater degree of variability in the level of resources in patches. We used the model to show that the effect of this variability on the animal's intake depends on the pattern of patch replenishment. (C) 1998 Elsevier Science B.V. All rights reserved.</p>

Improving multi-site benefit functions via Bayesian model averaging: A new approach to benefit transfer

A benefit function transfer obtains estimates of willingness-to-pay (WTP) for the evaluation of a given policy at a site by combining existing information from different study sites. This has the advantage that more efficient estimates are obtained, but it relies on the assumption that the heterogeneity between sites is appropriately captured in the benefit transfer model. A more expensive alternative to estimate WTP is to analyze only data from the policy site in question while ignoring information from other sites. We make use of the fact that these two choices can be viewed as a model selection problem and extend the set of models to allow for the hypothesis that the benefit function is only applicable to a subset of sites. We show how Bayesian model averaging (BMA) techniques can be used to optimally combine information from all models. The Bayesian algorithm searches for the set of sites that can form the basis for estimating a benefit function and reveals whether such information can be transferred to new sites for which only a small data set is available. We illustrate the method with a sample of 42 forests from U.K. and Ireland. We find that BMA benefit function transfer produces reliable estimates and can increase about 8 times the information content of a small sample when the forest is 'poolable'. © 2008 Elsevier Inc. All rights reserved.

A design model: the Autism Spectrum Disorder Classroom Design Kit

Architects and designers have a responsibility to provide an inclusive built environment. However for those with a diagnosis of Autism Spectrum Disorder (ASD), the built environment can be a frightening and confusing place, difficult to negotiate and tolerate. The challenge of integrating more fully into society is denied by an alienating built environment. For ASD pupils in a poorly designed school, their environment can distance them from learning. Instead, if more at ease in their surroundings, in an ASD-friendly environment, the ASD pupil stands a greater chance of doing better.

However a difficulty exists in that most architects are not knowledgeable in designing for those with ASD. Any available design guidelines for architects tend, because of the inherent difficulties associated with a spectrum, to be general in their information. Therefore, if wanting to provide an ASD-friendly learning environment, there is a need to ensure that teachers, as the experts, can most clearly and effectively impart their knowledge and requirements to architects.

This paper sets out the challenges and difficulties inherent in the design process when designing for ASD. It then sets out an alternative strategy to the usual method of drawing-centric dialogue between teacher and architect by using models instead as a basis for a more common language. An ASD Classroom Design Kit was designed and developed by Queen’s University of Belfast Architecture students. It was then used by ASD teaching staff from the Southern Education and Library Board in Northern Ireland as a case study to trial its effectiveness. The paper outlines how the study was carried out before concluding with reflections by both teaching staff and architect on using the ASD Classroom Design Kit.

It is hoped that this paper will firstly highlight the need for better dialogue between expert and architect when considering ASD and the Built Environment and secondly, that it may encourage others to consider using models to convey their ideas and knowledge when designing, not just for ASD, but for other Special Educational Needs and disabilities.

Road traffic congestion and public information - An experimental investigation

This paper reports laboratory experiments designed to study the impact of public information about past departure rates on congestion levels and travel costs. Our design is based on a discrete version of Arnott et al.'s (1990) bottleneck model. In all treatments, congestion occurs and the observed travel costs are quite similar to the predicted ones. Subjects' capacity to coordinate is not affected by the availability of public information on past departure rates, by the number of drivers or by the relative cost of delay. This seemingly absence of treatment effects is confirmed by our finding that a parameter-free reinforcement learning model best characterises individual behaviour.

A Data Model for Content Modelling of Temporal Media

This paper describes a data model for content representation of temporal media in an IP based sensor network. The model is formed by introducing the idea of semantic-role from linguistics into the underlying concepts of formal event representation with the aim of developing a common event model. The architecture of a prototype system for a multi camera surveillance system, based on the proposed model is described. The important aspects of the proposed model are its expressiveness, its ability to model content of temporal media, and its suitability for use with a natural language interface. It also provides a platform for temporal information fusion, as well as organizing sensor annotations by help of ontologies.

Modified Information Criteria and Selection of Long Memory Time Series Models

The problem of model selection of a univariate long memory time series is investigated once a semi parametric estimator for the long memory parameter has been used. Standard information criteria are not consistent in this case. A Modified Information Criterion (MIC) that overcomes these difficulties is introduced and proofs that show its asymptotic validity are provided. The results are general and cover a wide range of short memory processes. Simulation evidence compares the new and existing methodologies and empirical applications in monthly inflation and daily realized volatility are presented.

Determining the response of African biota to climate change: using the past to model the future

Prediction of biotic responses to future climate change in tropical Africa tends to be based on two modelling approaches: bioclimatic species envelope models and dynamic vegetation models. Another complementary but underused approach is to examine biotic responses to similar climatic changes in the past as evidenced in fossil and historical records. This paper reviews these records and highlights the information that they provide in terms of understanding the local- and regional-scale responses of African vegetation to future climate change. A key point that emerges is that a move to warmer and wetter conditions in the past resulted in a large increase in biomass and a range distribution of woody plants up to 400–500 km north of its present location, the so-called greening of the Sahara. By contrast, a transition to warmer and drier conditions resulted in a reduction in woody vegetation in many regions and an increase in grass/savanna-dominated landscapes. The rapid rate of climate warming coming into the current interglacial resulted in a dramatic increase in community turnover, but there is little evidence for widespread extinctions. However, huge variation in biotic response in both space and time is apparent with, in some cases, totally different responses to the same climatic driver. This highlights the importance of local features such as soils, topography and also internal biotic factors in determining responses and resilience of the African biota to climate change, information that is difficult to obtain from modelling but is abundant in palaeoecological records.

Load Balanced Scalable Byzantine Agreement through Quorum Building, with Full Information

We address the problem of designing distributed algorithms for large scale networks that are robust to Byzantine faults. We consider a message passing, full information model: the adversary is malicious, controls a constant fraction of processors, and can view all messages in a round before sending out its own messages for that round. Furthermore, each bad processor may send an unlimited number of messages. The only constraint on the adversary is that it must choose its corrupt processors at the start, without knowledge of the processors’ private random bits.

A good quorum is a set of O(logn) processors, which contains a majority of good processors. In this paper, we give a synchronous algorithm which uses polylogarithmic time and Õ(vn) bits of communication per processor to bring all processors to agreement on a collection of n good quorums, solving Byzantine agreement as well. The collection is balanced in that no processor is in more than O(logn) quorums. This yields the first solution to Byzantine agreement which is both scalable and load-balanced in the full information model.

The technique which involves going from situation where slightly more than 1/2 fraction of processors are good and and agree on a short string with a constant fraction of random bits to a situation where all good processors agree on n good quorums can be done in a fully asynchronous model as well, providing an approach for extending the Byzantine agreement result to this model.

A Sensitivity Approach for Eliminating Clashes from Computer Aided Design Model Assemblies

Clashes occur when components in an assembly unintentionally violate others. If clashes are not identified and designed out before manufacture, product function will be reduced or substantial cost will be incurred in rework. This paper introduces a novel approach for eliminating clashes by identifying which parameters defining the part features in a computer aided design (CAD) assembly need to change and by how much. Sensitivities are calculated for each parameter defining the part and the assembly as the change in clash volume due to a change in each parameter value. These sensitivities give an indication of important parameters and are used to predict the optimum combination of changes in each parameter to eliminate the clash. Consideration is given to the fact that it is sometimes preferable to modify some components in an assembly rather than others and that some components in an assembly cannot be modified as the designer does not have control over their shape. Successful elimination of clashes has been demonstrated in a number of example assemblies.

A feasibility study testing four hypotheses with phase II outcomes in advanced colorectal cancer (MRC FOCUS3): a model for randomised controlled trials in the era of personalised medicine?

Background: Molecular characteristics of cancer vary between individuals. In future, most trials will require assessment of biomarkers to allocate patients into enriched populations in which targeted therapies are more likely to be effective. The MRC FOCUS3 trial is a feasibility study to assess key elements in the planning of such studies.

Patients and methods: Patients with advanced colorectal cancer were registered from 24 centres between February 2010 and April 2011. With their consent, patients' tumour samples were analysed for KRAS/BRAF oncogene mutation status and topoisomerase 1 (topo-1) immunohistochemistry. Patients were then classified into one of four molecular strata; within each strata patients were randomised to one of two hypothesis-driven experimental therapies or a common control arm (FOLFIRI chemotherapy). A 4-stage suite of patient information sheets (PISs) was developed to avoid patient overload.

Results: A total of 332 patients were registered, 244 randomised. Among randomised patients, biomarker results were provided within 10 working days (w.d.) in 71%, 15 w.d. in 91% and 20 w.d. in 99%. DNA mutation analysis was 100% concordant between two laboratories. Over 90% of participants reported excellent understanding of all aspects of the trial. In this randomised phase II setting, omission of irinotecan in the low topo-1 group was associated with increased response rate and addition of cetuximab in the KRAS, BRAF wild-type cohort was associated with longer progression-free survival.

Conclusions: Patient samples can be collected and analysed within workable time frames and with reproducible mutation results. Complex multi-arm designs are acceptable to patients with good PIS. Randomisation within each cohort provides outcome data that can inform clinical practice.