Readmission of older patients after hospital discharge for hip fracture: a multilevel approach

ABSTRACT OBJECTIVE To identify individual and hospital characteristics associated with the risk of readmission in older inpatients for proximal femoral fracture in the period of 90 days after discharge. METHODS Deaths and readmissions were obtained by a linkage of databases of the Hospital Information System of the Unified Health System and the System of Information on Mortality of the city of Rio de Janeiro from 2008 to 2011. The population of 3,405 individuals aged 60 or older, with non-elective hospitalization for proximal femoral fracture was followed for 90 days after discharge. Cox multilevel model was used for discharge time until readmission, and the characteristics of the patients were used on the first level and the characteristics of the hospitals on the second level. RESULTS The risk of readmission was higher for men (hazard ratio [HR] = 1.37; 95%CI 1.08–1.73), individuals more than 79 years old (HR = 1.45; 95%CI 1.06–1.98), patients who were hospitalized for more than two weeks (HR = 1.33; 95%CI 1.06-1.67), and for those who underwent arthroplasty when compared with the ones who underwent osteosynthesis (HR = 0.57; 95%CI 0.41–0.79). Besides, patients admitted to state hospitals had lower risk for readmission when compared with inpatients in municipal (HR = 1.71; 95%CI 1.09–2.68) and federal hospitals (HR = 1.81; 95%CI 1.00–3.27). The random effect of the hospitals in the adjusted model remained statistically significant (p < 0.05). CONCLUSIONS Hospitals have complex structures that reflect in the quality of care. Thus, we propose that future studies may include these complexities and the severity of the patients in the analysis of the data, also considering the correlation between readmission and mortality to reduce biases.

An unsupervised approach to feature discretization and selection

Many learning problems require handling high dimensional datasets with a relatively small number of instances. Learning algorithms are thus confronted with the curse of dimensionality, and need to address it in order to be effective. Examples of these types of data include the bag-of-words representation in text classification problems and gene expression data for tumor detection/classification. Usually, among the high number of features characterizing the instances, many may be irrelevant (or even detrimental) for the learning tasks. It is thus clear that there is a need for adequate techniques for feature representation, reduction, and selection, to improve both the classification accuracy and the memory requirements. In this paper, we propose combined unsupervised feature discretization and feature selection techniques, suitable for medium and high-dimensional datasets. The experimental results on several standard datasets, with both sparse and dense features, show the efficiency of the proposed techniques as well as improvements over previous related techniques.

ECG-based biometrics: A real time classification approach

Behavioral biometrics is one of the areas with growing interest within the biosignal research community. A recent trend in the field is ECG-based biometrics, where electrocardiographic (ECG) signals are used as input to the biometric system. Previous work has shown this to be a promising trait, with the potential to serve as a good complement to other existing, and already more established modalities, due to its intrinsic characteristics. In this paper, we propose a system for ECG biometrics centered on signals acquired at the subject's hand. Our work is based on a previously developed custom, non-intrusive sensing apparatus for data acquisition at the hands, and involved the pre-processing of the ECG signals, and evaluation of two classification approaches targeted at real-time or near real-time applications. Preliminary results show that this system leads to competitive results both for authentication and identification, and further validate the potential of ECG signals as a complementary modality in the toolbox of the biometric system designer.

Coalition based approach for shop floor agility – a multiagent approach

Dissertation submitted for a PhD degree in Electrical Engineering, speciality of Robotics and Integrated Manufacturing from the Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

An interdisciplinary approach to the study of colour in portuguese manuscript illuminations

Dissertação apresentada para obtenção do Grau de Doutor em Conservação e Restauro, especialidade Teoria, História e Técnicas, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Land use / land cover change detection: an object oriented approach, Münster, Germany

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

Evaluation of the influence of testing parameters on the melt flow index of thermoplastics

The main goals of the present work are the evaluation of the influence of several variables and test parameters on the melt flow index (MFI) of thermoplastics, and the determination of the uncertainty associated with the measurements. To evaluate the influence of test parameters on the measurement of MFI the design of experiments (DOE) approach has been used. The uncertainty has been calculated using a "bottom-up" approach given in the "Guide to the Expression of the Uncertainty of Measurement" (GUM). Since an analytical expression relating the output response (MFI) with input parameters does not exist, it has been necessary to build mathematical models by adjusting the experimental observations of the response variable in accordance with each input parameter. Subsequently, the determination of the uncertainty associated with the measurement of MFI has been performed by applying the law of propagation of uncertainty to the values of uncertainty of the input parameters. Finally, the activation energy (Ea) of the melt flow at around 200 degrees C and the respective uncertainty have also been determined.

SmART: an application reconfiguration framework

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para a obtenção do Grau de Mestre em Engenharia Informática.

Generalized models from Beta(p,2) densities with strong allee effect: dynamical approach

A dynamical approach to study the behaviour of generalized populational growth models from Bets(p, 2) densities, with strong Allee effect, is presented. The dynamical analysis of the respective unimodal maps is performed using symbolic dynamics techniques. The complexity of the correspondent discrete dynamical systems is measured in terms of topological entropy. Different populational dynamics regimes are obtained when the intrinsic growth rates are modified: extinction, bistability, chaotic semistability and essential extinction.

A coherent approach to non-integer order derivatives

Signal Processing, vol. 86, nº 10

A new least-squares approach to differintegration modeling

Signal Processing, Vol. 86, nº 10

A stochastic programming approach for the development of offering strategies for a wind power producer

A stochastic programming approach is proposed in this paper for the development of offering strategies for a wind power producer. The optimization model is characterized by making the analysis of several scenarios and treating simultaneously two kinds of uncertainty: wind power and electricity market prices. The approach developed allows evaluating alternative production and offers strategies to submit to the electricity market with the ultimate goal of maximizing profits. An innovative comparative study is provided, where the imbalances are treated differently. Also, an application to two new realistic case studies is presented. Finally, conclusions are duly drawn.

Short-term electricity prices forecasting in a competetive market by a hybrid Pso-Anfis approach

In this paper, a novel hybrid approach is proposed for electricity prices forecasting in a competitive market, considering a time horizon of 1 week. The proposed approach is based on the combination of particle swarm optimization and adaptive-network based fuzzy inference system. Results from a case study based on the electricity market of mainland Spain are presented. A thorough comparison is carried out, taking into account the results of previous publications, to demonstrate its effectiveness regarding forecasting accuracy and computation time. Finally, conclusions are duly drawn.

Adaption of the Creative Commons approach and the roaming concept to spatial data infrastructures (SDI)

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

The portuguese pharmaceutial market in the near future - A time series exploration approach

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Estatística e Gestão de Informação