Investigation of Air Transportation Technology at Princeton University, 1989-1990

The Air Transportation Technology Program at Princeton University proceeded along six avenues during the past year: microburst hazards to aircraft; machine-intelligent, fault tolerant flight control; computer aided heuristics for piloted flight; stochastic robustness for flight control systems; neural networks for flight control; and computer aided control system design. These topics are briefly discussed, and an annotated bibliography of publications that appeared between January 1989 and June 1990 is given

Preventing Emergency Department Overutilization for Florida’s Seasonal Resident Population

Background/Local Problem: Seasonal migration of elderly patients to Lee County, Florida result in overcrowding and prolonged wait times in emergency departments. Many of these seasonal residents dissociate the management of their chronic health conditions with a local provider, therefore utilizing the emergency department for non-urgent needs. Purpose: The Seasonal Resident Navigator Program was intended to enhance the coordination of primary care services for elderly seasonal residents by establishing appointments with local primary care providers (PCP) in order to reduce the overutilization of emergency services and improve patient throughput. Methods: A residency and provider assessment tool was incorporated into the Healthpark Medical Center Emergency Department (ED) nurse triage workflow between November 2017-February 2018 in order to identify seasonal residents, age 65 or greater, without an assigned local provider and facilitate proper follow up appointments. Interventions: The percentage of all seasonal resident encounters at Healthpark Medical Center ED pre-and-post intervention were evaluated as well as the percentage of all seasonal residents that maintained their assigned PCP follow up appointment. Open commentary from patients was evaluated to identify perceived barriers from outpatient follow up. Results/Conclusion: The Seasonal Resident Navigator program will contribute to future trends in emergency department utilization and seasonal resident access to care through enhanced coordination between the acute care and primary care sector

In-Network View Synthesis for Interactive Multiview Video Systems

To enable Interactive multiview video systems with a minimum view-switching delay, multiple camera views are sent to the users, which are used as reference images to synthesize additional virtual views via depth-image-based rendering. In practice, bandwidth constraints may however restrict the number of reference views sent to clients per time unit, which may in turn limit the quality of the synthesized viewpoints. We argue that the reference view selection should ideally be performed close to the users, and we study the problem of in-network reference view synthesis such that the navigation quality is maximized at the clients. We consider a distributed cloud network architecture where data stored in a main cloud is delivered to end users with the help of cloudlets, i.e., resource-rich proxies close to the users. In order to satisfy last-hop bandwidth constraints from the cloudlet to the users, a cloudlet re-samples viewpoints of the 3D scene into a discrete set of views (combination of received camera views and virtual views synthesized) to be used as reference for the synthesis of additional virtual views at the client. This in-network synthesis leads to better viewpoint sampling given a bandwidth constraint compared to simple selection of camera views, but it may however carry a distortion penalty in the cloudlet-synthesized reference views. We therefore cast a new reference view selection problem where the best subset of views is defined as the one minimizing the distortion over a view navigation window defined by the user under some transmission bandwidth constraints. We show that the view selection problem is NP-hard, and propose an effective polynomial time algorithm using dynamic programming to solve the optimization problem. Simulation results finally confirm the performance gain offered by virtual view synthesis in the network

A Multi-Level Fit-Based Quality Improvement Initiative to Improve Colorectal Cancer Screening in a Managed Care Population.

IntroductionColorectal cancer (CRC) is a common but largely preventable disease with suboptimal screening rates despite national guidelines to screen individuals age 50-75. Single-component interventions aimed to improve screening uptake only modestly improve rates; data suggest that multi-modal approaches may be more effective.MethodsWe designed, implemented, and evaluated the impact of a multi-modal intervention on CRC screening uptake among unscreened patients in a large managed care population. Patient-level components included a mailed letter with education about screening options and pre-colonoscopy telephone counseling. For providers, we facilitated communication of screening test results and work-flow for abnormal results. System-level modifications included establishment of a patient navigator, expedited work-up for abnormal results, and stream-lined colonoscopy scheduling. We measured the rate of screening uptake overall, screening uptake by modality, change in the proportion of the population screened, and positive fecal immunochemical test (FIT) follow-up rates in the 1-year study period.ResultsThere were 5093 patients in the intervention cohort. Of these, 33.2% participated in FIT or colonoscopy screening within 1 year of the mailing. A total of 1078 (21.2%) participants completed a FIT and 611 (12.0%) completed a screening colonoscopy. The screening rate in the managed care population increased from 65.1 to 76.6%. Fifty-nine patients (5.5%) had a positive FIT, of which 30 (50.8%) completed a diagnostic colonoscopy.ConclusionMulti-modal interventions can result in substantial improvement in CRC screening uptake in large and diverse managed care populations.Translational impactHealth systems should shift their focus from single-level to multi-level interventions when addressing barriers to CRC screening