142 research outputs found

    Automatic Adaptation of SOA Systems Supported by Machine Learning

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    Part 3: Service OrientationInternational audienceRecent advances in the development of information systems have led to increased complexity and cost in terms of the required maintenance and management. On the other hand, systems built in accordance with modern architectural paradigms, such as Service Oriented Architecture (SOA), posses features enabling extensive adaptation, not present in traditional systems. Automatic adaptation mechanisms can be used to facilitate system management. The goal of this work is to show that automatic adaptation can be effectively implemented in SOA systems using machine learning algorithms. The presented concept relies on a combination of clustering and reinforcement learning algorithms. The paper discusses assumptions which are necessary to apply machine learning algorithms to automatic adaptation of SOA systems, and presents a machine learning-based management framework prototype. Possible benefits and disadvantages of the presented approach are discussed and the approach itself is validated with a representative case study

    Renal Denervation for Resistant Hypertension in the contemporary era: A Systematic Review and Meta-analysis

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    Renal denervation (RDN) is a catheter-based ablation procedure designed to treat resistant hypertension (RH). The objective of our study is to determine the effect of RDN on blood pressure and renal function in patients with RH in comparison to medical therapy alone. We performed an extensive literature search for randomized control trials (RCT) reporting office and 24 hr. blood pressure changes and estimated glomerular filtration rate (eGFR) at baseline and 6 months. We calculated a weighted standardized mean difference of blood pressure and renal outcomes between RDN and control groups using random effects models. Our search yielded 608 studies of which we included 15 studies for the final analysis. A total of 857 patients were treated with RDN and 616 patients treated with medical therapy +/- sham procedure. Only 5 studies were double-blinded RCT with sham control. The adjusted standardized mean difference in the change in office based systolic and diastolic pressures (p = 0.18; p = 0.14); 24 hr. systolic and diastolic pressures (p = 0.20; p = 0.18); and eGFR (p = 0.20) from baseline to 6 months is statistically insignificant with significant heterogeneity. Subgroup analysis showed that among sham controlled trials, 24 hr. systolic blood pressure showed a modest but statistically significant benefit favoring renal denervation in patients with RH. Our meta-analysis of 15 RCTs showed no significant benefit of RDN on blood pressure control in patients with resistant hypertension. Subgroup analysis of sham control studies showed a modest benefit in 24 hr. systolic blood pressure at 6 months with RDN.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

    The Financial Burden of Non-Communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures

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    Objectives Better insights into health care utilization and out-of-pocket expenditures for non-communicable chronic diseases (NCCD) are needed to develop accessible health care and limit the increasing financial burden of NCCDs in Sub-Saharan Africa. Methods A household survey was conducted in rural Kwara State, Nigeria, among 5,761 individuals. Data were obtained using biomedical and socio-economic questionnaires. Health care utilization, NCCD-related health expenditures and distances to health care providers were compared by sex and by wealth quintile, and a Heckman regression model was used to estimate health expenditures taking selection bias in health care utilization into account. Results The prevalence of NCCDs in our sample was 6.2%. NCCD-affected individuals from the wealthiest quintile utilized formal health care nearly twice as often as those from the lowest quintile (87.8% vs 46.2%, p = 0.002). Women reported foregone formal care more often than men (43.5% vs. 27.0%, p = 0.058). Health expenditures relative to annual consumption of the poorest quintile exceeded those of the highest quintile 2.2-fold, and the poorest quintile exhibited a higher rate of catastrophic health spending (10.8% among NCCD-affected households) than the three upper quintiles (4.2% to 6.7%). Long travel distances to the nearest provider, highest for the poorest quintile, were a significant deterrent to seeking care. Using distance to the nearest facility as instrument to account for selection into health care utilization, we estimated out-of-pocket health care expenditures for NCCDs to be significantly higher in the lowest wealth quintile compared to the three upper quintiles. Conclusions Facing potentially high health care costs and poor accessibility of health care facilities, many individuals suffering from NCCDs—particularly women and the poor—forego formal care, thereby increasing the risk of more severe illness in the future. When seeking care, the poor spend less on treatment than the rich, suggestive of lower quality care, while their expenditures represent a higher share of their annual household consumption. This calls for targeted interventions that enhance health care accessibility and provide financial protection from the consequences of NCCDs, especially for vulnerable populations

    Impact of statins based on high-risk plaque features on coronary plaque progression in mild stenosis lesions: results from the PARADIGM study

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    AimsTo investigate the impact of statins on plaque progression according to high-risk coronary atherosclerotic plaque (HRP) features and to identify predictive factors for rapid plaque progression in mild coronary artery disease (CAD) using serial coronary computed tomography angiography (CCTA).Methods and resultsWe analyzed mild stenosis (25–49%) CAD, totaling 1432 lesions from 613 patients (mean age, 62.2 years, 63.9% male) and who underwent serial CCTA at a ≥2 year inter-scan interval using the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (NCT02803411) registry. The median inter-scan period was 3.5 ± 1.4 years; plaques were quantitatively assessed for annualized percent atheroma volume (PAV) and compositional plaque volume changes according to HRP features, and the rapid plaque progression was defined by the ≥90th percentile annual PAV. In mild stenotic lesions with ≥2 HRPs, statin therapy showed a 37% reduction in annual PAV (0.97 ± 2.02 vs. 1.55 ± 2.22, P = 0.038) with decreased necrotic core volume and increased dense calcium volume compared to non-statin recipient mild lesions. The key factors for rapid plaque progression were ≥2 HRPs [hazard ratio (HR), 1.89; 95% confidence interval (CI), 1.02–3.49; P = 0.042], current smoking (HR, 1.69; 95% CI 1.09–2.57; P = 0.017), and diabetes (HR, 1.55; 95% CI, 1.07–2.22; P = 0.020).ConclusionIn mild CAD, statin treatment reduced plaque progression, particularly in lesions with a higher number of HRP features, which was also a strong predictor of rapid plaque progression. Therefore, aggressive statin therapy might be needed even in mild CAD with higher HRPs.Cardiolog

    Quality assessment of OpenStreetMap data using trajectory mining

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    OpenStreetMap (OSM) data are widely used but their reliability is still variable. Many contributors to OSM have not been trained in geography or surveying and consequently their contributions, including geometry and attribute data inserts, deletions, and updates, can be inaccurate, incomplete, inconsistent, or vague. There are some mechanisms and applications dedicated to discovering bugs and errors in OSM data. Such systems can remove errors through user-checks and applying predefined rules but they need an extra control process to check the real-world validity of suspected errors and bugs. This paper focuses on finding bugs and errors based on patterns and rules extracted from the tracking data of users. The underlying idea is that certain characteristics of user trajectories are directly linked to the type of feature. Using such rules, some sets of potential bugs and errors can be identified and stored for further investigation

    A method for enterprise architecture alignment

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    Business and ICT strategic alignment remains an ongoing challenge facing organizations as they react to changing requirements by adapting or introducing new technologies to existing infrastructure. Enterprise Architecture (EA) has increasingly become relevant to these demands and as a consequence numerous methods and frameworks have emerged. However these approaches remain bloated, time-consuming and lacking in precision. This paper proposes a light-weight method for EA called LEAP and introduces a language for EA simulation that is illustrated with a detailed case study of business change currently being addressed by UK higher education institutions

    Synthesizing a Criterion for SOA Reference Architecture to Sustain eParticipation

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