SLIDES: Energy Development Water Needs Assessment and Water Supply Alternatives and Analysis

Presenter: Benjamin Harding, Principal Engineer, AMEC Earth and Environmental 15 slide

Accuracy of medical billing data against the electronic health record in the measurement of colorectal cancer screening rates.

ObjectiveMedical billing data are an attractive source of secondary analysis because of their ease of use and potential to answer population-health questions with statistical power. Although these datasets have known susceptibilities to biases, the degree to which they can distort the assessment of quality measures such as colorectal cancer screening rates are not widely appreciated, nor are their causes and possible solutions.MethodsUsing a billing code database derived from our institution's electronic health records, we estimated the colorectal cancer screening rate of average-risk patients aged 50-74 years seen in primary care or gastroenterology clinic in 2016-2017. 200 records (150 unscreened, 50 screened) were sampled to quantify the accuracy against manual review.ResultsOut of 4611 patients, an analysis of billing data suggested a 61% screening rate, an estimate that matches the estimate by the Centers for Disease Control. Manual review revealed a positive predictive value of 96% (86%-100%), negative predictive value of 21% (15%-29%) and a corrected screening rate of 85% (81%-90%). Most false negatives occurred due to examinations performed outside the scope of the database-both within and outside of our institution-but 21% of false negatives fell within the database's scope. False positives occurred due to incomplete examinations and inadequate bowel preparation. Reasons for screening failure include ordered but incomplete examinations (48%), lack of or incorrect documentation by primary care (29%) including incorrect screening intervals (13%) and patients declining screening (13%).ConclusionsBilling databases are prone to substantial bias that may go undetected even in the presence of confirmatory external estimates. Caution is recommended when performing population-level inference from these data. We propose several solutions to improve the use of these data for the assessment of healthcare quality

Eliminating Mole Size in Melanoma Classification

While skin cancer classification has been a popular and valuable deep learning application for years, there has been little consideration of the context in which testing images are taken. Traditional melanoma classifiers rely on the assumption that their testing environments are analogous to the structured images on which they are trained. This paper combats this notion, arguing that mole size, a vital attribute in professional dermatology, is a red herring in automated melanoma detection. Although malignant melanomas are consistently larger than benign melanomas, this distinction proves unreliable and harmful when images cannot be contextually scaled. This implementation builds a custom model that eliminates size as a training feature to prevent overfitting to incorrect parameters. Additionally, random rotation and contrast augmentations are performed to simulate the real-world use of melanoma detection applications. Several custom models with varying forms of data augmentation are implemented to demonstrate the most significant features of the generalization abilities of mole classifiers. These implementations show that user unpredictability is crucial when utilizing such applications. The caution required when manually modifying data is acknowledged, as data loss and biased conclusions are necessary considerations in this process. Additionally, mole size inconsistency and its significance are discussed in both the dermatology and deep learning communities

Towards a comprehensive, empirical model of language assessment literacy across stakeholder groups:Developing the Language Assessment Literacy Survey

While scholars have proposed different models of language assessment literacy (LAL), these models have mostly comprised prescribed sets of components based on principles of good practice. As such, these models remain theoretical in nature, and represent the perspectives of language assessment researchers rather than stakeholders themselves. The project from which the current study is drawn was designed to address this issue through an empirical investigation of the LAL needs of different stakeholder groups. Central to this aim was the development of a rigorous and comprehensive survey which would illuminate the dimensionality of LAL and generate profiles of needs across these dimensions. This paper reports on the development of an instrument designed for this purpose: the Language Assessment Literacy Survey. We first describe the expert review and pretesting stages of survey development. Then we report on the results of an exploratory factor analysis based on data from a large-scale administration (N = 1086), where respondents from a range of stakeholder groups across the world judged the LAL needs of their peers. Finally, selected results from the large-scale administration are presented to illustrate the survey’s utility, specifically comparing the responses of language teachers, language testing/assessment developers and language testing/assessment researchers

Reliability as a Performance Metric for Water Resources Management

This paper describes the historical development of methods of quantitative water resource analysis, and illustrates modern reliability-based approaches with some examples

State-sanctioned torture in Uzbekistan and beyond : a legal analysis

This purpose of this study is to provide a greater understanding and awareness of the existence of state-sanctioned torture that is being committed in Uzbekistan. In the early chapters, the definitions, meanings and understanding of what torture is and represents in a contemporary society are investigated, whilst the historical origins, uses and justifications for torture are also explored. Following this, the main case study, Uzbekistan, is formally introduced. Torture in Uzbekistan is endemic, and wholly supported by its authoritarian government. This study investigates why that is the case; Chapter 3 in particular critically examines Uzbek domestic law to determine its current legal position, and compares this stance with the international provisions relating to torture. This study also investigates the instances of torture in both Europe and Latin America, in order to draw similar comparisons with Uzbekistan, and to provide contextualisation. This involves examining key cases such as Ireland v UK, Tomasi v France and Selmouni v France. The conclusions drawn from the European legal landscape illustrate that torture is very much the exception rather than the norm, and that through clear precedent and rigorous protection of both Article 3 of the European Convention on Human Rights and Article 5 of the Universal Declaration of Human Rights, as well as relevant domestic law, European judges are well-placed to make torture a thankfully rare occurrence. Latin America is exposed in Chapter 5 as having had a more problematic and legally concerning history of torture; in particular the dictatorships of Pinochet of Chile, Peron of Argentina, and Branco of Brazil during the 1960s, 1970s and 1980s. These regimes and the torture that was authorised under the command of these leaders are contrasted with that of former President Karimov of Uzbekistan, who ruled from 1992 to 2016. The leaders of these nations have trodden similar paths with regard to state-sanctioned torture, and again, provide relevant contextualisation and precedent for Uzbekistan to be compared to. The difficulty Uzbekistan faces with its history of torture is then addressed in the closing chapters of this thesis, and questions are raised about its likely future occurrence and potential reforms, which may serve to limit or prevent this

Virtual Town Hall on 2021 Commencement

President Joan Ferrini-Mundy was joined by Kimberly Whitehead, Geremy Chubbuck, Benjamin Evans, Kathleen Harding-Heber, and John Volin for a Virtual Town Hall on the topic of UMaine’s 2021 Commencement plans

Glycosylation-mediated phenylpropanoid partitioning in Populus tremuloides cell cultures

<p>Abstract</p> <p>Background</p> <p>Phenylpropanoid-derived phenolic glycosides (PGs) and condensed tannins (CTs) comprise large, multi-purpose non-structural carbon sinks in <it>Populus</it>. A negative correlation between PG and CT concentrations has been observed in several studies. However, the molecular mechanism underlying the relationship is not known.</p> <p>Results</p> <p><it>Populus </it>cell cultures produce CTs but not PGs under normal conditions. Feeding salicyl alcohol resulted in accumulation of salicins, the simplest PG, in the cells, but not higher-order PGs. Salicin accrual reflected the stimulation of a glycosylation response which altered a number of metabolic activities. We utilized this suspension cell feeding system as a model for analyzing the possible role of glycosylation in regulating the metabolic competition between PG formation, CT synthesis and growth. Cells accumulated salicins in a dose-dependent manner following salicyl alcohol feeding. Higher feeding levels led to a decrease in cellular CT concentrations (at 5 or 10 mM), and a negative effect on cell growth (at 10 mM). The competition between salicin and CT formation was reciprocal, and depended on the metabolic status of the cells. We analyzed gene expression changes between controls and cells fed with 5 mM salicyl alcohol for 48 hr, a time point when salicin accumulation was near maximum and CT synthesis was reduced, with no effect on growth. Several stress-responsive genes were up-regulated, suggestive of a general stress response in the fed cells. Salicyl alcohol feeding also induced expression of genes associated with sucrose catabolism, glycolysis and the Krebs cycle. Transcript levels of phenylalanine ammonia lyase and most of the flavonoid pathway genes were reduced, consistent with down-regulated CT synthesis.</p> <p>Conclusions</p> <p>Exogenous salicyl alcohol was readily glycosylated in <it>Populus </it>cell cultures, a process that altered sugar utilization and phenolic partitioning in the cells. Using this system, we identified candidate genes for glycosyltransferases that may mediate the glycosylation, and for transporters that mediate the subcellular compartmentalization of sugars and phenolic glycosides. The suspension cells appear to represent a facile system for dissecting the regulation of phenolic carbon partitioning, and in turn, its effects on growth in <it>Populus</it>.</p

Undergraduate Course in Environmental Design and Manufacturing

This paper is a progress report on the development of an undergraduate course in environmental design and manufacturing. The importance of the topic is clear from National Academy of Engineering statements regarding the need to incorporate content on sustainable technology. The multidisciplinary team includes academic faculty from engineering, science, liberal studies, and business in collaboration with industry partners. The team\u27s approach is to create a case-based course by adapting existing educational modules from Ford Motor Company. The group has received National Science Foundation funding for this project (DUE-0511322), and the project is currently in its beginning phases