Modelling of Information Flow and Resource Utilization in the EDGE Distributed Web System

The adoption of Distributed Web Systems (DWS) into modern engineering design process has dramatically increased in recent years. The Engineering Design Guide and Environment (EDGE) is one such DWS, intended to provide an integrated set of tools for use in the development of new products and services. Previous attempts to improve the efficiency and scalability of DWS focused largely on hardware utilization (i.e. multithreading and virtualization) and software scalability (i.e. load balancing and cloud services). However, these techniques are often limited to analysis of the computational complexity of the algorithms implemented. This work seeks to improve the understanding of efficiency and scalability of DWS by modelling the dynamics of information flow and resource utilization by characterizing DWS workloads through historical usage data (i.e. request type, frequency, access time). The design and implementation of EDGE is described. A DWS model of an EDGE system is developed and validated against theoretical limiting cases. The DWS model is used to predict the throughput of an EDGE system given a resource allocation and workflow. Results of the simulation suggest that proposed DWS designs can be evaluated according to the usage requirements of an engineering firm, ultimately guiding an informed decision for the selection and deployment of a DWS in an enterprise environment. Recommendations for future work related to the continued development of EDGE, DWS modelling of EDGE installation environments, and the extension of DWS modelling to new product development processes are presented

A Comparative Analysis of Influenza Vaccination Programs

The threat of avian influenza and the 2004-2005 influenza vaccine supply shortage in the United States has sparked a debate about optimal vaccination strategies to reduce the burden of morbidity and mortality caused by the influenza virus. We present a comparative analysis of two classes of suggested vaccination strategies: mortality-based strategies that target high risk populations and morbidity-based that target high prevalence populations. Applying the methods of contact network epidemiology to a model of disease transmission in a large urban population, we evaluate the efficacy of these strategies across a wide range of viral transmission rates and for two different age-specific mortality distributions. We find that the optimal strategy depends critically on the viral transmission level (reproductive rate) of the virus: morbidity-based strategies outperform mortality-based strategies for moderately transmissible strains, while the reverse is true for highly transmissible strains. These results hold for a range of mortality rates reported for prior influenza epidemics and pandemics. Furthermore, we show that vaccination delays and multiple introductions of disease into the community have a more detrimental impact on morbidity-based strategies than mortality-based strategies. If public health officials have reasonable estimates of the viral transmission rate and the frequency of new introductions into the community prior to an outbreak, then these methods can guide the design of optimal vaccination priorities. When such information is unreliable or not available, as is often the case, this study recommends mortality-based vaccination priorities

The Shifting Demographic Landscape of Pandemic Influenza

Shweta Bansal is with Pennsylvania State University and NIH, Babak Pourbohloul is with British Columbia Centre for Disease Control and University of British Columbia, Nathaniel Hupert is with Weill Cornell Medical College and CDC, Bryan Grenfell is with Princeton University, Lauren Ancel Meyers is with UT Austin and Santa Fe Institute.Background -- As Pandemic (H1N1) 2009 influenza spreads around the globe, it strikes school-age children more often than adults. Although there is some evidence of pre-existing immunity among older adults, this alone may not explain the significant gap in age-specific infection rates. Methods and Findings -- Based on a retrospective analysis of pandemic strains of influenza from the last century, we show that school-age children typically experience the highest attack rates in primarily naive populations, with the burden shifting to adults during the subsequent season. Using a parsimonious network-based mathematical model which incorporates the changing distribution of contacts in the susceptible population, we demonstrate that new pandemic strains of influenza are expected to shift the epidemiological landscape in exactly this way. Conclusions -- Our analysis provides a simple demographic explanation for the age bias observed for H1N1/09 attack rates, and suggests that this bias may shift in coming months. These results have significant implications for the allocation of public health resources for H1N1/09 and future influenza pandemics.This work was supported by the Research and Policy for Infectious Disease Dynamics (RAPIDD) program of the Science and Technology Directorate, Department of Homeland Security, and the Fogarty International Center, National Institutes of Health (NIH); grants from the James F. McDonnell Foundation, National Science Foundation (DEB-0749097), and NIH Models of Infectious Disease Agent Study (MIDAS) (U01-GM087719-01) to L.A.M.; and support from the Canadian Institutes of Health Research (PTL97125 and PAP93425) and the Michael Smith Foundation for Health Research to B.P. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Biological Sciences, School o

Reconstruction of material losses by perimeter penalization and phase-field methods

We treat the inverse problem of determining material losses, such as cavities, in a conducting body, by performing electrostatic measurements at the boundary. We develop a numerical approach, based on variational methods, to reconstruct the unknown material loss by a single boundary measurement of current and voltage type. The method is based on the use of phase-field functions to model the material losses and on a perimeter-like penalization to regularize the otherwise ill-posed problem.We justify the proposed approach by a convergence result, as the error on the measurement goes to zero.Comment: 28 page

Treatment utilization and outcomes in elderly patients with locally advanced esophageal carcinoma: A review of the National Cancer Database

For elderly patients with locally advanced esophageal cancer, therapeutic approaches and outcomes in a modern cohort are not well characterized. Patients ≥70 years old with clinical stage II and III esophageal cancer diagnosed between 1998 and 2012 were identified from the National Cancer Database and stratified based on treatment type. Variables associated with treatment utilization were evaluated using logistic regression and survival evaluated using Cox proportional hazards analysis. Propensity matching (1:1) was performed to help account for selection bias. A total of 21,593 patients were identified. Median and maximum ages were 77 and 90, respectively. Treatment included palliative therapy (24.3%), chemoradiation (37.1%), trimodality therapy (10.0%), esophagectomy alone (5.6%), or no therapy (12.9%). Age ≥80 (OR 0.73), female gender (OR 0.81), Charlson-Deyo comorbidity score ≥2 (OR 0.82), and high-volume centers (OR 0.83) were associated with a decreased likelihood of palliative therapy versus no treatment. Age ≥80 (OR 0.79) and Clinical Stage III (OR 0.33) were associated with a decreased likelihood, while adenocarcinoma histology (OR 1.33) and nonacademic cancer centers (OR 3.9), an increased likelihood of esophagectomy alone compared to definitive chemoradiation. Age ≥80 (OR 0.15), female gender (OR 0.80), and non-Caucasian race (OR 0.63) were associated with a decreased likelihood, while adenocarcinoma histology (OR 2.10) and high-volume centers (OR 2.34), an increased likelihood of trimodality therapy compared to definitive chemoradiation. Each treatment type demonstrated improved survival compared to no therapy: palliative treatment (HR 0.49) to trimodality therapy (HR 0.25) with significance between all groups. Any therapy, including palliative care, was associated with improved survival; however, subsets of elderly patients with locally advanced esophageal cancer are less likely to receive aggressive therapy. Care should be taken to not unnecessarily deprive these individuals of treatment that may improve survival

Single-Lung Transplantation in the Setting of Aborted Bilateral Lung Transplantation

Background. The outcome of patients undergoing a single-lung transplant in the setting of an aborted bilateral lung transplant is unclear. Methods. A retrospective review of single lung transplants at an institutional program. Results. Of the 543 lung transplants performed over the last 10 years, 31 (5.7%) were single-lung transplants. Nineteen of 31 (61%) were planned single-lung transplants, while 12/31 (39%) were intraoperatively aborted, double lung transplants converted to single-lung transplants. The aborted and planned groups were similar in age, lung allocation score and NYHA status. The reasons for aborted double lung transplantation were cardiac/hemodynamic instability 4/12 (33%), difficult pneumonectomy 3/12 (25%), size mismatch 4/12(33%), and technical issues 1/12 (8%). The aborted group had higher CPB utilization (5/12 versus 1/19, P = .02), similar ischemic times (260 versus 234 min) and similar incidence of grade 3 primary graft dysfunction (6/12 versus 3/19, P = .13). ECMO was required for graft dysfunction in 2 patients in the aborted group. The one and two-year survival was 84% and 79% in the planned group and 62% and 52% in the aborted group, respectively. Conclusions. Patients undergoing single-lung transplantation in the setting of an aborted bilateral lung transplant may be at a higher risk of worse outcomes

Feasibility and safety of the airway bypass procedure for patients with emphysema

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