If You Build It, Will They Use It? Challenges in Adoption and Use of Patient-centered E-health

Preventive healthcare services require consumers to coordinate and manage several healthcare activities with multiple service providers. In this paper, we explore the adoption and use of a patient-centered e-health system for managing personal healthcare requirements. Specifically, using the patient-centered e-health (PCEH) framework, we analyzed the data we collected from a qualitative study of consumers who participated in a preventive care program called the Health Enhancement Program (HEP) in Connecticut in the United States and the accompanying e-health service the program offered. Data from the interviews of 15 participants revealed that users found several challenges in adopting and using the e-health system when examined in the context of their lifestyle even though the system had a patient-centric design. These findings provide implications for designing and assessing patient-centered e-health to ensure that users effectively adopt and continue to use them and insights for expanding PCEH theory and practice

Multiple testing procedures for complex structured hypotheses and directional decisions

Several multiple testing procedures are developed based on the inherent structure of the tested hypotheses and specific needs of data analysis. Incorporating the inherent structure of the hypotheses results in development of more powerful and situation-specific multiple testing procedures than existing ones. The focus of this dissertation is on developing multiple testing procedures that utilize the information on this structure of the hypotheses and aims at answering research questions while controlling appropriate error rates. In the first part of the thesis, a mixed directional false discovery rate (mdFDR) controlling procedure is developed in the context of uterine fibroid gene expression data (Davis et al., 2013). The main question of interest that arises in this research is to discover genes associated with various stages of tumor progression, such as tumor onset, growth and development of tumors and large size tumors. To answer such questions, a three-step testing strategy is introduced and a general procedure is proposed that can be used with any mixed directional familywise error rate (mdFWER) controlling procedure for each gene, while controlling the mdFDR as the overall error rate. The procedure is proved to control mdFDR when the underlying test statistics are independent across the genes. A specific methodology, based on the Dunnett procedure, is developed and applied to the uterine fibroid gene expression data of Davis et al. (2013). Several important genes and pathways are identified that play important role in fibroid formation and growth. In the second part, the problem of simultaneously testing many two-sided hypotheses is considered when rejections of null hypotheses are accompanied by claims on the direction of the alternative. The fundamental goal is to construct methods that control the mdFWER, which is the probability of making a Type I or Type III (directional) error. In particular, attention is focused on cases where the hypotheses are ordered as H1, ... , Hn, so that Hi+1 is tested only if H1, ... , Hi have all been previously rejected. This research proves that the conventional fixed sequence procedure, which tests each hypothesis at level α, when augmented with directional decisions, can control mdFWER under independence and positive regression dependence of the test statistics. Another more conservative directional procedure is also developed that strongly controls mdFWER under arbitrary dependence of test statistics. Finally, in the third part, multiple testing procedures are developed for making real-time decisions while testing a sequence of a-priori ordered hypotheses. In large scale multiple testing problems in applications such as stream data, statistical process control, etc., the underlying process is regularly monitored and it is desired to control False Discovery Rate (FDR) while making real time decisions about the process being out of control or not. The existing stepwise FDR controlling procedures, such as the Benjamini-Hochb erg procedure, are not applicable here because of the implicit assumption that all the p-values are available for applying the testing procedure. In this part of the thesis, powerful Fallback-type procedures are developed under various dependencies for controlling FDR that award the critical constants on rejection of a hypothesis. These procedures overcome the drawback of the conventional FDR controlling procedures by making real-time decisions based on partial information available when a hypothesis is tested and allowing testing of each a-priori ordered hypothesis. Simulation studies demonstrate the effectiveness of these procedures in terms of FDR control and average power

Optimum structural design with static aeroelastic constraints

The static aeroelastic performance characteristics, divergence velocity, control effectiveness and lift effectiveness are considered in obtaining an optimum weight structure. A typical swept wing structure is used with upper and lower skins, spar and rib thicknesses, and spar cap and vertical post cross-sectional areas as the design parameters. Incompressible aerodynamic strip theory is used to derive the constraint formulations, and aerodynamic load matrices. A Sequential Unconstrained Minimization Technique (SUMT) algorithm is used to optimize the wing structure to meet the desired performance constraints

A Multi-criteria Group Decision Making Method for Selecting Big Data Visualization Tools

Big data visualization tools are providing opportunities for businesses to strengthen decision making and achieve competitive advantages. Evaluating and selecting the most suitable big data visualization tool is however challenging. To effectively deal with this issue, this paper presents a multicriteria group decision making method for evaluating and selecting of big data visualization tools. Intuitionistic fuzzy numbers are used to tackle the subjectiveness and imprecision of the decision making process. The concept based on ideal solutions is applied for producing a relative closeness coefficient value for every big data visualization tool alternative across all evaluation criteria. A big data visualization tool selection problem is presented to demonstrate the applicability of the method

Differences between the east culture and the west culture

Nowadays no one is surprised to see foreigners in the streets of the city. But few people understand how to communicate with a representative of another country, came to a mutual understanding. The purpose of this study is to consider the main distinctions of culture of the East and West. Theoretical methods have been used to achieve this goal. The result of this research is more in-depth understanding of communication with representatives of the East and West cultures. В наши дни уже никто не удивляется, увидев на улицах своего города иностранцев. Но мало кто понимает, каким образом следует общаться с представителем другой страны, чтобы возникло взаимопонимание. Цель данного исследования заключается в том, чтобы изучить различия между западной и восточной культурами. Для достижения этой цели были использованы общетеоретические методы. Результатом данного исследования является более углубленное понимание особенностей общения с представителями западной и восточной культур

Study on influence of polymer and surfactant on in vitro performance of biodegradable aqueous-core nanocapsules of tenofovirdisoproxil fumarate by response surface methodology

The major objective of this study was to investigate the effect of biodegradable polymer type and surfactant concentration on various characteristics viz. particle size, entrapment efficiency and drug release rate constant of aqueous core nanocapsules (ACNs) containing tenofovirdisoproxil fumarate. In this study, the nanocapsules were prepared by modified multiple emulsion technique with biodegradable polymers viz. poly(lactide-co-glycolide) of two different grades (PLGA RG502H and PLGA RG503H) and poly lactic acid (PLA R203H); and the surfactant employed was span 80. The experiments were designed under response surface methodology by employing the Design Expert software. Entrapment efficiency, particle size and drug release rate constant were taken as response variables. The prepared nanocapsules were subjected to characterization studies and the obtained results were statistically analyzed by Analysis of Variance (ANOVA) for response surface 2-Factorial Interaction model. ANOVA studies showed that the influence of both factors on all the response variables were significant at p<0.05. The optimized formulation was found to have the entrapment efficiency of 71.58%, particle size of 252.41 nm and the drug release rate constant of 0.045 h-1; thus, indicating that the ACNs were obtained with finest characteristics. SEM studies showed that the particles were spherical