An examination of factors influencing the choice of therapy for patients with coronary artery disease

Background A diverse range of factors influence clinicians' decisions regarding the allocation of patients to different treatments for coronary artery disease in routine cardiology clinics. These include demographic measures, risk factors, co-morbidities, measures of objective cardiac disease, symptom reports and functional limitations. This study examined which of these factors differentiated patients receiving angioplasty from medication; bypass surgery from medication; and bypass surgery from angioplasty. Methods Univariate and multivariate logistic regression analyses were conducted on patient data from 214 coronary artery disease patients who at the time of recruitment had been received a clinical assessment and were reviewed by their cardiologist in order to determine the form of treatment they were to undergo: 70 would receive/continue medication, 71 were to undergo angioplasty and 73 were to undergo bypass surgery. Results Analyses differentiating patients receiving angioplasty from medication produced 9 significant univariate predictors, of which 5 were also multivariately significant (left anterior descending artery disease, previous coronary interventions, age, hypertension and frequency of angina). The analyses differentiating patients receiving surgery from angioplasty produced 12 significant univariate predictors, of which 4 were multivariately significant (limitations in mobility range, circumflex artery disease, previous coronary interventions and educational level). The analyses differentiating patients receiving surgery from medication produced 14 significant univariate predictors, of which 4 were multivariately significant (left anterior descending artery disease, previous cerebral events, limitations in mobility range and circumflex artery disease). Conclusion Variables emphasised in clinical guidelines are clearly involved in coronary artery disease treatment decisions. However, variables beyond these may also be important factors when therapy decisions are undertaken thus their roles require further investigation

Graph Metrics for Temporal Networks

Temporal networks, i.e., networks in which the interactions among a set of elementary units change over time, can be modelled in terms of time-varying graphs, which are time-ordered sequences of graphs over a set of nodes. In such graphs, the concepts of node adjacency and reachability crucially depend on the exact temporal ordering of the links. Consequently, all the concepts and metrics proposed and used for the characterisation of static complex networks have to be redefined or appropriately extended to time-varying graphs, in order to take into account the effects of time ordering on causality. In this chapter we discuss how to represent temporal networks and we review the definitions of walks, paths, connectedness and connected components valid for graphs in which the links fluctuate over time. We then focus on temporal node-node distance, and we discuss how to characterise link persistence and the temporal small-world behaviour in this class of networks. Finally, we discuss the extension of classic centrality measures, including closeness, betweenness and spectral centrality, to the case of time-varying graphs, and we review the work on temporal motifs analysis and the definition of modularity for temporal graphs.Comment: 26 pages, 5 figures, Chapter in Temporal Networks (Petter Holme and Jari Saram\"aki editors). Springer. Berlin, Heidelberg 201

Multiple dynamical time-scales in networks with hierarchically nested modular organization

Many natural and engineered complex networks have intricate mesoscopic organization, e.g., the clustering of the constituent nodes into several communities or modules. Often, such modularity is manifested at several different hierarchical levels, where the clusters defined at one level appear as elementary entities at the next higher level. Using a simple model of a hierarchical modular network, we show that such a topological structure gives rise to characteristic time-scale separation between dynamics occurring at different levels of the hierarchy. This generalizes our earlier result for simple modular networks, where fast intra-modular and slow inter-modular processes were clearly distinguished. Investigating the process of synchronization of oscillators in a hierarchical modular network, we show the existence of as many distinct time-scales as there are hierarchical levels in the system. This suggests a possible functional role of such mesoscopic organization principle in natural systems, viz., in the dynamical separation of events occurring at different spatial scales.Comment: 10 pages, 4 figure

Guilty Plea Decisions: Moving Beyond the Autonomy Myth

This is the final version. Available on open access from Wiley via the DOI in this recordWhen a defendant pleads guilty to a criminal charge against them their conviction may be justified on the basis of autonomy rather than accuracy. In this context, autonomy can make the difference between a legitimate conviction and the breach of fundamental rights. However, autonomy in this context is not clearly defined. This article argues, based on philosophical conceptions of autonomy and empirical realities, that true autonomy is an ideal rather than a practical reality. It considers the level of autonomy necessary to legitimise a criminal conviction via plea, and suggests that current conceptions of autonomy in this context are inadequate since they rely on a formalistic autonomy “myth,” presuming autonomy in the absence of threats. An analysis drawing on original empirical data from two studies demonstrates how autonomy may be being depleted to unacceptable levels in the current system, and reform proposals are presented.Medical Research Council (MRC

The evolution of interdisciplinarity in physics research

Science, being a social enterprise, is subject to fragmentation into groups that focus on specialized areas or topics. Often new advances occur through cross-fertilization of ideas between sub-fields that otherwise have little overlap as they study dissimilar phenomena using different techniques. Thus to explore the nature and dynamics of scientific progress one needs to consider the large-scale organization and interactions between different subject areas. Here, we study the relationships between the sub-fields of Physics using the Physics and Astronomy Classification Scheme (PACS) codes employed for self-categorization of articles published over the past 25 years (1985-2009). We observe a clear trend towards increasing interactions between the different sub-fields. The network of sub-fields also exhibits core-periphery organization, the nucleus being dominated by Condensed Matter and General Physics. However, over time Interdisciplinary Physics is steadily increasing its share in the network core, reflecting a shift in the overall trend of Physics research.Comment: Published version, 10 pages, 8 figures + Supplementary Informatio

Null Geodesic Congruences, Asymptotically Flat Space-Times and Their Physical Interpretation

Shear-free or asymptotically shear-free null geodesic congruences possess a large number of fascinating geometric properties and to be closely related, in the context of general relativity, to a variety of physically significant affects. It is the purpose of this paper to develop these issues and find applications in GR. The applications center around the problem of extracting interior physical properties of an asymptotically flat space-time directly from the asymptotic gravitational (and Maxwell) field itself in analogy with the determination of total charge by an integral over the Maxwell field at infinity or the identification of the interior mass (and its loss) by (Bondi's) integrals of the Weyl tensor, also at infinity. More specifically we will see that the asymptotically shear-free congruences lead us to an asymptotic definition of the center-of-mass and its equations of motion. This includes a kinematic meaning, in terms of the center of mass motion, for the Bondi three-momentum. In addition, we obtain insights into intrinsic spin and, in general, angular momentum, including an angular momentum conservation law with well-defined flux terms. When a Maxwell field is present the asymptotically shear-free congruences allow us to determine/define at infinity a center-of-charge world-line and intrinsic magnetic dipole moment.Comment: 98 pages, 6 appendices. v2: typos corrected; v3: significant changes made to results section using simpler arguments, added discussion of real structures, additional references, 2 new appendice

A Universal Lifetime Distribution for Multi-Species Systems

Lifetime distributions of social entities, such as enterprises, products, and media contents, are one of the fundamental statistics characterizing the social dynamics. To investigate the lifetime distribution of mutually interacting systems, simple models having a rule for additions and deletions of entities are investigated. We found a quite universal lifetime distribution for various kinds of inter-entity interactions, and it is well fitted by a stretched-exponential function with an exponent close to 1/2. We propose a "modified Red-Queen" hypothesis to explain this distribution. We also review empirical studies on the lifetime distribution of social entities, and discussed the applicability of the model.Comment: 10 pages, 6 figures, Proceedings of Social Modeling and Simulations + Econophysics Colloquium 201

Mesoscopic organization reveals the constraints governing C. elegans nervous system

One of the biggest challenges in biology is to understand how activity at the cellular level of neurons, as a result of their mutual interactions, leads to the observed behavior of an organism responding to a variety of environmental stimuli. Investigating the intermediate or mesoscopic level of organization in the nervous system is a vital step towards understanding how the integration of micro-level dynamics results in macro-level functioning. In this paper, we have considered the somatic nervous system of the nematode Caenorhabditis elegans, for which the entire neuronal connectivity diagram is known. We focus on the organization of the system into modules, i.e., neuronal groups having relatively higher connection density compared to that of the overall network. We show that this mesoscopic feature cannot be explained exclusively in terms of considerations, such as optimizing for resource constraints (viz., total wiring cost) and communication efficiency (i.e., network path length). Comparison with other complex networks designed for efficient transport (of signals or resources) implies that neuronal networks form a distinct class. This suggests that the principal function of the network, viz., processing of sensory information resulting in appropriate motor response, may be playing a vital role in determining the connection topology. Using modular spectral analysis, we make explicit the intimate relation between function and structure in the nervous system. This is further brought out by identifying functionally critical neurons purely on the basis of patterns of intra- and inter-modular connections. Our study reveals how the design of the nervous system reflects several constraints, including its key functional role as a processor of information.Comment: Published version, Minor modifications, 16 pages, 9 figure

Inference of hidden structures in complex physical systems by multi-scale clustering

We survey the application of a relatively new branch of statistical physics--"community detection"-- to data mining. In particular, we focus on the diagnosis of materials and automated image segmentation. Community detection describes the quest of partitioning a complex system involving many elements into optimally decoupled subsets or communities of such elements. We review a multiresolution variant which is used to ascertain structures at different spatial and temporal scales. Significant patterns are obtained by examining the correlations between different independent solvers. Similar to other combinatorial optimization problems in the NP complexity class, community detection exhibits several phases. Typically, illuminating orders are revealed by choosing parameters that lead to extremal information theory correlations.Comment: 25 pages, 16 Figures; a review of earlier work