Physician Self-Referral and Physician-Owned Specialty Facilities

Outlines issues of self-referral -- physicians referring patients to a group or facility in which they have a financial interest -- and the prevalence of physician-owned facilities, as well as the effects on healthcare quality, cost, and access

Sequential Dimensionality Reduction for Extracting Localized Features

Linear dimensionality reduction techniques are powerful tools for image analysis as they allow the identification of important features in a data set. In particular, nonnegative matrix factorization (NMF) has become very popular as it is able to extract sparse, localized and easily interpretable features by imposing an additive combination of nonnegative basis elements. Nonnegative matrix underapproximation (NMU) is a closely related technique that has the advantage to identify features sequentially. In this paper, we propose a variant of NMU that is particularly well suited for image analysis as it incorporates the spatial information, that is, it takes into account the fact that neighboring pixels are more likely to be contained in the same features, and favors the extraction of localized features by looking for sparse basis elements. We show that our new approach competes favorably with comparable state-of-the-art techniques on synthetic, facial and hyperspectral image data sets.Comment: 24 pages, 12 figures. New numerical experiments on synthetic data sets, discussion about the convergenc

Recent Advances in Silicon Photodetectors Based on the Internal Photoemission Effect

Silicon technologies provide an excellent platform in order to realize microsystems where photonic and microelectronic functionalities are monolithically integrated on the same substrate. In recent years, a lot of passive and active silicon photonic devices have been optimized to work at telecom wavelengths where, unfortunately, silicon has a neglectable optical absorption due to its bandgap of 1.12 eV. Although silicon cannot detect wavelengths above 1.1 μm, in recent years, tremendous advances have been made in order to make it suitable for operation in the near-infrared spectrum. One of the approaches is to take advantage of the internal photoemission effect through a Schottky junction where a metal absorbs the incoming radiation and emits hot carriers into silicon making sub-bandgap detection possible. The present chapter describes the more recent advances in the field of the silicon photodetectors based on the internal photoemission effect showing as devices based on new emerging materials and complex nanostructure are leading this family of device to compare favorably with the well-established technologies commonly used for telecom wavelengths based on germanium and III–V semiconductors

Computational Intelligence in Healthcare

This book is a printed edition of the Special Issue Computational Intelligence in Healthcare that was published in Electronic

Pre-mRNA Splicing: An Evolutionary Computational Journey from Ribozymes to Spliceosome

The intron\u2013exon organization of the genes is nowadays taken for granted and constitutes a fully established theory. DNA protein-coding sequences (exons) are not contiguous but rather separated by silent intervening fragments (introns), which must be removed in a process called pre-mRNA splicing. However, this fragmented composition of the eukaryotic genome has ancient origins. It appears that, during the initial stages of eukaryotic evolution, group II introns, i.e. self-splicing catalytic ribozymes, invaded the eukaryotic genome via the endosymbiosis of an alpha-proteobacterium in an archaeal host. At a later time, they split into the inert spliceosomal introns and the catalytically active small nuclear (sn)RNAs, which, together with additional splicing factors, gave rise to the eukaryotic spliceosome. This marked the transition from the autocatalytic splicing, mediated by ribozymes (RNA filaments endowed with an intrinsic catalytic activity) to splicing mediated by a protein-RNA machinery, the spliceosome. In the present thesis, the evolutionary relationship between group II introns and the spliceosome is retraced from a computational perspective by means of classical molecular dynamics simulations (MD), quantum mechanics calculations (QM) and combined quantum-classical simulations (QM/MM). The splicing process of these two different \u2013 but mechanistically related \u2013 large and sophisticated biomolecules is investigated with the aim of deciphering the reactivity and the structural properties from a computational point of view, with a focus on the role played by the Mg2+ ions as splicing cofactors. In Chapter 2, the importance of Mg2+ ions in the RNA biology is introduced. Not only they participate to the catalysis, but also represent essential structural and functional elements for RNA filaments. Moreover, the structural and molecular biology of group II intron ribozymes and the spliceosome machinery are widely discussed with a focus on their evolutionary links. Chapter 3 consists of a brief review of all the computational techniques employed in this thesis, from classical MD to QM and QM/MM simulations and enhanced sampling methods aimed at reconstructing the free energy of a process. Chapter 4 is entirely dedicated to the splicing mechanism promoted by group II intron ribozymes, representing the starting point of the evolutionary journey. In this chapter, a QM/MM study of the molecular mechanism of group II introns first-step hydrolytic splicing is presented, unveiling an RNA-adapted Steitz and Steitz\u2019s two-Mg2+-ion dissociative catalysis which differs from the one observed in protein enzymes. Chapter 5 is focused on Mg2+ ions, which are the natural cofactors of splicing, both in group II introns and in the spliceosome. Mg2+/RNA interplay is here addressed using a group II intron as a prototype of a large RNA molecule binding Mg2+. The performances of five different force fields currently used to describe Mg2+ in MD simulations are benchmarked, showing strengths and drawbacks. Moreover, the non-trivial electronic effects induced by Mg2+ on its ligands, such as charge transfer and polarization, are also characterized using 16 recurrent binding motifs. Overall, the study offers some guidelines on Mg2+ force fields for users and developers. Chapter 6 represents the final stop of the evolutionary journey. Here, an exquisite cryo-EM model of the ILS spliceosomal complex solved at 3.6 \uc5 resolution is used for a long-time scale MD study. This provides precious insights on the main proteins and snRNAs involved in the pre-mRNA splicing in eukaryotes as well as on the catalytic site. Unprecedentedly, the structural and dynamical properties of the spliceosome machinery are investigated at the atomistic level, with a particular emphasis on protein/RNA interplay through the characterization of their principal motions, among which the intron lariat/U2 snRNA helix unwinding

Flexible human-robot cooperation models for assisted shop-floor tasks

The Industry 4.0 paradigm emphasizes the crucial benefits that collaborative robots, i.e., robots able to work alongside and together with humans, could bring to the whole production process. In this context, an enabling technology yet unreached is the design of flexible robots able to deal at all levels with humans' intrinsic variability, which is not only a necessary element for a comfortable working experience for the person but also a precious capability for efficiently dealing with unexpected events. In this paper, a sensing, representation, planning and control architecture for flexible human-robot cooperation, referred to as FlexHRC, is proposed. FlexHRC relies on wearable sensors for human action recognition, AND/OR graphs for the representation of and reasoning upon cooperation models, and a Task Priority framework to decouple action planning from robot motion planning and control.Comment: Submitted to Mechatronics (Elsevier