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Background:
COVID-19 has infected millions of people worldwide and is responsible for several hundred thousand fatalities. The COVID-19 pandemic has necessitated thoughtful resource allocation and early identification of high-risk patients. However, effective methods to meet these needs are lacking.
Objective:
The aims of this study were to analyze the electronic health records (EHRs) of patients who tested positive for COVID-19 and were admitted to hospitals in the Mount Sinai Health System in New York City; to develop machine learning models for making predictions about the hospital course of the patients over clinically meaningful time horizons based on patient characteristics at admission; and to assess the performance of these models at multiple hospitals and time points.
Methods:
We used Extreme Gradient Boosting (XGBoost) and baseline comparator models to predict in-hospital mortality and critical events at time windows of 3, 5, 7, and 10 days from admission. Our study population included harmonized EHR data from five hospitals in New York City for 4098 COVID-19-positive patients admitted from March 15 to May 22, 2020. The models were first trained on patients from a single hospital (n=1514) before or on May 1, externally validated on patients from four other hospitals (n=2201) before or on May 1, and prospectively validated on all patients after May 1 (n=383). Finally, we established model interpretability to identify and rank variables that drive model predictions.
Results:
Upon cross-validation, the XGBoost classifier outperformed baseline models, with an area under the receiver operating characteristic curve (AUC-ROC) for mortality of 0.89 at 3 days, 0.85 at 5 and 7 days, and 0.84 at 10 days. XGBoost also performed well for critical event prediction, with an AUC-ROC of 0.80 at 3 days, 0.79 at 5 days, 0.80 at 7 days, and 0.81 at 10 days. In external validation, XGBoost achieved an AUC-ROC of 0.88 at 3 days, 0.86 at 5 days, 0.86 at 7 days, and 0.84 at 10 days for mortality prediction. Similarly, the unimputed XGBoost model achieved an AUC-ROC of 0.78 at 3 days, 0.79 at 5 days, 0.80 at 7 days, and 0.81 at 10 days. Trends in performance on prospective validation sets were similar. At 7 days, acute kidney injury on admission, elevated LDH, tachypnea, and hyperglycemia were the strongest drivers of critical event prediction, while higher age, anion gap, and C-reactive protein were the strongest drivers of mortality prediction.
Conclusions:
We externally and prospectively trained and validated machine learning models for mortality and critical events for patients with COVID-19 at different time horizons. These models identified at-risk patients and uncovered underlying relationships that predicted outcomes.
CloudStrike
(2020)
Most cyber-attacks and data breaches in cloud infrastructure are due to human errors and misconfiguration vulnerabilities. Cloud customer-centric tools are imperative for mitigating these issues, however existing cloud security models are largely unable to tackle these security challenges. Therefore, novel security mechanisms are imperative, we propose Risk-driven Fault Injection (RDFI) techniques to address these challenges. RDFI applies the principles of chaos engineering to cloud security and leverages feedback loops to execute, monitor, analyze and plan security fault injection campaigns, based on a knowledge-base. The knowledge-base consists of fault models designed from secure baselines, cloud security best practices and observations derived during iterative fault injection campaigns. These observations are helpful for identifying vulnerabilities while verifying the correctness of security attributes (integrity, confidentiality and availability). Furthermore, RDFI proactively supports risk analysis and security hardening efforts by sharing security information with security mechanisms. We have designed and implemented the RDFI strategies including various chaos engineering algorithms as a software tool: CloudStrike. Several evaluations have been conducted with CloudStrike against infrastructure deployed on two major public cloud infrastructure: Amazon Web Services and Google Cloud Platform. The time performance linearly increases, proportional to increasing attack rates. Also, the analysis of vulnerabilities detected via security fault injection has been used to harden the security of cloud resources to demonstrate the effectiveness of the security information provided by CloudStrike. Therefore, we opine that our approaches are suitable for overcoming contemporary cloud security issues.
Mary, Hugo, and Hugo*
(2020)
Distributed data-parallel processing systems like MapReduce, Spark, and Flink are popular for analyzing large datasets using cluster resources. Resource management systems like YARN or Mesos in turn allow multiple data-parallel processing jobs to share cluster resources in temporary containers. Often, the containers do not isolate resource usage to achieve high degrees of overall resource utilization despite overprovisioning and the often fluctuating utilization of specific jobs. However, some combinations of jobs utilize resources better and interfere less with each other when running on the same shared nodes than others. This article presents an approach for improving the resource utilization and job throughput when scheduling recurring distributed data-parallel processing jobs in shared clusters. The approach is based on reinforcement learning and a measure of co-location goodness to have cluster schedulers learn over time which jobs are best executed together on shared resources. We evaluated this approach over the last years with three prototype schedulers that build on each other: Mary, Hugo, and Hugo*. For the evaluation we used exemplary Flink and Spark jobs from different application domains and clusters of commodity nodes managed by YARN. The results of these experiments show that our approach can increase resource utilization and job throughput significantly.
Background:
There are limited data regarding the clinical impact of coronavirus disease 2019 (COVID-19) on people living with human immunodeficiency virus (PLWH). In this study, we compared outcomes for PLWH with COVID-19 to a matched comparison group.
Methods:
We identified 88 PLWH hospitalized with laboratory-confirmed COVID-19 in our hospital system in New York City between 12 March and 23 April 2020. We collected data on baseline clinical characteristics, laboratory values, HIV status, treatment, and outcomes from this group and matched comparators (1 PLWH to up to 5 patients by age, sex, race/ethnicity, and calendar week of infection). We compared clinical characteristics and outcomes (death, mechanical ventilation, hospital discharge) for these groups, as well as cumulative incidence of death by HIV status.
Results:
Patients did not differ significantly by HIV status by age, sex, or race/ethnicity due to the matching algorithm. PLWH hospitalized with COVID-19 had high proportions of HIV virologic control on antiretroviral therapy. PLWH had greater proportions of smoking (P < .001) and comorbid illness than uninfected comparators. There was no difference in COVID-19 severity on admission by HIV status (P = .15). Poor outcomes for hospitalized PLWH were frequent but similar to proportions in comparators; 18% required mechanical ventilation and 21% died during follow-up (compared with 23% and 20%, respectively). There was similar cumulative incidence of death over time by HIV status (P = .94).
Conclusions:
We found no differences in adverse outcomes associated with HIV infection for hospitalized COVID-19 patients compared with a demographically similar patient group.
IMDfence
(2020)
Over the past decade, focus on the security and privacy aspects of implantable medical devices (IMDs) has intensified, driven by the multitude of cybersecurity vulnerabilities found in various existing devices. However, due to their strict computational, energy and physical constraints, conventional security protocols are not directly applicable to IMDs. Custom-tailored schemes have been proposed instead which, however, fail to cover the full spectrum of security features that modern IMDs and their ecosystems so critically require. In this paper we propose IMDfence, a security protocol for IMD ecosystems that provides a comprehensive yet practical security portfolio, which includes availability, non-repudiation, access control, entity authentication, remote monitoring and system scalability. The protocol also allows emergency access that results in the graceful degradation of offered services without compromising security and patient safety. The performance of the security protocol as well as its feasibility and impact on modern IMDs are extensively analyzed and evaluated. We find that IMDfence achieves the above security requirements at a mere less than 7% increase in total IMD energy consumption, and less than 14 ms and 9 kB increase in system delay and memory footprint, respectively.
In today's world, many applications produce large amounts of data at an enormous rate. Analyzing such datasets for metadata is indispensable for effectively understanding, storing, querying, manipulating, and mining them. Metadata summarizes technical properties of a dataset which rang from basic statistics to complex structures describing data dependencies. One type of dependencies is inclusion dependency (IND), which expresses subset-relationships between attributes of datasets. Therefore, inclusion dependencies are important for many data management applications in terms of data integration, query optimization, schema redesign, or integrity checking. So, the discovery of inclusion dependencies in unknown or legacy datasets is at the core of any data profiling effort.
For exhaustively detecting all INDs in large datasets, we developed S-indd++, a new algorithm that eliminates the shortcomings of existing IND-detection algorithms and significantly outperforms them. S-indd++ is based on a novel concept for the attribute clustering for efficiently deriving INDs. Inferring INDs from our attribute clustering eliminates all redundant operations caused by other algorithms. S-indd++ is also based on a novel partitioning strategy that enables discording a large number of candidates in early phases of the discovering process. Moreover, S-indd++ does not require to fit a partition into the main memory--this is a highly appreciable property in the face of ever-growing datasets. S-indd++ reduces up to 50% of the runtime of the state-of-the-art approach.
None of the approach for discovering INDs is appropriate for the application on dynamic datasets; they can not update the INDs after an update of the dataset without reprocessing it entirely. To this end, we developed the first approach for incrementally updating INDs in frequently changing datasets. We achieved that by reducing the problem of incrementally updating INDs to the incrementally updating the attribute clustering from which all INDs are efficiently derivable. We realized the update of the clusters by designing new operations to be applied to the clusters after every data update. The incremental update of INDs reduces the time of the complete rediscovery by up to 99.999%.
All existing algorithms for discovering n-ary INDs are based on the principle of candidate generation--they generate candidates and test their validity in the given data instance. The major disadvantage of this technique is the exponentially growing number of database accesses in terms of SQL queries required for validation. We devised Mind2, the first approach for discovering n-ary INDs without candidate generation. Mind2 is based on a new mathematical framework developed in this thesis for computing the maximum INDs from which all other n-ary INDs are derivable. The experiments showed that Mind2 is significantly more scalable and effective than hypergraph-based algorithms.
In many revenue management applications risk-averse decision-making is crucial. In dynamic settings, however, it is challenging to find the right balance between maximizing expected rewards and minimizing various kinds of risk. In existing approaches utility functions, chance constraints, or (conditional) value at risk considerations are used to influence the distribution of rewards in a preferred way. Nevertheless, common techniques are not flexible enough and typically numerically complex. In our model, we exploit the fact that a distribution is characterized by its mean and higher moments. We present a multi-valued dynamic programming heuristic to compute risk-sensitive feedback policies that are able to directly control the moments of future rewards. Our approach is based on recursive formulations of higher moments and does not require an extension of the state space. Finally, we propose a self-tuning algorithm, which allows to identify feedback policies that approximate predetermined (risk-sensitive) target distributions. We illustrate the effectiveness and the flexibility of our approach for different dynamic pricing scenarios. (C) 2020 Elsevier Ltd. All rights reserved.
In many businesses, firms are selling different types of products, which share mutual substitution effects in demand. To compute effective pricing strategies is challenging as the sales probabilities of each of a firm's products can also be affected by the prices of potential substitutes. In this paper, we analyze stochastic dynamic multi-product pricing models for the sale of perishable goods. To circumvent the limitations of time-consuming optimal solutions for highly complex models, we propose different relaxation techniques, which allow to reduce the size of critical model components, such as the state space, the action space, or the set of potential sales events. Our heuristics are able to decrease the size of those components by forming corresponding clusters and using subsets of representative elements. Using numerical examples, we verify that our heuristics make it possible to dramatically reduce the computation time while still obtaining close-to-optimal expected profits. Further, we show that our heuristics are (i) flexible, (ii) scalable, and (iii) can be arbitrarily combined in a mutually supportive way.
Matching dependencies (MDs) are data profiling results that are often used for data integration, data cleaning, and entity matching. They are a generalization of functional dependencies (FDs) matching similar rather than same elements. As their discovery is very difficult, existing profiling algorithms find either only small subsets of all MDs or their scope is limited to only small datasets.
We focus on the efficient discovery of all interesting MDs in real-world datasets. For this purpose, we propose HyMD, a novel MD discovery algorithm that finds all minimal, non-trivial MDs within given similarity boundaries. The algorithm extracts the exact similarity thresholds for the individual MDs from the data instead of using predefined similarity thresholds. For this reason, it is the first approach to solve the MD discovery problem in an exact and truly complete way. If needed, the algorithm can, however, enforce certain properties on the reported MDs, such as disjointness and minimum support, to focus the discovery on such results that are actually required by downstream use cases. HyMD is technically a hybrid approach that combines the two most popular dependency discovery strategies in related work: lattice traversal and inference from record pairs. Despite the additional effort of finding exact similarity thresholds for all MD candidates, the algorithm is still able to efficiently process large datasets, e.g., datasets larger than 3 GB.
When this journal was founded in 1992 by Tudor Rickards and Susan Moger, there was no academic outlet available that addressed issues at the intersection of creativity and innovation. From zero to 1,163 records, from the new kid on the block to one of the leading journals in creativity and innovation management has been quite a journey, and we would like to reflect on the past 28 years and the intellectual and conceptual structure of Creativity and Innovation Management (CIM). Specifically, we highlight milestones and influential articles, identify how key journal characteristics evolved, outline the (co-)authorship structure, and finally, map the thematic landscape of CIM by means of a text-mining analysis. This study represents the first systematic and comprehensive assessment of the journal's published body of knowledge and helps to understand the journal's influence on the creativity and innovation management community. We conclude by discussing future topics and paths of the journal as well as limitations of our approach.
Generative multi-adversarial network for striking the right balance in abdominal image segmentation
(2020)
Purpose: The identification of abnormalities that are relatively rare within otherwise normal anatomy is a major challenge for deep learning in the semantic segmentation of medical images. The small number of samples of the minority classes in the training data makes the learning of optimal classification challenging, while the more frequently occurring samples of the majority class hamper the generalization of the classification boundary between infrequently occurring target objects and classes. In this paper, we developed a novel generative multi-adversarial network, called Ensemble-GAN, for mitigating this class imbalance problem in the semantic segmentation of abdominal images. Method: The Ensemble-GAN framework is composed of a single-generator and a multi-discriminator variant for handling the class imbalance problem to provide a better generalization than existing approaches. The ensemble model aggregates the estimates of multiple models by training from different initializations and losses from various subsets of the training data. The single generator network analyzes the input image as a condition to predict a corresponding semantic segmentation image by use of feedback from the ensemble of discriminator networks. To evaluate the framework, we trained our framework on two public datasets, with different imbalance ratios and imaging modalities: the Chaos 2019 and the LiTS 2017. Result: In terms of the F1 score, the accuracies of the semantic segmentation of healthy spleen, liver, and left and right kidneys were 0.93, 0.96, 0.90 and 0.94, respectively. The overall F1 scores for simultaneous segmentation of the lesions and liver were 0.83 and 0.94, respectively. Conclusion: The proposed Ensemble-GAN framework demonstrated outstanding performance in the semantic segmentation of medical images in comparison with other approaches on popular abdominal imaging benchmarks. The Ensemble-GAN has the potential to segment abdominal images more accurately than human experts.
Introduction:
mobile phone technology is increasingly used to overcome traditional barriers to limiting access to diabetes care. This study evaluated mobile phone ownership and willingness to receive and pay for mobile phone-based diabetic services among people with diabetes in South-West, Nigeria.
Methods:
two hundred and fifty nine patients with diabetes were consecutively recruited from three tertiary health institutions in South-West, Nigeria. Questionnaire was used to evaluate mobile phone ownership, willingness to receive and pay for mobile phone-based diabetic health care services via voice call and text messaging.
Results:
97.3% owned a mobile phone, with 38.9% and 61.1% owning smartphone and basic phone respectively. Males were significantly more willing to receive mobile-phone-based health services than females (81.1% vs 68.1%, p=0.025), likewise married compared to unmarried [77.4% vs 57.1%, p=0.0361. Voice calls (41.3%) and text messages (32.4%), were the most preferred modes of receiving diabetes-related health education with social media (3.1%) and email (1.5%) least. Almost three-quarter of participants (72.6%) who owned mobile phone, were willing to receive mobile phone-based diabetes health services. The educational status of patients (adjusted OR [AORJ: 1.7(95% CI: 1.6 to 2.11), glucometers possession (ACM: 2.0 [95% CI: 1.9 to 2.1) and type of mobile phone owned (AOR: 2.9 [95% CI: 2.8 to 5.0]) were significantly associated with the willingness to receive mobile phone-based diabetic services.
Conclusion:
the majority of study participants owned mobile phones and would be willing to receive and pay for diabetes-related healthcare delivery services provided the cost is minimal and affordable.
Recently, substantial research effort has focused on how to apply CNNs or RNNs to better capture temporal patterns in videos, so as to improve the accuracy of video classification. In this paper, we investigate the potential of a purely attention based local feature integration. Accounting for the characteristics of such features in video classification, we first propose Basic Attention Clusters (BAC), which concatenates the output of multiple attention units applied in parallel, and introduce a shifting operation to capture more diverse signals. Experiments show that BAC can achieve excellent results on multiple datasets. However, BAC treats all feature channels as an indivisible whole, which is suboptimal for achieving a finer-grained local feature integration over the channel dimension. Additionally, it treats the entire local feature sequence as an unordered set, thus ignoring the sequential relationships. To improve over BAC, we further propose the channel pyramid attention schema by splitting features into sub-features at multiple scales for coarse-to-fine sub-feature interaction modeling, and propose the temporal pyramid attention schema by dividing the feature sequences into ordered sub-sequences of multiple lengths to account for the sequential order. Our final model pyramidxpyramid attention clusters (PPAC) combines both channel pyramid attention and temporal pyramid attention to focus on the most important sub-features, while also preserving the temporal information of the video. We demonstrate the effectiveness of PPAC on seven real-world video classification datasets. Our model achieves competitive results across all of these, showing that our proposed framework can consistently outperform the existing local feature integration methods across a range of different scenarios.
This special issue contains extended versions of four selected papers from the 11th International Conference on Graph Transformation (ICGT 2018). The articles cover a tool for computing core graphs via SAT/SMT solvers (graph language definition), graph transformation through graph surfing in reaction systems (a new graph transformation formalism), the essence and initiality of conflicts in M-adhesive transformation systems, and a calculus of concurrent graph-rewriting processes (theory on conflicts and parallel independence).
For theoretical analyses there are two specifics distinguishing GP from many other areas of evolutionary computation: the variable size representations, in particular yielding a possible bloat (i.e. the growth of individuals with redundant parts); and also the role and the realization of crossover, which is particularly central in GP due to the tree-based representation. Whereas some theoretical work on GP has studied the effects of bloat, crossover had surprisingly little share in this work. <br /> We analyze a simple crossover operator in combination with randomized local search, where a preference for small solutions minimizes bloat (lexicographic parsimony pressure); we denote the resulting algorithm Concatenation Crossover GP. We consider three variants of the well-studied MAJORITY test function, adding large plateaus in different ways to the fitness landscape and thus giving a test bed for analyzing the interplay of variation operators and bloat control mechanisms in a setting with local optima. We show that the Concatenation Crossover GP can efficiently optimize these test functions, while local search cannot be efficient for all three variants independent of employing bloat control. (C) 2019 Elsevier B.V. All rights reserved.
Affect-aware word clouds
(2020)
Word clouds are widely used for non-analytic purposes, such as introducing a topic to students, or creating a gift with personally meaningful text. Surveys show that users prefer tools that yield word clouds with a stronger emotional impact. Fonts and color palettes are powerful typographical signals that may determine this impact. Typically, these signals are assigned randomly, or expected to be chosen by the users. We present an affect-aware font and color palette selection methodology that aims to facilitate more informed choices. We infer associations of fonts with a set of eight affects, and evaluate the resulting data in a series of user studies both on individual words as well as in word clouds. Relying on a recent study to procure affective color palettes, we carry out a similar user study to understand the impact of color choices on word clouds. Our findings suggest that both fonts and color palettes are powerful tools contributing to the affects evoked by a word cloud. The experiments further confirm that the novel datasets we propose are successful in enabling this. We also find that, for the majority of the affects, both signals need to be congruent to create a stronger impact. Based on this data, we implement a prototype that allows users to specify a desired affect and recommends congruent fonts and color palettes for the word.
The Univariate Marginal Distribution Algorithm (UMDA) - a popular estimation-of-distribution algorithm - is studied from a run time perspective. On the classical OneMax benchmark function on bit strings of length n, a lower bound of Omega(lambda + mu root n + n logn), where mu and lambda are algorithm-specific parameters, on its expected run time is proved. This is the first direct lower bound on the run time of UMDA. It is stronger than the bounds that follow from general black-box complexity theory and is matched by the run time of many evolutionary algorithms. The results are obtained through advanced analyses of the stochastic change of the frequencies of bit values maintained by the algorithm, including carefully designed potential functions. These techniques may prove useful in advancing the field of run time analysis for estimation-of-distribution algorithms in general.
MDedup
(2020)
Duplicate detection is an integral part of data cleaning and serves to identify multiple representations of same real-world entities in (relational) datasets. Existing duplicate detection approaches are effective, but they are also hard to parameterize or require a lot of pre-labeled training data. Both parameterization and pre-labeling are at least domain-specific if not dataset-specific, which is a problem if a new dataset needs to be cleaned.
For this reason, we propose a novel, rule-based and fully automatic duplicate detection approach that is based on matching dependencies (MDs). Our system uses automatically discovered MDs, various dataset features, and known gold standards to train a model that selects MDs as duplicate detection rules. Once trained, the model can select useful MDs for duplicate detection on any new dataset. To increase the generally low recall of MD-based data cleaning approaches, we propose an additional boosting step. Our experiments show that this approach reaches up to 94% F-measure and 100% precision on our evaluation datasets, which are good numbers considering that the system does not require domain or target data-specific configuration.
Data errors represent a major issue in most application workflows. Before any important task can take place, a certain data quality has to be guaranteed by eliminating a number of different errors that may appear in data. Typically, most of these errors are fixed with data preparation methods, such as whitespace removal. However, the particular error of duplicate records, where multiple records refer to the same entity, is usually eliminated independently with specialized techniques. Our work is the first to bring these two areas together by applying data preparation operations under a systematic approach prior to performing duplicate detection. <br /> Our process workflow can be summarized as follows: It begins with the user providing as input a sample of the gold standard, the actual dataset, and optionally some constraints to domain-specific data preparations, such as address normalization. The preparation selection operates in two consecutive phases. First, to vastly reduce the search space of ineffective data preparations, decisions are made based on the improvement or worsening of pair similarities. Second, using the remaining data preparations an iterative leave-one-out classification process removes preparations one by one and determines the redundant preparations based on the achieved area under the precision-recall curve (AUC-PR). Using this workflow, we manage to improve the results of duplicate detection up to 19% in AUC-PR.