Routing and Rebalancing Intermodal Autonomous Mobility-on-Demand Systems in Mixed Traffic.

This paper studies congestion-aware route-planning policies for intermodal Autonomous Mobility-on-Demand (AMoD) systems, whereby a fleet of autonomous vehicles provides on-demand mobility jointly with public transit under mixed traffic conditions (consisting of AMoD and private vehicles). First, we devise a network flow model to jointly optimize the AMoD routing and rebalancing strategies in a congestion-aware fashion by accounting for the endogenous impact of AMoD flows on travel time. Second, we capture the effect of exogenous traffic stemming from private vehicles adapting to the AMoD flows in a user-centric fashion by leveraging a sequential approach. Since our results are in terms of link flows, we then provide algorithms to retrieve the explicit recommended routes to users. Finally, we showcase our framework with two case-studies considering the transportation sub-networks in Eastern Massachusetts and New York City, respectively. Our results suggest that for high levels of demand, pure AMoD travel can be detrimental due to the additional traffic stemming from its rebalancing flows. However, blending AMoD with public transit, walking and micromobility options can significantly improve the overall system performance by leveraging the high-throughput of public transit combined with the flexibility of walking and micromobility.

Physiological and socioeconomic characteristics predict COVID-19 mortality and resource utilization in Brazil.

BACKGROUND: Given the severity and scope of the current COVID-19 pandemic, it is critical to determine predictive features of COVID-19 mortality and medical resource usage to effectively inform health, risk-based physical distancing, and work accommodation policies. Non-clinical sociodemographic features are important explanatory variables of COVID-19 outcomes, revealing existing disparities in large health care systems. METHODS AND FINDINGS: We use nation-wide multicenter data of COVID-19 patients in Brazil to predict mortality and ventilator usage. The dataset contains hospitalized patients who tested positive for COVID-19 and had either recovered or were deceased between March 1 and June 30, 2020. A total of 113,214 patients with 50,387 deceased, were included. Both interpretable (sparse versions of Logistic Regression and Support Vector Machines) and state-of-the-art non-interpretable (Gradient Boosted Decision Trees and Random Forest) classification methods are employed. Death from COVID-19 was strongly associated with demographics, socioeconomic factors, and comorbidities. Variables highly predictive of mortality included geographic location of the hospital (OR = 2.2 for Northeast region, OR = 2.1 for North region); renal (OR = 2.0) and liver (OR = 1.7) chronic disease; immunosuppression (OR = 1.7); obesity (OR = 1.7); neurological (OR = 1.6), cardiovascular (OR = 1.5), and hematologic (OR = 1.2) disease; diabetes (OR = 1.4); chronic pneumopathy (OR = 1.4); immunosuppression (OR = 1.3); respiratory symptoms, ranging from respiratory discomfort (OR = 1.4) and dyspnea (OR = 1.3) to oxygen saturation less than 95% (OR = 1.7); hospitalization in a public hospital (OR = 1.2); and self-reported patient illiteracy (OR = 1.1). Validation accuracies (AUC) for predicting mortality and ventilation need reach 79% and 70%, respectively, when using only pre-admission variables. Models that use post-admission disease progression information reach accuracies (AUC) of 86% and 87% for predicting mortality and ventilation use, respectively. CONCLUSIONS: The results highlight the predictive power of socioeconomic information in assessing COVID-19 mortality and medical resource allocation, and shed light on existing disparities in the Brazilian health care system during the COVID-19 pandemic.

Personalized predictive models for symptomatic COVID-19 patients using basic preconditions: Hospitalizations, mortality, and the need for an ICU or ventilator.

BACKGROUND: The rapid global spread of the SARS-CoV-2 virus has provoked a spike in demand for hospital care. Hospital systems across the world have been over-extended, including in Northern Italy, Ecuador, and New York City, and many other systems face similar challenges. As a result, decisions on how to best allocate very limited medical resources and design targeted policies for vulnerable subgroups have come to the forefront. Specifically, under consideration are decisions on who to test, who to admit into hospitals, who to treat in an Intensive Care Unit (ICU), and who to support with a ventilator. Given today's ability to gather, share, analyze and process data, personalized predictive models based on demographics and information regarding prior conditions can be used to (1) help decision-makers allocate limited resources, when needed, (2) advise individuals how to better protect themselves given their risk profile, (3) differentiate social distancing guidelines based on risk, and (4) prioritize vaccinations once a vaccine becomes available. OBJECTIVE: To develop personalized models that predict the following events: (1) hospitalization, (2) mortality, (3) need for ICU, and (4) need for a ventilator. To predict hospitalization, it is assumed that one has access to a patient's basic preconditions, which can be easily gathered without the need to be at a hospital and hence serve citizens and policy makers to assess individual risk during a pandemic. For the remaining models, different versions developed include different sets of a patient's features, with some including information on how the disease is progressing (e.g., diagnosis of pneumonia). MATERIALS AND METHODS: National data from a publicly available repository, updated daily, containing information from approximately 91,000 patients in Mexico were used. The data for each patient include demographics, prior medical conditions, SARS-CoV-2 test results, hospitalization, mortality and whether a patient has developed pneumonia or not. Several classification methods were applied and compared, including robust versions of logistic regression, and support vector machines, as well as random forests and gradient boosted decision trees. RESULTS: Interpretable methods (logistic regression and support vector machines) perform just as well as more complex models in terms of accuracy and detection rates, with the additional benefit of elucidating variables on which the predictions are based. Classification accuracies reached 72 %, 79 %, 89 %, and 90 % for predicting hospitalization, mortality, need for ICU and need for a ventilator, respectively. The analysis reveals the most important preconditions for making the predictions. For the four models derived, these are: (1) for hospitalization:age, pregnancy, diabetes, gender, chronic renal insufficiency, and immunosuppression; (2) for mortality: age, immunosuppression, chronic renal insufficiency, obesity and diabetes; (3) for ICU need: development of pneumonia (if available), age, obesity, diabetes and hypertension; and (4) for ventilator need: ICU and pneumonia (if available), age, obesity, and hypertension.

Personalized Predictive Models for Symptomatic COVID-19 Patients Using Basic Preconditions: Hospitalizations, Mortality, and the Need for an ICU or Ventilator.

BACKGROUND: The rapid global spread of the virus SARS-CoV-2 has provoked a spike in demand for hospital care. Hospital systems across the world have been over-extended, including in Northern Italy, Ecuador, and New York City, and many other systems face similar challenges. As a result, decisions on how to best allocate very limited medical resources have come to the forefront. Specifically, under consideration are decisions on who to test, who to admit into hospitals, who to treat in an Intensive Care Unit (ICU), and who to support with a ventilator. Given today's ability to gather, share, analyze and process data, personalized predictive models based on demographics and information regarding prior conditions can be used to (1) help decision-makers allocate limited resources, when needed, (2) advise individuals how to better protect themselves given their risk profile, (3) differentiate social distancing guidelines based on risk, and (4) prioritize vaccinations once a vaccine becomes available. OBJECTIVE: To develop personalized models that predict the following events: (1) hospitalization, (2) mortality, (3) need for ICU, and (4) need for a ventilator. To predict hospitalization, it is assumed that one has access to a patient's basic preconditions, which can be easily gathered without the need to be at a hospital. For the remaining models, different versions developed include different sets of a patient's features, with some including information on how the disease is progressing (e.g., diagnosis of pneumonia). MATERIALS AND METHODS: Data from a publicly available repository, updated daily, containing information from approximately 91,000 patients in Mexico were used. The data for each patient include demographics, prior medical conditions, SARS-CoV-2 test results, hospitalization, mortality and whether a patient has developed pneumonia or not. Several classification methods were applied, including robust versions of logistic regression, and support vector machines, as well as random forests and gradient boosted decision trees. RESULTS: Interpretable methods (logistic regression and support vector machines) perform just as well as more complex models in terms of accuracy and detection rates, with the additional benefit of elucidating variables on which the predictions are based. Classification accuracies reached 61%, 76%, 83%, and 84% for predicting hospitalization, mortality, need for ICU and need for a ventilator, respectively. The analysis reveals the most important preconditions for making the predictions. For the four models derived, these are: (1) for hospitalization: age, gender, chronic renal insufficiency, diabetes, immunosuppression; (2) for mortality: age, SARS-CoV-2 test status, immunosuppression and pregnancy; (3) for ICU need: development of pneumonia (if available), cardiovascular disease, asthma, and SARS-CoV-2 test status; and (4) for ventilator need: ICU and pneumonia (if available), age, gender, cardiovascular disease, obesity, pregnancy, and SARS-CoV-2 test result.

A pan-cancer analysis of progression mechanisms and drug sensitivity in cancer cell lines.

Biomarker discovery involves identifying genetic abnormalities within a tumor. However, one of the main challenges in defining such therapeutic targets is accounting for the molecular heterogeneity of cancer. By integrating somatic mutation and gene expression data from hundreds of heterogeneous cell lines from the Cancer Cell Line Encyclopedia (CCLE), we identify sequences of genetic events that may help explain common patterns of oncogenesis across 22 tumor types, and evaluate the general effect of late-stage mutations on drug sensitivity and resistance mechanisms. Through gene enrichment analysis, we find several cancer-specific and immune pathways that are significantly enriched in each of our three proposed phases of cancer progression. By further analyzing the drug activity area associated with compounds that target the BRAF oncogene, a known predictor of drug sensitivity for several compounds used in cancer treatment, we verify that the acquisition of new driver mutations interferes with the targeted drug mechanism, meaning that cells without late-stage mutations generally respond better to drugs.

A Mobile App to Increase Informed Decisions About Colorectal Cancer Screening Among African American and Caucasian Women: A Pilot Study.

At this time, there are no interactive mobile apps designed to increase informed decisions about colorectal cancer screening among women. Colorectal cancer is the third leading cause of cancer death among women. The study's purpose was to explore the usability, acceptability, and satisfaction with a mobile app designed to increase colorectal cancer screening informed decisions among 50- to 64-year-old women. Using previous research, an interactive mobile app to increase informed decisions about colorectal cancer screening was developed and pilot tested among African American and Caucasian women (N = 41). In total, 80.6% of women strongly agree/agreed that the mobile app made them think about colorectal cancer screening, 83.8% strongly agree/agreed that the mobile app provided enough information to make a decision about colorectal cancer screening, and 86.1% strongly agree/agreed that the mobile app could help them talk to their provider about colorectal cancer screening. Participants (63.2%) identified family/spouse as who they would talk to about their colorectal cancer screening decision. Participants found the mobile app easy to use and useful in making colorectal cancer screening decisions. Social support is important when making decisions about colorectal cancer screening. Healthcare professionals need new strategies, such as mobile apps, that engage patients, have the potential to increase patient-provider communication, and increase colorectal cancer screening adherence.

Integrating mutation and gene expression cross-sectional data to infer cancer progression.

BACKGROUND: A major problem in identifying the best therapeutic targets for cancer is the molecular heterogeneity of the disease. Cancer is often caused by an accumulation of mutations which produce irreversible damage to the cell's control mechanisms of survival and proliferation. Different mutations may affect these cellular anachronisms through a combination of molecular interactions which may be dynamically changing during cancer progression. It has been previously shown that cancer accumulates mutations over time. In this paper we address the problem of cancer heterogeneity by modeling cancer progression using somatic mutation and gene expression cross-sectional data. RESULTS: We propose a novel formulation of integrating somatic mutation and gene expression data to infer the temporal sequence of events from cross-sectional data. Using a mixed integer linear program we model the interaction between groups of different mutated genes and the resulting modifications at the gene expression level. Our approach identifies a partition of mutation events which gradually produce gene expression changes to a partition of genes over time. The proposed formulation is tested using both simulated data and real breast cancer data with matched somatic mutations and gene expression measurements from The Cancer Genome Atlas. First, we classify the genes as oncogenes or tumor suppressors based on the frequency of driver mutations. As expected, the most frequently mutated genes in breast cancer are PIK3CA and TP53 genes. Then, we select those genes with most frequent driver mutations and a set of genes known to play roles in cancer development. Furthermore, we apply the proposed mixed integer linear program to identify the temporal order in which genes mutate and, simultaneously, the changes they produce at the gene expression level during cancer progression. In addition, we are able to identify known causal relationships between mutations and gene expression changes in PI3K/AKT and TP53 pathways. CONCLUSIONS: This paper proposes a new model to infer the temporal sequence in which mutations occur and lead to changes at the gene expression level during cancer progression. The approach is general and can be applied to any data sets with available somatic mutations and gene expression measurements.