SOA-enabled compliance management: instrumenting, assessing, and analyzing service-based business processes

Facilitating compliance management, that is, assisting a company’s management in conforming to laws, regulations, standards, contracts, and policies, is a hot but non-trivial task. The service-oriented architecture (SOA) has evolved traditional, manual business practices into modern, service-based IT practices that ease part of the problem: the systematic definition and execution of business processes. This, in turn, facilitates the online monitoring of system behaviors and the enforcement of allowed behaviors—all ingredients that can be used to assist compliance management on the fly during process execution. In this paper, instead of focusing on monitoring and runtime enforcement of rules or constraints, we strive for an alternative approach to compliance management in SOAs that aims at assessing and improving compliance. We propose two ingredients: (i) a model and tool to design compliant service-based processes and to instrument them in order to generate evidence of how they are executed and (ii) a reporting and analysis suite to create awareness of a company’s compliance state and to enable understanding why and where compliance violations have occurred. Together, these ingredients result in an approach that is close to how the real stakeholders—compliance experts and auditors—actually assess the state of compliance in practice and that is less intrusive than enforcing compliance.     

A novel feature-based approach to characterize algorithm performance for the traveling salesperson problem

Meta-heuristics are frequently used to tackle NP-hard combinatorial optimization problems. With this paper we contribute to the understanding of the success of 2-opt based local search algorithms for solving the traveling salesperson problem (TSP). Although 2-opt is widely used in practice, it is hard to understand its success from a theoretical perspective. We take a statistical approach and examine the features of TSP instances that make the problem either hard or easy to solve. As a measure of problem difficulty for 2-opt we use the approximation ratio that it achieves on a given instance. Our investigations point out important features that make TSP instances hard or easy to be approximated by 2-opt.     

Symbiosis of nurse and machine through fuzzy logic: improved specificity of a neonatal pulse oximeter alarm

This article describes the theoretical underpinnings that preceded the design of a new neonatal pulse oximeter alarm that differentiates true from false alarms based on an artificial intelligence theory called "fuzzy logic." The connection between the intuition and sense of advocacy gained through neonatal primary nursing and the application of fuzzy logic to solve the problem of false alarms--that is, the symbiosis between nurse and machine--are explained. Emphasis is placed throughout on the importance of involving nurses in the development of the technology for which they are responsible.     

Longitudinal analysis of utilization of inpatient treatment based on insurance data of mandatory health insurance

AIM: To investigate which of the routinely collected claims data from the German "Legal sickness funds" on hospital utilisation may be used, in addition to that prescribed by the legislator. DESIGN: We used claims data to study a cohort of sickness fund beneficiaries who were insured during the complete year 1992 (n = 81,309). Six utilisation parameters, using the number of cases and in hospital days overall as well as diseases specific (i.e. readmission rates, in-hospital days per person with [at least] one hospital stay) were calculated. RESULTS: There are 88 persons with (at least) one hospital stay, 116 hospital cases and a total of 1306 in-hospital days per 1000 insured persons in the study cohort. The average hospital days per person (14.8 days) are ca. 30% higher than the average length of stay (11.2 days). Hospital utilisation increases with age. Hospital stays associated with ICD-239 (neoplasms of unknown origin) resulted in a higher than average number of hospital days in total although the mean length of stay is not above the average. This is due to a high readmission rate. Hospital stays associated with elective surgical procedures have a high prevalence rate but a low readmission ratio and short length of stay. CONCLUSION: The parameters related to insured persons, cases and specifically personal parameters of hospital utilisation allow a detailed analysis of hospital care; different utilisation and user patterns can be investigated and possible determinants of utilisation can be identified. After technical transformation, routine data of the sickness funds can be used to obtain information relevant for health care planners as well as for quality management.     

Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance

BACKGROUND: Optimal criteria for valve replacement are unclear in asymptomatic/minimally symptomatic patients with aortic regurgitation (AR) and normal left ventricular (LV) performance at rest. Moreover, previous studies have not assessed the prognostic capacity of load-adjusted LV performance ("contractility") variables, which may be fundamentally related to clinical state. Therefore, 18 years ago, we set out to test prospectively the hypothesis that objective noninvasive measures of LV size and performance and, specifically, of load-adjusted variables, assessed at rest and during exercise (ex), could predict the development of currently accepted indications for operation for AR. METHODS AND RESULTS: Clinical variables and measures of LV size, performance, and end-systolic wall stress (ESS) were assessed annually in 104 patients by radionuclide cineangiography at rest and maximal ex and by echocardiography at rest; ESS was derived during ex. During an average 7.3-year follow-up among patients who had not been operated on, 39 of 104 patients either died suddenly (n = 4) or developed operable symptoms only (n = 22) or subnormal LV performance with or without symptoms (n = 13) (progression rate=6.2%/y). By multivariate Cox model analysis, change (delta) in LV ejection fraction (EF) from rest to ex, normalized for deltaESS from rest to ex (deltaLVEF-deltaESS index), was the strongest predictor of progression to any end point or to sudden cardiac death alone. Unadjusted deltaLVEF was almost as efficient. Symptom status modified prediction on the basis of the deltaLVEF-deltaESS index. The population tercile at highest risk by deltaLVEF-deltaESS progressed to end points at a rate of 13.3%/y, and the lowest-risk tercile progressed at 1.8%/y. CONCLUSIONS: Currently accepted symptom and LV performance indications for valve replacement, as well as sudden cardiac death, can be predicted in asymptomatic/minimally symptomatic patients with AR by load-adjusted deltaLVEF-deltaESS index, which includes data obtained during exercise.     

Comparison of molecular changes in lung cancers in HIV-positive and HIV-indeterminate subjects

CONTEXT: Human immunodeficiency virus (HIV) infection has been associated with an increasing incidence of malignancy, and HIV-infected persons have an increased incidence of primary lung carcinoma compared with the general population. OBJECTIVE: To investigate the molecular changes present in HIV-associated lung tumors and compare them with those present in lung carcinomas arising in HIV-indeterminate subjects ("sporadic tumors"). DESIGN: Convenience sample. SUBJECTS: Archival tissues from 11 HIV-positive persons and from 35 persons of indeterminate HIV status. SETTING: University-based medical centers and affiliated hospitals. MAIN OUTCOME MEASURES: Analysis of frequency of loss of heterozygosity (LOH) and microsatellite alteration (MA) using polymerase chain reaction and 16 polymorphic microsatellite markers at 8 chromosomal regions frequently deleted in lung cancer. Presence of HIV and human papillomavirus (HPV) sequences. RESULTS: The overall frequency of LOH at all chromosomal regions tested and the frequencies at most of the individual regions were similar in the 2 groups. Frequency of MA present in the HIV-associated tumors (0.18) was 6-fold higher than in sporadic tumors (0.03) (P<.001). At least 1 MA was present in 10 (91%) of 11 HIV-associated tumors vs 17 (48%) of 35 sporadic tumors (P=.02). Molecular changes were independent of tumor stage and gender. HIV and HPV sequences were not detected in the HIV-associated lung carcinomas. CONCLUSIONS: Microsatellite alterations, which reflect widespread genomic instability, occur at greatly increased frequency in HIV-associated lung carcinomas. Although the mechanism underlying the development of increased MAs is unknown, it may play a crucial role in the development of many HIV-associated tumors.     

Modelling the three-dimensional elastic constants of parallel-fibred and lamellar bone

The complex hierarchical structure of lamellar bone makes understanding structure–mechanical function relations, very difficult. We approach the problem by first using the relatively simple structure of parallel-fibred bone to construct a mathematical model for calculating Young's moduli in three-dimensions. Parallel-fibred bone is composed essentially of arrays of mineralized collagen fibrils, which are also the basic structural motif of the individual lamellae of lamellar bone. Parallel-fibred bone structure has orthotropic symmetry. As the sizes and shapes of crystals in bone are not well known, the model is also used to compare the cases of platelet-, ribbon- and sheet-reinforced composites. The far more complicated rotated plywood structure of lamellar bone results in the loss of the orthotropic symmetry of individual lamellae. The mathematical model used circumvents this problem by sub-dividing the lamellar unit into a thin lamella, thick lamella, transition zone between them, and the recently observed back-flip lamella. Each of these is regarded as having orthotropic symmetry. After the calculation of their Young's moduli they are rotated in space in accordance with the rotated plywood model, and then the segments are combined to present the overall modulus values in three-dimensions. The calculated trends compare well with the trends in microhardness values measured for circumferential lamellar bone. Microhardness values are, as yet, the only measurements available for direct comparison. Although the model is not directly applicable to osteonal bone, which is composed of many hollow cylinders of lamellar bone, the range of calculated modulus values and the trends observed for off-axis calculations, compare well with measured values. © 1998 Chapman & Hall     

Photorefractive processing for large adaptive phased arrays

An adaptive null-steering phased-array optical processor that utilizes a photorefractive crystal to time integrate the adaptive weights and null out correlated jammers is described. This is a beam-steering processor in which the temporal waveform of the desired signal is known but the look direction is not. The processor computes the angle(s) of arrival of the desired signal and steers the array to look in that direction while rotating the nulls of the antenna pattern toward any narrow-band jammers that may be present. We have experimentally demonstrated a simplified version of this adaptive phased-array-radar processor that nulls out the narrow-band jammers by using feedback-correlation detection. In this processor it is assumed that we know a priori only that the signal is broadband and the jammers are narrow band. These are examples of a class of optical processors that use the angular selectivity of volume holograms to form the nulls and look directions in an adaptive phased-array-radar pattern and thereby to harness the computational abilities of three-dimensional parallelism in the volume of photorefractive crystals. The development of this processing in volume holographic system has led to a new algorithm for phased-array-radar processing that uses fewer tapped-delay lines than does the classic time-domain beam former. The optical implementation of the new algorithm has the further advantage of utilization of a single photorefractive crystal to implement as many as a million adaptive weights, allowing the radar system to scale to large size with no increase in processing hardware.