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BackgroundPeripheral artery disease (PAD) affects 8 to 10 million Americans, who face significantly elevated risks of both mortality and major limb events such as amputation. Unfortunately, PAD is relatively underdiagnosed, undertreated, and underresearched, leading to wide variations in treatment patterns and outcomes. Efforts to improve PAD care and outcomes have been hampered by persistent difficulties identifying patients with PAD for clinical and investigatory purposes. ObjectiveThe aim of this study is to develop and validate a model-based algorithm to detect patients with peripheral artery disease (PAD) using data from an electronic health record (EHR) system. MethodsAn initial query of the EHR in a large health system identified all patients with PAD-related diagnosis codes for any encounter during the study period. Clinical adjudication of PAD diagnosis was performed by chart review on a random subgroup. A binary logistic regression to predict PAD was built and validated using a least absolute shrinkage and selection operator (LASSO) approach in the adjudicated patients. The algorithm was then applied to the nonsampled records to further evaluate its performance. ResultsThe initial EHR data query using 406 diagnostic codes yielded 15,406 patients. Overall, 2500 patients were randomly selected for ground truth PAD status adjudication. In the end, 108 code flags remained after removing rarely- and never-used codes. We entered these code flags plus administrative encounter, imaging, procedure, and specialist flags into a LASSO model. The area under the curve for this model was 0.862. ConclusionsThe algorithm we constructed has two main advantages over other approaches to the identification of patients with PAD. First, it was derived from a broad population of patients with many different PAD manifestations and treatment pathways across a large health system. Second, our model does not rely on clinical notes and can be applied in situations in which only administrative billing data (eg, large administrative data sets) are available. A combination of diagnosis codes and administrative flags can accurately identify patients with PAD in large cohorts.

Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention is necessary for preventing stent thrombosis and ensuring long-term cardiovascular protection. It is important to be thoughtful in balancing thrombotic and bleeding risk when deciding therapy regimen and duration. Revascularization randomized trials have studied many specific, at-risk populations; however, women remain underrepresented. Although there is evidence to support shortened DAPT duration in women, especially those at higher bleeding risk or on chronic oral anticoagulation, we need trials specifically enrolling and focusing on women. [ABSTRACT FROM AUTHOR]

To improve the reliability and the energy efficiency of datacenters, as well as to reduce infrastructure costs and environmental impacts, we demonstrated and evaluated the use of a 10 kW Proton Exchange Membrane Fuel Cell (PEMFC) stack and system for powering the servers in a data center. In this study, we designed, tested and demonstrated a PEMFC system as a Distributed Generation (DG) prime mover that has high reliability and efficiency for both steady state and dynamic operations. The 10kW PEMFC stack and system was designed to power a server rack and eliminate the power distribution system in the datacenter. The steady state electrical properties such as efficiency and polarization curves were evaluated. The ramp rate and dynamic response of the PEMFC system to server and system dynamics was also characterized and can be used to determine energy storage requirements and develop optimal control strategies to enable the dynamic load following capability.

Sustainable operation of battery powered wireless embedded systems (such as sensor nodes) is a key challenge, and considerable research effort has been devoted to energy optimization of such systems. Environmental energy harvesting, in particular solar based, has emerged as a viable technique to supplement battery supplies. However, designing an efficient solar harvesting system to realize the potential benefits of energy harvesting requires an in-depth understanding of several factors. For example, solar energy supply is highly time varying and may not always be sufficient to power the embedded system. Harvesting components, such as solar panels, and energy storage elements, such as batteries or ultracapacitors, have different voltage-current characteristics, which must be matched to each other as well as the energy requirements of the system to maximize harvesting efficiency. Further, battery nonidealities, such as self-discharge and round trip efficiency, directly affect energy usage and storage decisions. The ability of the system to modulate its power consumption by selectively deactivating its sub-components also impacts the overall power management architecture. This paper describes key issues and tradeoffs which arise in the design of solar energy harvesting, wireless embedded systems and presents the design, implementation, and performance evaluation of Heliomote, our prototype that addresses several of these issues. Experimental results demonstrate that Heliomote, which behaves as a plug-in to the Berkeley/Crossbow motes and autonomously manages energy harvesting and storage, enables near-perpetual, harvesting aware operation of the sensor node.

Distributed embedded sensor networks are now being successfully deployed in environmental monitoring of natural phenomena as well as for applications in commerce and physical security. While substantial progress in sensor network performance has appeared, new challenges have also emerged as these systems have been deployed in the natural environment. First, in order to achieve minimum sensing fidelity performance, the rapid spatiotemporal variation of environmental phenomena requires impractical deployment densities. The presence of obstacles in the environment introduces sensing uncertainty and degrades the performance of sensor fusion systems in particular for the many new applications of image sensing. The physical obstacles encountered by sensing may be circumvented by a new mobile sensing method or Networked Infomechanical Systems (NIMS). NIMS integrates distributed, embedded sensing and computing systems with infrastructure-supported mobility. NIMS now includes coordinated mobility methods that exploits adaptive articulation of sensor perspective and location as well as management of sensor population to provide the greatest certainty in sensor fusion results. The architecture, applications, and implementation of NIMS will be discussed here. In addition, results of environmentally-adaptive sampling, and direct measurement of sensing uncertainty will be described.

Computer networks have historically considered support for mobile devices as an extra overhead to be borne by the system. Recently however, researchers have proposed methods by which the network can take advantage of mobile components. We exploit mobility to develop a fluid infrastructure: mobile components are deliberately built into the system infrastructure for enabling specific functionality that is very hard to achieve using other methods. Built-in intelligence helps our system adapt to run time dynamics when pursuing pre-defined performance objectives. Our approach yields significant advantages for energy constrained systems, sparsely deployed networks, delay tolerant networks, and in security sensitive situations. We first show why our approach is advantageous in terms of network lifetime and data fidelity. Second, we present adaptive algorithms that are used to control mobility. Third, we design the communication protocol supporting a fluid infrastructure and long sleep durations on energy-constrained devices. Our algorithms are not based on abstract radio range models or idealized unobstructed environments but founded on real world behavior of wireless devices. We implement a prototype system in which infrastructure components move autonomously to carry out important networking tasks. The prototype is used to validate and evaluate our suggested mobility control methods.

A key challenge in sensor networks is ensuring the sustainability of the system at the required performance level, in an autonomous manner. Sustainability is a major concern because of severe resource constraints in terms of energy, bandwidth and sensing capabilities in the system. In this paper, we envision the use of a new design dimension to enhance sustainability of in sensor networks—the use of controlled mobility. We argue that this capability can alleviate resource limitations and improve system performance by adapting to deployment demands. While opportunistic use of external mobility has been considered before, the use of controlled mobility is largely unexplored. We also outline the research issues associated with effectively utilizing this new design dimension. Two system prototypes are described to present first steps towards realizing the proposed vision.

Monitoring of environmental phenomena with embedded networked sensing confronts the challenges of both unpredictable variability in the spatial distribution of phenomena, coupled with demands for a high spatial sampling rate in three dimensions. For example, low distortion mapping of critical solar radiation properties in forest environments may require two-dimensional spatial sampling rates of greater than 10 samples/m² over transects exceeding 1000 m². Clearly, adequate sampling coverage of such a transect requires an impractically large number of sensing nodes. This paper describes a new approach where the deployment of a combination of autonomous-articulated and static sensor nodes enables sufficient spatiotemporal sampling density over large transects to meet a general set of environmental mapping demands.To achieve this we have developed an embedded networked sensor architecture that merges sensing and articulation with adaptive algorithms that are responsive to both variability in environmental phenomena discovered by the mobile sensors and to discrete events discovered by static sensors. We begin by describing the class of important driving applications, the statistical foundations for this new approach, and task allocation. We then describe our experimental implementation of adaptive, event aware, exploration algorithms, which exploit our wireless, articulated sensors operating with deterministic motion over large areas. Results of experimental measurements and the relationship among sampling methods, event arrival rate, and sampling performance are presented.

Actuation ability introduces a fundamentally new design dimension in wireless ad-hoc sensor networks, allowing the network to adaptively reconfigure and repair itself in response to unpredictable run-time dynamics. One of the key network resources in these systems is energy and several uncontrollable factors lead to situations where a certain segment of the network becomes energy constrained before the remaining network. The performance gets limited due to the constrained sections. We argue that in this scenario, instead of rendering the complete network useless, the remaining energy resources should be reorganized to form a new functional topology in the network. We present methods for the network to be aware of its own integrity and use actuation to improve performance when needed. This capability of the system is referred to as “self aware actuation”.In this paper, we consider a network where nodes (or a subset of the nodes) have traction ability. The network uses mobility to repair the coverage loss in the area being monitored by it. We present a completely distributed energy aware algorithm (referred to as Co-Fi) for coordinated coverage fidelity maintenance in sensor networks. The energy overheads of mobility are incorporated in the algorithm, thus leaving no hidden costs. Our preliminary analysis shows that Co-Fi can significantly help improve the usable lifetime of these networks.

The performance of a sensor network may be best judged by the quality of application specific information return. The actual sensing performance of a deployed sensor network depends on several factors which cannot be accounted at design time, such as environmental obstacles to sensing. We propose the use of mobility to overcome the effect of unpredictable environmental influence and to adapt to run time dynamics. Now, mobility with its dependencies such as precise localization and navigation is expensive in terms of hardware resources and energy constraints, and may not be feasible in compact, densely deployed and widespread sensor nodes. We present a method based on low complexity and low energy actuation primitives which are feasible for implementation in sensor networks. We prove how these primitives improve the detection capabilities with theoretical analysis, extensive simulations and real world experiments. The significant coverage advantage recurrent in our investigation justifies our own and other parallel ongoing work in the implementation and refinement of self-actuated systems.