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Drive-by sensing for on-street parking spot detection
No full textOn-street parking remains a persistent challenge, leading to driver frustration and wasted time. More critically, drivers circling streets in search of parking contribute to traffic congestion, increased carbon emissions, and unnecessary fuel consumption. The crux of the on-street parking dilemma lies in the insufficient awareness of available parking spaces. To tackle this issue, various solutions, including static and mobile sensing methods, have been explored and implemented. Yet, these strategies have encountered obstacles that hinder widespread adoption. Static sensors, for instance, are typically limited to monitoring a single parking space each, leading to high costs for comprehensive coverage. Mobile sensing strategies, on the other hand, aim to maximize sensor utility by collecting data on multiple spaces. However, these methods have traditionally required specialized hardware installations on vehicles, posing barriers to large-scale application.
In this thesis, we introduce an innovative passive mobile sensing solution that mitigates the need for dedicated hardware installation. Our key observation is that moving vehicles inherently emit signals, predominantly in the form of tire noise and aerodynamic noise. When parked cars are present along the roadside, these sounds reflect back to the moving vehicle. By leveraging a smartphone to capture these naturally generated signals, we can effectively differentiate between empty spaces and parked cars. To realize this idea, we have developed an end-to-end system that achieves equal performance with the state-of-art mobile sensing technologies in detecting available on-street parking spots. Our system comprises a pre-processing module that employs signal processing techniques for automatic data segmentation, a Deep Neural Network (DNN) model for parking spot availability prediction, and a post-processing component that refines the parking information. To support our model, we created our own dataset from data collected over 2 weeks, including 2,512 samples in total. Our approach not only demonstrates the feasibility of hardware-free, software-based solutions for on-street parking spot detection but also holds the potential for scalable implementation across urban environments
A Program to Reduce Post-Transplant Alcohol Use
No full textDue to the scarcity of available organs for patients on the liver transplant waiting list, not everyone who needs a liver transplant will receive one. Thus, it is vital that transplant centers provide patients with resources and support to take proper care of their new organ, including abstaining from drinking alcohol. Alcohol-related Liver Disease is now the most common indication for liver transplant. Patients who excessively consume alcohol after transplant are at higher risk of negative outcomes, like graft failure/loss or death. A number of pre-transplant factors predict post-transplant alcohol use, including age, level of social support, length of sobriety, smoking, and
comorbid psychiatric disorders. These factors can be used in risk stratification models to predict the likelihood that a patient will struggle with recurrence of alcohol use after transplant. This study seeks to understand whether providers at the Starzl Transplantation Institute (STI) believe that
post-transplant alcohol use is an issue and whether UPMC has the resources to assess and treat patients who experience a recurrence of alcohol use after transplant. Members of the liver transplant selection committee were invited to complete a survey to assess these factors. Results
demonstrate that providers do believe post-transplant alcohol use is an issue among patients at UPMC and that the STI can do more to assess and treat patients who resume drinking after transplant. Additionally, the study seeks to identify the extent of this issue at UPMC through a chart review of 75 patients who received a liver transplant at UPMC during a 4-year period. Results of the chart review demonstrate that 28% of patients examined had at least one instance of documented alcohol use after receiving their transplant. Finally, numerous recommendations are provided to improve documentation and tracking of post-transplant alcohol use and provide more comprehensive treatment to patients who experience a recurrence of alcohol use after transplant. These recommendations include consistent Phosphatidylethanol testing, improved provider documentation, changes to protocols at the STI, increasing and improving in-house resources, and educating providers
A Computational Framework for Detecting Rhythmic Spiking Through the Power Spectra of Point Process Model Residuals
No full textNeurons communicate through rapid, all-or-nothing action potential events (“spikes”). Researchers often predict that oscillatory drives will shape spike trains. For example, computational models of Parkinson’s Disease (PD) predict pathological 12-30 Hz spike rhythms. The detection of spike train oscillations presents an algorithmic challenge. We must devise an automated, scalable means of inferring when a noisy point process arose from a rate function that oscillates at a specific frequency, versus one that oscillates at a different frequency, or does not reliably oscillate.
To identify oscillations, a naïve algorithm might compute the spike train’s power spectral density (PSD) – the distribution of signal power over frequencies – and detect oscillations as significant PSD peaks, contrasted against an assumed flat baseline. Yet non-oscillatory spike trains can exhibit aperiodic features that render this flat baseline inappropriate.
This dissertation investigates whether two common baseline-distorting features can be removed through point process models (PPM), which predict instantaneous spike rates as a function of covariates. I first focus on the “recovery period” (RP): an inevitable, transient post-spike suppression in subsequent spiking. The RP creates global spectral distortion. An established “shuffling” method removes this distortion, but can also reduce the power associated with true spike rhythms. I developed an alternative “residuals” method that accounts for the RP-associated variance in the spike train with a PPM, and generates a corrected PSD from the PPM residuals.
In some spike trains, a second, “burst-firing” feature can create further distortion. To accommodate bursts, I developed a “two-state” residuals method. This method infers the timing of burst- and non-burst states, and separately accounts for these states in the PPM.
I compared the above methods’ ability to enable accurate oscillation detection with flat baseline-assuming tests. Over synthetic data, the residuals method improved upon the shuffling method’s detection accuracy, and the two-state variant offered further improvement when bursts were simulated. Moreover, in empirical data from a parkinsonian monkey, the residuals PSDs yielded increased incidence of the anticipated pathological oscillations.
This work demonstrates that we can use PPMs to remove the distortion that aperiodic features introduce into power spectra, thereby improving the sensitivity and specificity of oscillation detection
Identifying Ways Graduate Medical Education Can Increase Retention Among the New Generation of Physicians
No full textPhysician shortage is a critical issue that is impacting the health care delivery systems in the United States. It is important that we use multi-faceted strategies to address this challenge because it impacts the health care delivery system through access to care in some communities and patient overall outcomes. Graduation Medical Education (GME) plays a crucial role in healthcare delivery because it is the initial experience of any graduated medical student. So GME programs need to make sure that they start employing strategies and really take care of the residents entering the practice at the beginning as that can greatly influence a reduction in turnover. And some ways for GME programs to work towards addressing this critical issue and increasing retention among the next generation of physicians are to provide resources for mental health and well-being, have a mentoring program and provide flexibility with schedules. Health care organizations need to increase resources to recruit the next generation of physicians, and more importantly, some changes in the health care delivery system will be needed to retain them
What is a Political Worker? Leadership & Leaderlessness in Lebanon’s Independence Intifada
No full textThere have been scholarly advances in terms of situating “leadership” in the larger map of other structural and dynamic conditions of mobilization; nevertheless, these contributions have not sealed the debate regarding the emergence and manifestation of leadership and initiative in relatively “leaderless environments”, especially those which have clear shortcomings on the level of institutional politics. After dissecting the conceptual and empirical debate within the leadership literature in social movement studies, I utilize a Gramscian framework to present the concept of “political workers” as a theoretical and methodological instrument to observe the ways in which the "political biographies" and day-to-day labor of particular actors can shape an alternative "common sense". I make use of empirical illustrations, particularly from in-depth semi-structured interviews, to sketch the case of non-sectarian actors who participated in Lebanon's 2005 Independence Intifada, further elaborating four elements of political work: conceptions of sovereignty, alliances, organizational factors, and moral leadership
Deciphering the impact of health disparities and medication use on risk of developing adverse events amongst post-traumatic stress disorder patients using electronic medical records
No full textThe dynamic field of precision medicine relies heavily on integrating artificial intelligence (AI) methods to overcome persistent challenges in biomarker identification, understanding health disparities, and exploring novel drug repurposing. This dissertation employs a novel approach, leveraging electronic medical records (EMRs) with advanced deep learning (DL), natural language processing (NLP), and statistical methodologies for more efficient risk prediction.
Beginning with a focus on predicting suicide-related events (SREs) in post traumatic stress disorder (PTSD) patients using DL models, the research identifies biomarkers, explores drug repurposing, and fosters multi-systemic hypotheses. It unravels the intricate interactions within multi-modal data, shedding light on dynamic factors in PTSD and co-occurring disorders. To address health disparities, a novel NLP approach is introduced, utilizing context-specific dictionaries and a sentence transformer model to identify social determinants of health (SDoH) and transdiagnostic factors. Simultaneously, the DL model is enhanced to predict worse outcomes in PTSD patients, incorporating contribution-based analyses for improved risk prediction accuracy.
A clinical trial emulation study assesses the impact of antidepressants on SRE risk, successfully identifying a beneficial antidepressant associated with decreased risk of SREs. The dissertation introduces DeepBiomarker, a novel deep learning model and its iterations as tools for biomarker identification, accelerating the process by integrating NLP-extracted multi-modal data.
In conclusion, this research effectively combines computational modeling and AI to address key challenges in PTSD research, expanding the horizon for discovering novel risk factors. These methodologies set a new benchmark in pharmaceutical research, emphasizing the potential of precision medicine in the realm of drug discovery and development
A patient's a person, no matter how small: maternal-fetal medicine's call for a postliberal 'cardinal virtues bioethics'
No full textThe remarkable promise of maternal-fetal medicine, offering prenatal diagnosis, fetal surgery, and in utero therapeutic strategies, is hindered by the inability of modern bioethical approaches to recognize the personhood and patienthood of the unborn child. This leads to not only semantic contradictions but also philosophical conflict with the foundational human good of life. This thesis provides grounds for a rejection of Beauchamp and Childress’ principlism and the autonomy-dominated bioethical framework which, if not expressly authorized by Principles of Biomedical Ethics, has naturally descended from it. At the root of this model’s shortcomings is not that the wrong principles were specified, that too many principles were specified, or that too few principles were specified. Instead, the prevailing liberal headwinds of political philosophy are the true culprits, beating back the ship of bioethics sailing along the promising tide of effective fetal screenings, surgeries, and therapies that elevate the status of the in utero child. Live-and-let-live liberal bioethics is, regrettably, not letting the weakest and most vulnerable humans live.
Pro-life advocates who wish to defend the sanctity and dignity of all human life, from conception to natural death, need a new bioethics. Clinicians who seek the good of a mother and her unborn child while pioneering prenatal and neonatal therapeutic approaches, which revolutionize the prospects of infants with congenital defects, need a new bioethics. Patients across the lifespan and the physiological states need confidence that they are being treated in pursuit of life and health; they, too, need a new bioethics.
Cardinal virtues bioethics is that new bioethics. Developed from the natural law theory of Aquinas, Finnis, Eberl, and others, it provides a new set of mid-level principles—justice, prudence, fortitude, and temperance. In accord with recent bioethical texts—from Gomez-Lobo, Keown, Curlin, and Tollefsen—it articulates the goods which ought to be particularly pursued in the practice of healthcare and its relational associations. In parallel with Deneen’s postliberal political theory, it goes beyond criticisms of liberalism to image a new polis and a new virtue ethics model normatively centered on the common good
Affective entanglements: shifting attitudes toward the ancient Greek body
No full textThis work is rooted in my understanding that the ancient Greek world’s conceptions of Nature and natures-in-the-world are fundamentally affective and entangled. In the chapter entitled “Somatophobia: Anxieties of Subjection,” I study the Homeric uses of the word sōma, arguing that, as opposed to the dominant belief that it purely means “corpse,” it displays a fear of becoming objected to culturally inadmissible forms of subjection. Moving away from the reading of sōma as simply a matter of death, I make the claim that sōma’s inertness is a pivotal notion in the (re)casting of it as irrecuperable for social life. I contend that sōma may be understood as a material form that has been stripped of its instrumentality (i.e., its ability to be an active agent) and, thereafter, exposed to improper and culturally inadmissible forms of subjection and consumption.
Concluding that this sōma is an epistemic and conceptual object, in chapter two, “Holistic Networks of Care, Perception, and Community,” I argue that this medicalized sōma is the form that comes to be articulated as the subject of anthropologically driven care that emerges out of the peri phúseōs historía (“inquiry into nature”) tradition and the emergence of medicine as a tékhnē (“technical craft”) with significant resonances philosophical and enviro-medical discourses. I understand this body, one deeply porous and liable to “affection” (páthē), to be a response particularly to the latter, and I postulate that the innovatively ethnographic tinge of the Hippocratic Corpus’ "On Airs, Waters, Places" (c. fifth-century B.C.E.) reveals the exegetical nature of medicine as implicit in the explication and perpetuation of communities that share nomoí (“customs”), a particular look, a glôssa (“language”), and geographic space. Nonetheless, this type of deeply shared community building abounds, too, in the creation of firm boundaries.
I attend to this dichotomy in the third chapter, “Sunalgeîn: Community, Kátharsis, and Exclusion,” wherein I study the ability of unique ability of tragedy, in its provocations of éleos (“pity”) and phóbos (“fear”), to both extend and withhold ties of empathy within and beyond a proscribed group, appealing to Aeschylus’ "Suppliants" (c. 463 B.C.E.) as my case-study
Enhancing Pain Management Access through Marketing, Physician Alignment, and Patient Transition Strategies
No full textPatient Access refers to the ease with which patients can obtain and utilize healthcare services through various modalities. During my coursework, I was able to join the Department of Anesthesiology and Perioperative Medicine as an extended resident working alongside faculty and staff. During this residency, I was able to lead three projects focused on inducing access to pain management services through different strategic initiatives. The first project looks at streamlining access opportunities by developing a staff and provider alignment model at a pediatric pain management clinic. The second project is the collection of marketing materials I was able to create to expand access to our services throughout the UPMC landscape. The final project contained within this portfolio is the development of a policy and plan for transitioning pediatric patients to adult pain management providers to create access within pediatric care settings and improve patient population management
Determinants of Experienced Health Barriers Among People Living with HIV in Southwestern Pennsylvania
No full textIt is crucial that people living with HIV (PLWH) are linked to care, remain in care, and adhere to treatment, however, there are numerous factors that impact access to mental, social, and physical care. Barriers include living in a rural area (limited transportation and health facility access), low socioeconomic status, stigma and discrimination, and other health demands. Previous region and state consumer surveys were reviewed to guide survey development. HIV medical care and services, dental care, case management, housing and food, substance use, mental health, and aging with HIV were components of the survey with an emphasis of importance. Numerous question modes of rating, select all that apply, select one of the following, and open-ended questions were utilized to collect responses. Surveys were distributed via flyers in clinics and support service agencies, email, online newsletters, in-person distribution at one-on-one case manager meetings and in group settings (e.g., dinners, events, and support groups), and mail (pre-stamped return envelopes included). Trends suggest that dental care, legal assistance, help paying for utilities, food, housing, transportation, and mental health care are unmet but needed services in the region. At the surveys conclusion, results were analyzed. Results helped to understand unmet needs and barriers to accessing medical and supportive service care for PLWH in the southwest region of Pennsylvania. Furthermore, the results helped to inform regional Ryan White programming (e.g., types of services funded, locations services are offered, regional staff trainings offered) that works to remove barriers to accessing quality HIV care. Removing barriers experienced by PLWH is a key step in maintaining the HIV care continuum and limiting transmission of HIV. Barriers are experienced by different communities and play a role in viral suppression and overall health outcomes. Understanding these barriers and tailoring HIV and supportive care to PLWH is a significant public health matter considering the expansive impacts of HIV on overall mental, social, emotional, and physical health