Using Statistical Significance and Prediction to Test Long/Short Term Public Services and Patients Cohorts: A Case Study in Scotland

Health and Social care (HSc) services planning and scheduling are facing unprecedented challenges, due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven approaches can help to improve policies, plan and design services provision schedules using algorithms that assist healthcare managers to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as Classification and Regression Trees (CART), Random Forests (RF), and Logistic Regression (LGR). The significance tests Chi-Squared and Student’s test are used on data over a 39 years span for which data exist for services delivered in Scotland. The demands are associated using probabilities and are parts of statistical hypotheses. These hypotheses, as their NULL part, assume that the target demand is statistically dependent on other services’ demands. This linking is checked using the data. In addition, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus, groups of services. Statistical tests confirmed ML coupling and made the prediction statistically meaningful and proved that a target service can be matched reliably to other services while ML showed that such marked relationships can also be linear ones. Zero padding was used for missing years records and illustrated better such relationships both for limited years and for the entire span offering long-term data visualizations while limited years periods explained how well patients numbers can be related in short periods of time or that they can change over time as opposed to behaviours across more years. The prediction performance of the associations were measured using metrics such as Receiver Operating Characteristic (ROC), Area Under Curve (AUC) and Accuracy (ACC) as well as the statistical tests Chi-Squared and Student. Co-plots and comparison tables for the RF, CART, and LGR methods as well as the p-value from tests and Information Exchange (IE/MIE) measures are provided showing the relative performance of ML methods and of the statistical tests as well as the behaviour using different learning ratios. The impact of k-neighbours classification (k-NN), Cross-Correlation (CC) and C-Means (CM) first groupings was also studied over limited years and for the entire span. It was found that CART was generally behind RF and LGR but in some interesting cases, LGR reached an AUC = 0 falling below CART, while the ACC was as high as 0.912 showing that ML methods can be confused by zero-padding or by data’s irregularities or by the outliers. On average, 3 linear predictors were sufficient, LGR was found competing well RF and CART followed with the same performance at higher learning ratios. Services were packed only when a significance level (p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, low birth weights, alcoholism, drug abuse, and emergency admissions. The work found  that different HSc services can be well packed as plans of limited duration, across various services sectors, learning configurations, as confirmed by using statistical hypotheses.

Parametric Approach for Reserve Liability Estimate in Mortgage Insurance

Chain Ladder (CL) method, Expected Loss Ratio (ELR) method and Bornhuetter-Ferguson (BF) method, in addition to more complex transition-rate modeling, are commonly used actuarial reserving methods in general insurance. There is limited published research about their relative performance in the context of Mortgage Insurance (MI). In our experience, these traditional techniques pose unique challenges and do not provide stable claim estimates for medium to longer term liabilities. The relative strengths and weaknesses among various alternative approaches revolve around: stability in the recent loss development pattern, sufficiency and reliability of loss development data, and agreement/disagreement between reported losses to date and ultimate loss estimate. CL method results in volatile reserve estimates, especially for accident periods with little development experience. The ELR method breaks down especially when ultimate loss ratios are not stable and predictable. While the BF method provides a good tradeoff between the loss development approach (CL) and ELR, the approach generates claim development and ultimate reserves that are disconnected from the ever-to-date (ETD) development experience for some accident years that have more development experience. Further, BF is based on subjective a priori assumption. The fundamental shortcoming of these methods is their inability to model exogenous factors, like the economy, which impact various cohorts at the same chronological time but at staggered points along their life-time development. This paper proposes an alternative approach of parametrizing the loss development curve and using logistic regression to generate the ultimate loss estimate for each homogeneous group (accident year or delinquency period). The methodology was tested on an actual MI claim development dataset where various cohorts followed a sigmoidal trend, but levels varied substantially depending upon the economic and operational conditions during the development period spanning over many years. The proposed approach provides the ability to indirectly incorporate such exogenous factors and produce more stable loss forecasts for reserving purposes as compared to the traditional CL and BF methods.

Complementing Assessment Processes with Standardized Tests: A Work in Progress

ABET accredited programs must assess the development of student learning outcomes (SOs) in engineering programs. Different institutions implement different strategies for this assessment, and they are usually designed “in house.” This paper presents a proposal for including standardized tests to complement the ABET assessment model in an engineering college made up of six distinct engineering programs. The engineering college formulated a model of quality assurance in education to be implemented throughout the six engineering programs to regularly assess and evaluate the achievement of SOs in each program offered. The model uses diverse techniques and sources of data to assess student performance and to implement actions of improvement based on the results of this assessment. The model is called “Assessment Process Model” and it includes SOs A through K, as defined by ABET. SOs can be divided into two categories: “hard skills” and “professional skills” (soft skills). The first includes abilities, such as: applying knowledge of mathematics, science, and engineering and designing and conducting experiments, as well as analyzing and interpreting data. The second category, “professional skills”, includes communicating effectively, and understanding professional and ethnical responsibility. Within the Assessment Process Model, various tools were used to assess SOs, related to both “hard” as well as “soft” skills. The assessment tools designed included: rubrics, surveys, questionnaires, and portfolios. In addition to these instruments, the Engineering College decided to use tools that systematically gather consistent quantitative data. For this reason, an in-house exam was designed and implemented, based on the curriculum of each program. Even though this exam was administered during various academic periods, it is not currently considered standardized. In 2017, the Engineering College included three standardized tests: one to assess mathematical and scientific reasoning and two more to assess reading and writing abilities. With these exams, the college hopes to obtain complementary information that can help better measure the development of both hard and soft skills of students in the different engineering programs. In the first semester of 2017, the three exams were given to three sample groups of students from the six different engineering programs. Students in the sample groups were either from the first, fifth, and tenth semester cohorts. At the time of submission of this paper, the engineering college has descriptive statistical data and is working with various statisticians to have a more in-depth and detailed analysis of the sample group of students’ achievement on the three exams. The overall objective of including standardized exams in the assessment model is to identify more precisely the least developed SOs in order to define and implement educational strategies necessary for students to achieve them in each engineering program.

Inter-Specific Differences in Leaf Phenology, Growth of Seedlings of Cork OAK (Quercus suber L.), Zeen Oak (Quercus canariensis Willd.) and Their Hybrid Afares Oak (Quercus afares Pomel) in the Nursery

Leaf Life Span (LLS) is used to classify trees into two main groups: evergreen and deciduous species. It varies according to the forms of life between taxonomic groups. Co-occurrence of deciduous and evergreen oaks is common in some Mediterranean type climate areas. Nevertheless, in the Tunisian forests, there is no enough information about the functional inter-specific diversity among oak species, especially in the mixed stand marked by the simultaneous presence of Q. suber L., Q. canariensis Willd. and their hybrid (Q. afares), the latter being an endemic oak species threatened with extinction. This study has been conducted to estimate the LLS, the relative growth rate, and the count of different growth flushes of samplings in semi-controlled conditions. Our study took 17 months, with an observation's interval of 4 weeks. The aim is to characterize and compare the hybrid species to the parental ones. Differences were observed among species, both for phenology and growth. Indeed, Q. suber saplings reached higher total height and number of growth flushes then Q. canariensis, while Q. afares showed much less growth flushes than the parental species. The LLS of parental species has exceeded the duration of the experiment, but their hybrid lost all leaves on all cohorts. The short LLSs of hybrid species are in accordance with this phenology in the field, but for Q. canariensis there was a contrast with observations in the field where phenology is strictly annual. This study allowed us to differentiate the hybrid from both parental species.

A Developmental Study of the Flipped Classroom Approach on Students’ Learning in English Language Modules in British University in Egypt

The flipped classroom approach as a mode of blended learning was formally introduced to students of the English language modules at the British University in Egypt (BUE) at the start of the academic year 2015/2016. This paper aims to study the impact of the flipped classroom approach after three semesters of implementation. It will restrict itself to the examination of students’ achievement rates, student satisfaction, and how different student cohorts have benefited differently from the flipped practice. The paper concludes with recommendations of how the experience can be further developed.

Comparison of Statins Dose Intensity on HbA1c Control in Outpatients with Type 2 Diabetes: A Prospective Cohort Study

The effect of statins dose intensity (SDI) on glycemic control in patients with existing diabetes is unclear. Also, there are many contradictory findings were reported in the literature; thus, it is limiting the possibility to draw conclusions. This project was designed to compare the effect of SDI on glycated hemoglobin (HbA1c%) control in outpatients with Type 2 diabetes in the endocrine clinic at Hospital Pulau Pinang, Malaysia, between July 2015 and August 2016. A prospective cohort study was conducted, where records of 345 patients with Type 2 diabetes (Moderate-SDI group 289 patients and high-SDI cohort 56 patients) were reviewed to identify demographics and laboratory tests. The target of glycemic control (HbA1c < 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, and the results were presented as descriptive statistics. From 289 moderate-SDI cohorts with a mean age of 57.3 ± 12.4 years, only 86 (29.8%) cases were shown to have controlled glycemia, while there were 203 (70.2%) cases with uncontrolled glycemia with confidence interval (CI) of 95% (6.2–10.8). On the other hand, the high-SDI group of 56 patients with Type 2 diabetes with a mean age 57.7±12.4 years is distributed among 11 (19.6%) patients with controlled diabetes, and 45 (80.4%) of them had uncontrolled glycemia, CI: 95% (7.1–11.9). The study has demonstrated that the relative risk (RR) of uncontrolled glycemia in patients with Type 2 diabetes that used high-SDI is 1.15, and the excessive relative risk (ERR) is 15%. The absolute risk (AR) is 10.2%, and the number needed to harm (NNH) is 10. Outpatients with Type 2 diabetes who use high-SDI of statin have a higher risk of uncontrolled glycemia than outpatients who had been treated with a moderate-SDI.

Experiences on the Application of WIKI Based Coursework in a Fourth-Year Engineering Module

This paper presents work on the application of wiki based coursework for a fourth-year engineering module delivered as part of both a MEng and MSc programme in Chemical Engineering. The module was taught with an equivalent structure simultaneously on two separate campuses, one in the United Kingdom (UK) and one in Malaysia, and the subsequent results were compared. Student feedback was sought via questionnaires, with 45 respondents from the UK and 49 from Malaysia. Results include discussion on; perceived difficulty; student enjoyment and experiences; differences between MEng and MSc students; differences between cohorts on different campuses. The response of students to the use of wiki-based coursework was found to vary based on their experiences and background, with UK students being generally more positive on its application than those in Malaysia.

Enhancing Learning for Research Higher Degree Students

Universities’ push toward the production of high quality research is not limited to academic staff and experienced researchers. In this environment of research rich agendas, Higher Degree Research (HDR) students are increasingly expected to engage in the publishing of good quality papers in high impact journals. IFN001: Advanced Information Research Skills (AIRS) is a credit bearing mandatory coursework requirement for Queensland University of Technology (QUT) doctorates. Since its inception in 1989, this unique blended learning program has provided the foundations for new researchers to produce original and innovative research. AIRS was redeveloped in 2012, and has now been evaluated with reference to the university’s strategic research priorities. Our research is the first comprehensive evaluation of the program from the learner perspective. We measured whether the program develops essential transferrable skills and graduate capabilities to ensure best practice in the areas of publishing and data management. In particular, we explored whether AIRS prepares students to be agile researchers with the skills to adapt to different research contexts both within and outside academia. The target group for our study consisted of HDR students and supervisors at QUT. Both quantitative and qualitative research methods were used for data collection. Gathering data was by survey and focus groups with qualitative responses analyzed using NVivo. The results of the survey show that 82% of students surveyed believe that AIRS assisted their research process and helped them learn skills they need as a researcher. The 18% of respondents who expressed reservation about the benefits of AIRS were also examined to determine the key areas of concern. These included trends related to the timing of the program early in the candidature and a belief among some students that their previous research experience was sufficient for postgraduate study. New insights have been gained into how to better support HDR learners in partnership with supervisors and how to enhance learning experiences of specific cohorts, including international students and mature learners.

Development of Lodging Business Management Standards of Bang Khonthi Community in Samut Songkram Province

This research aims to develop ways of lodging business management of Bang Khonthi community in Samut Songkram province that are appropriate with the cultural context of the Bang Khonthi community. Eight lodging business owners were interviewed. It was found that lodging business that are family business must be done with passion, correct understanding of self, culture, nature, Thai way of life, thorough, professional development, environmentally concerned, building partnerships with various networks both community level, and public sector and business cohorts. Public relations should be done through media both traditional and modern outlets, such as websites and social networks to provide customers convenience, security, happiness, knowledge, love and value when travel to Bang Khonthi. This will also help them achieve sustainability in business, in line with the 10 Home Stay Standard Thailand. Suggestions for operators are as follows: Operators need to improve their public relations work. They need to use technology in public relations such as the internet. Management standards must be improved. Souvenir and local products shops should be arranged in the compound. Product pricing must be set accordingly. They need to join hands to help each other. Quality of the business operation should be raised to meet the standards. Educational measures to reduce the impact caused by tourism on the community such as efforts to reduce energy consumption.

Increase Success by Decreasing Admission for Maths– Fairytale or Reality?

South Africa is facing a crisis with not being able to produce enough graduates in the scarce skills areas to sustain economic growth. The crisis is fuelled by a school system that does not produce enough potential students with Mathematics, Accounting and Science. Since the introduction of the new school curriculum in 2008, there is no longer an option to take pure maths on a standard grade level. Instead, only two mathematical subjects are offered: pure maths (which is on par with higher grade maths) and mathematical literacy. It is compulsory to take one or the other. As a result, lees student finishes Grade 12 with pure mathematics every year. This national problem needs urgent attention if South Africa is to make any headway in critical skills development as mathematics is a gateway to scarce skills professions. Higher education institutions initiated several initiatives in an attempt to address the above, including preparatory courses, bridging programmes and extended curricula with foundation provisions. In view of the above, and government policy directives to broaden access in the scarce skills areas to increase student throughput, foundation provision was introduced for Commerce and Information Technology programmes at the Vaal Triangle Campus (VTC) of North-West University (NWU) in 2010. Students enrolling for extended programmes do not comply with the minimum prerequisites for the normal programmes. The question then arises as to whether these programmes have the intended impact? This paper reports the results of a two year longitudinal study, tracking the first year academic achievement of the two cohorts of enrolments since 2010. The results provide valuable insight into the structuring of an extended programme and its potential impact.

Effect of Open-Ended Laboratory toward Learners Performance in Environmental Engineering Course: Case Study of Civil Engineering at Universiti Malaysia Sabah

Laboratory activities have produced benefits in student learning. With current drives of new technology resources and evolving era of education methods, renewal status of learning and teaching in laboratory methods are in progress, for both learners and the educators. To enhance learning outcomes in laboratory works particularly in engineering practices and testing, learning via handson by instruction may not sufficient. This paper describes and compares techniques and implementation of traditional (expository) with open-ended laboratory (problem-based) for two consecutive cohorts studying environmental laboratory course in civil engineering program. The transition of traditional to problem-based findings and effect were investigated in terms of course assessment student feedback survey, course outcome learning measurement and student performance grades. It was proved that students have demonstrated better performance in their grades and 12% increase in the course outcome (CO) in problem-based open-ended laboratory style than traditional method; although in perception, students has responded less favorable in their feedback.

Identification of Complex Sense-antisense Gene's Module on 17q11.2 Associated with Breast Cancer Aggressiveness and Patient's Survival

Sense-antisense gene pair (SAGP) is a pair of two oppositely transcribed genes sharing a common region on a chromosome. In the mammalian genomes, SAGPs can be organized in more complex sense-antisense gene architectures (CSAGA) in which at least one gene could share loci with two or more antisense partners. Many dozens of CSAGAs can be found in the human genome. However, CSAGAs have not been systematically identified and characterized in context of their role in human diseases including cancers. In this work we characterize the structural-functional properties of a cluster of 5 genes –TMEM97, IFT20, TNFAIP1, POLDIP2 and TMEM199, termed TNFAIP1 / POLDIP2 module. This cluster is organized as CSAGA in cytoband 17q11.2. Affymetrix U133A&B expression data of two large cohorts (410 atients, in total) of breast cancer patients and patient survival data were used. For the both studied cohorts, we demonstrate (i) strong and reproducible transcriptional co-regulatory patterns of genes of TNFAIP1/POLDIP2 module in breast cancer cell subtypes and (ii) significant associations of TNFAIP1/POLDIP2 CSAGA with amplification of the CSAGA region in breast cancer, (ii) cancer aggressiveness (e.g. genetic grades) and (iv) disease free patient-s survival. Moreover, gene pairs of this module demonstrate strong synergetic effect in the prognosis of time of breast cancer relapse. We suggest that TNFAIP1/ POLDIP2 cluster can be considered as a novel type of structural-functional gene modules in the human genome.

Gene Expression Signature for Classification of Metastasis Positive and Negative Oral Cancer in Homosapiens

Cancer classification to their corresponding cohorts has been key area of research in bioinformatics aiming better prognosis of the disease. High dimensionality of gene data has been makes it a complex task and requires significance data identification technique in order to reducing the dimensionality and identification of significant information. In this paper, we have proposed a novel approach for classification of oral cancer into metastasis positive and negative patients. We have used significance analysis of microarrays (SAM) for identifying significant genes which constitutes gene signature. 3 different gene signatures were identified using SAM from 3 different combination of training datasets and their classification accuracy was calculated on corresponding testing datasets using k-Nearest Neighbour (kNN), Fuzzy C-Means Clustering (FCM), Support Vector Machine (SVM) and Backpropagation Neural Network (BPNN). A final gene signature of only 9 genes was obtained from above 3 individual gene signatures. 9 gene signature-s classification capability was compared using same classifiers on same testing datasets. Results obtained from experimentation shows that 9 gene signature classified all samples in testing dataset accurately while individual genes could not classify all accurately.