Emergency admissions are a major source of healthcare spending. We aimed to derive, validate, and compare conventional and machine learning models for prediction of the first emergency admission. Machine learning methods are capable of capturing complex interactions that are likely to be present when predicting less specific outcomes, such as this one. We used longitudinal data from linked electronic health records of 4.6 million patients aged 18–100 years from 389 practices across England between 1985 to 2015. The population was divided into a derivation cohort (80%, 3.75 million patients from 300 general practices) and a validation cohort (20%, 0.88 million patients from 89 general practices) from geographically distinct regions with different risk levels. We first replicated a previously reported Cox proportional hazards (CPH) model for prediction of the risk of the first emergency admission up to 24 months after baseline. This reference model was then compared with 2 machine learning models, random forest (RF) and gradient boosting classifier (GBC). The initial set of predictors for all models included 43 variables, including patient demographics, lifestyle factors, laboratory tests, currently prescribed medications, selected morbidities, and previous emergency admissions. We then added 13 more variables (marital status, prior general practice visits, and 11 additional morbidities), and also enriched all variables by incorporating temporal information whenever possible (e.g., time since first diagnosis). We also varied the prediction windows to 12, 36, 48, and 60 months after baseline and compared model performances. For internal validation, we used 5-fold cross-validation. When the initial set of variables was used, GBC outperformed RF and CPH, with an area under the receiver operating characteristic curve (AUC) of 0.779 (95% CI 0.777, 0.781), compared to 0.752 (95% CI 0.751, 0.753) and 0.740 (95% CI 0.739, 0.741), respectively. In external validation, we observed an AUC of 0.796, 0.736, and 0.736 for GBC, RF, and CPH, respectively. The addition of temporal information improved AUC across all models. In internal validation, the AUC rose to 0.848 (95% CI 0.847, 0.849), 0.825 (95% CI 0.824, 0.826), and 0.805 (95% CI 0.804, 0.806) for GBC, RF, and CPH, respectively, while the AUC in external validation rose to 0.826, 0.810, and 0.788, respectively. This enhancement also resulted in robust predictions for longer time horizons, with AUC values remaining at similar levels across all models. Overall, compared to the baseline reference CPH model, the final GBC model showed a 10.8% higher AUC (0.848 compared to 0.740) for prediction of risk of emergency admission within 24 months. GBC also showed the best calibration throughout the risk spectrum. Despite the wide range of variables included in models, our study was still limited by the number of variables included; inclusion of more variables could have further improved model performances. The use of machine learning and addition of temporal information led to substantially improved discrimination and calibration for predicting the risk of emergency admission. Model performance remained stable across a range of prediction time windows and when externally validated. These findings support the potential of incorporating machine learning models into electronic health records to inform care and service planning.

Balanced graph partitioning is a well known NP-complete problem with a wide range of applications. These applications include many large-scale distributed problems including the optimal storage of large sets of graph-structured data over several hosts-a key problem in today's Cloud infrastructure. However, in very large-scale distributed scenarios, state-of-the-art algorithms are not directly applicable, because they typically involve frequent global operations over the entire graph. In this paper, we propose a fully distributed algorithm, called JA-BE-JA, that uses local search and simulated annealing techniques for graph partitioning. The algorithm is massively parallel: there is no central coordination, each node is processed independently, and only the direct neighbors of the node, and a small subset of random nodes in the graph need to be known locally. Strict synchronization is not required. These features allow JA-BE-JA to be easily adapted to any distributed graph-processing system from data centers to fully distributed networks. We perform a thorough experimental analysis, which shows that the minimal edge-cut value achieved by JA-BE-JA is comparable to state-of-the-art centralized algorithms such as METIS. In particular, on large social networks JA-BEJA outperforms METIS, which makes JA-BE-JA-a bottom-up, self-organizing algorithm-a highly competitive practical solution for graph partitioning.

Peer-to-peer (P2P) video streaming is an emerging technology that reduces the barrier to stream live events over the Internet. Unfortunately, satisfying soft real-time constraints on the delay between the generation of the stream and its actual delivery to users is still a challenging problem. Bottlenecks in the available upload bandwidth, both at the media source and inside the overlay network, may limit the quality of service (QoS) experienced by users. A potential solution for this problem is assisting the P2P streaming network by a cloud computing infrastructure to guarantee a minimum level of QoS. In such approach, rented cloud resources (helpers) are added on demand to the overlay, to increase the amount of total available bandwidth and the probability of receiving the video on time. Hence, the problem to be solved becomes minimizing the economical cost, provided that a set of constraints on QoS is satisfied. The main contribution of this paper is CLIVE, a cloud-assisted P2P live streaming system that demonstrates the feasibility of these ideas. CLIVE estimates the available capacity in the system through a gossip-based aggregation protocol and provisions the required resources from the cloud to guarantee a given level of QoS at low cost. We perform extensive simulations and evaluate CLIVE using large-scale experiments under dynamic realistic settings.

Peer-to-peer overlay networks are attractive solutions for building Internet-scale publish/subscribe systems. However, scalability comes with a cost: a message published on a certain topic often needs to traverse a large number of uninterested (unsubscribed) nodes before reaching all its subscribers. This might sharply increase resource consumption for such relay nodes (in terms of bandwidth transmission cost, CPU, etc) and could ultimately lead to rapid deterioration of the system's performance once the relay nodes start dropping the messages or choose to permanently abandon the system. In this paper, we introduce Vitis, a gossip-based publish/subscribe system that significantly decreases the number of relay messages, and scales to an unbounded number of nodes and topics. This is achieved by the novel approach of enabling rendezvous routing on unstructured overlays. We construct a hybrid system by injecting structure into an otherwise unstructured network. The resulting structure resembles a navigable small-world network, which spans along clusters of nodes that have similar subscriptions. The properties of such an overlay make it an ideal platform for efficient data dissemination in large-scale systems. We perform extensive simulations and evaluate Vitis by comparing its performance against two base-line publish/subscribe systems: one that is oblivious to node subscriptions, and another that exploits the subscription similarities. Our measurements show that Vitis significantly outperforms the base-line solutions on various subscription and churn scenarios, from both synthetic models and real-world traces.

Graph processing has become an integral part of big data analytics. With the ever increasing size of the graphs, one needs to partition them into smaller clusters, which can be managed and processed more easily on multiple machines in a distributed fashion. While there exist numerous solutions for edge-cut partitioning of graphs, very little effort has been made for vertex-cut partitioning. This is in spite of the fact that vertex-cuts are proved significantly more effective than edge-cuts for processing most real world graphs. In this paper we present Ja-be-Ja-vc, a parallel and distributed algorithm for vertex-cut partitioning of large graphs. In a nutshell, Ja-be-Ja-vc is a local search algorithm that iteratively improves upon an initial random assignment of edges to partitions. We propose several heuristics for this optimization and study their impact on the final partitioning. Moreover, we employ simulated annealing technique to escape local optima. We evaluate our solution on various graphs and with variety of settings, and compare it against two state-of-the-art solutions. We show that Ja-be-Ja-vc outperforms the existing solutions in that it not only creates partitions of any requested size, but also requires a vertex-cut that is better than its counterparts and more than 70% better than random partitioning.

In the era of big data, considerable research focus is being put on designing efficient algorithms capable of learning and extracting high-level knowledge from ubiquitous data streams in an online fashion. While, most existing algorithms assume that data samples are drawn from a stationary distribution, several complex environments deal with data streams that are subject to change over time. Taking this aspect into consideration is an important step towards building truly aware and intelligent systems. In this paper, we propose GNG-A, an adaptive method for incremental unsupervised learning from evolving data streams experiencing various types of change. The proposed method maintains a continuously updated network (graph) of neurons by extending the Growing Neural Gas algorithm with three complementary mechanisms, allowing it to closely track both gradual and sudden changes in the data distribution. First, an adaptation mechanism handles local changes where the distribution is only non-stationary in some regions of the feature space. Second, an adaptive forgetting mechanism identifies and removes neurons that become irrelevant due to the evolving nature of the stream. Finally, a probabilistic evolution mechanism creates new neurons when there is a need to represent data in new regions of the feature space. The proposed method is demonstrated for anomaly and novelty detection in non-stationary environments. Results show that the method handles different data distributions and efficiently reacts to various types of change.