Critical infrastructures in a multi-hazard environment: identifying globally consistent heuristics to model interdependencies

Mapping Intimacies ◽

10.5194/egusphere-egu21-945 ◽

2021 ◽

Author(s):

Evelyn Mühlhofer ◽

David N. Bresch ◽

Elco Koks

Keyword(s):

Open Source ◽

Real World ◽

Natural Hazard ◽

Cooling Power ◽

Critical Infrastructures ◽

Global Risk ◽

Real World Data ◽

Risk Modelling ◽

Power Generators ◽

Trade Offs

Critical infrastructures (CIs) such as powerlines, road & rail transport, and telecommunications are networked systems, through which disruptions, for instance from natural hazards, may propagate far beyond their initial incidence.There is, however, a gap when it comes to identifying how CIs interdepend on each other (such as water for cooling power generators, and electricity for powering water pumps), and how their joint system-of-systems (SOS) character can amplify possible consequences. Anecdotal evidence on such behaviour is frequently derived from artificially generated or locally constrained cases with few CIs under consideration. A full picture of CISOS risks throughout greater geographies is absent.This research project aims to contribute to a more consistent view on natural hazard risks from CI interdependencies by<ul><li>systematically identifying and deriving interdependency heuristics between a range of CIs,</li> <li>transferring those interdependency heuristics to a network model based on real-world, spatially explicit open-source CI data,</li> <li>combining this CISOS network layer with an open-source global risk modelling platform, CLIMADA (Aznar-Siguan, G. & Bresch, D. N. 2019), to allow for globally consistent impact calculations from a range of natural hazard scenarios.</li> </ul>I will give first insights on the trade-offs between identified CI interdependencies, real-world data constraints and generalisability of a CISOS modelling approach across national scales. I will also present opportunities from combining the networked layer with the risk modelling platform CLIMADA for studying CISOS disruptions in a multi-hazard space, and possible extensions to social impacts and basic service disruptions.

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An Open-Source Web Portal for Managing Self-reported Data and Real-world Data Donation in Diabetes Research: Feasibility Study. (Preprint)

JMIR Diabetes ◽

10.2196/33213 ◽

2021 ◽

Author(s):

Drew Cooper ◽

Tebbe Ubben ◽

Christine Knoll ◽

Hanne Ballhausen ◽

Shane O'Donnell ◽

...

Keyword(s):

Open Source ◽

Feasibility Study ◽

Real World ◽

Diabetes Research ◽

Web Portal ◽

Real World Data ◽

World Data ◽

Reported Data

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An Open-Source Web Portal for Managing Self-reported Data and Real-world Data Donation in Diabetes Research: Feasibility Study. (Preprint)

10.2196/preprints.33213 ◽

2021 ◽

Author(s):

Drew Cooper ◽

Tebbe Ubben ◽

Christine Knoll ◽

Hanne Ballhausen ◽

Shane O'Donnell ◽

...

Keyword(s):

Healthcare Professional ◽

Data Management ◽

Open Source ◽

Medical Device ◽

Real World ◽

Diabetes Research ◽

Real World Data ◽

Follow Up Studies ◽

Reported Data

BACKGROUND People with diabetes and their support networks have developed open-source automated insulin delivery systems to help manage their diabetes therapy, as well as to improve their quality of life and glycemic outcomes. Under the hashtag #WeAreNotWaiting, a wealth of knowledge and real-world data has been generated by users of these systems but has been left largely untapped by research; the opportunity for multimodal studies investigating this group remains open. OBJECTIVE Developing a mixed-methods study to evaluate several aspects of open-source automated insulin delivery presents challenges relating to data management and security across multiple disparate online platforms, and implementation of follow-up studies with study participants. This research article reports on the feasibility of such a multimodal concept. METHODS A web portal was developed to manage both front-end participant interactions with study elements and back-end data management of survey responses and donated anonymized diabetes data. Participant data in REDCap and Open Humans was pseudonymously and securely linked and stored within a custom-built database using both open-source and commercial software. Participants—which included adults and children with diabetes, their partners and caregivers—were recruited through multiple online diabetes community groups. Participants were later given the option to include their healthcare providers in the study; database architecture was designed specifically with this kind of extensibility in mind. RESULTS Of 1052 visitors to the study landing page, 930 participated and completed at least one or multiple questionnaires. After the implementation of healthcare professional validation of self-reported clinical outcomes to the study, an additional 145 individuals visited the landing page, with 124 completing at least one or multiple questionnaires. Of the optional study elements, 7 participant-healthcare professional dyads participated in the survey, and 97 participants who completed the survey joined Open Humans to also donate their anonymized medical device data. CONCLUSIONS The study design proved successful in being both accessible for participants and manageable for researchers while maintaining compliance with data regulations. The gateway proved scalable when tested with the later addition of validation of self-reported data. Custom software solutions like the gateway may become increasingly common in diabetes research, especially with medical device data donation and follow-up studies. The gateway portal code has been made available open-source and can also be leveraged by other research projects.

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Abstract #946: Assessment of Acromegaly Patients with and Without Diabetes Treated with Lanreotide Depot: 2-Year Real World Data

Endocrine Practice ◽

10.1016/s1530-891x(20)45236-x ◽

2016 ◽

Vol 22 ◽

pp. 219

Author(s):

Roberto Salvatori ◽

Olga Gambetti ◽

Whitney Woodmansee ◽

David Cox ◽

Beloo Mirakhur ◽

...

Keyword(s):

Real World ◽

Real World Data ◽

World Data

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Safety and efficacy of direct acting oral anticoagulants and vitamin K antagonists in nonvalvular atrial fibrillation – a network meta-analysis of real-world data

VASA ◽

10.1024/0301-1526/a000746 ◽

2019 ◽

Vol 48 (2) ◽

pp. 134-147 ◽

Cited By ~ 8

Author(s):

Mirko Hirschl ◽

Michael Kundi

Keyword(s):

Real World ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Efficacy And Safety ◽

Nonvalvular Atrial Fibrillation ◽

Real World Data ◽

Hazard Ratios ◽

Direct Acting ◽

Event Rates

Abstract. Background: In randomized controlled trials (RCTs) direct acting oral anticoagulants (DOACs) showed a superior risk-benefit profile in comparison to vitamin K antagonists (VKAs) for patients with nonvalvular atrial fibrillation. Patients enrolled in such studies do not necessarily reflect the whole target population treated in real-world practice. Materials and methods: By a systematic literature search, 88 studies including 3,351,628 patients providing over 2.9 million patient-years of follow-up were identified. Hazard ratios and event-rates for the main efficacy and safety outcomes were extracted and the results for DOACs and VKAs combined by network meta-analysis. In addition, meta-regression was performed to identify factors responsible for heterogeneity across studies. Results: For stroke and systemic embolism as well as for major bleeding and intracranial bleeding real-world studies gave virtually the same result as RCTs with higher efficacy and lower major bleeding risk (for dabigatran and apixaban) and lower risk of intracranial bleeding (all DOACs) compared to VKAs. Results for gastrointestinal bleeding were consistently better for DOACs and hazard ratios of myocardial infarction were significantly lower in real-world for dabigatran and apixaban compared to RCTs. By a ranking analysis we found that apixaban is the safest anticoagulant drug, while rivaroxaban closely followed by dabigatran are the most efficacious. Risk of bias and heterogeneity was assessed and had little impact on the overall results. Analysis of effect modification could guide the clinical decision as no single DOAC was superior/inferior to the others under all conditions. Conclusions: DOACs were at least as efficacious as VKAs. In terms of safety endpoints, DOACs performed better under real-world conditions than in RCTs. The current real-world data showed that differences in efficacy and safety, despite generally low event rates, exist between DOACs. Knowledge about these differences in performance can contribute to a more personalized medicine.

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