Age-related loss of brain volume and T2 relaxation time in youth with type 1 diabetes

OBJECTIVE: Childhood-onset type 1 diabetes is associated with neurocognitive deficits, but there is limited evidence to date regarding associated neuroanatomical brain changes and their relationship to illness variables such as age at disease onset. This report examines age-related changes in volume and T2 relaxation time (a fundamental parameter of magnetic resonance imaging that reflects tissue health) across the whole brain. RESEARCH DESIGN AND METHODS: Type 1 diabetes, N = 79 (mean age 20.32 ± 4.24 years), and healthy control participants, N = 50 (mean age 20.53 ± 3.60 years). There were no substantial group differences on socioeconomic status, sex ratio, or intelligence quotient. RESULTS: Regression analyses revealed a negative correlation between age and brain changes, with decreasing gray matter volume and T2 relaxation time with age in multiple brain regions in the type 1 diabetes group. In comparison, the age-related decline in the control group was small. Examination of the interaction of group and age confirmed a group difference (type 1 diabetes vs. control) in the relationship between age and brain volume/T2 relaxation time. CONCLUSIONS: We demonstrated an interaction between age and group in predicting brain volumes and T2 relaxation time such that there was a decline in these outcomes in type 1 diabetic participants that was much less evident in control subjects. Findings suggest the neurodevelopmental pathways of youth with type 1 diabetes have diverged from those of their healthy peers by late adolescence and early adulthood but the explanation for this phenomenon remains to be clarified.

A fragment of the LG3 peptide of endorepellin is present in the urine of physically active mining workers : a potential marker of physical activity

Biomarker analysis has been implemented in sports research in an attempt to monitor the effects of exertion and fatigue in athletes. This study proposed that while such biomarkers may be useful for monitoring injury risk in workers, proteomic approaches might also be utilised to identify novel exertion or injury markers. We found that urinary urea and cortisol levels were significantly elevated in mining workers following a 12 hour overnight shift. These levels failed to return to baseline over 24h in the more active maintenance crew compared to truck drivers (operators) suggesting a lack of recovery between shifts. Use of a SELDI-TOF MS approach to detect novel exertion or injury markers revealed a spectral feature which was associated with workers in both work categories who were engaged in higher levels of physical activity. This feature was identified as the LG3 peptide, a C-terminal fragment of the anti-angiogenic / anti-tumourigenic protein endorepellin. This finding suggests that urinary LG3 peptide may be a biomarker of physical activity. It is also possible that the activity mediated release of LG3 / endorepellin into the circulation may represent a biological mechanism for the known inverse association between physical activity and cancer risk / survival.

Delegation framework for federated systems

It is not uncommon for enterprises today to be faced with the demand to integrate and incor- porate many different and possibly heterogeneous systems which are generally independently designed and developed, to allow seamless access. In effect, the integration of these systems results in one large whole system that must be able, at the same time, to maintain the local autonomy and to continue working as an independent entity. This problem has introduced a new distributed architecture called federated systems. The most challenging issue in federated systems is to find answers for the question of how to efficiently cooperate while preserving their autonomous characteristic, especially the security autonomy. This thesis intends to address this issue. The thesis reviews the evolution of the concept of federated systems and discusses the organisational characteristics as well as remaining security issues with the existing approaches. The thesis examines how delegation can be used as means to achieve better security, especially authorisation while maintaining autonomy for the participating member of the federation. A delegation taxonomy is proposed as one of the main contributions. The major contribution of this thesis is to study and design a mechanism to support dele- gation within and between multiple security domains with constraint management capability. A novel delegation framework is proposed including two modules: Delegation Constraint Man- agement module and Policy Management module. The first module is designed to effectively create, track and manage delegation constraints, especially for delegation processes which require re-delegation (indirect delegation). The first module employs two algorithms to trace the root authority of a delegation constraint chain and to prevent the potential conflict when creating a delegation constraint chain if necessary. The first module is designed for conflict prevention not conflict resolution. The second module is designed to support the first module via the policy comparison capability. The major function of this module is to provide the delegation framework the capability to compare policies and constraints (written under the format of a policy). The module is an extension of Lin et al.'s work on policy filtering and policy analysis. Throughout the thesis, some case studies are used as examples to illustrate the discussed concepts. These two modules are designed to capture one of the most important aspects of the delegation process: the relationships between the delegation transactions and the involved constraints, which are not very well addressed by the existing approaches. This contribution is significant because the relationships provide information to keep track and en- force the involved delegation constraints and, therefore, play a vital role in maintaining and enforcing security for transactions across multiple security domains.

Renewal decision support for linear assets

Linear (or continuous) assets are engineering infrastructure that usually spans long distances and can be divided into different segments, all of which perform the same function but may be subject to different loads and environmental factors. Typical linear assets include railway lines, roads, pipelines and cables. How and when to renew such assets are critical decisions for asset owners as they normally involves significant capital investment. Through investigating the characteristics of linear asset renewal decisions and identifying the critical requirements that are associated with renewal decisions, we present a multi-criteria decision support method to help optimise renewal decisions. A case study that concerns renewal of an economiser's tubing system is a coal-fired power station is adopted to demonstrate the application of this method. Although the paper concerns a particular linear asset decision type, the approach has broad applicability for linear asset management.

Bringing the MIMOSA OSA-EAI into an object-orientated world

Despite being poised as a standard for data exchange for operation and maintenance data, the database heritage of the MIMOSA OSA-EAI is clearly evident from using a relational model at its core. The XML schema (XSD) definitions, which are used for communication between asset management systems, are based on the MIMOSA common relational information schema (CRIS), a relational model, and consequently, many database concepts permeate the communications layer. The adoption of a relational model leads to several deficiencies, and overlooks advances in object-oriented approach for an upcoming version of the specification, and the common conceptual object model (CCOM) sees a transition to fully utilising object-oriented features for the standard. Unified modelling language (UML) is used as a medium for documentation as well as facilitating XSD code generation. This paper details some of the decisions faced in developing the CCOM and provides a glimpse into the future of asset management and data exchange models.

Less but more : weaving disparate disciplines together for learners to construct their own knowledge

This paper reports on a Professional Learning Program conducted in China with 140 general technology teachers. It aimed to integrate robotics technology across and within the disciplines of science, technology, engineering and mathematics. With the help of university facilitators teachers developed General Technology lessons that seamlessly integrated with rich learning content across disciplines. Teachers engaged in seminars and workshops, which provided the opportunities for them to actively couch sound principles of learning in their daily work. They gained first-hand experience in applying an aligned system of assessments, standards and quality learning experiences geared to the needs of each student. Teachers worked collaboratively in teams to create inquiry, design and collaborative learning activities that aligned with their curriculum and which dealt with real world problems, issues and challenges. They continually discussed and reflected deeply on the activities and shared the newly developed resources online with teachers across the entire country. It is evident from the preliminary analysis of data that teachers are beginning to apply rich pedagogical practices and are becoming ‘adaptive’ in their approach when using LEGO® robotic tools to design, redesign, create and re-create learning activities for their students.

Prevalence of malnutrition risk and its relationship with risk factors of hospital re-admission in older adults

Background: Risk of malnutrition in older people continues to be a global problem. Malnutrition is often unrecognized and under-treated across health care settings and may result in undesirable health consequences, impaired recovery from illness and a poorer quality of life. Aim: This study aimed to determine the prevalence of malnutrition risk in a sample of older people at high risk of hospital re-admission. The association between risk factors of hospital re-admission and risk of malnutrition were also explored. Methods: One hundred and twenty five hospitalised patients aged 65 years and older at risk of hospital readmission (24% male, 76% female, mean age 77 ± 6 years) were recruited from a tertiary metropolitan hospital in Australia. The valid and reliable Malnutrition Screen Tool (MST) was employed to screen for malnutrition risk. It consists of two questions related to recent weight loss and appetite. Results: Prevalence of older adults at risk of malnutrition was 27.4%. Risk of malnutrition was not associated with age, gender and living arrangement. However, among risk factors of hospital readmission, lack of social support (χ2 = 4.18, N = 125, p = 0.028), and fair –poor self-rating of health (χ2 = 4.13, N = 125, p = 0.042) were statistically significant associated with risk of malnutrition. Conclusion: Risk of malnutrition in older people continues to be a concern in health care, and increasing psycho social support may help shed light on reducing risk of malnutrition.

Validity of the malnutrition screening tool for older adults at high risk of hospital readmission

Malnutrition is a serious problem in older adults, particularly for those at risk of hospital readmission. The essential step in managing malnutrition is early identification using a valid nutrition screening tool. The purpose of this study was to validate the Malnutrition Screening Tool (MST) in older adults at high risk of hospital readmission. Two registered nurses administered the MST to identify malnutrition risk, and compared it to the comprehensive Subjective Global Assessment (SGA) to assess nutritional status for patients aged 65 years who had at least one risk factor for hospital readmission. The MST demonstrates substantial sensitivity, specificity and agreement with the SGA. These findings indicate that nursing staff can use the MST as a valid tool for routine screening and rescreening to identify patients at risk of malnutrition. Use of the MST may prevent hospital-acquired malnutrition for acute hospitalized older adults at high risk of readmission.

A Bayesian‐Markov process for reliability prediction

Accurate reliability prediction for large-scale, long lived engineering is a crucial foundation for effective asset risk management and optimal maintenance decision making. However, a lack of failure data for assets that fail infrequently, and changing operational conditions over long periods of time, make accurate reliability prediction for such assets very challenging. To address this issue, we present a Bayesian-Marko best approach to reliability prediction using prior knowledge and condition monitoring data. In this approach, the Bayesian theory is used to incorporate prior information about failure probabilities and current information about asset health to make statistical inferences, while Markov chains are used to update and predict the health of assets based on condition monitoring data. The prior information can be supplied by domain experts, extracted from previous comparable cases or derived from basic engineering principles. Our approach differs from existing hybrid Bayesian models which are normally used to update the parameter estimation of a given distribution such as the Weibull-Bayesian distribution or the transition probabilities of a Markov chain. Instead, our new approach can be used to update predictions of failure probabilities when failure data are sparse or nonexistent, as is often the case for large-scale long-lived engineering assets.

A note on the ‘Linsanity’ of measuring the relative efficiency of National Basketball Association (NBA) guards

This note examines the productive efficiency of 62 starting guards during the 2011/12 National Basketball Association (NBA) season. This period coincides with the phenomenal and largely unanticipated performance of New York Knicks’ starting point guard Jeremy Lin and the attendant public and media hype known as Linsanity. We employ a data envelopment analysis (DEA) approach that includes allowance for an undesirable output, here turnovers per game, with the desirable outputs of points, rebounds, assists, steals, and blocks per game and an input of minutes per game. The results indicate that depending upon the specification, between 29 and 42 percent of NBA guards are fully efficient, including Jeremy Lin, with a mean inefficiency of 3.7 and 19.2 percent. However, while Jeremy Lin is technically efficient, he seldom serves as a benchmark for inefficient players, at least when compared with established players such as Chris Paul and Dwayne Wade. This suggests the uniqueness of Jeremy Lin’s productive solution and may explain why his unique style of play, encompassing individual brilliance, unselfish play, and team leadership, is of such broad public appeal.

Evaluation of image resolution and super-resolution on face recognition performance

While researchers strive to improve automatic face recognition performance, the relationship between image resolution and face recognition performance has not received much attention. This relationship is examined systematically and a framework is developed such that results from super-resolution techniques can be compared. Three super-resolution techniques are compared with the Eigenface and Elastic Bunch Graph Matching face recognition engines. Parameter ranges over which these techniques provide better recognition performance than interpolated images is determined.

Clinical utility of mental state screening as a predictor of intellectual outcomes 6 months after diagnosis of type 1 diabetes

Background Screening tests of basic cognitive status or ‘mental state’ have been shown to predict mortality and functional outcomes in adults. This study examined the relationship between mental state and outcomes in children with type 1 diabetes. Objective We aimed to determine whether mental state at diagnosis predicts longer term cognitive function of children with a new diagnosis of type 1 diabetes. Methods Mental state of 87 patients presenting with newly diagnosed type 1 diabetes was assessed using the School-Years Screening Test for the Evaluation of Mental Status. Cognitive abilities were assessed 1 wk and 6 months postdiagnosis using standardized tests of attention, memory, and intelligence. Results Thirty-seven children (42.5%) had reduced mental state at diagnosis. Children with impaired mental state had poorer attention and memory in the week following diagnosis, and, after controlling for possible confounding factors, significantly lower IQ at 6 months compared to those with unimpaired mental state (p < 0.05). Conclusions Cognition is impaired acutely in a significant number of children presenting with newly diagnosed type 1 diabetes. Mental state screening is an effective method of identifying children at risk of ongoing cognitive difficulties in the days and months following diagnosis. Clinicians may consider mental state screening for all newly diagnosed diabetic children to identify those at risk of cognitive sequelae.

Diesel knock combustion and its detection using acoustic emission

This paper presents an experimental investigation into the detection of excessive Diesel knock using acoustic emission signals. Three different dual-fuel Diesel engine operating regimes were induced into a compression ignition (Diesel) engine operating on both straight Diesel fuel and two different mixtures of fumigated ethanol and Diesel. The experimentally induced engine operating regimes were; normal, or Diesel only operation, acceptable dual-fuel operation and dual-fuel operation with excessive Diesel knock. During the excessive Diesel knock operating regime, high rates of ethanol substitution induced potentially damaging levels of Diesel knock. Acoustic emission data was captured along with cylinder pressure, crank-angle encoder, and top-dead centre signals for the different engine operating regimes. Using these signals, it was found that acoustic emission signals clearly distinguished between the two acceptable operating regimes and the operating regime experiencing excessive Diesel knock. It was also found that acoustic emission sensor position is critical. The acoustic emission sensor positioned on the block of the engine clearly related information concerning the level of Diesel knock occurring in the engine whist the sensor positioned on the head of the engine gave no indication concerning Diesel knock severity levels.

Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality

Background & aims: The confounding effect of disease on the outcomes of malnutrition using diagnosis-related groups (DRG) has never been studied in a multidisciplinary setting. This study aims to determine the prevalence of malnutrition in a tertiary hospital in Singapore and its impact on hospitalization outcomes and costs, controlling for DRG. Methods: This prospective cohort study included a matched case control study. Subjective Global Assessment was used to assess the nutritional status on admission of 818 adults. Hospitalization outcomes over 3 years were adjusted for gender, age, ethnicity, and matched for DRG. Results: Malnourished patients (29%) had longer hospital stays (6.9 ± 7.3 days vs. 4.6 ± 5.6 days, p < 0.001) and were more likely to be readmitted within 15 days (adjusted relative risk = 1.9, 95%CI 1.1–3.2, p = 0.025). Within a DRG, the mean difference between actual cost of hospitalization and the average cost for malnourished patients was greater than well-nourished patients (p = 0.014). Mortality was higher in malnourished patients at 1 year (34% vs. 4.1 %), 2 years (42.6% vs. 6.7%) and 3 years (48.5% vs. 9.9%); p < 0.001 for all. Overall, malnutrition was a significant predictor of mortality (adjusted hazard ratio = 4.4, 95% CI 3.3-6.0, p < 0.001). Conclusions: Malnutrition was evident in up to one third of the inpatients and led to poor hospitalization outcomes and survival as well as increased costs of care, even after matching for DRG. Strategies to prevent and treat malnutrition in the hospital and post-discharge are needed.

Condition deterioration prediction of bridge elements using Dynamic Bayesian Networks (DBNs)

The ability of bridge deterioration models to predict future condition provides significant advantages in improving the effectiveness of maintenance decisions. This paper proposes a novel model using Dynamic Bayesian Networks (DBNs) for predicting the condition of bridge elements. The proposed model improves prediction results by being able to handle, deterioration dependencies among different bridge elements, the lack of full inspection histories, and joint considerations of both maintenance actions and environmental effects. With Bayesian updating capability, different types of data and information can be utilised as inputs. Expert knowledge can be used to deal with insufficient data as a starting point. The proposed model established a flexible basis for bridge systems deterioration modelling so that other models and Bayesian approaches can be further developed in one platform. A steel bridge main girder was chosen to validate the proposed model.