A dynamic real time scheduling methodology for the emergency department

This project constructs a scheduling solution for the Emergency Department. The schedules are generated in real-time to adapt to new patient arrivals and changing conditions. An integrated scheduling formulation assigns patients to beds and treatment tasks to resources. The schedule efficiency is assessed using waiting time and total care time experienced by patients. The solution algorithm incorporates dispatch rules, meta-heuristics and a new extended disjunctive graph formulation which provide high quality solutions in a fast time-frame for real time decision support. This algorithm can be implemented in an electronic patient management system to improve patient flow in the Emergency Department.

Numerical modelling and design of unlined cold-formed steel wall frames

Cold-formed steel wall frame systems using lipped or unlipped C-sections and gypsum plasterboard lining are commonly utilised in the construction of both the load bearing and non-load bearing walls in the residential, commercial and industrial buildings. However, the structural behaviour of unlined and lined stud wall frames is not well understood and adequate design rules are not available. A detailed research program was therefore undertaken to investigate the behaviour of stud wall frame systems. As the first step in this research, the problem relating to the degree of end fixity of stud was investigated. The studs are usually connected to the top and bottom tracks and the degree of end fixity provided by these tracks is not adequately addressed by the design codes. A finite element model of unlined frames was therefore developed, and validated using full scale experimental results. It was then used in a detailed parametric study to develop appropriate design rules for unlined wall frames. This study has shown that by using appropriate effective length factors, the ultimate load and failure modes of the unlined studs can be accurately predicted using the provisions of Australian or American cold-formed steel structures design codes. This paper presents the details of the finite element analyses, the results and recommended design rules for unlined wall frames.

A "Candidate-Interactome" Aggregate Analysis of Genome-Wide Association Data in Multiple Sclerosis

Though difficult, the study of gene-environment interactions in multifactorial diseases is crucial for interpreting the relevance of non-heritable factors and prevents from overlooking genetic associations with small but measurable effects. We propose a "candidate interactome" (i.e. a group of genes whose products are known to physically interact with environmental factors that may be relevant for disease pathogenesis) analysis of genome-wide association data in multiple sclerosis. We looked for statistical enrichment of associations among interactomes that, at the current state of knowledge, may be representative of gene-environment interactions of potential, uncertain or unlikely relevance for multiple sclerosis pathogenesis: Epstein-Barr virus, human immunodeficiency virus, hepatitis B virus, hepatitis C virus, cytomegalovirus, HHV8-Kaposi sarcoma, H1N1-influenza, JC virus, human innate immunity interactome for type I interferon, autoimmune regulator, vitamin D receptor, aryl hydrocarbon receptor and a panel of proteins targeted by 70 innate immune-modulating viral open reading frames from 30 viral species. Interactomes were either obtained from the literature or were manually curated. The P values of all single nucleotide polymorphism mapping to a given interactome were obtained from the last genome-wide association study of the International Multiple Sclerosis Genetics Consortium & the Wellcome Trust Case Control Consortium, 2. The interaction between genotype and Epstein Barr virus emerges as relevant for multiple sclerosis etiology. However, in line with recent data on the coexistence of common and unique strategies used by viruses to perturb the human molecular system, also other viruses have a similar potential, though probably less relevant in epidemiological terms. © 2013 Mechelli et al.

Numerical study of LSF floors made of hollow flange channels in fire

Light gauge steel frame (LSF) floor systems are generally made of lipped channel section joists and lined with gypsum plasterboards to provide adequate fire resistance rating under fire conditions. Recently a new LSF floor system made of welded hollow flange channel (HFC) section was developed and its fire performance was investigated using full scale fire tests. The new floor systems gave higher fire resistance ratings in comparison to conventional LSF floor systems. To avoid expensive and time consuming full scale fire tests, finite element analyses were also performed to simulate the fire performance of LSF floors made of HFC joists using both steady and transient state methods. This paper presents the details of the developed finite element models of HFC joists to simulate the structural fire performance of the LSF floor systems under standard fire conditions. Finite element analyses were performed using the measured time–temperature profiles of the failed joists from the fire tests, and their failure times, temperatures and modes, and deflection versus time curves were obtained. The developed finite element models successfully predicted the structural performance of LSF floors made of HFC joists under fire conditions. They were able to simulate the complex behaviour of thin cold-formed steel joists subjected to non-uniform temperature distributions, and local buckling and yielding effects. This study also confirmed the superior fire performance of the newly developed LSF floors made of HFC joists.

Experimental study of cold-formed steel floors made of hollow flange channel section joists under fire conditions

Fire safety plays a vital role in building design because appropriate level of fire safety is important to safeguard lives and property. Cold-formed steel channel sections along with fire-resistive plasterboards are used to construct light-gauge steel frame (LSF) floor systems to provide adequate fire resistance ratings (FRR). It is common practice to use lipped channel sections (LCS) as joists in LSF floor systems, and past research has only considered such systems. This research focuses on adopting improved joist sections such as hollow flange channel (HFC) sections to improve the structural performance and FRR of cold-formed LSF floor systems under standard fire conditions. The structural and thermal performances of LSF floor systems made of a welded HFC, LiteSteel Beams (LSB), with different plasterboard and insulation configurations, were investigated using four full-scale fire tests under standard fires. These fire tests showed that the new LSF floor system with LSB joists improved the FRR in comparison to that of conventional LCS joists. Fire tests have provided valuable structural and thermal performance data of tested floor systems that included time-temperature profiles and failure times, temperatures, and modes. This paper presents the details of the fire tests conducted in this study and their results along with some important findings.

A new single-phase frequency adaptive Phase-Locked Loop (PLL) for harmonic measurement

The paper presents an improved Phase-Locked Loop (PLL) for measuring the fundamental frequency and selective harmonic content of a distorted signal. This information can be used by grid interfaced devices and harmonic compensators. The single-phase structure is based on the Synchronous Reference Frame (SRF) PLL. The proposed PLL needs only a limited number of harmonic stages by incorporating Moving Average Filters (MAF) for eliminating the undesired harmonic content at each stage. The frequency dependency of MAF in effective filtering of undesired harmonics is also dealt with by a proposed method for adaptation to frequency variations of input signal. The method is suitable for high sampling rates and a wide frequency measurement range. Furthermore, an extended model of this structure is proposed which includes the response to both the frequency and phase angle variations. The proposed algorithm is simulated and verified using Hardware-in-the-Loop (HIL) testing.

Dual acquisition of 18F-FMISO and 18F-FDOPA

Metabolic imaging using positron emission tomography (PET) has found increasing clinical use for the management of infiltrating tumours such as glioma. However, the heterogeneous biological nature of tumours and intrinsic treatment resistance in some regions means that knowledge of multiple biological factors is needed for effective treatment planning. For example, the use of 18F-FDOPA to identify infiltrative tumour and 18F-FMISO for localizing hypoxic regions. Performing multiple PET acquisitions is impractical in many clinical settings, but previous studies suggest multiplexed PET imaging could be viable. The fidelity of the two signals is affected by the injection interval, scan timing and injected dose. The contribution of this work is to propose a framework to explicitly trade-off signal fidelity with logistical constraints when designing the imaging protocol. The particular case of estimating 18F-FMISO from a single frame prior to injection of 18F-FDOPA is considered. Theoretical experiments using simulations for typical biological scenarios in humans demonstrate that results comparable to a pair of single-tracer acquisitions can be obtained provided protocol timings are carefully selected. These results were validated using a pre-clinical data set that was synthetically multiplexed. The results indicate that the dual acquisition of 18F-FMISO and 18F-FDOPA could be feasible in the clinical setting. The proposed framework could also be used to design protocols for other tracers.

Dissimilarities in alignment-free methods for phylogenetic analysis based on genomes

Whole genome sequences are generally accepted as excellent tools for studying evolutionary relationships. Due to the problems caused by the uncertainty in alignment, existing tools for phylogenetic analysis based on multiple alignments could not be directly applied to the whole-genome comparison and phylogenomic studies. There has been a growing interest in alignment-free methods for phylogenetic analysis using complete genome data. The “distances” used in these alignment-free methods are not proper distance metrics in the strict mathematical sense. In this study, we first review them in a more general frame — dissimilarity. Then we propose some new dissimilarities for phylogenetic analysis. Last three genome datasets are employed to evaluate these dissimilarities from a biological point of view.

Self-management support for people with chronic kidney disease: Patient perspectives

Background Self-management of chronic kidney disease (CKD) is crucial for health outcomes and people need to be effectively supported by healthcare professionals (HCPs). Some programmes designed to improve self-management have been implemented, but people with the disease are rarely consulted regarding what they desire from these programmes. Objectives To provide a synthesis of the literature on preferences for self-management support of people with CKD. Design An integrative review. Methods Four databases (MedLine, CINAHL, PsycARTICLES and PsycINFO) were searched using relevant search terms. Results The search strategy identified 1,913 records, of which 12 studies met inclusion criteria. Ten themes were identified as important areas to be addressed by self-management interventions. In addition, patient suggestions for implementation of such interventions are discussed. Conclusion The principles of a person-centred approach ought to frame the support provided by HCPs when supporting those with CKD to better self-manage.

'Sink or swim': An evaluation of the clinical characteristics of individuals with high bone mass

Summary High bone mineral density on routine dual energy X-ray absorptiometry (DXA) may indicate an underlying skeletal dysplasia. Two hundred fifty-eight individuals with unexplained high bone mass (HBM), 236 relatives (41% with HBM) and 58 spouses were studied. Cases could not float, had mandible enlargement, extra bone, broad frames, larger shoe sizes and increased body mass index (BMI). HBM cases may harbour an underlying genetic disorder. Introduction High bone mineral density is a sporadic incidental finding on routine DXA scanning of apparently asymptomatic individuals. Such individuals may have an underlying skeletal dysplasia, as seen in LRP5 mutations. We aimed to characterize unexplained HBM and determine the potential for an underlying skeletal dysplasia. Methods Two hundred fifty-eight individuals with unexplained HBM (defined as L1 Z-score ≥ +3.2 plus total hip Z-score ≥ +1.2, or total hip Z-score ≥ +3.2) were recruited from 15 UK centres, by screening 335,115 DXA scans. Unexplained HBM affected 0.181% of DXA scans. Next 236 relatives were recruited of whom 94 (41%) had HBM (defined as L1 Z-score + total hip Z-score ≥ +3.2). Fifty-eight spouses were also recruited together with the unaffected relatives as controls. Phenotypes of cases and controls, obtained from clinical assessment, were compared using random-effects linear and logistic regression models, clustered by family, adjusted for confounders, including age and sex. Results Individuals with unexplained HBM had an excess of sinking when swimming (7.11 [3.65, 13.84], p < 0.001; adjusted odds ratio with 95% confidence interval shown), mandible enlargement (4.16 [2.34, 7.39], p < 0.001), extra bone at tendon/ligament insertions (2.07 [1.13, 3.78], p = 0.018) and broad frame (3.55 [2.12, 5.95], p < 0.001). HBM cases also had a larger shoe size (mean difference 0.4 [0.1, 0.7] UK sizes, p = 0.009) and increased BMI (mean difference 2.2 [1.3, 3.1] kg/m 2, p < 0.001). Conclusion Individuals with unexplained HBM have an excess of clinical characteristics associated with skeletal dysplasia and their relatives are commonly affected, suggesting many may harbour an underlying genetic disorder affecting bone mass.

Genome-wide association study identifies eight loci associated with blood pressure

Elevated blood pressure is a common, heritable cause of cardiovascular disease worldwide. To date, identification of common genetic variants influencing blood pressure has proven challenging. We tested 2.5 million genotyped and imputed SNPs for association with systolic and diastolic blood pressure in 34,433 subjects of European ancestry from the Global BPgen consortium and followed up findings with direct genotyping (N 71,225 European ancestry, N 12,889 Indian Asian ancestry) and in silico comparison (CHARGE consortium, N = 29,136). We identified association between systolic or diastolic blood pressure and common variants in eight regions near the CYP17A1 (P = 7 × 10 24), CYP1A2 (P = 1 × 10 23), FGF5 (P = 1 × 10 21), SH2B3 (P = 3 × 10 18), MTHFR (P = 2 × 10 13), c10orf107 (P = 1 × 10 9), ZNF652 (P = 5 × 10 9) and PLCD3 (P = 1 × 10 8) genes. All variants associated with continuous blood pressure were associated with dichotomous hypertension. These associations between common variants and blood pressure and hypertension offer mechanistic insights into the regulation of blood pressure and may point to novel targets for interventions to prevent cardiovascular disease.

Embedding metacognitive skills in spatial design

Metacognitive skills are considered to be essential for graduates from higher education institutions. In teaching spatial design, a fundamental aspect of student learning is the ability to ‘frame’ problems, generate solutions and explore possibilities of different solutions. This article proposes an innovative approach to design education through the implementation of strategies into the design process. The externalisation of implicit and tacit learning through metacognition connects theoretical concepts to interior design process and practice, as well as allowing students to engage and critically analyse issues surrounding theory and practice, thus equipping them with the skills as future design professionals.

Predicting the performance of LSF walls made of hollow flange channel sections in fire

Fire resistance of load bearing Light Gauge Steel Frame (LSF) wall systems is important to protect lives and properties in fire accidents. Recent fire tests of LSF walls made of the new cold-formed and welded hollow flange channel (HFC) section studs and the commonly used lipped channel section (LCS) studs have shown the influence of stud sections on the fire resistance rating (FRR) of LSF walls. To advance the use of HFC section studs and to verify the outcomes from the fire tests, finite element models were developed to predict the structural fire performance of LSF walls made of welded HFC section studs. The developed models incorporated the measured non-uniform temperature distributions in LSF wall studs due to the exposure of standard fire on one side, and accurate elevated temperature mechanical properties of steel used in the stud sections. These models simulated the various complexities involved such as thermal bowing and neutral axis shift caused by the non-uniform temperature distribution in the studs. The finite element analysis (FEA) results agreed well with the full scale fire test results including the FRR, outer hot and cold flange temperatures at failure and axial deformation and lateral displacement profiles. They also confirmed the superior fire performance of LSF walls made of HFC section studs. The applicability of both transient and steady state FEA of LSF walls under fire conditions was verified in this study, which also investigated the effects of using various temperature distribution patterns across the cross-section of HFC section studs on the FRR of LSF walls. This paper presents the details of this numerical study and the results.

The trend toward pre-graduation professional work experience for Australian young planners: Essential experience or essentially exploitation

This paper explores the changing employment expectations that frame the early professional work experiences of young planners in Australia. In particular, it considers the rising popularity of pre-graduation professional work experience as a precursor to formal entry into the workforce as a practising planner. This shift is being driven in part by employer expectations that graduates will already have ‘real world’ and relevant work experience. However, an equally significant driver appears to be a growing desire for early career and graduate planners to find ways to distinguish themselves from their peers in an increasingly tight labour market. Using data from an ongoing research project into the formative work experiences of young people this paper describes the three main types of pre-graduation professional work experience undertaken by young planners. It highlights the potential challenges and benefits of pre-graduation work experience from a legal, social and ethical perspective as well as from the perspective of young planners themselves. The paper concludes by reflecting on the role of the planning profession – employers, peak bodies and planning educators – in managing the tensions between producing ‘work ready’ graduates and safeguarding the employment conditions of early career planning professionals.

A framing analysis on Nepalese media portrayal of disaster events using news frames and PPRR cycle

This study seeks to understand the prevailing status of Nepalese media portrayal of natural disasters and develop a disaster management framework to improve the effectiveness and efficiency of news production through the continuum of prevention, preparedness, response and recovery (PPRR) phases of disaster management. The study is currently under progress. It is being undertaken in three phases. In phase-1, a qualitative content analysis is conducted. The news contents are categorized in frames as proposed in the 'Framing theory' and pre-defined frames. However, researcher has looked at the theories of the Press, linking to social responsibility theory as it is regarded as the major obligation of the media towards the society. Thereafter, the contents are categorized as per PPRR cycle. In Phase-2, based on the findings of content analysis, 12 in-depth interviews with journalists, disaster managers and community leaders are conducted. In phase-3, based on the findings of content analysis and in-depth interviews, a framework for effective media management of disaster are developed using thematic analysis. As the study is currently under progress hence, findings from the pilot study are elucidated. The response phase of disasters is most commonly reported in Nepal. There is relatively low coverage of preparedness and prevention. Furthermore, the responsibility frame in the news is most prevalent following human interest. Economic consequences and conflict frames are also used while reporting and vulnerability assessment has been used as an additional frame. The outcomes of this study are multifaceted: At the micro-level people will be benefited as it will enable a reduction in the loss of human lives and property through effective dissemination of information in news and other mode of media. They will be ‘well prepared for', 'able to prevent', 'respond to' and 'recover from' any natural disasters. At the meso level the media industry will be benefited and have their own 'disaster management model of news production' as an effective disaster reporting tool which will improve in media's editorial judgment and priority. At the macro-level it will assist government and other agencies to develop appropriate policies and strategies for better management of natural disasters.