Deliberative assessment of surrogate consent in dementia research

Background Research involving incapacitated persons with dementia entails complex scientific, legal, and ethical issues, making traditional surveys of layperson views on the ethics of such research challenging. We therefore assessed the impact of democratic deliberation (DD), involving balanced, detailed education and peer deliberation, on the views of those responsible for persons with dementia. Methods One hundred and seventy-eight community-recruited caregivers or primary decision-makers for persons with dementia were randomly assigned to either an all-day DD session group or a control group. Educational materials used for the DD session were vetted for balance and accuracy by an interdisciplinary advisory panel. We assessed the acceptability of family-surrogate consent for dementia research (“surrogate-based research”) from a societal policy perspective as well as from the more personal perspectives of deciding for a loved one or for oneself (surrogate and self-perspectives), assessed at baseline, immediately post-DD session, and 1 month after DD date, for four research scenarios of varying risk-benefit profiles. Results At baseline, a majority in both the DD and control groups supported a policy of family consent for dementia research in all research scenarios. The support for a policy of family consent for surrogate-based research increased in the DD group, but not in the control group. The change in the DD group was maintained 1 month later. In the DD group, there were transient changes in attitudes from surrogate or self-perspectives. In the control group, there were no changes from baseline in attitude toward surrogate consent from any perspective. Conclusions Intensive, balanced, and accurate education, along with peer deliberation provided by democratic deliberation, led to a sustained increase in support for a societal policy of family consent in dementia research among those responsible for dementia patients.

The role of cardiopulmonary signals in the dynamics of the eye's wavefront aberrations

Abstract—The role of cardiopulmonary signals in the dynamics of wavefront aberrations in the eye has been examined. Synchronous measurement of the eye’s wavefront aberrations, cardiac function, blood pulse, and respiration signals were taken for a group of young, healthy subjects. Two focusing stimuli, three breathing patterns, as well as natural and cycloplegic eye conditions were examined. A set of tools, including time–frequency coherence and its metrics, has been proposed to acquire a detailed picture of the interactions of the cardiopulmonary system with the eye’s wavefront aberrations. The results showed that the coherence of the blood pulse and its harmonics with the eye’s aberrations was, on average, weak (0.4 ± 0.15), while the coherence of the respiration signal with eye’s aberrations was, on average, moderate (0.53 ± 0.14). It was also revealed that there were significant intervals during which high coherence occurred. On average, the coherence was high (>0.75) during 16% of the recorded time, for the blood pulse, and 34% of the time for the respiration signal. A statistically significant decrease in average coherence was noted for the eye’s aberrations with respiration in the case of fast controlled breathing (0.5 Hz). The coherence between the blood pulse and the defocus was significantly larger for the far target than for the near target condition. After cycloplegia, the coherence of defocus with the blood pulse significantly decreased, while this was not the case for the other aberrations. There was also a noticeable, but not statistically significant, increase in the coherence of the comatic term and respiration in that case. By using nonstationary measures of signal coherence, a more detailed picture of interactions between the cardiopulmonary signals and eye’s wavefront aberrations has emerged.

Effect of pedestrian movement on MIMO-OFDM channel capacity in an indoor environment

The rapid growth of mobile telephone use, satellite services, and now the wireless Internet and WLANs are generating tremendous changes in telecommunication and networking. As indoor wireless communications become more prevalent, modeling indoor radio wave propagation in populated environments is a topic of significant interest. Wireless MIMO communication exploits phenomena such as multipath propagation to increase data throughput and range, or reduce bit error rates, rather than attempting to eliminate effects of multipath propagation as traditional SISO communication systems seek to do. The MIMO approach can yield significant gains for both link and network capacities, with no additional transmitting power or bandwidth consumption when compared to conventional single-array diversity methods. When MIMO and OFDM systems are combined and deployed in a suitable rich scattering environment such as indoors, a significant capacity gain can be observed due to the assurance of multipath propagation. Channel variations can occur as a result of movement of personnel, industrial machinery, vehicles and other equipment moving within the indoor environment. The time-varying effects on the propagation channel in populated indoor environments depend on the different pedestrian traffic conditions and the particular type of environment considered. A systematic measurement campaign to study pedestrian movement effects in indoor MIMO-OFDM channels has not yet been fully undertaken. Measuring channel variations caused by the relative positioning of pedestrians is essential in the study of indoor MIMO-OFDM broadband wireless networks. Theoretically, due to high multipath scattering, an increase in MIMO-OFDM channel capacity is expected when pedestrians are present. However, measurements indicate that some reductions in channel capacity could be observed as the number of pedestrians approaches 10 due to a reduction in multipath conditions as more human bodies absorb the wireless signals. This dissertation presents a systematic characterization of the effects of pedestrians in indoor MIMO-OFDM channels. Measurement results, using the MIMO-OFDM channel sounder developed at the CSIRO ICT Centre, have been validated by a customized Geometric Optics-based ray tracing simulation. Based on measured and simulated MIMO-OFDM channel capacity and MIMO-OFDM capacity dynamic range, an improved deterministic model for MIMO-OFDM channels in indoor populated environments is presented. The model can be used for the design and analysis of future WLAN to be deployed in indoor environments. The results obtained show that, in both Fixed SNR and Fixed Tx for deterministic condition, the channel capacity dynamic range rose with the number of pedestrians as well as with the number of antenna combinations. In random scenarios with 10 pedestrians, an increment in channel capacity of up to 0.89 bits/sec/Hz in Fixed SNR and up to 1.52 bits/sec/Hz in Fixed Tx has been recorded compared to the one pedestrian scenario. In addition, from the results a maximum increase in average channel capacity of 49% has been measured while 4 antenna elements are used, compared with 2 antenna elements. The highest measured average capacity, 11.75 bits/sec/Hz, corresponds to the 4x4 array with 10 pedestrians moving randomly. Moreover, Additionally, the spread between the highest and lowest value of the the dynamic range is larger for Fixed Tx, predicted 5.5 bits/sec/Hz and measured 1.5 bits/sec/Hz, in comparison with Fixed SNR criteria, predicted 1.5 bits/sec/Hz and measured 0.7 bits/sec/Hz. This has been confirmed by both measurements and simulations ranging from 1 to 5, 7 and 10 pedestrians.

Hierarchical fuzzy logic traffic control at a road junction using genetic algorithms

Traffic control at a road junction by a complex fuzzy logic controller is investigated. The increase in the complexity of junction means more number of input variables must be taken into account, which will increase the number of fuzzy rules in the system. A hierarchical fuzzy logic controller is introduced to reduce the number of rules. Besides, the increase in the complexity of the controller makes formulation of the fuzzy rules difficult. A genetic algorithm based off-line leaning algorithm is employed to generate the fuzzy rules. The learning algorithm uses constant flow-rates as training sets. The system is tested by both constant and time-varying flow-rates. Simulation results show that the proposed controller produces lower average delay than a fixed-time controller does under various traffic conditions.

Modal parameter estimation in the presence of non-linearities

This paper investigates the use of time-frequency techniques to assist in the estimation of power system modes which are resolvable by a Digital Fourier Transform (DFT). The limitations of linear estimation techniques in the presence of large disturbances which excite system non-linearities, particularly the swing equation non-linearity are shown. Where a nonlinearity manifests itself as time varying modal frequencies the Wigner-Ville Distribution (WVD) is used to describe the variation in modal frequencies and construct a window over which standard linear estimation techniques can be used. The error obtained even in the presence of multiple resolvable modes is better than 2%.

Policy analysis of disaster health management in China

Humankind has been dealing with all kinds of disasters since the dawn of time. The risk and impact of disasters producing mass casualties worldwide is increasing, due partly to global warming as well as to increased population growth, increased density and the aging population. China, as a country with a large population, vast territory, and complex climatic and geographical conditions, has been plagued by all kinds of disasters. Disaster health management has traditionally been a relatively arcane discipline within public health. However, SARS, Avian Influenza, and earthquakes and floods, along with the need to be better prepared for the Olympic Games in China has brought disasters, their management and their potential for large scale health consequences on populations to the attention of the public, the government and the international community alike. As a result significant improvements were made to the disaster management policy framework, as well as changes to systems and structures to incorporate an improved disaster management focus. This involved the upgrade of the Centres for Disease Control and Prevention (CDC) throughout China to monitor and better control the health consequences particularly of infectious disease outbreaks. However, as can be seen in the Southern China Snow Storm and Wenchuan Earthquake in 2008, there remains a lack of integrated disaster management and efficient medical rescue, which has been costly in terms of economics and health for China. In the context of a very large and complex country, there is a need to better understand whether these changes have resulted in effective management of the health impacts of such incidents. To date, the health consequences of disasters, particularly in China, have not been a major focus of study. The main aim of this study is to analyse and evaluate disaster health management policy in China and in particular, its ability to effectively manage the health consequences of disasters. Flood has been selected for this study as it is a common and significant disaster type in China and throughout the world. This information will then be used to guide conceptual understanding of the health consequences of floods. A secondary aim of the study is to compare disaster health management in China and Australia as these countries differ in their length of experience in having a formalised policy response. The final aim of the study is to determine the extent to which Walt and Gilson’s (1994) model of policy explains how disaster management policy in China was developed and implemented after SARS in 2003 to the present day. This study has utilised a case study methodology. A document analysis and literature search of Chinese and English sources was undertaken to analyse and produce a chronology of disaster health management policy in China. Additionally, three detailed case studies of flood health management in China were undertaken along with three case studies in Australia in order to examine the policy response and any health consequences stemming from the floods. A total of 30 key international disaster health management experts were surveyed to identify fundamental elements and principles of a successful policy framework for disaster health management. Key policy ingredients were identified from the literature, the case-studies and the survey of experts. Walt and Gilson (1994)’s policy model that focuses on the actors, content, context and process of policy was found to be a useful model for analysing disaster health management policy development and implementation in China. This thesis is divided into four parts. Part 1 is a brief overview of the issues and context to set the scene. Part 2 examines the conceptual and operational context including the international literature, government documents and the operational environment for disaster health management in China. Part 3 examines primary sources of information to inform the analysis. This involves two key studies: • A comparative analysis of the management of floods in China and Australia • A survey of international experts in the field of disaster management so as to inform the evaluation of the policy framework in existence in China and the criteria upon which the expression of that policy could be evaluated Part 4 describes the key outcomes of this research which include: • A conceptual framework for describing the health consequences of floods • A conceptual framework for disaster health management • An evaluation of the disaster health management policy and its implementation in China. The research outcomes clearly identified that the most significant improvements are to be derived from improvements in the generic management of disasters, rather than the health aspects alone. Thus, the key findings and recommendations tend to focus on generic issues. The key findings of this research include the following: • The health consequences of floods may be described in terms of time as ‘immediate’, ‘medium term’ and ‘long term’ and also in relation to causation as ‘direct’ and ‘indirect’ consequences of the flood. These two aspects form a matrix which in turn guides management responses. • Disaster health management in China requires a more comprehensive response throughout the cycle of prevention, preparedness, response and recovery but it also requires a more concentrated effort on policy implementation to ensure the translation of the policy framework into effective incident management. • The policy framework in China is largely of international standard with a sound legislative base. In addition the development of the Centres for Disease Control and Prevention has provided the basis for a systematic approach to health consequence management. However, the key weaknesses in the current system include: o The lack of a key central structure to provide the infrastructure with vital support for policy development, implementation and evaluation. o The lack of well-prepared local response teams similar to local government based volunteer groups in Australia. • The system lacks structures to coordinate government action at the local level. The result of this is a poorly coordinated local response and lack of clarity regarding the point at which escalation of the response to higher levels of government is advisable. These result in higher levels of risk and negative health impacts. The key recommendations arising from this study are: 1. Disaster health management policy in China should be enhanced by incorporating disaster management considerations into policy development, and by requiring a disaster management risk analysis and disaster management impact statement for development proposals. 2. China should transform existing organizations to establish a central organisation similar to the Federal Emergency Management Agency (FEMA) in the USA or the Emergency Management Australia (EMA) in Australia. This organization would be responsible for leading nationwide preparedness through planning, standards development, education and incident evaluation and to provide operational support to the national and local government bodies in the event of a major incident. 3. China should review national and local plans to reflect consistency in planning, and to emphasize the advantages of the integrated planning process. 4. Enhance community resilience through community education and the development of a local volunteer organization. China should develop a national strategy which sets direction and standards in regard to education and training, and requires system testing through exercises. Other initiatives may include the development of a local volunteer capability with appropriate training to assist professional response agencies such as police and fire services in a major incident. An existing organisation such as the Communist Party may be an appropriate structure to provide this response in a cost effective manner. 5. Continue development of professional emergency services, particularly ambulance, to ensure an effective infrastructure is in place to support the emergency response in disasters. 6. Funding for disaster health management should be enhanced, not only from government, but also from other sources such as donations and insurance. It is necessary to provide a more transparent mechanism to ensure the funding is disseminated according to the needs of the people affected. 7. Emphasis should be placed on prevention and preparedness, especially on effective disaster warnings. 8. China should develop local disaster health management infrastructure utilising existing resources wherever possible. Strategies for enhancing local infrastructure could include the identification of local resources (including military resources) which could be made available to support disaster responses. It should develop operational procedures to access those resources. Implementation of these recommendations should better position China to reduce the significant health consequences experienced each year from major incidents such as floods and to provide an increased level of confidence to the community about the country’s capacity to manage such events.

Adaptive cache aware multiprocessor scheduling framework

Computer resource allocation represents a significant challenge particularly for multiprocessor systems, which consist of shared computing resources to be allocated among co-runner processes and threads. While an efficient resource allocation would result in a highly efficient and stable overall multiprocessor system and individual thread performance, ineffective poor resource allocation causes significant performance bottlenecks even for the system with high computing resources. This thesis proposes a cache aware adaptive closed loop scheduling framework as an efficient resource allocation strategy for the highly dynamic resource management problem, which requires instant estimation of highly uncertain and unpredictable resource patterns. Many different approaches to this highly dynamic resource allocation problem have been developed but neither the dynamic nature nor the time-varying and uncertain characteristics of the resource allocation problem is well considered. These approaches facilitate either static and dynamic optimization methods or advanced scheduling algorithms such as the Proportional Fair (PFair) scheduling algorithm. Some of these approaches, which consider the dynamic nature of multiprocessor systems, apply only a basic closed loop system; hence, they fail to take the time-varying and uncertainty of the system into account. Therefore, further research into the multiprocessor resource allocation is required. Our closed loop cache aware adaptive scheduling framework takes the resource availability and the resource usage patterns into account by measuring time-varying factors such as cache miss counts, stalls and instruction counts. More specifically, the cache usage pattern of the thread is identified using QR recursive least square algorithm (RLS) and cache miss count time series statistics. For the identified cache resource dynamics, our closed loop cache aware adaptive scheduling framework enforces instruction fairness for the threads. Fairness in the context of our research project is defined as a resource allocation equity, which reduces corunner thread dependence in a shared resource environment. In this way, instruction count degradation due to shared cache resource conflicts is overcome. In this respect, our closed loop cache aware adaptive scheduling framework contributes to the research field in two major and three minor aspects. The two major contributions lead to the cache aware scheduling system. The first major contribution is the development of the execution fairness algorithm, which degrades the co-runner cache impact on the thread performance. The second contribution is the development of relevant mathematical models, such as thread execution pattern and cache access pattern models, which in fact formulate the execution fairness algorithm in terms of mathematical quantities. Following the development of the cache aware scheduling system, our adaptive self-tuning control framework is constructed to add an adaptive closed loop aspect to the cache aware scheduling system. This control framework in fact consists of two main components: the parameter estimator, and the controller design module. The first minor contribution is the development of the parameter estimators; the QR Recursive Least Square(RLS) algorithm is applied into our closed loop cache aware adaptive scheduling framework to estimate highly uncertain and time-varying cache resource patterns of threads. The second minor contribution is the designing of a controller design module; the algebraic controller design algorithm, Pole Placement, is utilized to design the relevant controller, which is able to provide desired timevarying control action. The adaptive self-tuning control framework and cache aware scheduling system in fact constitute our final framework, closed loop cache aware adaptive scheduling framework. The third minor contribution is to validate this cache aware adaptive closed loop scheduling framework efficiency in overwhelming the co-runner cache dependency. The timeseries statistical counters are developed for M-Sim Multi-Core Simulator; and the theoretical findings and mathematical formulations are applied as MATLAB m-file software codes. In this way, the overall framework is tested and experiment outcomes are analyzed. According to our experiment outcomes, it is concluded that our closed loop cache aware adaptive scheduling framework successfully drives co-runner cache dependent thread instruction count to co-runner independent instruction count with an error margin up to 25% in case cache is highly utilized. In addition, thread cache access pattern is also estimated with 75% accuracy.

Interactive axial shortening of columns and walls in high rise buildings

Concrete is commonly used as a primary construction material for tall building construction. Load bearing components such as columns and walls in concrete buildings are subjected to instantaneous and long term axial shortening caused by the time dependent effects of "shrinkage", "creep" and "elastic" deformations. Reinforcing steel content, variable concrete modulus, volume to surface area ratio of the elements and environmental conditions govern axial shortening. The impact of differential axial shortening among columns and core shear walls escalate with increasing building height. Differential axial shortening of gravity loaded elements in geometrically complex and irregular buildings result in permanent distortion and deflection of the structural frame which have a significant impact on building envelopes, building services, secondary systems and the life time serviceability and performance of a building. Existing numerical methods commonly used in design to quantify axial shortening are mainly based on elastic analytical techniques and therefore unable to capture the complexity of non-linear time dependent effect. Ambient measurements of axial shortening using vibrating wire, external mechanical strain, and electronic strain gauges are methods that are available to verify pre-estimated values from the design stage. Installing these gauges permanently embedded in or on the surface of concrete components for continuous measurements during and after construction with adequate protection is uneconomical, inconvenient and unreliable. Therefore such methods are rarely if ever used in actual practice of building construction. This research project has developed a rigorous numerical procedure that encompasses linear and non-linear time dependent phenomena for prediction of axial shortening of reinforced concrete structural components at design stage. This procedure takes into consideration (i) construction sequence, (ii) time varying values of Young's Modulus of reinforced concrete and (iii) creep and shrinkage models that account for variability resulting from environmental effects. The capabilities of the procedure are illustrated through examples. In order to update previous predictions of axial shortening during the construction and service stages of the building, this research has also developed a vibration based procedure using ambient measurements. This procedure takes into consideration the changes in vibration characteristic of structure during and after construction. The application of this procedure is illustrated through numerical examples which also highlight the features. The vibration based procedure can also be used as a tool to assess structural health/performance of key structural components in the building during construction and service life.

Wind-energy based path planning for electric unmanned aerial vehicles using Markov Decision Processes

Exploiting wind-energy is one possible way to ex- tend flight duration for Unmanned Arial Vehicles. Wind-energy can also be used to minimise energy consumption for a planned path. In this paper, we consider uncertain time-varying wind fields and plan a path through them. A Gaussian distribution is used to determine uncertainty in the Time-varying wind fields. We use Markov Decision Process to plan a path based upon the uncertainty of Gaussian distribution. Simulation results that compare the direct line of flight between start and target point and our planned path for energy consumption and time of travel are presented. The result is a robust path using the most visited cell while sampling the Gaussian distribution of the wind field in each cell.

Wind-energy based path planning for unmanned aerial vehicles using Markov decision processes

Exploiting wind-energy is one possible way to extend flight duration for Unmanned Arial Vehicles. Wind-energy can also be used to minimise energy consumption for a planned path. In this paper, we consider uncertain time-varying wind fields and plan a path through them. A Gaussian distribution is used to determine uncertainty in the Time-varying wind fields. We use Markov Decision Process to plan a path based upon the uncertainty of Gaussian distribution. Simulation results that compare the direct line of flight between start and target point and our planned path for energy consumption and time of travel are presented. The result is a robust path using the most visited cell while sampling the Gaussian distribution of the wind field in each cell.

Return distribution predictability and its implications for portfolio selection

The inquiries to return predictability are traditionally limited to conditional mean, while literature on portfolio selection is replete with moment-based analysis with up to the fourth moment being considered. This paper develops a distribution-based framework for both return prediction and portfolio selection. More specifically, a time-varying return distribution is modeled through quantile regressions and copulas, using quantile regressions to extract information in marginal distributions and copulas to capture dependence structure. A preference function which captures higher moments is proposed for portfolio selection. An empirical application highlights the additional information provided by the distributional approach which cannot be captured by the traditional moment-based methods.

Revision total hip replacement using the cement-in-cement technique for the acetabular component : technique and results for 60 hips

The technique of femoral cement-in-cement revision is well established, but there are no previous series reporting its use on the acetabular side at the time of revision total hip arthroplasty. We describe the surgical technique and report the outcome of 60 consecutive cement-in-cement revisions of the acetabular component at a mean follow-up of 8.5 years (range 5-12 years). All had a radiologically and clinically well fixed acetabular cement mantle at the time of revision. 29 patients died. No case was lost to follow-up. The 2 most common indications for acetabular revision were recurrent dislocation (77%) and to compliment a femoral revision (20%). There were 2 cases of aseptic cup loosening (3.3%) requiring re-revision. No other hip was clinically or radiologically loose (96.7%) at latest follow-up. One case was re-revised for infection, 4 for recurrent dislocation and 1 for disarticulation of a constrained component. At 5 years, the Kaplan-Meier survival rate was 100% for aseptic loosening and 92.2% (95% CI; 84.8-99.6%) with revision for all causes as the endpoint. These results support the use of the cement-in-cement revision technique in appropriate cases on the acetabular side. Theoretical advantages include preservation of bone stock, reduced operating time, reduced risk of complications and durable fixation.

Fast and robust stereo matching algorithms for mining automation

The mining environment, being complex, irregular, and time-varying, presents a challenging prospect for stereo vision. For this application, speed, reliability, and the ability to produce a dense depth map are of foremost importance. This paper evaluates a number of matching techniques for possible use in a stereo vision sensor for mining automation applications. Area-based techniques have been investigated because they have the potential to yield dense maps, are amenable to fast hardware implementation, and are suited to textured scenes. In addition, two nonparametric transforms, namely, rank and census, have been investigated. Matching algorithms using these transforms were found to have a number of clear advantages, including reliability in the presence of radiometric distortion, low computational complexity, and amenability to hardware implementation.

Fast and robust stereo matching algorithms for mining automation

The mining environment, being complex, irregular and time varying, presents a challenging prospect for stereo vision. The objective is to produce a stereo vision sensor suited to close-range scenes consisting primarily of rocks. This sensor should be able to produce a dense depth map within real-time constraints. Speed and robustness are of foremost importance for this investigation. A number of area based matching metrics have been implemented, including the SAD, SSD, NCC, and their zero-meaned versions. The NCC and the zero meaned SAD and SSD were found to produce the disparity maps with the highest proportion of valid matches. The plain SAD and SSD were the least computationally expensive, due to all their operations taking place in integer arithmetic, however, they were extremely sensitive to radiometric distortion. Non-parametric techniques for matching, in particular, the rank and the census transform, have also been investigated. The rank and census transforms were found to be robust with respect to radiometric distortion, as well as being able to produce disparity maps with a high proportion of valid matches. An additional advantage of both the rank and the census transform is their amenability to fast hardware implementation.