Value of total body potassium in assessing the nutritional status of children with end-stage liver disease

Malnutrition is a common problem in children with end-stage liver disease (ESLD), and accurate assessment of nutritional status is essential in managing these children. In a retrospective study, we compared nutritional assessment by anthropometry with that by body composition. We analyzed all consecutive measurements of total body potassium (TBK, n = 186) of children less than 3 years old with ESLD awaiting transplantation found in our database. The TBK values obtained by whole body counting of 40K were compared with reference TRK values of healthy children. The prevalence of malnutrition, as assessed by weight (weight Z score < -2) was 28%, which was significantly lower (chi-square test, p < 0.0001) than the prevalence of malnutrition (76%) assessed by TBK (< 90% of expected TRK for age). These results demonstrated that body weight underestimated the nutritional deficit and stressed the importance of measuring body composition as part of assessing nutritional status of children with ESLD.

Nutritional status of children with cystic fibrosis measured by total body potassium as a marker of body cell mass: Lack of sensitivity of anthropometric measures

Objective: To investigate measures aimed at defining the nutritional status of cystic fibrosis (CF) populations, this study compared standard anthropometric measurements and total body potassium (TBK) as indicators of malnutrition. Methods: Height, weight, and TBK measurements of 226 children with CF from Royal Children's Hospital, Brisbane, Australia, were analyzed. Z scores for height for age, weight for age, and weight for height were analyzed by means of the National Centre for Health Statistics reference. TBK was measured by means of whole body counting and compared with predicted TBK for age. Two criteria were evaluated with respect to malnutrition: (1) a z score < -2.0 and (2) a TBK for age <80% of predicted. Results: Males and females with CF had lower mean height-for-age and weight-for-age z scores than the National Centre for Health Statistics reference (P < .01), but mean weight-for-height z score was not significantly different. There were no significant gender differences. According to anthropometry, only 7.5% of this population were underweight and 7.6% were stunted. However, with TBK as an indicator of nutritional status, 29.9% of males and 22.0% of females were malnourished. Conclusion: There are large differences in the percentage of patients with CF identified as malnourished depending on whether anthropometry or body composition data are used as the nutritional indicator. At an individual level, weight-based indicators are not sensitive indicators of suboptimal nutritional status in CF, significantly underestimating the extent of malnutrition. Current recommendations in which anthropometry is used as the indicator of malnutrition in CF should be revised.

Architecture, the body and authority in performance

This is a theoretical investigation seeking to learn more about architecture by looking at architectural practice through another discipline. In this research architecture is investigated by examining its relationship with bodies through performance and theatre set design. This thesis aims to build on existing architectural theory, in which an absence of discourse on the body has been identified, by analysing representations of architecture and the body in performance. The research specifically examines the relationship between the body, architecture and authority in performance through the analysis of several performance works.

A three-dimensional hybrid smoothed finite element method (H-SFEM) for nonlinear solid mechanics problems

This paper presents a novel three-dimensional hybrid smoothed finite element method (H-SFEM) for solid mechanics problems. In 3D H-SFEM, the strain field is assumed to be the weighted average between compatible strains from the finite element method (FEM) and smoothed strains from the node-based smoothed FEM with a parameter α equipped into H-SFEM. By adjusting α, the upper and lower bound solutions in the strain energy norm and eigenfrequencies can always be obtained. The optimized α value in 3D H-SFEM using a tetrahedron mesh possesses a close-to-exact stiffness of the continuous system, and produces ultra-accurate solutions in terms of displacement, strain energy and eigenfrequencies in the linear and nonlinear problems. The novel domain-based selective scheme is proposed leading to a combined selective H-SFEM model that is immune from volumetric locking and hence works well for nearly incompressible materials. The proposed 3D H-SFEM is an innovative and unique numerical method with its distinct features, which has great potential in the successful application for solid mechanics problems.

Evaluation of growth and changes in body composition following neonatal diagnosis of cystic fibrosis

Early deficits in nutritional status that might require specific treatment and early response to nutritional therapy were studied longitudinally in 25 infants with cystic fibrosis (CF) diagnosed by neonatal screening, using anthropometric and research body composition methodology, and evaluation of pancreatic function. At the time of confirmed diagnosis (mean 5.4 weeks), body mass, length, total body fat (TBF), and total body potassium (TBK) were all significantly reduced. Following diagnosis and commencement of therapy there was a normalization of weight, length, and TBK by 6-12 months of age, indicating catch-up growth. But in some individuals the response was incomplete, and as a group, mean total body fat remained significantly lower than normal at 1 year of age. Seven of 25 (28%) were pancreatic sufficient at diagnosis, and all but one had evidence of declining pancreatic function requiring the institution of pancreatic enzyme therapy during the next 1-9 months. The median age of commencement of enzyme therapy was 10 weeks (range 5 weeks to 11 months). These longitudinal assessments emphasize the dynamic changes occurring in absorptive function, body composition, and nutritional status following neonatal diagnosis of cystic fibrosis and may reflect previously described abnormalities of energy metabolism in this age group. Abnormal body composition is evident in most CF infants following diagnosis by neonatal screening but pancreatic damage may still be evolving. We suggest that early active nutritional therapy and surveillance for changes in pancreatic function are warranted in CF infants diagnosed by neonatal screening.

Body composition studies in cystic fibrosis and myelomeningocele

One of the major considerations of improving the management of many chronic diseases has been the realisation of the importance of nutrition, and, in children, the maintenance of normal growth. Cystic Fibrosis (CF) and Myelomeningocele (MMC) are two such disease states in which nutritional status has a significant effect on morbidity.

A robust approach to design a single facility layout plan in dynamic manufacturing environments using a permutation-based genetic algorithm

During the past few decades, developing efficient methods to solve dynamic facility layout problems has been focused on significantly by practitioners and researchers. More specifically meta-heuristic algorithms, especially genetic algorithm, have been proven to be increasingly helpful to generate sub-optimal solutions for large-scale dynamic facility layout problems. Nevertheless, the uncertainty of the manufacturing factors in addition to the scale of the layout problem calls for a mixed genetic algorithm–robust approach that could provide a single unlimited layout design. The present research aims to devise a customized permutation-based robust genetic algorithm in dynamic manufacturing environments that is expected to be generating a unique robust layout for all the manufacturing periods. The numerical outcomes of the proposed robust genetic algorithm indicate significant cost improvements compared to the conventional genetic algorithm methods and a selective number of other heuristic and meta-heuristic techniques.

Total body potassium in cystic fibrosis

To further evaluate the nature of malnutrition, define at-risk groups, and confirm the efficacy of nutritional supplementation on body composition in cystic fibrosis (CF), we have conducted longitudinal and cross-sectional studies of total body potassium (TBK) in 161 unselected CF subjects aged 1 month to 17 years. TBK was determined by measurement of40K in a whole body counter, reflecting body cell mass (BCM), the vital work-performing and growing cellular component of the body. Compared with normal TBK data for age and sex from pooled measurements of 1,629 healthy children aged 1 week to 17 years, CF infants (n = 12) diagnosed by newborn screening were depleted in TBK at diagnosis and showed catch-up with therapy by 1 year; CF children aged 2-17 years (n = 140) showed a tendency for inadequate accretion of TBK (and thus BCM) with increasing age, although the normal correlation between TBK and weight and height was maintained in the majority suggesting a pattern of nutritional stunting of growth; and malnourished CF children (n = 9) showed significant catchup in TBK with long-term nutritional rehabilitation (85-98% of TBK predicted for weight and height). These studies suggest that potentially serious, but possibly correctable deficits, in the growth of the body cell mass as measured by TBK occur commonly in CF. These deficits may be established very early in life and if not corrected lead to progressive nutritional growth retardation with increasing age. © 1989 Raven Press, Ltd., New York.

Closed-form solutions for low-rank non-rigid reconstruction

Recovering the motion of a non-rigid body from a set of monocular images permits the analysis of dynamic scenes in uncontrolled environments. However, the extension of factorisation algorithms for rigid structure from motion to the low-rank non-rigid case has proved challenging. This stems from the comparatively hard problem of finding a linear “corrective transform” which recovers the projection and structure matrices from an ambiguous factorisation. We elucidate that this greater difficulty is due to the need to find multiple solutions to a non-trivial problem, casting a number of previous approaches as alleviating this issue by either a) introducing constraints on the basis, making the problems nonidentical, or b) incorporating heuristics to encourage a diverse set of solutions, making the problems inter-dependent. While it has previously been recognised that finding a single solution to this problem is sufficient to estimate cameras, we show that it is possible to bootstrap this partial solution to find the complete transform in closed-form. However, we acknowledge that our method minimises an algebraic error and is thus inherently sensitive to deviation from the low-rank model. We compare our closed-form solution for non-rigid structure with known cameras to the closed-form solution of Dai et al. [1], which we find to produce only coplanar reconstructions. We therefore make the recommendation that 3D reconstruction error always be measured relative to a trivial reconstruction such as a planar one.

Serendipitous road trips: Enhancing tourists’ experiences through social interaction

Driving can be a lonely activity. While there has been a lot of research and technical inventions concerning car-to-car communication and passenger entertainment, there is still little work concerning connecting drivers. Whereas tourism is very much a social activity, drive tourists have few options to communicate with fellow travellers. The proposed project is placed at the intersection of tourism and driving and aims to enhance the trip experience during driving through social interaction. This thesis explores how a mobile application that allows instant messaging between travellers sharing similar context can add to road trip experiences. To inform the design of such an application, the project adopted the principle of the user-centred design process. User needs were assessed by running an ideation workshop and a field trip. Findings of both studies have shown that tourists have different preferences and diverse attitudes towards contacting new people. Yet all participants stressed the value of social recommendations. Based on those results and a later expert review, three prototype versions of the system were created. A prototyping session with potential end users highlighted the most important features including the possibility to view user profiles, choose between text and audio input and receive up-to-date information. An implemented version of the prototype was evaluated in an exploratory study to identify usability related problems in an actual use case scenario as well as to find implementation bugs. The outcomes of this research are relevant for the design of future mobile tourist guides that leverage from benefits of social recommendations.

Public Open Spaces in Kathmandu Valley: A Review of Contemporary Problems and Historic Precedents

The current growth of Kathmandu Valley has been malignant in many ways which suggests a decline of public realm in the city. As the current efforts for planning and design of public open space exhibit numerous problems related to both physical and social aspects of city building, this book examines the shortcomings with contemporary urban development from urban planning and design point of view and attempts to suggest methods to overcome such shortcomings based on the study of historic urban squares. This book identifies the inherent urban design qualities of the historic urban squares in order to learn from them and also attempts to put forward the principles and guidelines for contemporary public space design based on such findings.

Hybrid game strategies for MO problems in aerospace design

Game strategies have been developed in past decades and used in the field of economics, engineering, computer science and biology due to their efficiency in solving design optimisation problems. In addition, research on Multi-Objective (MO) and Multidisciplinary Design Optimisation (MDO) has focused on developing robust and efficient optimisation method to produce quality solutions with less computational time. In this paper, a new optimisation method Hybrid Game Strategy for MO problems is introduced and compared to CMA-ES based optimisation approach. Numerical results obtained from both optimisation methods are compared in terms of computational expense and model quality. The benefits of using Game-strategies are demonstrated.

The complexities of knowing what it is you are trapping

The effectiveness of any trapping system is highly dependent on the ability to accurately identify the specimens collected. For many fruit fly species, accurate identification (= diagnostics) using morphological or molecular techniques is relatively straightforward and poses few technical challenges. However, nearly all genera of pest tephritids also contain groups of species where single, stand-alone tools are not sufficient for accurate identification: such groups include the Bactrocera dorsalis complex, the Anastrepha fraterculus complex and the Ceratitis FAR complex. Misidentification of high-impact species from such groups can have dramatic consequences and negate the benefits of an otherwise effective trapping program. To help prevent such problems, this chapter defines what is meant by a species complex and describes in detail how the correct identification of species within a complex requires the use of an integrative taxonomic approach. Integrative taxonomy uses multiple, independent lines of evidence to delimit species boundaries, and the underpinnings of this approach from both the theoretical speciation literature and the systematics/taxonomy literature are described. The strength of the integrative approach lies in the explicit testing of hypotheses and the use of multiple, independent species delimitation tools. A case is made for a core set of species delimitation tools (pre- and post-zygotic compatibility tests, multi-locus phylogenetic analysis, chemoecological studies, and morphometric and geometric morphometric analyses) to be adopted as standards by tephritologists aiming to resolve economically important species complexes. In discussing the integrative approach, emphasis is placed on the subtle but important differences between integrative and iterative taxonomy. The chapter finishes with a case study that illustrates how iterative taxonomy applied to the B. dorsalis species complex led to incorrect taxonomic conclusions, which has had major implications for quarantine, trade, and horticultural pest management. In contrast, an integrative approach to the problem has resolved species limits in this taxonomically difficult group, meaning that robust diagnostics are now available.

A dosimetric retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC)

Purpose A retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC). Methods and materials Five randomly selected early stage lung cancer patients were included in the study. For each patient, four plans were created: the SBRT plan and three VMAT plans using different optimisation methodologies. A total of 20 different plans were evaluated. The dose parameters of dose conformity results and the target dose constraints results were compared for these plans. Results The mean planning target volume (PTV) for all the plans (SBRT and VMAT) was 18·3 cm3, with a range from 15·6 to 20·1 cm3. The maximum dose tolerance to 1 cc of all the plans was within 140% (84 Gy) of the prescribed dose, and 95% of the PTV of all the plans received 100% of the prescribed dose (60 Gy). In all the plans, 99% of the PTV received a dose >90% of the prescribed dose, and the mean dose in all the plans ranged from 67 to 72 Gy. The planning target dose conformity for the SBRT and the VMAT (0°, 15° collimator single arc plans and dual arc) plans showed the tightness of the prescription isodose conformity to the target. Conclusions SBRT and VMAT are radiotherapy approaches that increase doses to small tumour targets without increasing doses to the organs at risk. Although VMAT offers an alternative to SBRT for NSCLC and the potential advantage of VMAT is the reduced treatment times over SBRT, the statistical results show that there was no significant difference between the SBRT and VMAT optimised plans in terms of dose conformity and organ-at-risk sparing.