Design and evaluation of an MRI compatible axial compression device for 3D assessment of spinal deformity and flexibility

Magnetic Resonance Imaging (MRI) offers a valuable research tool for the assessment of 3D spinal deformity in AIS, however the horizontal patient position imposed by conventional scanners removes the axial compressive loading on the spine which is an important determinant of deformity shape and magnitude in standing scoliosis patients. The objective of this study was to design, construct and test an MRI compatible compression device for research into the effect of axial loading on spinal deformity using supine MRI scans. The compression device was designed and constructed, consisting of a vest worn by the patient, which was attached via straps to a pneumatically actuated footplate. An applied load of 0.5 x bodyweight was remotely controlled by a unit in the scanner operator’s console. The entire device was constructed using non-metallic components for MRI compatibility. The device was evaluated by performing unloaded and loaded supine MRI scans on a series of 10 AIS patients. The study concluded that an MRI compatible compression device had been successfully designed and constructed, providing a research tool for studies into the effect of axial loading on 3D spinal deformity in scoliosis. The 3D axially loaded MR imaging capability developed in this study will allow future research investigations of the effect of axial loading on spinal rotation, and for imaging the response of scoliotic spinal tissues to axial loading.

Sudanese refugees in Australia the impact of acculturation stress

Refugees from Sudan are the fastest growing community in Australia. Australian mental health professionals have to be prepared to offer services to this ethnic group along with the other mainstream and diverse consumers. In order to offer culturally competent services, these mental health professionals are required to be familiar with this emerging community. As such a review was undertaken with two main goals. Firstly, the review aimed to educate Australian mental health professionals about the demographics and culture of Sudan, the traumas encountered as a result of the civil war, factors leading to massive exodus, and the difficulties of the transit and post migration phase. Secondly, the review intended to inform Australian mental health professionals about the possible acculturation stress that is manifested in the form of intergeneration and role conflict and marital difficulties. The review highlights that there are few studies addressing acculturation stress of Sudanese refugees, and even fewer on the impact it has on relationships. Future research directions are discussed.

Axial shortening in reinforced concrete members using vibration characteristics - Part 1 - Theory

Differential axial shortening in vertical members of reinforced concrete high-rise buildings occurs due to shrinkage, creep and elastic shortening, which are time dependent effects of concrete. This has to be quantified in order to make adequate provisions and mitigate its adverse effects. This paper presents a novel procedure for quantifying the axial shortening of vertical members using the variations in vibration characteristics of the structure, in lieu of using gauges which can pose problems in use during and after the construction. This procedure is based on the changes in the modal flexiblity matrix which is expressed as a function of the mode shapes and the reciprocal of the natural frequencies. This paper will present the development of this novel procedure.

Axial shortening in reinforced concrete members using vibration characteristics - part 2 - Application

Controlling differential axial shortening in vertical load bearing concrete elements is a major concern for new generation tall buildings with complex geometries and mechanisms. Quantification of axial shortening using gauges to verify the pre-estimated numerical values used at the design stage is a well established method. This method makes adequate provision to mitigate the adverse effects during the construction. However, this method is becoming increasingly unusable due to its drawbacks. This highlights the need a novel method to quantify the axial shortening using ambient measurements. This paper will first brief introduce the method and then illustrate its application to a high-rise building with two outrigger and belt systems. Moreover, this procedure can be used as a health or performance monitoring tool of the building structure, both during and after construction.

Empowerment and role stress in the human interface between the firm and its markets

Frontline employees constitute one of the key interfaces that service organisations have with their markets. Many strategies to enhance the ability of these employees to satisfy the needs of customers have been proposed. Amongst these, empowering employees has been suggested to enhance the customer orientation of the firm and consequently its effectiveness in serving the market. However, the impact of empowerment in service organisations remains somewhat contentious. This paper examines the role of empowerments an organisational service strategy and identifies its consequences for role stress, job satisfaction and the willingness of service employees to serve their customers.

TCP-DR an effective protocol for infrastructure based wireless networks

TCP is a dominant protocol for consistent communication over the internet. It provides flow, congestion and error control mechanisms while using wired reliable networks. Its congestion control mechanism is not suitable for wireless links where data corruption and its lost rate are higher. The physical links are transparent from TCP that takes packet losses due to congestion only and initiates congestion handling mechanisms by reducing transmission speed. This results in wasting already limited available bandwidth on the wireless links. Therefore, there is no use to carry out research on increasing bandwidth of the wireless links until the available bandwidth is not optimally utilized. This paper proposed a hybrid scheme called TCP Detection and Recovery (TCP-DR) to distinguish congestion, corruption and mobility related losses and then instructs the data sending host to take appropriate action. Therefore, the link utilization is optimal while losses are either due to high bit error rate or mobility.

Psychosocial outcomes of Hong Kong Chinese diagnosed with acute coronary syndromes: a prospective repeated measures study.

BACKGROUND: Western studies have suggested that emotional stress and distress impacted on the morbidity and mortality in people following acute coronary events. Symptoms of anxiety and depression have been associated with re-infarction and death, prolonged recovery and disability and depression may precipitate the client's low self-esteem. This study examined perceived anxiety, depression and self-esteem of Hong Kong Chinese clients diagnosed with acute coronary syndrome (ACS) over a 6-month period following hospital admission. OBJECTIVES: To examine: DESIGN: A prospective, repeated measures design with measures taken on two occasions over a 6-month period; (1) within the 1st week of hospital admission following the onset of ACS and (2) at 6 months follow up. SETTING AND PARTICIPANTS: Convenient sample of 182 voluntary consented clients admitted with ACS to a major public hospital in Hong Kong who could communicate in Chinese, complete questionnaires, cognitive intact, and were haemodynamically stable and free from acute chest pain at the time of interview. METHODS: Baseline data were obtained within 1 week after hospital admission. The follow-up data was collected 6 months after hospital discharge. The Chinese version of the Hospital Anxiety and Depression Scale (HADS), State Self-esteem Scale (SSES), and Rosenberg's Self-Esteem Scale (RSES) were used to assess anxiety and depression, state self-esteem, and trait self-esteem, respectively. RESULTS: Findings suggested gender differences in clients' perception in anxiety, depression and self-esteem. Improvements in clients' perception of these variables were evident over the 6-month period following their acute coronary events. CONCLUSION: The study confirmed the western notion that psychosocial problems are common among coronary clients and this also applies to Hong Kong Chinese diagnosed with ACS. Further studies to explore effective interventions to address these psychosocial issues are recommended.

Animal Control - What constitutes a reliable cue to stop animal movement ?

Controlling free-ranging livestock requires low-stress cues to alter animal behaviour. Recently modulated sound and electric shock were demonstrated to be effective in controlling free-ranging cattle. In this study the behaviour of 60, 300 kg Belmont Red heifers were observed for behavioural changes when presented cues designed to impede their movement through an alley. The heifers were given an overnight drylot shrink off feed but not drinking water prior to being tested. Individual cattle were allowed to move down a 6.5 m wide alley towards a pen of peers and feed located 71 m from their point of release. Each animal was allowed to move through the alley unimpeded five times to establish a basal behavioural pattern. Animals were then randomly assigned to treatments consisting of sound plus shock, vibration plus shock, a visual cue plus shock, shock by itself and a control. The time each animal required to reach the pen of peers and feed was recorded. If the animal was prevented from reaching the pen of peers and feed by not penetrating through the cue barrier at set points along the alley for at least 60 sec the test was stopped and the animal was returned to peers located behind the release pen. Cues and shock were manually applied from a laptop while animals were observed from a 3.5 m tower located outside the alley. Electric shock, sound, vibration and Global Position System (GPS) hardware were housed in a neck collar. Results and implications will be discussed.

Gamma-tocotrienol as an effective agent in targeting prostate cancer stem cell-like population

Emerging evidence supports that prostate cancer originates from a rare sub-population of cells, namely prostate cancer stem cells (CSCs). Conventional therapies for prostate cancer are believed to mainly target the majority of differentiated tumor cells but spare CSCs, which may account for the subsequent disease relapse after treatment. Therefore, successful elimination of CSCs may be an effective strategy to achieve complete remission from this disease. Gamma-tocotrienols (-T3) is one of the vitamin-E constituents which have been shown to have anticancer effects against a wide-range of human cancers. Recently, we have reported that -T3 treatment not only inhibits prostate cancer cell invasion but also sensitizes the cells to docetaxel-induced apoptosis, suggesting that -T3 may be an effective therapeutic agent against advanced stage prostate cancer. Here, we demonstrate for the first time that -T3 can down-regulate the expression of prostate CSC markers (CD133/CD44) in androgen independent (AI) prostate cancer cell lines (PC-3 & DU145), as evident from western blotting analysis. Meanwhile, the spheroid formation ability of the prostate cancer cells was significantly hampered by -T3 treatment. In addition, pre-treatment of PC-3 cells with -T3 was found to suppress tumor initiation ability of the cells. More importantly, while CD133-enriched PC-3 cells were highly resistant to docetaxel treatment, these cells were as sensitive to -T3 treatment as the CD133-depleted population. Our data suggest that -T3 may be an effective agent in targeting prostate CSCs, which may account for its anticancer and chemosensitizing effects reported in previous studies.

Influence of axial deformation on modal strain energy

Axial loads of load bearing elements impact on the vibration characteristics. Several methods have been developed to quantify axial loads and hence axial deformations of individual structural members using their natural frequencies. Nevertheless, these methods cannot be applied to individual members in structural framing systems as the natural frequency is a global parameter for the entire framing system. This paper proposes an innovative method which uses modal strain energy phenomenon to quantify axial deformations of load bearing elements of structural framing systems. The procedure is illustrated through examples and results confirm that the proposed method has an ability to quantify the axial deformations of individual elements of structural framing systems

A vibration based method to update axial shortening of load bearing elements

Axial shortening in vertical load bearing elements of reinforced concrete high-rise buildings is caused by the time dependent effects of shrinkage, creep and elastic shortening of concrete under loads. Such phenomenon has to be predicted at design stage and then updated during and after construction of the buildings in order to provide mitigation against the adverse effects of differential axial shortening among the elements. Existing measuring methods for updating previous predictions of axial shortening pose problems. With this in mind, a innovative procedure with a vibration based parameter called axial shortening index is proposed to update axial shortening of vertical elements based on variations in vibration characteristics of the buildings. This paper presents the development of the procedure and illustrates it through a numerical example of an unsymmetrical high-rise building with two outrigger and belt systems. Results indicate that the method has the capability to capture influence of different tributary areas, shear walls of outrigger and belt systems as well as the geometric complexity of the building.

Influence of axial deformation of structural members on vibration characteristics

The vibration characteristics of structural members are significantly influenced by the axial loads and hence axial deformation of the member. Numerous methods have been developed to quantify the axial loads in individual structural members using their natural frequencies. However, the findings of these methods cannot be applied to individual members in a structural framing system as the natural frequency is a global parameter for the entire framing system. This paper proposes an innovative method which uses the modal flexibility parameter to quantify axial deformations in load bearing elements of structural framing systems. The proposed method is illustrated through examples and results highlight that the method can be used to quantify the axial deformations of Individual elements of structural framing systems.

A numerical method to quantify differential axial shortening in concrete buildings

Differential distortion comprising axial shortening and consequent rotation in concrete buildings is caused by the time dependent effects of “shrinkage”, “creep” and “elastic” deformation. Reinforcement content, variable concrete modulus, volume to surface area ratio of elements and environmental conditions influence these distortions and their detrimental effects escalate with increasing height and geometric complexity of structure and non vertical load paths. Differential distortion has a significant impact on building envelopes, building services, secondary systems and the life time serviceability and performance of a building. Existing methods for quantifying these effects are unable to capture the complexity of such time dependent effects. This paper develops a numerical procedure that can accurately quantify the differential axial shortening that contributes significantly to total distortion in concrete buildings by taking into consideration (i) construction sequence and (ii) time varying values of Young’s Modulus of reinforced concrete and creep and shrinkage. Finite element techniques are used with time history analysis to simulate the response to staged construction. This procedure is discussed herein and illustrated through an example.

Design and evaluation of an MRI compatible axial compression device for 3D assessment of spinal deformity and flexibility in adolescent idiopathic scoliosis

Magnetic Resonance Imaging (MRI) offers a valuable research tool for the assessment of 3D spinal deformity in AIS, however the horizontal patient position imposed by conventional scanners removes the axial compressive loading on the spine. The objective of this study was to design, construct and test an MRI compatible compression device for research into the effect of axial loading on spinal deformity using supine MRI scans. The device was evaluated by performing unloaded and loaded supine MRI scans on a series of 10 AIS patients. The patient group had a mean initial (unloaded) major Cobb angle of 43±7º, which increased to 50±9º on application of the compressive load. The 7° increase in mean Cobb angle is consistent with that reported by a previous study comparing standing versus supine posture in scoliosis patients (Torell et al, 1985. Spine 10:425-7).

Application of data mining techniques in the prediction of coronary artery disease : use of anaesthesia time-series and patient risk factor data

The high morbidity and mortality associated with atherosclerotic coronary vascular disease (CVD) and its complications are being lessened by the increased knowledge of risk factors, effective preventative measures and proven therapeutic interventions. However, significant CVD morbidity remains and sudden cardiac death continues to be a presenting feature for some subsequently diagnosed with CVD. Coronary vascular disease is also the leading cause of anaesthesia related complications. Stress electrocardiography/exercise testing is predictive of 10 year risk of CVD events and the cardiovascular variables used to score this test are monitored peri-operatively. Similar physiological time-series datasets are being subjected to data mining methods for the prediction of medical diagnoses and outcomes. This study aims to find predictors of CVD using anaesthesia time-series data and patient risk factor data. Several pre-processing and predictive data mining methods are applied to this data. Physiological time-series data related to anaesthetic procedures are subjected to pre-processing methods for removal of outliers, calculation of moving averages as well as data summarisation and data abstraction methods. Feature selection methods of both wrapper and filter types are applied to derived physiological time-series variable sets alone and to the same variables combined with risk factor variables. The ability of these methods to identify subsets of highly correlated but non-redundant variables is assessed. The major dataset is derived from the entire anaesthesia population and subsets of this population are considered to be at increased anaesthesia risk based on their need for more intensive monitoring (invasive haemodynamic monitoring and additional ECG leads). Because of the unbalanced class distribution in the data, majority class under-sampling and Kappa statistic together with misclassification rate and area under the ROC curve (AUC) are used for evaluation of models generated using different prediction algorithms. The performance based on models derived from feature reduced datasets reveal the filter method, Cfs subset evaluation, to be most consistently effective although Consistency derived subsets tended to slightly increased accuracy but markedly increased complexity. The use of misclassification rate (MR) for model performance evaluation is influenced by class distribution. This could be eliminated by consideration of the AUC or Kappa statistic as well by evaluation of subsets with under-sampled majority class. The noise and outlier removal pre-processing methods produced models with MR ranging from 10.69 to 12.62 with the lowest value being for data from which both outliers and noise were removed (MR 10.69). For the raw time-series dataset, MR is 12.34. Feature selection results in reduction in MR to 9.8 to 10.16 with time segmented summary data (dataset F) MR being 9.8 and raw time-series summary data (dataset A) being 9.92. However, for all time-series only based datasets, the complexity is high. For most pre-processing methods, Cfs could identify a subset of correlated and non-redundant variables from the time-series alone datasets but models derived from these subsets are of one leaf only. MR values are consistent with class distribution in the subset folds evaluated in the n-cross validation method. For models based on Cfs selected time-series derived and risk factor (RF) variables, the MR ranges from 8.83 to 10.36 with dataset RF_A (raw time-series data and RF) being 8.85 and dataset RF_F (time segmented time-series variables and RF) being 9.09. The models based on counts of outliers and counts of data points outside normal range (Dataset RF_E) and derived variables based on time series transformed using Symbolic Aggregate Approximation (SAX) with associated time-series pattern cluster membership (Dataset RF_ G) perform the least well with MR of 10.25 and 10.36 respectively. For coronary vascular disease prediction, nearest neighbour (NNge) and the support vector machine based method, SMO, have the highest MR of 10.1 and 10.28 while logistic regression (LR) and the decision tree (DT) method, J48, have MR of 8.85 and 9.0 respectively. DT rules are most comprehensible and clinically relevant. The predictive accuracy increase achieved by addition of risk factor variables to time-series variable based models is significant. The addition of time-series derived variables to models based on risk factor variables alone is associated with a trend to improved performance. Data mining of feature reduced, anaesthesia time-series variables together with risk factor variables can produce compact and moderately accurate models able to predict coronary vascular disease. Decision tree analysis of time-series data combined with risk factor variables yields rules which are more accurate than models based on time-series data alone. The limited additional value provided by electrocardiographic variables when compared to use of risk factors alone is similar to recent suggestions that exercise electrocardiography (exECG) under standardised conditions has limited additional diagnostic value over risk factor analysis and symptom pattern. The effect of the pre-processing used in this study had limited effect when time-series variables and risk factor variables are used as model input. In the absence of risk factor input, the use of time-series variables after outlier removal and time series variables based on physiological variable values’ being outside the accepted normal range is associated with some improvement in model performance.