Clinical Accuracy of the MedGem Indirect Calorimeter for Measuring Resting Energy Expenditure in Cancer Patients

OBJECTIVE: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGem) and predicted REE. DESIGN: Cross-sectional clinical validation study. SETTING: Private radiation oncology centre, Brisbane, Australia. SUBJECTS: Cancer patients (n = 18) and healthy subjects (n = 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m(2). INTERVENTIONS: Oxygen consumption (VO(2)) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. RESULTS: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias -5% with limits of -45 to 35% for healthy subjects. Less than half of the cancer patients (n = 7, 46.7%) and only a third (n = 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of -5% for cancer patients and 4% for healthy subjects, with limits of agreement of -30 to 20% and -27 to 34%, respectively. CONCLUSIONS: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.

Optimisation of maintenance expenditure for buildings : refurbish or demolish

With an increase in growing number of aging public building infrastructure globally, there is an opportunity for an efficient life care management rather then mere demolition and rebuild. By carefully implementing appropriate structural engineering practices with facility management, the whole of life cycle costs for public building assets can be optimised and public money can be saved and better utilised elsewhere. A need of decision support tool/methodology which can assist asset manager make better decision among demolish, refurbish, do nothing or rebuilt option for any typical building under consideration is growing in order to optimise maintenance funds. The paper is part of research project focusing on development of such methodology known as residual service life prediction. The paper is mainly focusing on following three major aspects of public building infrastructure; first, issues and challenges in optimisation of maintenance funds, second, residual service life prediction methodology and issues and challenges in the development of such methodology. The paper concludes with the authors’ observations and further research potentials

Fashion retailing and the bottom line : The effects of generational cohorts, gender, fashion fanship, attitudes and impulse buying on fashion expenditure

This study examines the influence of demographic ( eg. gender and generational cohort) and psychographic ( eg. fashion fanship, attitudes and impulse buying) drivers on frequency and levels of expenditure on fanship purchases, Using regression analysis, the results suggest that for weekly and monthly expenditure, gender and fashion fanship were significant influences, while for yearly expenditure, gender and impulse buying were significant. Attitudes towards fanship had no significant influence on expenditure. Females purchase more often and were significantly different from males on yearly expenditure, fashion fanship, attitudes and impulse buying. Generation Y is higher on purchase frequency, fashion fanship, attitudes and impulse buying compared with other cohorts under investigation.

Exercise, appetite, and energy balance: The interactions between energy expenditure and intake, and the implications for weight management

This book disseminates current information pertaining to the modulatory effects of foods and other food substances on behavior and neurological pathways and, importantly, vice versa. This ranges from the neuroendocrine control of eating to the effects of life-threatening disease on eating behavior. The importance of this contribution to the scientific literature lies in the fact that food and eating are an essential component of cultural heritage but the effects of perturbations in the food/cognitive axis can be profound. The complex interrelationship between neuropsychological processing, diet, and behavioral outcome is explored within the context of the most contemporary psychobiological research in the area. This comprehensive psychobiology- and pathology-themed text examines the broad spectrum of diet, behavioral, and neuropsychological interactions from normative function to occurrences of severe and enduring psychopathological processes

Exercise-induced energy expenditure : implications for exercise prescription and obesity

Objective: Walking is commonly recommended to help with weight management. We measured total energy expenditure (TEE) and its components to quantify the impact of increasing exercise-induced energy expenditure (ExEE) on other components of TEE. Methods: Thirteen obese women underwent an 8-week walking group intervention. TEE was quantified using doubly labeled water, ExEE was quantified using heart rate monitors, daily movement was assessed by accelerometry and resting metabolic rate was measured using indirect calorimetry. Results: Four of the 13 participants achieved the target of 1500 kcal wk−1 of ExEE and all achieved 1000 kcal wk−1. The average ExEE achieved by the group across the 8 weeks was 1434 ± 237 kcal wk−1. Vigorous physical activity, as assessed by accelerometry, increased during the intervention by an average of 30 min per day. Non-exercise activity thermogenesis (NEAT) decreased, on average, by 175 kcal d−1 (−22%) from baseline to the intervention and baseline fitness was correlated with change in NEAT. Conclusions: Potential alterations in non-exercise activity should be considered when exercise is prescribed. The provision of appropriate education on how to self-monitor daily activity levels may improve intervention outcomes in groups who are new to exercise. Practice implications: Strategies to sustain incidental and light physical activity should be offered to help empower individuals as they develop and maintain healthy and long-lasting lifestyle habits.

Interactions between energy intake and expenditure in the development and treatment of obesity.

Summary There are four interactions to consider between energy intake (EI) and energy expenditure (EE) in the development and treatment of obesity. (1) Does sedentariness alter levels of EI or subsequent EE? and (2) Do high levels of EI alter physical activity or exercise? (3) Do exercise-induced increases in EE drive EI upwards and undermine dietary approaches to weight management and (4) Do low levels of EI elevate or decrease EE? There is little evidence that sedentariness alters levels of EI. This lack of cross-talk between altered EE and EI appears to promote a positive EB. Lifestyle studies also suggest that a sedentary routine actually offers the opportunity for over-consumption. Substantive changes in non exercise activity thermogenesis are feasible, but not clearly demonstrated. Cross talk between elevated EE and EI is initially too weak and takes too long to activate, to seriously threaten dietary approaches to weight management. It appears that substantial fat loss is possible before intake begins to track a sustained elevation of EE. There is more evidence that low levels of EI does lower physical activity levels, in relatively lean men under conditions of acute or prolonged semi-starvation and in dieting obese subjects. During altered EB there are a number of small but significant changes in the components of EE, including (i) sleeping and basal metabolic rate, (ii) energy cost of weight change alters as weight is gained or lost, (iii) exercise efficiency, (iv) energy cost of weight bearing activities, (v) during substantive overfeeding diet composition (fat versus carbohydrate) will influence the energy cost of nutrient storage by ~ 15%. The responses (i-v) above are all “obligatory” responses. Altered EB can also stimulate facultative behavioural responses, as a consequence of cross-talk between EI and EE. Altered EB will lead to changes in the mode duration and intensity of physical activities. Feeding behaviour can also change. The degree of inter-individual variability in these responses will define the scope within which various mechanisms of EB compensation can operate. The relative importance of “obligatory” versus facultative, behavioural responses -as components of EB control- need to be defined.

Reliability analysis of transform-based stereo matching techniques, and a new matching constraint

Stereo vision is a method of depth perception, in which depth information is inferred from two (or more) images of a scene, taken from different perspectives. Practical applications for stereo vision include aerial photogrammetry, autonomous vehicle guidance, robotics and industrial automation. The initial motivation behind this work was to produce a stereo vision sensor for mining automation applications. For such applications, the input stereo images would consist of close range scenes of rocks. A fundamental problem faced by matching algorithms is the matching or correspondence problem. This problem involves locating corresponding points or features in two images. For this application, speed, reliability, and the ability to produce a dense depth map are of foremost importance. This work implemented a number of areabased matching algorithms to assess their suitability for this application. Area-based techniques were investigated because of their potential to yield dense depth maps, their amenability to fast hardware implementation, and their suitability to textured scenes such as rocks. In addition, two non-parametric transforms, the rank and census, were also compared. Both the rank and the census transforms were found to result in improved reliability of matching in the presence of radiometric distortion - significant since radiometric distortion is a problem which commonly arises in practice. In addition, they have low computational complexity, making them amenable to fast hardware implementation. Therefore, it was decided that matching algorithms using these transforms would be the subject of the remainder of the thesis. An analytic expression for the process of matching using the rank transform was derived from first principles. This work resulted in a number of important contributions. Firstly, the derivation process resulted in one constraint which must be satisfied for a correct match. This was termed the rank constraint. The theoretical derivation of this constraint is in contrast to the existing matching constraints which have little theoretical basis. Experimental work with actual and contrived stereo pairs has shown that the new constraint is capable of resolving ambiguous matches, thereby improving match reliability. Secondly, a novel matching algorithm incorporating the rank constraint has been proposed. This algorithm was tested using a number of stereo pairs. In all cases, the modified algorithm consistently resulted in an increased proportion of correct matches. Finally, the rank constraint was used to devise a new method for identifying regions of an image where the rank transform, and hence matching, are more susceptible to noise. The rank constraint was also incorporated into a new hybrid matching algorithm, where it was combined a number of other ideas. These included the use of an image pyramid for match prediction, and a method of edge localisation to improve match accuracy in the vicinity of edges. Experimental results obtained from the new algorithm showed that the algorithm is able to remove a large proportion of invalid matches, and improve match accuracy.

A prioritised fuzzy constraint satisfaction approach to model agent negotiation for railway scheduling

With the recent regulatory reforms in a number of countries, railways resources are no longer managed by a single party but are distributed among different stakeholders. To facilitate the operation of train services, a train service provider (SP) has to negotiate with the infrastructure provider (IP) for a train schedule and the associated track access charge. This paper models the SP and IP as software agents and the negotiation as a prioritized fuzzy constraint satisfaction (PFCS) problem. Computer simulations have been conducted to demonstrate the effects on the train schedule when the SP has different optimization criteria. The results show that by assigning different priorities on the fuzzy constraints, agents can represent SPs with different operational objectives.