Development of microfluidic-based analytical methodology for studying the effects of chemotherapy agents on cancer tissue

Whilst a multitude of techniques have been employed to study the biology of tumour tissue and its response to chemotherapeutic reagents, most current methodologies do not capture the sophistication of the in vivo environment. Microfluidics however offers the ability to maintain and interrogate primary tissue samples in an environment with biomimetic flow characteristics. In this study head and neck squamous cell carcinoma (HNSCC) tumour biopsies have been used to investigate the performance of a microfluidic device for generating clinically-useful information. The response of fresh and cryogenically-frozen primary HNSCC or metastatic lymph node samples to chemotherapy drugs (cisplatin, 5-flurouracil or docetaxel), alone and in combination, were monitored for both proliferation (water-soluble tetrazolium salt metabolism) and cell death biomarker release (lactate dehydrogenase, LDH) “off-chip”. The frozen tissue showed no significant difference in terms of either proliferation or LDH release in comparison with the matched fresh samples. Administration of all drugs caused cell death, in a dose-response manner, with the combination showing the greatest amount of cytotoxicity particularly at days 8 and 9; correlating well with published clinical data. The system described here offers an innovative method for studying the tumour microenvironment in vitro and, through incorporation of relevant analytical modules, provides the basis of a pre-clinical device that can be used to define personalised treatment regimens.

An intelligent content discovery technique for health portal content management

Background: Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics.Objective: This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new contentMethods: A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper.Results: The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective content management.Conclusions: The prevalence of large numbers of online health resources is a key obstacle for domain experts involved in content management of health information portals and websites. The proposed technique has proven successful at search and identification of resources and the measurement of their relevance. It can be used to support the domain expert in content management and thereby ensure the health portal is up-to-date and current.

Problem based learning (PBL): a conundrum

Abstract Problem Based Learning (PBL) using minimal guided instruction is used as an educational strategy across a broad variety of disciplines in the tertiary sector. This paper includes some of the strengths and weaknesses of PBL, both in general and in relation to the health care setting, encompassing some of its philosophical underpinnings and its methodological approach. In an effort to explore some of the benefits and problems with PBL in the work setting, this account will comprise a realistic rather than idealistic focus and will include a range of perspectives from both a facilitator and student standpoint. We suggest that PBL is a useful strategy across a comprehensive nursing degree programme (as the ideal) provided the learning programme is supported financially and that its ideal creed which supports a small group approach are adhered to. What we find is that reality is often different, with individual facilitators condensing their PBL programmes to incorporate a modified PBL approach with this personalised approach often taking strength away from the original conceptions of PBL. What we suggest here is that these circumstances constitute a conundrum.

Crossing boundaries : acts of citizenship among migrant youth in Melbourne

This paper focuses on how migrant youth in Melbourne with experience of direct or indirect migration negotiate cross-cultural engagements and tensions between family, community and the greater society in which they are supposed to participate as political subjects. It examines whether the meaning and interpretation of citizenship in Australia allows migrant youth to act as full and active citizens with all the contradictions and difficulties inherent in acting as “a bridge between two worlds”. By voicing the personalised journeys of young people dealing with uneasy questions of dis-placement, identity and belonging, this paper examines the complex ways through which migrant youth negotiate and in some cases bridge intercultural tensions within a multicultural society.

Molecular imaging of metabolism in cancer metastasis

Cancer progression is characterised by extensive metabolic reprogramming. Renewed enthusiasm in this field has been sparked in part by the realisation that metabolic pathways, oncogenes and tumour suppressors are intimately linked and regulate tumour growth and metastasis through complex reciprocal interactions. The identification of key pathways and enzymes regulating metabolism in cancer cells provides new opportunities for cancer therapy. This has motivated the development of several specific inhibitors targeting metabolic pathways and their therapeutic evaluation in pre-clinical models or in cancer patients. The unravelling of metabolic pathways associated with cancer progression has also highlighted the extensive metabolic heterogeneity that exists between, and within, each cancer type as well as between metastatic sites. The translation of these findings into personalised therapy remains a considerable challenge. To this end, the use of positron emission tomography to non-invasively visualise tumour metabolism is likely to facilitate the implementation of and assessment of new targeted therapies. Here, we briefly review the key metabolic changes associated with cancer progression and discuss recent advances in the field of positron emission tomography for metabolic imaging of cancer and their potential to improve the clinical management of cancer patients.

Preference Networks: probabilistic models for recommendation systems

Abstract
Recommender systems are important to help users select relevant and personalised information over massive amounts of data available. We propose an unified framework called Preference Network (PN) that jointly models various types of domain knowledge for the task of recommendation. The PN is a probabilistic model that systematically combines both content-based filtering and collaborative filtering into a single conditional
Markov random field. Once estimated, it serves as a probabilistic database that supports various useful queries such as rating prediction and top-N recommendation. To handle the challenging problem of learning large networks of users and items, we employ a simple but effective pseudo-likelihood with regularisation. Experiments on the movie rating data demonstrate the merits of the PN.

Web-based alcohol screening and brief intervention for Māori and non-Māori: the New Zealand e-SBINZ trials

BACKGROUND: Hazardous alcohol consumption is a leading modifiable cause of mortality and morbidity among young people. Screening and brief intervention (SBI) is a key strategy to reduce alcohol-related harm in the community, and web-based approaches (e-SBI) have advantages over practitioner-delivered approaches, being cheaper, more acceptable, administrable remotely and infinitely scalable. An efficacy trial in a university population showed a 10-minute intervention could reduce drinking by 11% for 6 months or more among 17-24 year-old undergraduate hazardous drinkers. The e-SBINZ study is designed to examine the effectiveness of e-SBI across a range of universities and among Māori and non-Māori students in New Zealand. METHODS/DESIGN: The e-SBINZ study comprises two parallel, double blind, multi-site, individually randomised controlled trials. This paper outlines the background and design of the trial, which is recruiting 17-24 year-old students from seven of New Zealand's eight universities. Māori and non-Māori students are being sampled separately and are invited by e-mail to complete a web questionnaire including the AUDIT-C. Those who score >4 will be randomly allocated to no further contact until follow-up (control) or to assessment and personalised feedback (intervention) via computer. Follow-up assessment will occur 5 months later in second semester. Recruitment, consent, randomisation, intervention and follow-up are all online. Primary outcomes are (i) total alcohol consumption, (ii) frequency of drinking, (iii) amount consumed per typical drinking occasion, (iv) the proportions exceeding medical guidelines for acute and chronic harm, and (v) scores on an academic problems scale. DISCUSSION: The trial will provide information on the effectiveness of e-SBI in reducing hazardous alcohol consumption across diverse university student populations with separate effect estimates for Māori and non-Māori students. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12610000279022.

Statistical comparisons of non-deterministic IR systems using two dimensional variance

Retrieval systems with non-deterministic output are widely used in information retrieval. Common examples include sampling, approximation algorithms, or interactive user input. The effectiveness of such systems differs not just for different topics, but also for different instances of the system. The inherent variance presents a dilemma - What is the best way to measure the effectiveness of a non-deterministic IR system? Existing approaches to IR evaluation do not consider this problem, or the potential impact on statistical significance. In this paper, we explore how such variance can affect system comparisons, and propose an evaluation framework and methodologies capable of doing this comparison. Using the context of distributed information retrieval as a case study for our investigation, we show that the approaches provide a consistent and reliable methodology to compare the effectiveness of a non-deterministic system with a deterministic or another non-deterministic system. In addition, we present a statistical best-practice that can be used to safely show how a non-deterministic IR system has equivalent effectiveness to another IR system, and how to avoid the common pitfall of misusing a lack of significance as a proof that two systems have equivalent effectiveness.

Locating learning: making connections between virtual and physical spaces with mobile touch-screen devices

This paper is concerned with the potential of mobile touch-screen devices and emerging socio-technological practices to support pedagogies of place that provide a means for young people to reflect critically on the social construction of place and to take actions that speak of and to their own locatedness. Drawing on de Certeau’s (1984) concept of space as a practiced place and Massey’s (2005) perspective of spatiality and interrelatedness, we examine two school-based examples of learning activities that bring together the virtual and physical as in experiences and representations of place. The first example is an Australian local history unit, where lower secondary school students participated in a series of field trips, planned and conducted under the guidance of an indigenous elder. They used Smartphones and iPads to capture and create personalised audio-visual records of their knowledge of place that were then used to create geo-location games. In the second example, upper primary school students worked with local authorities and environmental educators to select sites for two environmental monitoring posts, which were then installed and provided a locus for the students’ school-based environmental science learning as well as a vehicle for community engagement. Drawing on interview, video and photographic data, this paper examines the way mobile technologies were deployed for student knowledge production, engagement with place, reconstruction of place and engagement with community.

The influence on population weight gain and obesity of the macronutrient composition and energy density of the food supply

Rates of overweight and obesity have increased dramatically in all regions of the world over the last few decades. Almost all of the world's population now has ubiquitous access to low-cost, but highly-processed, energy-dense, nutrient-poor food products. These changes in the food supply, rather than decreases in physical activity, are most likely the primary driver of population weight gain and obesity. To-date, the majority of prevention efforts focus on personalised approaches targeting individuals. Population-wide food supply interventions addressing sodium and trans fat reduction have proven highly effective and comparable efforts are now required to target obesity. The evidence suggests that strategies focusing upon reducing the energy density and portion size of foods will be more effective than those targeting specific macronutrients. Government leadership, clearly specified targets, accountability and transparency will be the key to achieving the food supply changes required to address the global obesity epidemic.

Learning entry profiles of children with autism from multivariate treatment information using restricted boltzmann machines

Entry profiles can be generated before children with Autism Spectrum Disorders (ASD) begin to traverse an intervention program. They can help evaluate the progress of each child on the dedicated syllabus in addition to enabling narrowing down the best intervention course over time. However, the traits of ASD are expressed in different ways in every individual affected. The resulting spectrum nature of the disorder makes it challenging to discover profiles of children with ASD. Using data from 491 children, traversing the syllabus of a comprehensive intervention program on iPad called TOBY Playpad, we learn the entry profiles of the children based on their age, sex and performance on their first skills of the syllabus. Mixed-variate restricted Boltzmann machines allow us to integrate the heterogeneous data into one model making it a suitable technique. The data based discovery of entry profiles may assist in developing systems that can automatically suggest best suitable paths through the syllabus by clustering the children based on the characteristics they present at the beginning of the program. This may open the pathway for personalised intervention.

Examining the effect of time constraint on the online mastery learning approach towards improving postgraduate students' achievement

Time control plays a critical role within the online mastery learning (OML) approach. This paper examines the two commonly implemented mastery learning strategies – personalised system of instructions and learning for mastery (LFM) – by focusing on what occurs when there is an instructional time constraint. Using a large data set from a postgraduate finance course offered at an Australian university, we explore students' online quiz-completion patterns, then empirically investigate whether the imposition of an instructional time constraint in the OML approach has an impact on their final-examination performance. Our results suggest that the LFM strategy with an instructional time constraint has a positive impact on students' learning behaviour and contributes to better overall academic performance. Further, our findings suggest that facilitators should be encouraged to implement an instructional time constraint when adopting an OML approach.

Locating learning: making connections between virtual and physical spaces with mobile touch-screen devices

This paper is concerned with the potential of mobile touch-screen devices and emerging socio-technological practices to support pedagogies of place that provide a means for young people to reflect critically on the social construction of place and to take actions that speak of and to their own locatedness. Drawing on de Certeau's (1984) concept of space as a practiced place and Massey's (2005) perspective of spatiality and interrelatedness, we examine two school-based examples of learning activities that bring together the virtual and physical as in experiences and representations of place. The first example is an Australian local history unit, where lower secondary school students participated in a series of field trips, planned and conducted under the guidance of an indigenous elder. They used Smartphones and iPads to capture and create personalised audio-visual records of their knowledge of place that were then used to create geo-location games. In the second example, upper primary school students worked with local authorities and environmental educators to select sites for two environmental monitoring posts, which were then installed and provided a locus for the students' school-based environmental science learning as well as a vehicle for community engagement. Drawing on interview, video and photographic data, this paper examines the way mobile technologies were deployed for student knowledge production, engagement with place, reconstruction of place and engagement with community.

Improving coronary heart disease self-management using mobile technologies (Text4Heart): a randomised controlled trial protocol

BACKGROUND: Cardiac rehabilitation (CR) is a secondary prevention program that offers education and support to assist patients with coronary heart disease (CHD) make lifestyle changes. Despite the benefits of CR, attendance at centre-based sessions remains low. Mobile technology (mHealth) has potential to reach more patients by delivering CR directly to mobile phones, thus providing an alternative to centre-based CR. The aim of this trial is to evaluate if a mHealth comprehensive CR program can improve adherence to healthy lifestyle behaviours (for example, physically active, fruit and vegetable intake, not smoking, low alcohol consumption) over and above usual CR services in New Zealand adults diagnosed with CHD.

METHODS/DESIGN: A two-arm, parallel, randomised controlled trial will be conducted at two Auckland hospitals in New Zealand. One hundred twenty participants will be randomised to receive a 24-week evidence- and theory-based personalised text message program and access to a supporting website in addition to usual CR care or usual CR care alone (control). The primary outcome is the proportion of participants adhering to healthy behaviours at 6 months, measured using a composite health behaviour score. Secondary outcomes include overall cardiovascular disease risk, body composition, illness perceptions, self-efficacy, hospital anxiety/depression and medication adherence.

DISCUSSION: This study is one of the first to examine an mHealth-delivered comprehensive CR program. Strengths of the trial include quality research design and in-depth description of the intervention to aid replication. If effective, the trial has potential to augment standard CR practices and to be used as a model for other disease prevention or self-management programs.

Consumer views on the potential use of mobile phones for the delivery of weight-loss interventions

BACKGROUND: The surge in the incidence of obesity and being overweight demands new options to extend the reach of weight-loss interventions. Mobile phones provide a medium for reaching large numbers of people in a cost-effective manner. The present study aimed to explore the potential for weight-loss interventions to be delivered via mobile phone. METHODS: A mixed methods approach was employed. A telephone survey was conducted with 306 randomly selected participants, and 10 focus groups were undertaken with 54 purposively selected participants. The telephone survey comprised questions exploring the nature and acceptability of any potential weight-loss programme that might be delivered via mobile phones. The focus groups were conducted to explore issues of acceptability in more depth than was possible in the survey. RESULTS: Two-thirds of participants reported support for a mobile phone weight-loss intervention, with greater levels of support amongst younger age groups and rural Māori (the indigenous population in New Zealand). Participants liked the idea of ready access to weight-loss information, and associated feedback and encouragement. The results suggest that interventions would need to include aspects of social support, use tailored and personalised content, and be practical and relevant so that they appeal to consumers. Appropriate methods of providing social support using a mobile phone require further exploration. CONCLUSIONS: Mobile phones may provide a novel but acceptable way to deliver a weight-loss intervention. They have the potential to be automatically personalised and tailored to the needs of the individual, at the same time as being delivered at a population level.