A biomimetic sensor for the detection of lead in water.

The monitoring of lead (II) ions (Pb(2+)) in water is essential for both human health and the environment. Herein, a simple yet innovative biosensor for Pb(2+) detection is presented. The sensor is developed by the self-assembly of gold nanoparticles (GNPs) core-satellite structure using naturally occurring tripeptide glutathione (GSH) as linker. The addition of Pb(2+) caused a red-to-blue color change and the localized surface plasmon resonance (LSPR) band was shifted to ca. 650nm. The limit of detection (LOD) is found to be 47.6nM (9.9ppb) by UV-vis spectroscopy with high selectivity against other heavy metals. This method offers a new strategy for heavy metal detection using functionalized GNPs.

A decade of change in Australia’s DBA landscape

Purpose – The purpose of this paper is to examine the dynamics of the Doctorate of Business Administration (DBA) in Australia through the lens of a changing higher education landscape. The paper reflects on issues raised in a previous analysis of DBA programmes undertaken a decade ago, and highlights persistent challenges and emerging opportunities for professional Doctorate programmes in the Australian context.Design/methodology/approach – Interviews were undertaken with higher degree research directors, deans of graduate schools, and DBA programme directors from all 18 Australian institutions offering the DBA in 2013. Quantitative data on enrolments, accreditation requirements, course structures; and demographics are contextualised within a qualitative view of programme purposes, student and institutional motivations, rationales and concerns. Particular focus is given to perceptions of the difference between traditional research doctorates (PhDs) and professional doctorates, especially the DBA.Findings – In the decade from 2003 to 2013 DBA enrolments are down but enquiries are up, indicating unmet demand. There is a shift in the players, with some smaller, regional universities dramatically increasing their enrolments, and larger, traditional institutions exiting the space altogether. Significant changes in accreditation criteria have generated a perceptual shift: where DBAs previously suffered from “academic snobbery” regarding their legitimacy, this perception is being challenged by standards which require DBA equivalence with a PhD. This shift in standards has also created some confusion amongst supervisors and candidates.Originality/value – There is limited research into the DBA award or its candidates, and academic literature is generally silent on DBA supervision. This piece of research, one of very few that specifically examine the DBA, reflects on the past decade, analyses the present context and identifies emerging issues for the delivery of DBA programmes in Australia.

Yaringa and French Island Marine National Park habitat mapping

Deakin University and the Department of Primary Industries were commissioned by ParksVictoria (PV) to create two updated habitat maps for Yaringa and French Island MarineNational Parks. The team obtained a ground-truth data set using in situ video and still photographs. This dataset was used to develop and assess predictive models of benthic marine habitat distributions incorporating data from World-View-2 imagery atmospherically corrected by CSIRO and LiDAR (Light Detection and Ranging) bathymetry. In addition, the team applied an unsupervised classification approach to an aerial photograph to assess the differences between the two remote sensors. This report describes the results of the mapping as well as the methodology used to produce these habitat maps.This study has provided mapping of intertidal and subtidal habitats of Yaringa and FrenchIsland MNPs at a 2 m resolution with fair to good accuracies (Kappa 0.40-0.75). These were combined with mangrove and saltmarsh habitats recently mapped by Boon et al. (2011) to provide compete-coverage habitat maps of Yaringa and French Island MNPs.The mapping showed that Yaringa MNP was dominated by mangroves, wet saltmarsh and dense Zostereaceae, covering 33%, 29% and 19%, respectively. Similarly, intertidalvegetation and subtidal vegetation (dominated by Zosteraceae) covered 26% and 25% ofFrench Island MNP. However, as a result of turbidity and missing satellite imagery 27% ofFrench Island MNP remains unmapped.The coupling of WV-2 and LiDAR reduced potential artefacts (e.g. sun glint causing whiteand black pixels known as the “salt and pepper effect”). The satellite classification appeared to provide better results than the aerial photography classification. However, since there is a two-year difference between the capture of the aerial photography and the collection of the ground-truth data this comparison is potentially temporally confounded. It must also be noted that there are differences in costs of the data,the spatial resolution between the two datasets (i.e. WV-2 = 2 m and the Aerial = 0.5 m) and the amount spectral information contained in the data (i.e. WV-2 = 8 bands and the aerial = 4 bands), which may ultimately determine its utility for a particular project.The spatial assessment using FRAGSTATs of habitat patches within Yaringa MNP provides a viable and cost effect way to assess habitat condition (i.e. shape, size and arrangement).This spatial assessment determined that dense Zosteraceae and NVSG habitat classeswere generally larger in patch size and continuity than the medium/sparse Zosteraceaehabitat. The application spatial techniques to time-series mapping may provide a way toremotely monitor the change in the spatial characteristics of marine habitats.This work was successful in providing new baseline habitat maps using a repeatable method meaning that any future changes in intertidal and shallow water marine habitats may be assessed in a consistent way with quantitative error assessments. In wider use, these maps should also allow improved conservation planning, fisheries and catchment management, and contribute toward infrastructure planning to limit impacts on Western Port.

Efficacy comparison of clustering systems for limb detection

This paper presents a comparison of applying different clustering algorithms on a point cloud constructed from the depth maps captured by a RGBD camera such as Microsoft Kinect. The depth sensor is capable of returning images, where each pixel represents the distance to its corresponding point not the RGB data. This is considered as the real novelty of the RGBD camera in computer vision compared to the common video-based and stereo-based products. Depth sensors captures depth data without using markers, 2D to 3D-transition or determining feature points. The captured depth map then cluster the 3D depth points into different clusters to determine the different limbs of the human-body. The 3D points clustering is achieved by different clustering techniques. Our Experiments show good performance and results in using clustering to determine different human-body limbs.

Individualized arrhythmia detection with ECG signals from wearable devices

Low cost pervasive electrocardiogram (ECG) monitors is changing how sinus arrhythmia are diagnosed among patients with mild symptoms. With the large amount of data generated from long-term monitoring, come new data science and analytical challenges. Although traditional rule-based detection algorithms still work on relatively short clinical quality ECG, they are not optimal for pervasive signals collected from wearable devices - they don't adapt to individual difference and assume accurate identification of ECG fiducial points. To overcome these short-comings of the rule-based methods, this paper introduces an arrhythmia detection approach for low quality pervasive ECG signals. To achieve the robustness needed, two techniques were applied. First, a set of ECG features with minimal reliance on fiducial point identification were selected. Next, the features were normalized using robust statistics to factors out baseline individual differences and clinically irrelevant temporal drift that is common in pervasive ECG. The proposed method was evaluated using pervasive ECG signals we collected, in combination with clinician validated ECG signals from Physiobank. Empirical evaluation confirms accuracy improvements of the proposed approach over the traditional clinical rules.

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING: Bill & Melinda Gates Foundation.

Protocol-directed sedation versus non-protocol-directed sedation to reduce duration of mechanical ventilation in mechanically ventilated intensive care patients (review)

Background : The sedation needs of critically ill patients have been recognized as a core component of critical care and meeting these is vital to assist recovery and ensure humane treatment. There is growing evidence to suggest that sedation requirements are not always optimally managed. Sub-optimal sedation incorporates both under- and over-sedation and has been linked to both short-term (e.g. length of stay) and long-term (e.g. psychological recovery) outcomes. Various strategies have been proposed to improve sedation management and address aspects of assessment as well as delivery of sedation.

Objectives : To assess the effects of protocol-directed sedation management on the duration of mechanical ventilation and other relevant patient outcomes in mechanically ventilated intensive care unit (ICU) patients. We looked at various outcomes and examined the role of bias in order to examine the level of evidence for this intervention.

Search methods : We searched the Cochrane Central Register of Controlled trials (CENTRAL) (2013; Issue 11), MEDLINE (OvidSP) (1990 to November 2013), EMBASE (OvidSP) (1990 to November 2013), CINAHL (BIREME host) (1990 to November 2013), Database of Abstracts of Reviews of Effects (DARE) (1990 to November 2013), LILACS (1990 to November 2013), Current Controlled Trials and US National Institutes of Health Clinical Research Studies (1990 to November 2013), and reference lists of articles. We re-ran the search in October 2014. We will deal with any studies of interest when we update the review.

Selection criteria : We included randomized controlled trials (RCTs) conducted in adult ICUs comparing management with and without protocol-directed sedation.

Data collection and analysis : Two authors screened the titles and abstracts and then the full-text reports identified from our electronic search. We assessed seven domains of potential risk of bias for the included studies. We examined the clinical, methodological and statistical heterogeneity and used the random-effects model for meta-analysis where we considered it appropriate. We calculated the mean difference (MD) for duration of mechanical ventilation and risk ratio (RR) for mortality across studies, with 95% confidence intervals (CI).

Main results : We identified two eligible studies with 633 participants. Both included studies compared the use of protocol-directed sedation, specifically protocols delivered by nurses, with usual care. We rated the risk of selection bias due to random sequence generation low for one study and unclear for one study. The risk of selection bias related to allocation concealment was low for both studies. We also assessed detection and attrition bias as low for both studies while we considered performance bias high due to the inability to blind participants and clinicians in both studies. Risk due to other sources of bias, such as potential for contamination between groups and reporting bias, was considered unclear. There was no clear evidence of differences in duration of mechanical ventilation (MD -5.74 hours, 95% CI -62.01 to 50.53, low quality evidence), ICU length of stay (MD -0.62 days, 95% CI -2.97 to 1.73) and hospital length of stay (MD -3.78 days, 95% CI -8.54 to 0.97) between people being managed with protocol-directed sedation versus usual care. Similarly, there was no clear evidence of difference in hospital mortality between the two groups (RR 0.96, 95% CI 0.71 to 1.31, low quality evidence). ICU mortality was only reported in one study preventing pooling of data. There was no clear evidence of difference in the incidence of tracheostomy (RR 0.77, 95% CI 0.31 to 1.89). The studies reported few adverse event outcomes; one study reported self extubation while the other study reported re-intubation; given this difference in outcomes, pooling of data was not possible. There was significant heterogeneity between studies for duration of mechanical ventilation (I2 = 86%, P value = 0.008), ICU length of stay (I2 = 82%, P value = 0.02) and incidence of tracheostomy (I2 = 76%, P value = 0.04), with one study finding a reduction in duration of mechanical ventilation and incidence of tracheostomy and the other study finding no difference.

Authors' conclusions : There is currently insufficient evidence to evaluate the effectiveness of protocol-directed sedation. Results from the two RCTs were conflicting, resulting in the quality of the body of evidence as a whole being assessed as low. Further studies, taking into account contextual and clinician characteristics in different ICU environments, are necessary to inform future practice. Methodological strategies to reduce the risk of bias need to be considered in future studies.

Playing Active Video Games may not develop movement skills: an intervention trial

Background: To investigate the impact of playing sports Active Video Games on children's actual and perceived object control skills. Methods: Intervention children played Active Video Games for 6. weeks (1. h/week) in 2012. The Test of Gross Motor Development-2 assessed object control skill. The Pictorial Scale of Perceived Movement Skill Competence assessed perceived object control skill. Repeated measurements of object control and perceived object control were analysed for the whole sample, using linear mixed models, which included fixed effects for group (intervention or control) and time (pre and post) and their interaction. The first model adjusted for sex only and the second model also adjusted for age, and prior ball sports experience (yes/no). Seven mixed-gender focus discussions were conducted with intervention children after programme completion. Results: Ninety-five Australian children (55% girls; 43% intervention group) aged 4 to 8. years (M 6.2, SD 0.95) participated. Object control skill improved over time (p=0.006) but there was no significant difference (p=0.913) between groups in improvement (predicted means: control 31.80 to 33.53, SED=0.748; intervention 30.33 to 31.83, SED=0.835). A similar result held for the second model. Similarly the intervention did not change perceived object control in Model 1 (predicted means: control: 19.08 to 18.68, SED=0.362; intervention 18.67 to 18.88, SED=0.406) or Model 2. Children found the intervention enjoyable, but most did not perceive direct equivalence between Active Video Games and 'real life' activities. Conclusions: Whilst Active Video Game play may help introduce children to sport, this amount of time playing is unlikely to build skill.

Change of school in early adolescence and adverse obesity-related dietary behavior: a longitudinal cohort study, Victoria, Australia, 2013-2014

INTRODUCTION: Environments that facilitate energy-dense, nutrient-poor diets are associated with childhood obesity. We examined the effect of a change of school environment on the prevalence of obesity and related dietary behavior in early adolescence. METHODS: Fifteen schools in Victoria, Australia, were recruited at random from the bottom 2 strata of a 5-level socioeconomic scale. In 9 schools, students in grade 6 primary school transitioned to different schools for grade 7 secondary school, whereas in 6 schools, students remained in the same school from grade 6 to grade 7. Time 1 measures were collected from students (N = 245) in grade 6 (aged 11-13 y). Time 2 data were collected from 243 (99%) of the original cohort in grade 7. Data collected were dietary recall self-reported by students via questionnaire, measured height and weight of students, and aspects of the school food environment via school staff survey. Comparative and mixed model regression analyses were conducted. RESULTS: Of 243 students, 63% (n = 152) changed schools from time 1 to time 2, with no significant difference in weight status. Students who changed schools reported an increase in purchases of after-school snack food, greater sweetened beverage intake, fewer fruit-and-vegetable classroom breaks, and less encouragement for healthy eating compared with students who remained in the same school. School staff surveys showed that more primary than secondary schools had written healthy canteen policies and fewer days of canteen or food services operation. CONCLUSION: A change of school environment has negative effects on children's obesity-related dietary behavior. Consistent policy is needed across school types to support healthy eating in school environments.

Detection of Candida spp. in the vagina of a cohort of nulliparous pregnant women by culture and molecular methods: is there an association between maternal vaginal and infant oral colonisation?

BACKGROUND: Most studies describing vaginal Candida spp. in pregnancy focus on symptomatic vaginitis, rather than asymptomatic colonisation, and solely utilise microbiological culture. The extent to which asymptomatic vaginal carriage may represent a reservoir for infant oral colonisation has been highly debated. MATERIALS AND METHODS: This study formed part of the Candida and Staphylococcus Transmission Longitudinal Evaluation (CASTLE) study, in Melbourne, Australia, from 2009 to 2011 and used culture and molecular methods to examine vaginal swabs collected late in the third trimester of pregnancy for Candida spp. Oral swabs from infants were also examined using culture methods. RESULTS: Overall, 80 of 356 (22%) women were positive for Candida spp; the majority being Candida albicans (83%). Candida glabrata and other Candida spp. were also identified, but in much lower numbers. Molecular analysis identified numerous positive samples not detected by culture, including 13 cases of C. albicans. In addition, some positive samples only recorded to genus level by culture were accurately identified as either C. albicans or C. glabrata following molecular analyses. Eighteen infants recorded positive Candida spp. cultures, predominantly C. albicans. However, there were only four (25%) mother/infant dyads where C. albicans was detected. CONCLUSIONS: This study provides valuable data on asymptomatic colonisation rates of Candida spp. within an asymptomatic population of women late in pregnancy. The utilisation of molecular methods improved the rate of detection and provided a more accurate means for identification of non-albicans Candida spp. The low mother/infant colonisation rate suggests that non-maternal sources are likely involved in determining infant oral colonisation status.

A path model of psychosocial and health behaviour change predictors of excessive gestational weight gain

This study aimed to evaluate a conceptual model of psychosocial, behaviour change, and behavioural predictors of excessive gestational weight gain (GWG). Background: Excessive GWG can place women and their babies at risk of poor health outcomes, including obesity. Models of psychosocial and behaviour change predictors of excessive GWG have not been extensively explored; understanding the mechanisms leading to excess GWG will provide crucial evidence towards the development of effective interventions. Method: Two hundred and eighty-eight pregnant women (≤18 weeks gestation) were recruited to a prospective study. Demographic, psychosocial, health behaviour change, and behavioural factors were assessed at 17 (Time 1, T1) and 33 weeks (Time 2, T2) gestation. Pre-pregnancy and final pregnancy weight were obtained and women were classified with/without excessive GWG. Logistic regressions refined the list of predictors of excessive GWG; variables with p < .1 were included in a path analysis. Results: Age, family income, T2 depression, T2 pregnancy-specific coping, T1 buttocks dissatisfaction, T2 GWG-specific self-efficacy, T1 dietary readiness, T1 dietary importance, and T1 vegetable intake predicted excessive GWG in the logistic regressions and were included in the path model. The baseline path model demonstrated poor fit. Once statistically and theoretically plausible paths were added, adequate model fit was achieved (χ² = 21.61(9), p < .05; RMSEA = .07; CFI = .93); this revised model explained 19.5% of the variance in excessive GWG. Women with high T1 buttocks dissatisfaction were more likely to exhibit low levels of dietary readiness. Women with low dietary readiness were more likely to have a lower vegetable intake, which predicted excessive GWG. Women with higher T2 depressive symptoms were more likely to report lower GWG self-efficacy and gain excessively. Conclusion: Future behavioural GWG trials should consider combining psychosocial and health behaviour change factors to optimise GWG.

A new color space based on K-medoids clustering for fire detection

Pixel color has proven to be a useful and robust cue for detection of most objects of interest like fire. In this paper, a hybrid intelligent algorithm is proposed to detect fire pixels in the background of an image. The proposed algorithm is introduced by the combination of a computational search method based on a swarm intelligence technique and the Kemdoids clustering method in order to form a Fire-based Color Space (FCS), in fact, the new technique converts RGB color system to FCS through a 3*3 matrix. This algorithm consists of five main stages:(1) extracting fire and non-fire pixels manually from the original image. (2) using K-medoids clustering to find a Cost function to minimize the error value. (3) applying Particle Swarm Optimization (PSO) to search and find the best W components in order to minimize the fitness function. (4) reporting the best matrix including feature weights, and utilizing this matrix to convert the all original images in the database to the new color space. (5) using Otsu threshold technique to binarize the final images. As compared with some state-of-the-art techniques, the experimental results show the ability and efficiency of the new method to detect fire pixels in color images.

Use of focus groups to identify health promotion strategies for the early detection of diabetic retinopathy

BACKGROUND: People with diabetes do not regularly utilise eye services for the early prevention of vision loss due to diabetic eye disease. A community-based screening program has been initiated in Victoria to address this issue. To encourage people to take preventive eye health care measures, the most effective health promotion strategies were identified. METHODS: Thirty-three health professionals were invited to attend focus groups. A sample of 35 people with diabetes was approached by their GPs or diabetes educators because of their motivation to participate in diabetes activities. Each group consisted of 10 members. Discussion points included the type of education messages available to people with diabetes; use of eye services among the participants with diabetes; and strategies required promoting the screening service. RESULTS: Five focus groups were conducted. The discussions highlighted that a great deal could be achieved by using local community networks to promote the benefits of early detection of diabetic retinopathy and local screening program. The group members recommended that particular attention be directed to general practitioners and their distribution of materials to patients. Key issues for planning and implementing the program were highlighted. The groups urged development of strategies to encourage people with diabetes in rural Victoria to participate in a program for the early detection of diabetic retinopathy.

Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition

OBJECTIVES: The Health of the Nation Outcome Scales (HoNOS) are mandated outcome-measures in many mental-health jurisdictions. When HoNOS are used in different care settings, it is important to assess if setting specific bias exists. This article examines the consistency of HoNOS in a sample of psychiatric patients transitioned from acute inpatient care and community centres.

SETTING: A regional mental health service with both acute and community facilities.

PARTICIPANTS: 111 psychiatric patients were transferred from inpatient care to community care from 2012 to 2014. Their HoNOS scores were extracted from a clinical database; Each inpatient-discharge assessment was followed by a community-intake assessment, with the median period between assessments being 4 days (range 0-14). Assessor experience and professional background were recorded.

PRIMARY AND SECONDARY OUTCOME MEASURES: The difference of HoNOS at inpatient-discharge and community-intake were assessed with Pearson correlation, Cohen's κ and effect size.

RESULTS: Inpatient-discharge HoNOS was on average lower than community-intake HoNOS. The average HoNOS was 8.05 at discharge (median 7, range 1-22), and 12.16 at intake (median 12, range 1-25), an average increase of 4.11 (SD 6.97). Pearson correlation between two total scores was 0.073 (95% CI -0.095 to 0.238) and Cohen's κ was 0.02 (95% CI -0.02 to 0.06). Differences did not appear to depend on assessor experience or professional background.

CONCLUSIONS: Systematic change in the HoNOS occurs at inpatient-to-community transition. Some caution should be exercised in making direct comparisons between inpatient HoNOS and community HoNOS scores.