Comparison of estimates and calculations of risk of coronary heart disease by doctors and nurses using different calculation tools in general practice: cross sectional study

OBJECTIVE: To assess the effect of using different risk calculation tools on how general practitioners and practice nurses evaluate the risk of coronary heart disease with clinical data routinely available in patients' records. DESIGN: Subjective estimates of the risk of coronary heart disease and results of four different methods of calculation of risk were compared with each other and a reference standard that had been calculated with the Framingham equation; calculations were based on a sample of patients' records, randomly selected from groups at risk of coronary heart disease. SETTING: General practices in central England. PARTICIPANTS: 18 general practitioners and 18 practice nurses. MAIN OUTCOME MEASURES: Agreement of results of risk estimation and risk calculation with reference calculation; agreement of general practitioners with practice nurses; sensitivity and specificity of the different methods of risk calculation to detect patients at high or low risk of coronary heart disease. RESULTS: Only a minority of patients' records contained all of the risk factors required for the formal calculation of the risk of coronary heart disease (concentrations of high density lipoprotein (HDL) cholesterol were present in only 21%). Agreement of risk calculations with the reference standard was moderate (kappa=0.33-0.65 for practice nurses and 0.33 to 0.65 for general practitioners, depending on calculation tool), showing a trend for underestimation of risk. Moderate agreement was seen between the risks calculated by general practitioners and practice nurses for the same patients (kappa=0.47 to 0.58). The British charts gave the most sensitive results for risk of coronary heart disease (practice nurses 79%, general practitioners 80%), and it also gave the most specific results for practice nurses (100%), whereas the Sheffield table was the most specific method for general practitioners (89%). CONCLUSIONS: Routine calculation of the risk of coronary heart disease in primary care is hampered by poor availability of data on risk factors. General practitioners and practice nurses are able to evaluate the risk of coronary heart disease with only moderate accuracy. Data about risk factors need to be collected systematically, to allow the use of the most appropriate calculation tools.

Using computer concordancing for the learning of French as a second language

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High-throughput manufacturing of size-tuned liposomes by a new microfluidics method using enhanced statistical tools for characterization

Microfluidics has recently emerged as a new method of manufacturing liposomes, which allows for reproducible mixing in miliseconds on the nanoliter scale. Here we investigate microfluidics-based manufacturing of liposomes. The aim of these studies was to assess the parameters in a microfluidic process by varying the total flow rate (TFR) and the flow rate ratio (FRR) of the solvent and aqueous phases. Design of experiment and multivariate data analysis were used for increased process understanding and development of predictive and correlative models. High FRR lead to the bottom-up synthesis of liposomes, with a strong correlation with vesicle size, demonstrating the ability to in-process control liposomes size; the resulting liposome size correlated with the FRR in the microfluidics process, with liposomes of 50 nm being reproducibly manufactured. Furthermore, we demonstrate the potential of a high throughput manufacturing of liposomes using microfluidics with a four-fold increase in the volumetric flow rate, maintaining liposome characteristics. The efficacy of these liposomes was demonstrated in transfection studies and was modelled using predictive modeling. Mathematical modelling identified FRR as the key variable in the microfluidic process, with the highest impact on liposome size, polydispersity and transfection efficiency. This study demonstrates microfluidics as a robust and high-throughput method for the scalable and highly reproducible manufacture of size-controlled liposomes. Furthermore, the application of statistically based process control increases understanding and allows for the generation of a design-space for controlled particle characteristics.

Computer aided geometric design of form-rolls for NC manufacture

Conventional methods of form-roll design and manufacture for Cold Roll-Forming of thin-walled metal sections have been entirely manual, time consuming and prone to errors, resulting in inefficiency and high production costs. With the use of computers, lead time can be significantly improved, particularly for those aspects involving routine but tedious human decisions and actions. This thesis describes the development of computer aided tools for producing form-roll designs for NC manufacture in the CAD/CAM environment. The work was undertaken to modernise the existing activity of a company manufacturing thin-walled sections. The investigated areas of the activity, including the design and drafting of the finished section, the flower patterns, the 10 to 1 templates, and the rolls complete with pinch-difference surfaces, side-rolls and extension-contours, have been successfully computerised by software development . Data generated by the developed software can be further processed for roll manufacturing using NC lathes. The software has been specially designed for portability to facilitate its implementation on different computers. The Opening-Radii method of forming was introduced as a subsitute to the conventional method for better forming. Most of the essential aspects in roll design have been successfully incorporated in the software. With computerisation, extensive standardisation in existing roll design practices and the use of more reliable and scientifically-based methods have been achieved. Satisfactory and beneficial results have also been obtained by the company in using the software through a terminal linked to the University by a GPO line. Both lead time and productivity in roll design and manufacture have been significantly improved. It is therefore concluded that computerisation in the design of form-rolls for automation by software development is viable. The work also demonstrated the promising nature of the CAD/CAM approach.

All-optical processing using cross-phase modulation

The following thesis presents results obtained from both numerical simulation and laboratory experimentation (both of which were carried out by the author). When data is propagated along an optical transmission line some timing irregularities can occur such as timing jitter and phase wander. Traditionally these timing problems would have been corrected by converting the optical signal into the electrical domain and then compensating for the timing irregularity before converting the signal back into the optical domain. However, this thesis posses a potential solution to the problem by remaining completely in the optical domain, eliminating the need for electronics. This is desirable as not only does optical processing reduce the latency effect that their electronic counterpart have, it also holds the possibility of an increase in overall speed. A scheme was proposed which utilises the principle of wavelength conversion to dynamically convert timing irregularities (timing jitter and phase wander) into a change in wavelength (this occurs on a bit-by-bit level and so timing jitter and phase wander can be compensated for simultaneously). This was achieved by optically sampling a linearly chirped, locally generated clock source (the sampling function was achieved using a nonlinear optical loop mirror). The data, now with each bit or code word having a unique wavelength, is then propagated through a dispersion compensation module. The dispersion compensation effectively re-aligns the data in time and so thus, the timing irregularities are removed. The principle of operation was tested using computer simulation before being re-tested in a laboratory environment. A second stage was added to the device to create 3R regeneration. The second stage is used to simply convert the timing suppressed data back into a single wavelength. By controlling the relative timing displacement between stage one and stage two, the wavelength that is finally produced can be controlled.

Modelling of induction motors for system faults and transient stability studies

The research carried out in this thesis was mainly concerned with the effects of large induction motors and their transient performance in power systems. Computer packages using the three phase co-ordinate frame of reference were developed to simulate the induction motor transient performance. A technique using matrix algebra was developed to allow extension of the three phase co-ordinate method to analyse asymmetrical and symmetrical faults on both sides of the three phase delta-star transformer which is usually required when connecting large induction motors to the supply system. System simulation, applying these two techniques, was used to study the transient stability of a power system. The response of a typical system, loaded with a group of large induction motors, two three-phase delta-star transformers, a synchronous generator and an infinite system was analysed. The computer software developed to study this system has the advantage that different types of fault at different locations can be studied by simple changes in input data. The research also involved investigating the possibility of using different integrating routines such as Runge-Kutta-Gill, RungeKutta-Fehlberg and the Predictor-Corrector methods. The investigation enables the reduction of computation time, which is necessary when solving the induction motor equations expressed in terms of the three phase variables. The outcome of this investigation was utilised in analysing an introductory model (containing only minimal control action) of an isolated system having a significant induction motor load compared to the size of the generator energising the system.

A computational model of prosody for Yorùbá text-to-speech synthesis

This work examines prosody modelling for the Standard Yorùbá (SY) language in the context of computer text-to-speech synthesis applications. The thesis of this research is that it is possible to develop a practical prosody model by using appropriate computational tools and techniques which combines acoustic data with an encoding of the phonological and phonetic knowledge provided by experts. Our prosody model is conceptualised around a modular holistic framework. The framework is implemented using the Relational Tree (R-Tree) techniques (Ehrich and Foith, 1976). R-Tree is a sophisticated data structure that provides a multi-dimensional description of a waveform. A Skeletal Tree (S-Tree) is first generated using algorithms based on the tone phonological rules of SY. Subsequent steps update the S-Tree by computing the numerical values of the prosody dimensions. To implement the intonation dimension, fuzzy control rules where developed based on data from native speakers of Yorùbá. The Classification And Regression Tree (CART) and the Fuzzy Decision Tree (FDT) techniques were tested in modelling the duration dimension. The FDT was selected based on its better performance. An important feature of our R-Tree framework is its flexibility in that it facilitates the independent implementation of the different dimensions of prosody, i.e. duration and intonation, using different techniques and their subsequent integration. Our approach provides us with a flexible and extendible model that can also be used to implement, study and explain the theory behind aspects of the phenomena observed in speech prosody.

A class of perfect fluids in general relativity

This thesis is concerned with exact solutions of Einstein's field equations of general relativity, in particular, when the source of the gravitational field is a perfect fluid with a purely electric Weyl tensor. General relativity, cosmology and computer algebra are discussed briefly. A mathematical introduction to Riemannian geometry and the tetrad formalism is then given. This is followed by a review of some previous results and known solutions concerning purely electric perfect fluids. In addition, some orthonormal and null tetrad equations of the Ricci and Bianchi identities are displayed in a form suitable for investigating these space-times. Conformally flat perfect fluids are characterised by the vanishing of the Weyl tensor and form a sub-class of the purely electric fields in which all solutions are known (Stephani 1967). The number of Killing vectors in these space-times is investigated and results presented for the non-expanding space-times. The existence of stationary fields that may also admit 0, 1 or 3 spacelike Killing vectors is demonstrated. Shear-free fluids in the class under consideration are shown to be either non-expanding or irrotational (Collins 1984) using both orthonormal and null tetrads. A discrepancy between Collins (1984) and Wolf (1986) is resolved by explicitly solving the field equations to prove that the only purely electric, shear-free, geodesic but rotating perfect fluid is the Godel (1949) solution. The irrotational fluids with shear are then studied and solutions due to Szafron (1977) and Allnutt (1982) are characterised. The metric is simplified in several cases where new solutions may be found. The geodesic space-times in this class and all Bianchi type 1 perfect fluid metrics are shown to have a metric expressible in a diagonal form. The position of spherically symmetric and Bianchi type 1 space-times in relation to the general case is also illustrated.

A modular holistic approach to prosody modelling for Standard Yorùbá speech synthesis

This paper presents a novel prosody model in the context of computer text-to-speech synthesis applications for tone languages. We have demonstrated its applicability using the Standard Yorùbá (SY) language. Our approach is motivated by the theory that abstract and realised forms of various prosody dimensions should be modelled within a modular and unified framework [Coleman, J.S., 1994. Polysyllabic words in the YorkTalk synthesis system. In: Keating, P.A. (Ed.), Phonological Structure and Forms: Papers in Laboratory Phonology III, Cambridge University Press, Cambridge, pp. 293–324]. We have implemented this framework using the Relational Tree (R-Tree) technique. R-Tree is a sophisticated data structure for representing a multi-dimensional waveform in the form of a tree. The underlying assumption of this research is that it is possible to develop a practical prosody model by using appropriate computational tools and techniques which combine acoustic data with an encoding of the phonological and phonetic knowledge provided by experts. To implement the intonation dimension, fuzzy logic based rules were developed using speech data from native speakers of Yorùbá. The Fuzzy Decision Tree (FDT) and the Classification and Regression Tree (CART) techniques were tested in modelling the duration dimension. For practical reasons, we have selected the FDT for implementing the duration dimension of our prosody model. To establish the effectiveness of our prosody model, we have also developed a Stem-ML prosody model for SY. We have performed both quantitative and qualitative evaluations on our implemented prosody models. The results suggest that, although the R-Tree model does not predict the numerical speech prosody data as accurately as the Stem-ML model, it produces synthetic speech prosody with better intelligibility and naturalness. The R-Tree model is particularly suitable for speech prosody modelling for languages with limited language resources and expertise, e.g. African languages. Furthermore, the R-Tree model is easy to implement, interpret and analyse.

Modeling, simulating, and simplifying links between stress, attachment, and reproduction

John Bowlby's use of evolutionary theory as a cornerstone of his attachment theory was innovative in its day and remains useful. Del Giudice's target article extends Belsky et al.'s and Chisholm's efforts to integrate attachment theory with more current thinking about evolution, ecology, and neuroscience. His analysis would be strengthened by (1) using computer simulation to clarify and simulate the effects of early environmental stress, (2) incorporating information about non-stress related sources of individual differences, (3) considering the possibility of adaptive behavior without specific evolutionary adaptations, and (4) considering whether the attachment construct is critical to his analysis.

Determining inventory service support levels in multi-national companies

Multi-national manufacturing companies are often faced with very difficult decisions regarding where and how to cost effectively manufacture products in a global setting. Clearly, they must utilize efficient and responsive manufacturing strategies to reach low cost solutions, but they must also consider the impact of manufacturing and transportation solutions upon their ability to support sales. One important sales consideration is determining how much work in process, in-transit stock, and finished goods to have on hand to support sales at a desired service level. This paper addresses this important consideration through a comprehensive scenario-based simulation approach, including sensitivity analysis on key study parameters. Results indicate that the inventory needs vary considerably for different manufacturing and delivery methods in ways that may not be obvious when using common evaluative tools.

Persistence in a random bond ising model of socio-econo dynamics

We study the persistence phenomenon in a socio-econo dynamics model using computer simulations at a nite temperature on hypercubic lattices in dimensions up to ve. The model includes a \social" local eld which contains the magnetization at time t. The nearest neighbour quenched interactions are drawn from a binary distribution which is a function of the bond concentration, p. The decay of the persistence probability in the model depends on both the spatial dimension and p. We nd no evidence of \blocking" in this model. We also discuss the implications of our results for possible applications in the social and economic elds. It is suggested that the absence, or otherwise, of blocking could be used as a criterion to decide on the validity of a given model in dierent scenarios.

BMI not WHR modulates BOLD fMRI responses in a sub-cortical reward network when participants judge the attractiveness of human female bodies

In perceptual terms, the human body is a complex 3d shape which has to be interpreted by the observer to judge its attractiveness. Both body mass and shape have been suggested as strong predictors of female attractiveness. Normally body mass and shape co-vary, and it is difficult to differentiate their separate effects. A recent study suggested that altering body mass does not modulate activity in the reward mechanisms of the brain, but shape does. However, using computer generated female body-shaped greyscale images, based on a Principal Component Analysis of female bodies, we were able to construct images which covary with real female body mass (indexed with BMI) and not with body shape (indexed with WHR), and vice versa. Twelve observers (6 male and 6 female) rated these images for attractiveness during an fMRI study. The attractiveness ratings were correlated with changes in BMI and not WHR. Our primary fMRI results demonstrated that in addition to activation in higher visual areas (such as the extrastriate body area), changing BMI also modulated activity in the caudate nucleus, and other parts of the brain reward system. This shows that BMI, not WHR, modulates reward mechanisms in the brain and we infer that this may have important implications for judgements of ideal body size in eating disordered individuals.

Exploring the effectiveness of similarity-based visualisations for colour-based image retrieval

In April 2009, Google Images added a filter for narrowing search results by colour. Several other systems for searching image databases by colour were also released around this time. These colour-based image retrieval systems enable users to search image databases either by selecting colours from a graphical palette (i.e., query-by-colour), by drawing a representation of the colour layout sought (i.e., query-by-sketch), or both. It was comments left by readers of online articles describing these colour-based image retrieval systems that provided us with the inspiration for this research. We were surprised to learn that the underlying query-based technology used in colour-based image retrieval systems today remains remarkably similar to that of systems developed nearly two decades ago. Discovering this ageing retrieval approach, as well as uncovering a large user demographic requiring image search by colour, made us eager to research more effective approaches for colour-based image retrieval. In this thesis, we detail two user studies designed to compare the effectiveness of systems adopting similarity-based visualisations, query-based approaches, or a combination of both, for colour-based image retrieval. In contrast to query-based approaches, similarity-based visualisations display and arrange database images so that images with similar content are located closer together on screen than images with dissimilar content. This removes the need for queries, as users can instead visually explore the database using interactive navigation tools to retrieve images from the database. As we found existing evaluation approaches to be unreliable, we describe how we assessed and compared systems adopting similarity-based visualisations, query-based approaches, or both, meaningfully and systematically using our Mosaic Test - a user-based evaluation approach in which evaluation study participants complete an image mosaic of a predetermined target image using the colour-based image retrieval system under evaluation.