Assessing fun in serious games: Formative evaluation of games from two diabetes prevention interventions

Purpose. To determine the usability of two video games to prevent type 2 diabetes and obesity among youth through analysis of data collected during alpha-testing. ^ Subjects. Ten children aged 9 to 12 were selected for three 2-hour alpha testing sessions.^ Methods. "Escape from Diab" and "Nanoswarm" were designed to change dietary and physical inactivity behaviors, based on a theoretical framework of mediating variables obtained from social cognitive theory, self-determination theory, elaboration likelihood model, and behavioral inoculation theory. Thirteen mini-games developed by the software company were divided into 3 groups based on completion date. Children tested 4-5 mini-games in each of three sessions. Observed game play was followed by a scripted interview. Results from observation forms and interview transcripts were tabulated and coded to determine usability. Suggestions for game modifications were delivered to the software design firm, and a follow-up table reports rationale for inclusion or exclusion of such modifications.^ Results. Participants were 50% frequent video game players and 20% non game-players. Most (60%) were female. The mean grade (indicating likeability as a subset of usability) across all games given by children was significantly greater than a neutral grade of 80% (89%, p < 0.01), indicating a positive likeability score. The games on average also received positive ratings for fun, helpfulness of instructions and length compared to neutral values (midpoint on likert scales) (all p < 0.01). Observation notes indicated that participants paid attention to the instructions, did not appear to have much difficulty with the games, and were "not frustrated", "not bored", "very engaged", "not fidgety" and "very calm" (all p < 0.01). The primary issues noted in observations and interviews were unclear instructions and unclear purpose of some games. Player suggestions primarily involved ways to make on screen cues more visible or noticeable, instructions more clear, and games more elaborate or difficult.^ Conclusions. The present study highlights the importance of alpha testing video game components for usability prior to completion to enhance usability and likeability. Results indicate that creating clear instructions, making peripheral screen cues more eye-catching or noticeable, and vigorously stating the purpose of the game to improve understandability are important elements. However, future interventions will each present unique materials and user-interfaces and should therefore also be thoroughly alpha-tested. ^

Systematic review of worksite-based behavior change programs that target metabolic syndrome risk factors

Approximately one-third of US adults have metabolic syndrome, the clustering of cardiovascular risk factors that include hypertension, abdominal adiposity, elevated fasting glucose, low high-density lipoprotein (HDL)-cholesterol and elevated triglyceride levels. While the definition of metabolic syndrome continues to be much debated among leading health research organizations, the fact is that individuals with metabolic syndrome have an increased risk of developing cardiovascular disease and/or type 2 diabetes. A recent report by the Henry J. Kaiser Family Foundation found that the US spent $2.2 trillion (16.2% of the Gross Domestic Product) on healthcare in 2007 and cited that among other factors, chronic diseases, including type 2 diabetes and cardiovascular disease, are large contributors to this growing national expenditure. Bearing a substantial portion of this cost are employers, the leading providers of health insurance. In lieu of this, many employers have begun implementing health promotion efforts to counteract these rising costs. However, evidence-based practices, uniform guidelines and policy do not exist for this setting in regard to the prevention of metabolic syndrome risk factors as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Therefore, the aim of this review was to determine the effects of worksite-based behavior change programs on reducing the risk factors for metabolic syndrome in adults. Using relevant search terms, OVID MEDLINE was used to search the peer-reviewed literature published since 1998, resulting in 23 articles meeting the inclusion criteria for the review. The American Dietetic Association's Evidence Analysis Process was used to abstract data from selected articles, assess the quality of each study, compile the evidence, develop a summarized conclusion, and assign a grade based upon the strength of supporting evidence. The results revealed that participating in a worksite-based behavior change program may be associated in one or more improved metabolic syndrome risk factors. Programs that delivered a higher dose (>22 hours), in a shorter duration (<2 years) using two or more behavior-change strategies were associated with more metabolic risk factors being positively impacted. A Conclusion Grade of III was obtained for the evidence, indicating that studies were of weak design or results were inconclusive due to inadequate sample sizes, bias and lack of generalizability. These results provide some support for the continued use of worksite-based health promotion and further research is needed to determine if multi-strategy, intense behavior change programs targeting multiple risk factors are able to sustain health improvements in the long-term.^

Survival analysis of circulating tumor cells in triple-negative breast cancer

Background. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% (1.38 million) of the total new cancer cases and 14% (458,400) of the total cancer deaths in 2008. [1] Triple-negative breast cancer (TNBC) is an aggressive phenotype comprising 10–20% of all breast cancers (BCs). [2-4] TNBCs show absence of estrogen, progesterone and HER2/neu receptors on the tumor cells. Because of the absence of these receptors, TNBCs are not candidates for targeted therapies. Circulating tumor cells (CTCs) are observed in blood of breast cancer patients even at early stages (Stage I & II) of the disease. Immunological and molecular analysis can be used to detect the presence of tumor cells in the blood (Circulating tumor cells; CTCs) of many breast cancer patients. These cells may explain relapses in early stage breast cancer patients even after adequate local control. CTC detection may be useful in identifying patients at risk for disease progression, and therapies targeting CTCs may improve outcome in patients harboring them. Methods . In this study we evaluated 80 patients with TNBC who are enrolled in a larger prospective study conducted at M D Anderson Cancer Center in order to determine whether the presence of circulating tumor cells is a significant prognostic factor in relapse free and overall survival . Patients with metastatic disease at the time of presentation were excluded from the study. CTCs were assessed using CellSearch System™ (Veridex, Raritan, NJ). CTCs were defined as nucleated cells lacking the presence of CD45 but expressing cytokeratins 8, 18 or 19. The distribution of patient and tumor characteristics was analyzed using chi square test and Fisher's exact test. Log rank test and Cox regression analysis was applied to establish the association of circulating tumor cells with relapse free and overall survival. Results. The median age of the study participants was 53years. The median duration of follow-up was 40 months. Eighty-eight percent (88%) of patients were newly diagnosed (without a previous history of breast cancer), and (60%) of patients were chemo naïve (had not received chemotherapy at the time of their blood draw for CTC analysis). Tumor characteristics such as stage (P=0.40), tumor size (P=69), sentinel nodal involvement (P=0.87), axillary lymph node involvement (P=0.13), adjuvant therapy (P=0.83), and high histological grade of tumor (P=0.26) did not predict the presence of CTCs. However, CTCs predicted worse relapse free survival (1 or more CTCs log rank P value = 0.04, at 2 or more CTCs P = 0.02 and at 3 or more CTCs P < 0.0001) and overall survival (at 1 or more CTCs log rank P value = 0.08, at 2 or more CTCs P = 0.01 and at 3 or more CTCs P = 0.0001. Conclusions. The number of circulating tumor cells predicted worse relapse free survival and overall survival in TNBC patients.^

Sedimentology and mineralogy of surface sediments from the Chilean continental margin

The regional patterns of texture and composition of modern continental slope and pelagic sediments off Chile between 25°S and 43°S reflect the latitudinal segmentation of geological, morphological, and climatic features of the continental hinterland. Grain-size characteristics are controlled by the grain-size of source rocks, the weathering regime, and mode of sediment input (eolian off northern Chile vs fluvial further south). Bulk-mineral assemblages reveal a low grade of maturity. Regional variations are governed by the source-rock composition of the different geological terranes and the relative source-rock contribution of the Coastal Range and Andes, as controlled by the continental hydrology. The relative abundance of clay minerals is also predominantly influenced by the source-rock composition and partly by continental smectite neoformation. Latitudinal variations of illite crystallinities along the Chilean continental slope (and west of the Peru-Chile trench) clearly reflect modifications of the weathering regime which correspond to the strong climatic zonation of Chile.

Chemical composition of hydrothermal sulfide minerals from the Rainbow, Logachev-1, and Logachev-2 hydrothermal fields

Composition of ore minerals in MAR sulflde occurrences related to ultramaflc rocks was studied using methods of mineragraphy, electron microscopy, microprobe analysis, and X-ray analysis. Objects are located at various levels of maturity of sulflde mounds owing to differences in age, duration and degree of activity of the following hydrothermal systems: generally inactive Logatchev-1 field (up to 66.5 ka old), inactive Logatchev-2 field (3.9 ka), and generally active Rainbow field (up to 23 ka). Relative to MAR submarine ore occurrences in the basalt substrate, mineralization in the hydrothermal fields mentioned above is characterized by high contents of Au, Cd, Co, and Ni, along with presence of accessory minerals of Co and Ni. The studied mounds differ in quantitative ratios of major minerals and structural-textural features of ores that suggest their transformation. Ores in the Logatchev-1 field are characterized by the highest Cu content and development of a wide range of multistage contrast exsolution structures of isocubanite and bornite. In the Logatchev-2 field, sphalerite-chalcopyrite and gold-arsenic exsolution structures are present, but isocubanite exsolution structures are less diverse and contrast. The Rainbow field is marked by presence of homogenous isocubanite and the subordinate development of exsolution structures. The authors have identified four new phases in the Cu-Fe-S system. Phases X and Y (close to chalcopyrite and isocubanite, respectively) make up lamellae among isocubanite exsolution products in the Logatchev-1 and Logatchev-2 fields. Phase Y includes homogenous zones in zonal chimneys of the Rainbow field. Phases A and B formed in the orange bornite domain at low-temperature alteration of chalcopyrite in the Logatchev-1 field. Mineral assemblages of the Cu-S system are most abundant and diverse in the Logatchev-1 field, but their development is minimal in the Logatchev-2 field where mainly Cu-poor sulfides of the geerite-covellite series have been identified. Specific features of mineral assemblages mentioned above reflect the maturity grade of sulfide mounds and can serve as indicators of maturity.

Hydrate, ice and quartz content of eight holes of Leg 204

The state of preservation of natural gas hydrate samples, recovered from 6 sites drilled during ODP Leg 204 at southern summit of Hydrate Ridge, Oregon Margin, has been investigated by X-ray diffraction (XRD) and cryo-scanning-electron-microscopy (cryo-SEM) techniques. A detailed characterization of the state of decomposition of gas hydrates is necessary since no pressurized autoclave tools were used for sampling and partial dissociation must have occurred during recovery prior to the quench and storage in liquid nitrogen. Samples from 16 distinct horizons have been investigated by synchrotron X-ray diffraction measurements at HASYLAB/ Hamburg. A full profile fitting analysis ("Rietveld method") of synchrotron XRD data provides quantitative phase determinations of the major sample constituents such as gas hydrate structure I (sI), hexagonal ice (Ih) and quartz. The ice content (Ih) in each sample is related to frozen water composed of both original existing pore water and the water from decomposed hydrates. Hydrate contents as measured by diffraction vary between 0 and 68 wt.% in the samples we measured. Samples with low hydrate content usually show micro-structural features in cryo-SEM ascribed to extensive decomposition. Comparing the appearance of hydrates at different scales, the grade of preservation seems to be primarily correlated with the contiguous volume of the original existing hydrate; the dissociation front appears to be indicated by micrometer-sized pores in a dense ice matrix.

Density of alkyl esters and its mixtures

Biodiesel density is a key parameter in biodiesel simulations and process development. In this work we selected, evaluated and improved two density models, one theoretical (Rackett-Soave) and one empirical (Lapuerta's method) for methanol based biodiesels (FAME) and ethanol based biodiesel (FAEE). For this purpose, biodiesel was produced from vegetable oils (sunflower, rapeseed, soybean, olive, safflower and other two commercial mixtures of vegetable oils) and animal fats (edible and crude pork fat and beef tallow) using both methanol and ethanol for the transesterification reactions, and blended to get 21 FAME and 21 FAEE, reporting their density and detailed composition. Bibliographic data have also been used. The Rackett-Soave method has been improved by the use of a new acentric factor correlation, whereas the parameters of the empirical one are improved by considering a bigger density data bank. Results show that the evaluated models could be used to estimate the biodiesel density with a good grade of accuracy but the performed modifications improve the accuracy of the models: ARD (%) for FAME; 0.33, and FAEE; 0.26, both calculated with the modification of Rackett-Soave method and ARD (%) for FAME; 0.40 calculated with the modification of the Lapuerta's method).

Tab. 3: Substrate pH values of crypthoendolithic microbial communities

Cryploendolithic microbial communities in the Ross Desert (McMurdo Dry Valleys) are characterized on the basis of photosymlictic microorganisms and fungi. Two eukaryotic communities (the lichen-dominated and Hemichloris communities) and three cyanobacterial communities (the red Gloeocapsa, Hormathonema-Gloeocapsa and Chroococcidiopsis communities) are described. Eleven coccoid. ohne pleurocapsoid, and five filamentous cyanobacteria occurring in these communities are characterized and illustrated. The moisture grade of the rock substrate seems to affect pH. Formation of primary iron stain, and the distribution of microbial communities.

Analyses of manganese deposits in the Riding Mountain area

Several bog manganese deposits were discovered in the Riding Mountain area in Manitoba during the spring and summer of 1940. A study was made of the known deposits to determine the grade of the occurrences, a possible source of the manganese oxides in the bog deposits and the possibilities of locating other manganese occurrences. Samples of the bog manganese, of spring waters from which the manganese oxides have apparently been precipitated, of the Odanah shale in which the deposits occur, and of "ironstone" nodules found in the Odanah and Riding Mountain shales were gathered in the field and later analyzed. In addition to chemical analyses of the above-mentioned samples, several polished sections of the manganese oxides were prepared and studied under the microscope, thin-sections of nodules were examined, and spectrographic analyses of both nodules and bog manganese were made. ...

Chemical composition of manganese nodules from the Southern Pacific

Deep sea manganese nodules from the Southern Ocean have been studied using chemical analysis, X-ray diffraction, optical mineragraphic and electron probe microanalysis techniques. The nodules were lower in manganese, iron and associated elements than the average grade of manganese nodules from other localities. A number of chemical relationships have been observed. Nickel, copper, cobalt, barium, zinc, molybdenum, strontium, sulphur and phosphorus are associated with the manganese rich phases and titanium with the iron rich phases. X-ray diffraction analysis and electron probe microanalysis results indicate that the manganese phases are similar to the disordered delta-MnO2 and "manganite" phases reported by other workers.

Tab. 1: Mineralogical composition and chemical analyses of major and trace elements of Ameghino Formation rocks

As a result of a petrographical, mineralogical and geochemical characterization of the Ameghino Formation mudstones (Upper Jurassic- Lower Cretaceous, Antarctic Peninsula), "epiclastic" radiolaria-rich and mixed (radiolaria-rich + tuff) mudstone types were recognized. Contents of clastic material in the mudstones generally increase with younger paleontological age, but local exceptions to this trend have been found. The anoxic environment of the lower part of the sequence changes to more oxidizing conditions towards the top, in transition to the Hauterivian - Barrêmian conglomerates. Element to element correlations show good agreement with the normal differentiation trends of volcanic (andesite-rhyolite) rocks, suggesting that the overall sequence is mainly volcanic in origin with various grade of reworking. For example, the radiolaria-rich mudstone matrix could have been originated from very fine touffaceous suspensions deposited very slowly after the main fall of the tuffs. However, in the upper part of the sequence, some epiclastic supply is revealed by petrographic evidence and illite crystallinity index. The clay mineral association (illite, chlorite and illite-smectite mixed layers) is mainly of diagenetic origin in the stratigraphically lower sections. Low percentages of expandable layers in the illite-smectite mixed layers, as well as the general mineralogical association, suggest a late mesodiagenetic stage, and together with geological evidence, a relatively deep burial (> 1000 m - probably > 2500 m) and temperatures exceeding 100°C.

Neuroanatomic-based detection algorithm for automatic labeling of brain structures in brain injury

The number and grade of injured neuroanatomic structures and the type of injury determine the degree of impairment after a brain injury event and the recovery options of the patient. However, the body of knowledge and clinical intervention guides are basically focused on functional disorder and they still do not take into account the location of injuries. The prognostic value of location information is not known in detail either. This paper proposes a feature-based detection algorithm, named Neuroanatomic-Based Detection Algorithm (NBDA), based on SURF (Speeded Up Robust Feature) to label anatomical brain structures on cortical and sub-cortical areas. Themain goal is to register injured neuroanatomic structures to generate a database containing patient?s structural impairment profile. This kind of information permits to establish a relation with functional disorders and the prognostic evolution during neurorehabilitation procedures.

Extending the expressiveness of fuzzy logic languages

En el trabajo que aquí presentamos se incluye la base teórica (sintaxis y semántica) y una implementación de un framework para codificar el razonamiento de la representación difusa o borrosa del mundo (tal y como nosotros, seres humanos, entendemos éste). El interés en la realización de éste trabajo parte de dos fuentes: eliminar la complejidad existente cuando se realiza una implementación con un lenguaje de programación de los llamados de propósito general y proporcionar una herramienta lo suficientemente inteligente para dar respuestas de forma constructiva a consultas difusas o borrosas. El framework, RFuzzy, permite codificar reglas y consultas en una sintaxis muy cercana al lenguaje natural usado por los seres humanos para expresar sus pensamientos, pero es bastante más que eso. Permite representar conceptos muy interesantes, como fuzzificaciones (funciones usadas para convertir conceptos no difusos en difusos), valores por defecto (que se usan para devolver resultados un poco menos válidos que los que devolveríamos si tuviésemos la información necesaria para calcular los más válidos), similaridad entre atributos (característica que utilizamos para buscar aquellos individuos en la base de datos con una característica similar a la buscada), sinónimos o antónimos y, además, nos permite extender el numero de conectivas y modificadores (incluyendo modificadores de negación) que podemos usar en las reglas y consultas. La personalización de la definición de conceptos difusos (muy útil para lidiar con el carácter subjetivo de los conceptos borrosos, donde nos encontramos con que cualificar a alguien de “alto” depende de la altura de la persona que cualifica) es otra de las facilidades incluida. Además, RFuzzy implementa la semántica multi-adjunta. El interés en esta reside en que introduce la posibilidad de obtener la credibilidad de una regla a partir de un conjunto de datos y una regla dada y no solo el grado de satisfacción de una regla a partir de el universo modelado en nuestro programa. De esa forma podemos obtener automáticamente la credibilidad de una regla para una determinada situación. Aún cuando la contribución teórica de la tesis es interesante en si misma, especialmente la inclusión del modificador de negacion, sus multiples usos practicos lo son también. Entre los diferentes usos que se han dado al framework destacamos el reconocimiento de emociones, el control de robots, el control granular en computacion paralela/distribuída y las busquedas difusas o borrosas en bases de datos. ABSTRACT In this work we provide a theoretical basis (syntax and semantics) and a practical implementation of a framework for encoding the reasoning and the fuzzy representation of the world (as human beings understand it). The interest for this work comes from two sources: removing the existing complexity when doing it with a general purpose programming language (one developed without focusing in providing special constructions for representing fuzzy information) and providing a tool intelligent enough to answer, in a constructive way, expressive queries over conventional data. The framework, RFuzzy, allows to encode rules and queries in a syntax very close to the natural language used by human beings to express their thoughts, but it is more than that. It allows to encode very interesting concepts, as fuzzifications (functions to easily fuzzify crisp concepts), default values (used for providing results less adequate but still valid when the information needed to provide results is missing), similarity between attributes (used to search for individuals with a characteristic similar to the one we are looking for), synonyms or antonyms and it allows to extend the number of connectives and modifiers (even negation) we can use in the rules. The personalization of the definition of fuzzy concepts (very useful for dealing with the subjective character of fuzziness, in which a concept like tall depends on the height of the person performing the query) is another of the facilities included. Besides, RFuzzy implements the multi-adjoint semantics. The interest in them is that in addition to obtaining the grade of satisfaction of a consequent from a rule, its credibility and the grade of satisfaction of the antecedents we can determine from a set of data how much credibility we must assign to a rule to model the behaviour of the set of data. So, we can determine automatically the credibility of a rule for a particular situation. Although the theoretical contribution is interesting by itself, specially the inclusion of the negation modifier, the practical usage of it is equally important. Between the different uses given to the framework we highlight emotion recognition, robocup control, granularity control in parallel/distributed computing and flexible searches in databases.

Role of the F-box protein Skp2 in lymphomagenesis

The F-box protein Skp2 (S-phase kinase-associated protein 2) positively regulates the G1-S transition by controlling the stability of several G1 regulators, such as the cell cycle inhibitor p27. We show here that Skp2 expression correlates directly with grade of malignancy and inversely with p27 levels in human lymphomas. To directly evaluate the potential of Skp2 to deregulate growth in vivo, we generated transgenic mice expressing Skp2 targeted to the T-lymphoid lineage as well as double transgenic mice coexpressing Skp2 and activated N-Ras. A strong cooperative effect between these two transgenes induced T cell lymphomas with shorter latency and higher penetrance, leading to significantly decreased survival when compared with control and single transgenic animals. Furthermore, lymphomas of Nras single transgenic animals often expressed higher levels of endogenous Skp2 than tumors of double transgenic mice. This study provides evidence of a role for an F-box protein in oncogenesis and establishes SKP2 as a protooncogene causally involved in the pathogenesis of lymphomas.

Does the scientific evidence support the advertising claims made for products containing Lactobacillus casei and Bifidobacterium lactis? A systematic review

Background To analyse the scientific evidence that exists for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis and to conduct a comparison between the published literature and what is presented in the corporate website. Methods Systematic review, using Medline through Pubmed and Embase. We included human clinical trials that exclusively measured the effect of Lactobacillus casei or Bifidobacterium lactis on a healthy population, and where the objective was related to the health claims made for certain products in advertising. We assessed the levels of evidence and the strength of the recommendation according to the classification criteria established by the Oxford Centre for Evidence Based Medicine (CEBM). We also assessed the outcomes of the studies published on the website that did not appear in the search. Results Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) of these presented a level of evidence of 1b and a recommendation grade of A, all corresponding to studies on product containing Bifidobacterium lactis, and only 12 of the 16 studies were published on the corporate website (47). Conclusions There is insufficient scientific evidence to support the health claims made for these products, especially in the case of product containing Lactobacillus casei.