Deriving a preference-based measure for cancer using the EORTC QLQ-C30 : a confirmatory versus exploratory approach

Background: To derive preference-based measures from various condition-specific descriptive health-related quality of life (HRQOL) measures. A general 2-stage method is evolved: 1) an item from each domain of the HRQOL measure is selected to form a health state classification system (HSCS); 2) a sample of health states is valued and an algorithm derived for estimating the utility of all possible health states. The aim of this analysis was to determine whether confirmatory or exploratory factor analysis (CFA, EFA) should be used to derive a cancer-specific utility measure from the EORTC QLQ-C30. Methods: Data were collected with the QLQ-C30v3 from 356 patients receiving palliative radiotherapy for recurrent or metastatic cancer (various primary sites). The dimensional structure of the QLQ-C30 was tested with EFA and CFA, the latter based on a conceptual model (the established domain structure of the QLQ-C30: physical, role, emotional, social and cognitive functioning, plus several symptoms) and clinical considerations (views of both patients and clinicians about issues relevant to HRQOL in cancer). The dimensions determined by each method were then subjected to item response theory, including Rasch analysis. Results: CFA results generally supported the proposed conceptual model, with residual correlations requiring only minor adjustments (namely, introduction of two cross-loadings) to improve model fit (increment χ2(2) = 77.78, p < .001). Although EFA revealed a structure similar to the CFA, some items had loadings that were difficult to interpret. Further assessment of dimensionality with Rasch analysis aligned the EFA dimensions more closely with the CFA dimensions. Three items exhibited floor effects (>75% observation at lowest score), 6 exhibited misfit to the Rasch model (fit residual > 2.5), none exhibited disordered item response thresholds, 4 exhibited DIF by gender or cancer site. Upon inspection of the remaining items, three were considered relatively less clinically important than the remaining nine. Conclusions: CFA appears more appropriate than EFA, given the well-established structure of the QLQ-C30 and its clinical relevance. Further, the confirmatory approach produced more interpretable results than the exploratory approach. Other aspects of the general method remain largely the same. The revised method will be applied to a large number of data sets as part of the international and interdisciplinary project to develop a multi-attribute utility instrument for cancer (MAUCa).

Cardiomyopathy classification : ongoing debate in the genomics era

Cardiomyopathies represent a group of diseases of the myocardium of the heart and include diseases both primarily of the cardiac muscle and systemic diseases leading to adverse effects on the heart muscle size, shape, and function. Traditionally cardiomyopathies were defined according to phenotypical appearance. Now, as our understanding of the pathophysiology of the different entities classified under each of the different phenotypes improves and our knowledge of the molecular and genetic basis for these entities progresses, the traditional classifications seem oversimplistic and do not reflect current understanding of this myriad of diseases and disease processes. Although our knowledge of the exact basis of many of the disease processes of cardiomyopathies is still in its infancy, it is important to have a classification system that has the ability to incorporate the coming tide of molecular and genetic information. This paper discusses how the traditional classification of cardiomyopathies based on morphology has evolved due to rapid advances in our understanding of the genetic and molecular basis for many of these clinical entities.

A SiC-based matrix converter topology for inductive power transfer system

Typical inductive power transfer (IPT) systems employ two power conversion stages to generate a high-frequency primary current from low-frequency utility supply. This paper proposes a matrix-converter-based IPT system, which employs high-speed SiC devices to facilitate the generation of high-frequency current through a single power conversion stage. The proposed matrix converter topology transforms a three-phase low-frequency voltage system to a high-frequency single-phase voltage, which, in turn, powers a series compensated IPT system. A comprehensive mathematical model is developed and power losses are evaluated to investigate the efficiency of the proposed converter topology. Theoretical results are presented with simulations, which are performed in MATLAB/Simulink, in comparison to a conventional two-stage converter. Experimental evident of a prototype IPT system is also presented to demonstrate the applicability of the proposed concept.

Z-source-inverter-based flexible distributed generation system solution for grid power quality improvement

Distributed generation (DG) systems are usually connected to the grid using power electronic converters. Power delivered from such DG sources depends on factors like energy availability and load demand. The converters used in power conversion do not operate with their full capacity all the time. The unused or remaining capacity of the converters could be used to provide some ancillary functions like harmonic and unbalance mitigation of the power distribution system. As some of these DG sources have wide operating ranges, they need special power converters for grid interfacing. Being a single-stage buck-boost inverter, recently proposed Z-source inverter (ZSI) is a good candidate for future DG systems. This paper presents a controller design for a ZSI-based DG system to improve power quality of distribution systems. The proposed control method is tested with simulation results obtained using Matlab/Simulink/PLECS and subsequently it is experimentally validated using a laboratory prototype.

A matrix converter based Inductive Power Transfer system

Typical Inductive Power Transfer (IPT) systems employ two power conversion stages to generate a high frequency current from low frequency utility supply. This paper proposes a matrix converter based IPT system that facilitates the generation of high frequency current through a single power conversion stage. The proposed matrix converter topology transforms a 3-phase low frequency voltage system to a high frequency single phase voltage which in turn powers a series compensated IPT system. A comprehensive mathematical model is developed to investigate the behavior of the proposed IPT topology. Theoretical results are presented in comparison to simulations, which are performed in Matlab/ Simulink, to demonstrate the applicability of the proposed concept and the validity of the developed model.

Deriving a preference-based utility measure for cancer patients from the European Organisation for the Research and Treatment of Cancer's Quality of Life Questionnaire C30 : a confirmatory versus exploratory approach

Background Multi attribute utility instruments (MAUIs) are preference-based measures that comprise a health state classification system (HSCS) and a scoring algorithm that assigns a utility value to each health state in the HSCS. When developing a MAUI from a health-related quality of life (HRQOL) questionnaire, first a HSCS must be derived. This typically involves selecting a subset of domains and items because HRQOL questionnaires typically have too many items to be amendable to the valuation task required to develop the scoring algorithm for a MAUI. Currently, exploratory factor analysis (EFA) followed by Rasch analysis is recommended for deriving a MAUI from a HRQOL measure. Aim To determine whether confirmatory factor analysis (CFA) is more appropriate and efficient than EFA to derive a HSCS from the European Organisation for the Research and Treatment of Cancer’s core HRQOL questionnaire, Quality of Life Questionnaire (QLQ-C30), given its well-established domain structure. Methods QLQ-C30 (Version 3) data were collected from 356 patients receiving palliative radiotherapy for recurrent/metastatic cancer (various primary sites). The dimensional structure of the QLQ-C30 was tested with EFA and CFA, the latter informed by the established QLQ-C30 structure and views of both patients and clinicians on which are the most relevant items. Dimensions determined by EFA or CFA were then subjected to Rasch analysis. Results CFA results generally supported the proposed QLQ-C30 structure (comparative fit index =0.99, Tucker–Lewis index =0.99, root mean square error of approximation =0.04). EFA revealed fewer factors and some items cross-loaded on multiple factors. Further assessment of dimensionality with Rasch analysis allowed better alignment of the EFA dimensions with those detected by CFA. Conclusion CFA was more appropriate and efficient than EFA in producing clinically interpretable results for the HSCS for a proposed new cancer-specific MAUI. Our findings suggest that CFA should be recommended generally when deriving a preference-based measure from a HRQOL measure that has an established domain structure.

Classification of inventory data suit for managing Australian railway bridges

With a focus to optimising the life cycle performance of Australian Railway bridges, new bridge classification and environmental classification systems are proposed. The new bridge classification system is mainly to facilitate the implementation of novel Bridge Management System (BMS) which optimise the life cycle cost both at project level and network level while environment classification is mainly to improve accuracy of Remaining Service Potential (RSP) module of the proposed BMS. In fact, limited capacity of the existing BMS to trigger the maintenance intervention point is an indirect result of inadequacies of the existing bridge and environmental classification systems. The proposed bridge classification system permits to identify the intervention points based on percentage deterioration of individual elements and maintenance cost, while allowing performance based rating technique to implement for maintenance optimisation and prioritisation. Simultaneously, the proposed environment classification system will enhance the accuracy of prediction of deterioration of steel components.

Genome-Wide Gene Expression Analysis Reveals a Dynamic Interplay between Luteotropic and Luteolytic Factors in the Regulation of Corpus Luteum Function in the Bonnet Monkey (Macaca radiata)

Although LH is essential for survival and function of the corpus luteum (CL) in higher primates, luteolysis occurs during nonfertile cycles without a discernible decrease in circulating LH levels. Using genome-wide expression analysis, several experiments were performed to examine the processes of luteolysis and rescue of luteal function in monkeys. Induced luteolysis with GnRH receptor antagonist (Cetrorelix) resulted in differential regulation of 3949 genes, whereas replacement with exogenous LH (Cetrorelix plus LH) led to regulation of 4434 genes (1563 down-regulation and 2871 up-regulation). A model system for prostaglandin (PG) F-2 alpha-induced luteolysis in the monkey was standardized and demonstrated that PGF(2 alpha) regulated expression of 2290 genes in the CL. Analysis of the LH-regulated luteal transcriptome revealed that 120 genes were regulated in an antagonistic fashion by PGF(2 alpha). Based on the microarray data, 25 genes were selected for validation by real-time RT-PCR analysis, and expression of these genes was also examined in the CL throughout the luteal phase and from monkeys treated with human chorionic gonadotropin (hCG) to mimic early pregnancy. The results indicated changes in expression of genes favorable to PGF(2 alpha) action during the late to very late luteal phase, and expressions of many of these genes were regulated in an opposite manner by exogenous hCG treatment. Collectively, the findings suggest that curtailment of expression of downstream LH-target genes possibly through PGF(2 alpha) action on the CL is among the mechanisms underlying cross talk between the luteotropic and luteolytic signaling pathways that result in the cessation of luteal function, but hCG is likely to abrogate the PGF(2 alpha)-responsive gene expression changes resulting in luteal rescue crucial for the maintenance of early pregnancy. (Endocrinology 150: 1473-1484, 2009)

A capability-based view of organisational renewal : Combining opportunity- and advantage-seeking growth in large, established European and North American wood-industry companies

The purpose of this study was to extend understanding of how large firms pursuing sustained and profitable growth manage organisational renewal. A multiple-case study was conducted in 27 North American and European wood-industry companies, of which 11 were chosen for closer study. The study combined the organisational-capabilities approach to strategic management with corporate-entrepreneurship thinking. It charted the further development of an identification and classification system for capabilities comprising three dimensions: (i) the dynamism between firm-specific and industry-significant capabilities, (ii) hierarchies of capabilities and capability portfolios, and (iii) their internal structure. Capability building was analysed in the context of the organisational design, the technological systems and the type of resource-bundling process (creating new vs. entrenching existing capabilities). The thesis describes the current capability portfolios and the organisational changes in the case companies. It also clarifies the mechanisms through which companies can influence the balance between knowledge search and the efficiency of knowledge transfer and integration in their daily business activities, and consequently the diversity of their capability portfolio and the breadth and novelty of their product/service range. The largest wood-industry companies of today must develop a seemingly dual strategic focus: they have to combine leading-edge, innovative solutions with cost-efficient, large-scale production. The use of modern technology in production was no longer a primary source of competitiveness in the case companies, but rather belonged to the portfolio of basic capabilities. Knowledge and information management had become an industry imperative, on a par with cost effectiveness. Yet, during the period of this research, the case companies were better in supporting growth in volume of the existing activity than growth through new economic activities. Customer-driven, incremental innovation was preferred over firm-driven innovation through experimentation. The three main constraints on organisational renewal were the lack of slack resources, the aim for lean, centralised designs, and the inward-bound communication climate.

Surface electrode switching of a 16-electrode wireless EIT system using RF-based digital data transmission scheme with 8 channel encoder/decoder ICs

A Radio Frequency (RF) based digital data transmission scheme with 8 channel encoder/decoder ICs is proposed for surface electrode switching of a 16-electrode wireless Electrical Impedance Tomography (EIT) system. A RF based wireless digital data transmission module (WDDTM) is developed and the electrode switching of a EIT system is studied by analyzing the boundary data collected and the resistivity images of practical phantoms. An analog multiplexers based electrode switching module (ESM) is developed with analog multiplexers and switched with parallel digital data transmitted by a wireless transmitter/receiver (T-x/R-x) module working with radio frequency technology. Parallel digital bits are generated using NI USB 6251 card working in LabVIEW platform and sent to transmission module to transmit the digital data to the receiver end. The transmitter/receiver module developed is properly interfaced with the personal computer (PC) and practical phantoms through the ESM and USB based DAQ system respectively. It is observed that the digital bits required for multiplexer operation are sequentially generated by the digital output (D/O) ports of the DAQ card. Parallel to serial and serial to parallel conversion of digital data are suitably done by encoder and decoder ICs. Wireless digital data transmission module successfully transmitted and received the parallel data required for switching the current and voltage electrodes wirelessly. 1 mA, 50 kHz sinusoidal constant current is injected at the phantom boundary using common ground current injection protocol and the boundary potentials developed at the voltage electrodes are measured. Resistivity images of the practical phantoms are reconstructed from boundary data using EIDORS. Boundary data and the resistivity images reconstructed from the surface potentials are studied to assess the wireless digital data transmission system. Boundary data profiles of the practical phantom with different configurations show that the multiplexers are operating in the required sequence for common ground current injection protocol. The voltage peaks obtained at the proper positions in the boundary data profiles proved the sequential operation of multiplexers and successful wireless transmission of digital bits. Reconstructed images and their image parameters proved that the boundary data are successfully acquired by the DAQ system which in turn again indicates a sequential and proper operation of multiplexers as well as the successful wireless transmission of digital bits. Hence the developed RF based wireless digital data transmission module (WDDTM) is found suitable for transmitting digital bits required for electrode switching in wireless EIT data acquisition system. (C) 2011 Elsevier Ltd. All rights reserved.

Seismic site classification and correlation between standard penetration test N value and shear wave velocity for Lucknow city in Indo-Gangetic basin

Subsurface lithology and seismic site classification of Lucknow urban center located in the central part of the Indo-Gangetic Basin (IGB) are presented based on detailed shallow subsurface investigations and borehole analysis. These are done by carrying out 47 seismic surface wave tests using multichannel analysis of surface waves (MASW) and 23 boreholes drilled up to 30 m with standard penetration test (SPT) N values. Subsurface lithology profiles drawn from the drilled boreholes show low- to medium-compressibility clay and silty to poorly graded sand available till depth of 30 m. In addition, deeper boreholes (depth >150 m) were collected from the Lucknow Jal Nigam (Water Corporation), Government of Uttar Pradesh to understand deeper subsoil stratification. Deeper boreholes in this paper refer to those with depth over 150 m. These reports show the presence of clay mix with sand and Kankar at some locations till a depth of 150 m, followed by layers of sand, clay, and Kankar up to 400 m. Based on the available details, shallow and deeper cross-sections through Lucknow are presented. Shear wave velocity (SWV) and N-SPT values were measured for the study area using MASW and SPT testing. Measured SWV and N-SPT values for the same locations were found to be comparable. These values were used to estimate 30 m average values of N-SPT (N-30) and SWV (V-s(30)) for seismic site classification of the study area as per the National Earthquake Hazards Reduction Program (NEHRP) soil classification system. Based on the NEHRP classification, the entire study area is classified into site class C and D based on V-s(30) and site class D and E based on N-30. The issue of larger amplification during future seismic events is highlighted for a major part of the study area which comes under site class D and E. Also, the mismatch of site classes based on N-30 and V-s(30) raises the question of the suitability of the NEHRP classification system for the study region. Further, 17 sets of SPT and SWV data are used to develop a correlation between N-SPT and SWV. This represents a first attempt of seismic site classification and correlation between N-SPT and SWV in the Indo-Gangetic Basin.

Influence of rock depth on seismic site classification for shallow bedrock regions

Seismic site classifications are used to represent site effects for estimating hazard parameters (response spectral ordinates) at the soil surface. Seismic site classifications have generally been carried out using average shear wave velocity and/or standard penetration test n-values of top 30-m soil layers, according to the recommendations of the National Earthquake Hazards Reduction Program (NEHRP) or the International Building Code (IBC). The site classification system in the NEHRP and the IBC is based on the studies carried out in the United States where soil layers extend up to several hundred meters before reaching any distinct soil-bedrock interface and may not be directly applicable to other regions, especially in regions having shallow geological deposits. This paper investigates the influence of rock depth on site classes based on the recommendations of the NEHRP and the IBC. For this study, soil sites having a wide range of average shear wave velocities (or standard penetration test n-values) have been collected from different parts of Australia, China, and India. Shear wave velocities of rock layers underneath soil layers have also been collected at depths from a few meters to 180 m. It is shown that a site classification system based on the top 30-m soil layers often represents stiffer site classes for soil sites having shallow rock depths (rock depths less than 25 m from the soil surface). A new site classification system based on average soil thickness up to engineering bedrock has been proposed herein, which is considered more representative for soil sites in shallow bedrock regions. It has been observed that response spectral ordinates, amplification factors, and site periods estimated using one-dimensional shear wave analysis considering the depth of engineering bedrock are different from those obtained considering top 30-m soil layers.

Damage Detection Sensitivity, Specificity and Classification Data Analysis for SHM Systems Design, Verification and Validation

In this paper, we consider applying derived knowledge base regarding the sensitivity and specificity of damage(s) to be detected by an SHM system being designed and qualified. These efforts are necessary toward developing capabilities in SHM system to classify reliably various probable damages through sequence of monitoring, i.e., damage precursor identification, detection of damage and monitoring its progression. We consider the particular problem of visual and ultrasonic NDE based SHM system design requirements, where the damage detection sensitivity and specificity data definitions for a class of structural components are established. Methodologies for SHM system specification creation are discussed in details. Examples are shown to illustrate how the physics of damage detection scheme limits particular damage detection sensitivity and specificity and further how these information can be used in algorithms to combine various different NDE schemes in an SHM system to enhance efficiency and effectiveness. Statistical and data driven models to determine the sensitivity and probability of damage detection (POD) has been demonstrated for plate with varying one-sided line crack using optical and ultrasonic based inspection techniques.

Kires: a data-centric telerehabilitation system based on kinect

185 p.

A Customizable Camera-based Human Computer Interaction System Allowing People With Disabilities Autonomous Hands Free Navigation of Multiple Computing Task

Many people suffer from conditions that lead to deterioration of motor control and makes access to the computer using traditional input devices difficult. In particular, they may loose control of hand movement to the extent that the standard mouse cannot be used as a pointing device. Most current alternatives use markers or specialized hardware to track and translate a user's movement to pointer movement. These approaches may be perceived as intrusive, for example, wearable devices. Camera-based assistive systems that use visual tracking of features on the user's body often require cumbersome manual adjustment. This paper introduces an enhanced computer vision based strategy where features, for example on a user's face, viewed through an inexpensive USB camera, are tracked and translated to pointer movement. The main contributions of this paper are (1) enhancing a video based interface with a mechanism for mapping feature movement to pointer movement, which allows users to navigate to all areas of the screen even with very limited physical movement, and (2) providing a customizable, hierarchical navigation framework for human computer interaction (HCI). This framework provides effective use of the vision-based interface system for accessing multiple applications in an autonomous setting. Experiments with several users show the effectiveness of the mapping strategy and its usage within the application framework as a practical tool for desktop users with disabilities.