Good nutrition for good surgery: clinical and quality of life outcomes

Undernutrition is common in patients admitted for surgery and is often unrecognised, untreated and worsens in hospital. The complex synergistic relationship between nutritional status and the physiological responses to surgery puts patients at high nutritional risk. There are clear prospective associations between inadequate nutritional status and the risk of poorer outcomes for surgical patients, including infection, complications and length of stay. However, practically and ethically evidence that nutritional interventions can significantly reduce these poor outcomes is difficult to obtain. Nevertheless health professionals have a duty of care to ensure our patients are properly fed, by whatever means, to meet their physiological requirements.

Evaluation of risk factors leading to cost overrun in delivery of highway construction projects

Accurate owner budget estimates are critical to the initial decision-to-build process for highway construction projects. However, transportation projects have historically experienced significant construction cost overruns from the time the decision to build has been taken by the owner. This paper addresses the problem of why highway projects overrun their predicted costs. It identifies the owner risk variables that contribute to significant cost overrun and then uses factor analysis, expert elicitation, and the nominal group technique to establish groups of importance ranked owner risks. Stepwise multivariate regression analysis is also used to investigate any correlation of the percentage of cost overrun with risks, together with attributes such as highway project type, indexed cost, geographics location, and project delivery method. The research results indicate a correlation between the reciprocal of project budgets size and percentage cost overrun. This can be useful for owners in determining more realistic decision-to-build highway budget estimates by taking into account the economies of scale associated with larger projects.

Benchmarking framework to measure extent of ICT adoption for building project management

This project discusses a component of the research study conducted to provide construction organizations with a generic benchmarking framework to assess their extent of information communication technology (ICT) adoption for building project management processes. It defines benchmarking and discusses objectives of the required benchmarking framework and development of the framework. The study focuses on ICT adoption by small and medium enterprises (SMEs) in the construction industry and with respect to SMEs it is important to understand processes, their indicators, and measures in the local context. Structure of the suggested benchmarking framework has been derived after extensive literature survey and a questionnaire survey conducted in the Indian construction industry. The suggested benchmarking process is an iterative process divided into four stages. It can be implemented at organization and industry levels for rating the construction organizations for ICT adoption and performance measurement. The framework has a generic structure and can be generalized and applied for other countries with due considerations.

Dynamic visual features for audio-visual speaker verification

The cascading appearance-based (CAB) feature extraction technique has established itself as the state-of-the-art in extracting dynamic visual speech features for speech recognition. In this paper, we will focus on investigating the effectiveness of this technique for the related speaker verification application. By investigating the speaker verification ability of each stage of the cascade we will demonstrate that the same steps taken to reduce static speaker and environmental information for the visual speech recognition application also provide similar improvements for visual speaker recognition. A further study is conducted comparing synchronous HMM (SHMM) based fusion of CAB visual features and traditional perceptual linear predictive (PLP) acoustic features to show that higher complexity inherit in the SHMM approach does not appear to provide any improvement in the final audio-visual speaker verification system over simpler utterance level score fusion.

Bottlenecks detection of track allocation schemes at rail stations by Petri nets

Robustness of the track allocation problem is rarely addressed in literatures and the obtained track allocation schemes (TAS) embody some bottlenecks. Therefore, an approach to detect bottlenecks is needed to support local optimization. First a TAS is transformed to an executable model by Petri nets. Then disturbances analysis is performed using the model and the indicators of the total trains' departure delays are collected to detect bottlenecks when each train suffers a disturbance. Finally, the results of the tests based on a rail hub linking six lines and a TAS about thirty minutes show that the minimum buffer time is 21 seconds and there are two bottlenecks where the buffer times are 57 and 44 seconds respectively, and it indicates that the bottlenecks do not certainly locate at the area where there is minimum buffer time. The proposed approach can further support selection of multi schemes and robustness optimization.

The effect of metamictization on the Raman spectroscopy of the uranyl titanate mineral davidite (La,Ce)(Y,U,Fe2+)(Ti,Fe3+)20(O,OH)38

Raman spectra of the uranyl titanate mineral davidite-(La) (La,Ce)(Y,U,Fe2+)(Ti,Fe3+)20(O,OH)38 were analysed and related to the mineral structure. Observed bands are attributed to the TiO and (UO2)2+ stretching and bending vibrations, U-OH bending vibrations, H2O and (OH)- stretching, bending and libration modes. U-O bond lengths in uranyls and O-H…O bond lengths are calculated from the wavenumbers assigned to the stretching vibrations. Raman bands of davidite-(La) are in harmony with those of the uranyl oxyhydroxides. The mineral davidite-(La) is metamict as is evidenced by the intensity of the UO stretching and bending modes being of lower intensity than expected and with bands that are significantly broader.

Time-dependent analysis of length of stay and mortality due urinary tract infections in ten developing countries : INICC findings

Catheter associated urinary tract infections (CAUTI) are a worldwide problem that may lead to increased patient morbidity, cost and mortality.1e3 The literature is divided on whether there are real effects from CAUTI on length of stay or mortality. Platt4 found the costs and mortality risks to be largeyetGraves et al found the opposite.5 A reviewof the published estimates of the extra length of stay showed results between zero and 30 days.6 The differences in estimates may have been caused by the different epidemiological methods applied. Accurately estimating the effects of CAUTI is difficult because it is a time-dependent exposure. This means that standard statistical techniques, such asmatched case-control studies, tend to overestimate the increased hospital stay and mortality risk due to infection. The aim of the study was to estimate excess length of stay andmortality in an intensive care unit (ICU) due to a CAUTI, using a statistical model that accounts for the timing of infection. Data collected from ICU units in lower and middle income countries were used for this analysis.7,8 There has been little research for these settings, hence the need for this paper.

Genetic analysis reveals two stocks of skipjack tuna (Katsuwonus pelamis) in the north western Indian Ocean

Skipjack (SJT) (Katsuwonus pelamis) is a medium sized, pelagic, highly dispersive tuna species that occurs widely across tropical and subtropical waters. SJT constitute the largest tuna fishery in the Indian Ocean, and are currently managed as a single stock. Patterns of genetic variation in a mtDNA gene and 6 microsatellite loci were examined to test for stock structure in the northwestern Indian Ocean. 324 individuals were sampled from five major fishing grounds around Sri Lanka, and single sites in the Maldive Islands and the Laccadive Islands. Phylogenetic reconstruction of mtDNA revealed two coexisting divergent clades in the region. AMOVA (Analysis of Molecular Variance) of mtDNA data revealed significant genetic differentiation among sites (ΦST = 0.2029, P < 0.0001), also supported by SAMOVA results. AMOVA of microsatellite data also showed significant differentiation among most sampled sites (FST = 0.0256, P<0.001) consistent with the mtDNA pattern. STRUCTURE analysis of the microsatellite data revealed two differentiated stocks. While the both two marker types examined identified two genetic groups, microsatellite analysis indicates that the sampled SJT are likely to represent individuals sourced from discrete breeding grounds that are mixed in feeding grounds in Sri Lankan waters.

The influence of platform walking on BRT station bus dwell time estimation

The common approach to estimate bus dwell time at a BRT station platform is to apply the traditional dwell time methodology derived for suburban bus stops. Current dwell time models are sensitive towards bus type, fare collection policy along with the number of boarding and alighting passengers. However, they fall short in accounting for the effects of passenger/s walking on a relatively longer BRT station platform. Analysis presented in this paper shows that the average walking time of a passenger at BRT platform is 10 times more than that of bus stop. The requirement of walking to the bus entry door at the BRT station platform may lead to the bus experiencing a higher dwell time. This paper presents a theory for a BRT network which explains the loss of station capacity during peak period operation. It also highlights shortcomings of present available bus dwell time models suggested for the analysis of BRT operation.

New media pathways : navigating the links between home, school and the workplace

The terms ‘literacy’ and ‘technology’ remain highly contentious within the field of education. What is meant by ‘literacy’ and the methods used to measure it vary quite markedly in educational and historical contexts across the world. Similarly, while there is a shared concern to research the potential impact of new information and communication technologies (ICTs) on patterns of teaching and learning, there are major discrepancies about which aspects and uses of these technologies should be incorporated into formal learning environments and how this can be accomplished. While government policy makers tend to regard ICTs in relation to ideas of ‘smartness’, efficiency, and the ‘knowledge’ (or ‘new’) economy, educators and educational researchers promote them as offering new tools for learning and critical thinking and the development of new literacies and socio-cultural identities. This clearly has ramifications for the ways literacy is taught and conceptualised throughout the years of schooling, K-12. Outside school, meanwhile, students engage with ICTs on another level entirely, as tools for the maintenance of social networks, for leisure, and for learning and participating in the cultures of their peers. Whatever the differences in perspective, it remains the case that a society’s dominant understandings about literacy and technology will have significant implications for the development of school curriculum.