The effect of St John's wort extracts on CYP3A: a systematic review of prospective clinical trials

Aim The aim of this systematic review was to assess the quality and outcomes of clinical trials investigating the effect of St John's wort extracts on the metabolism of drugs by CYP3A. Methods Prospective clinical trials assessing the effect of St John's wort (SJW) extracts on metabolism by CYP3A were identified through computer-based searches (from their inception to May 2005) of Medline, Cinahl, PsycINFO, AMED, Current Contents and Embase, hand-searches of bibliographies of relevant papers and consultation with manufacturers and researchers in the field. Two reviewers selected trials for inclusion, independently extracted data and recorded details on study design. Results Thirty-one studies met the eligibility criteria. More than two-thirds of the studies employed a before-and-after design, less than one-third of the studies used a crossover design, and only three studies were double-blind and placebo controlled. In 12 studies the SJW extract had been assayed, and 14 studies stated the specific SJW extract used. Results from 26 studies, including all of the 19 studies that used high-dose hyperforin extracts (> 10 mg day(-1)), had outcomes consistent with CYP3A induction. The three studies using low-dose hyperforin extracts (< 4 mg day(-1)) demonstrated no significant effect on CYP3A. Conclusion There is reasonable evidence to suggest that high-dose hyperforin SJW extracts induce CYP3A. More studies are required to determine whether decreased CYP3A induction occurs after low-dose hyperforin extracts. Future studies should adopt study designs with a control phase or control group, identify the specific SJW extract employed and provide quantitative analyses of key constituents.

Automatic measurement of vertebral rotation in idiopathic scoliosis

Study Design. Development of an automatic measurement algorithm and comparison with manual measurement methods. Objectives. To develop a new computer-based method for automatic measurement of vertebral rotation in idiopathic scoliosis from computed tomography images and to compare the automatic method with two manual measurement techniques. Summary of Background Data. Techniques have been developed for vertebral rotation measurement in idiopathic scoliosis using plain radiographs, computed tomography, or magnetic resonance images. All of these techniques require manual selection of landmark points and are therefore subject to interobserver and intraobserver error. Methods. We developed a new method for automatic measurement of vertebral rotation in idiopathic scoliosis using a symmetry ratio algorithm. The automatic method provided values comparable with Aaro and Ho's manual measurement methods for a set of 19 transverse computed tomography slices through apical vertebrae, and with Aaro's method for a set of 204 reformatted computed tomography images through vertebral endplates. Results. Confidence intervals (95%) for intraobserver and interobserver variability using manual methods were in the range 5.5 to 7.2. The mean (+/- SD) difference between automatic and manual rotation measurements for the 19 apical images was -0.5 degrees +/- 3.3 degrees for Aaro's method and 0.7 degrees +/- 3.4 degrees for Ho's method. The mean (+/- SD) difference between automatic and manual rotation measurements for the 204 endplate images was 0.25 degrees +/- 3.8 degrees. Conclusions. The symmetry ratio algorithm allows automatic measurement of vertebral rotation in idiopathic scoliosis without intraobserver or interobserver error due to landmark point selection.

Interference between propagating changes and its effect on system failure

Computer-based, socio-technical systems projects are frequently failures. In particular, computer-based information systems often fail to live up to their promise. Part of the problem lies in the uncertainty of the effect of combining the subsystems that comprise the complete system; i.e. the system's emergent behaviour cannot be predicted from a knowledge of the subsystems. This paper suggests uncertainty management is a fundamental unifying concept in analysis and design of complex systems and goes on to indicate that this is due to the co-evolutionary nature of the requirements and implementation of socio-technical systems. The paper shows a model of the propagation of a system change that indicates that the introduction of two or more changes over time can cause chaotic emergent behaviour.

Use of fundus imaging in quantification of age-related macular change

This review will discuss the use of manual grading scales, digital photography, and automated image analysis in the quantification of fundus changes caused by age-related macular disease. Digital imaging permits processing of images for enhancement, comparison, and feature quantification, and these techniques have been investigated for automated drusen analysis. The accuracy of automated analysis systems has been enhanced by the incorporation of interactive elements, such that the user is able to adjust the sensitivity of the system, or manually add and remove pixels. These methods capitalize on both computer and human image feature recognition and the advantage of computer-based methodologies for quantification. The histogram-based adaptive local thresholding system is able to extract useful information from the image without being affected by the presence of other structures. More recent developments involve compensation for fundus background reflectance, which has most recently been combined with the Otsu method of global thresholding. This method is reported to provide results comparable with manual stereo viewing. Developments in this area are likely to encourage wider use of automated techniques. This will make the grading of photographs easier and cheaper for clinicians and researchers. © 2007 Elsevier Inc. All rights reserved.

Process integration and improvement using systemic diagrams and a human-centred approach

If product cycle time reduction is the mission, and the multifunctional team is the means of achieving the mission, what then is the modus operandi by which this means is to accomplish its mission? This paper asserts that a preferred modus operandi for the multifunctional team is to adopt a process-oriented view of the manufacturing enterprise, and for this it needs the medium of a process map [16] The substance of this paper is a methodology which enables the creation of such maps Specific examples of process models drawn from the product develop ment life cycle are presented and described in order to support the methodology's integrity and value The specific deliverables we have so far obtained are a methodology for process capture and analysis, a collection of process models spanning the product development cycle, and, an engineering handbook which hosts these models and presents a computer-based means of navigating through these processes in order to allow users a better understanding of the nature of the business, their role in it, and why the job that they do benefits the work of the company We assert that this kind of thinking is the essence of concurrent engineering implementation, and further that the systemigram process models uniquely stim ulate and organise such thinking.

Mathematical modelling and control of agitated extraction columns

Liquid-liquid extraction has long been known as a unit operation that plays an important role in industry. This process is well known for its complexity and sensitivity to operation conditions. This thesis presents an attempt to explore the dynamics and control of this process using a systematic approach and state of the art control system design techniques. The process was studied first experimentally under carefully selected. operation conditions, which resembles the ranges employed practically under stable and efficient conditions. Data were collected at steady state conditions using adequate sampling techniques for the dispersed and continuous phases as well as during the transients of the column with the aid of a computer-based online data logging system and online concentration analysis. A stagewise single stage backflow model was improved to mimic the dynamic operation of the column. The developed model accounts for the variation in hydrodynamics, mass transfer, and physical properties throughout the length of the column. End effects were treated by addition of stages at the column entrances. Two parameters were incorporated in the model namely; mass transfer weight factor to correct for the assumption of no mass transfer in the. settling zones at each stage and the backmixing coefficients to handle the axial dispersion phenomena encountered in the course of column operation. The parameters were estimated by minimizing the differences between the experimental and the model predicted concentration profiles at steady state conditions using non-linear optimisation technique. The estimated values were then correlated as functions of operating parameters and were incorporated in·the model equations. The model equations comprise a stiff differential~algebraic system. This system was solved using the GEAR ODE solver. The calculated concentration profiles were compared to those experimentally measured. A very good agreement of the two profiles was achieved within a percent relative error of ±2.S%. The developed rigorous dynamic model of the extraction column was used to derive linear time-invariant reduced-order models that relate the input variables (agitator speed, solvent feed flowrate and concentration, feed concentration and flowrate) to the output variables (raffinate concentration and extract concentration) using the asymptotic method of system identification. The reduced-order models were shown to be accurate in capturing the dynamic behaviour of the process with a maximum modelling prediction error of I %. The simplicity and accuracy of the derived reduced-order models allow for control system design and analysis of such complicated processes. The extraction column is a typical multivariable process with agitator speed and solvent feed flowrate considered as manipulative variables; raffinate concentration and extract concentration as controlled variables and the feeds concentration and feed flowrate as disturbance variables. The control system design of the extraction process was tackled as multi-loop decentralised SISO (Single Input Single Output) as well as centralised MIMO (Multi-Input Multi-Output) system using both conventional and model-based control techniques such as IMC (Internal Model Control) and MPC (Model Predictive Control). Control performance of each control scheme was. studied in terms of stability, speed of response, sensitivity to modelling errors (robustness), setpoint tracking capabilities and load rejection. For decentralised control, multiple loops were assigned to pair.each manipulated variable with each controlled variable according to the interaction analysis and other pairing criteria such as relative gain array (RGA), singular value analysis (SVD). Loops namely Rotor speed-Raffinate concentration and Solvent flowrate Extract concentration showed weak interaction. Multivariable MPC has shown more effective performance compared to other conventional techniques since it accounts for loops interaction, time delays, and input-output variables constraints.

Expert systems for fault tree synthesis

Hazard and operability (HAZOP) studies on chemical process plants are very time consuming, and often tedious, tasks. The requirement for HAZOP studies is that a team of experts systematically analyse every conceivable process deviation, identifying possible causes and any hazards that may result. The systematic nature of the task, and the fact that some team members may be unoccupied for much of the time, can lead to tedium, which in turn may lead to serious errors or omissions. An aid to HAZOP are fault trees, which present the system failure logic graphically such that the study team can readily assimilate their findings. Fault trees are also useful to the identification of design weaknesses, and may additionally be used to estimate the likelihood of hazardous events occurring. The one drawback of fault trees is that they are difficult to generate by hand. This is because of the sheer size and complexity of modern process plants. The work in this thesis proposed a computer-based method to aid the development of fault trees for chemical process plants. The aim is to produce concise, structured fault trees that are easy for analysts to understand. Standard plant input-output equation models for major process units are modified such that they include ancillary units and pipework. This results in a reduction in the nodes required to represent a plant. Control loops and protective systems are modelled as operators which act on process variables. This modelling maintains the functionality of loops, making fault tree generation easier and improving the structure of the fault trees produced. A method, called event ordering, is proposed which allows the magnitude of deviations of controlled or measured variables to be defined in terms of the control loops and protective systems with which they are associated.

Automatic refinement of constructive solid geometry models

Geometric information relating to most engineering products is available in the form of orthographic drawings or 2D data files. For many recent computer based applications, such as Computer Integrated Manufacturing (CIM), these data are required in the form of a sophisticated model based on Constructive Solid Geometry (CSG) concepts. A recent novel technique in this area transfers 2D engineering drawings directly into a 3D solid model called `the first approximation'. In many cases, however, this does not represent the real object. In this thesis, a new method is proposed and developed to enhance this model. This method uses the notion of expanding an object in terms of other solid objects, which are either primitive or first approximation models. To achieve this goal, in addition to the prepared subroutine to calculate the first approximation model of input data, two other wireframe models are found for extraction of sub-objects. One is the wireframe representation on input, and the other is the wireframe of the first approximation model. A new fast method is developed for the latter special case wireframe, which is named the `first approximation wireframe model'. This method avoids the use of a solid modeller. Detailed descriptions of algorithms and implementation procedures are given. In these techniques utilisation of dashed line information is also considered in improving the model. Different practical examples are given to illustrate the functioning of the program. Finally, a recursive method is employed to automatically modify the output model towards the real object. Some suggestions for further work are made to increase the domain of objects covered, and provide a commercially usable package. It is concluded that the current method promises the production of accurate models for a large class of objects.

The evolving role of information specialists:change agents in process redesign

The research investigates the past, present and potential future role of Information Specialists (ISps) in process oriented companies. It tests the proposition that ISps in companies that have undertaken formal process reengineering exercises are likely to become more proactive and more business oriented (as opposed to technically oriented) than they had previously been when their organisations were organised along traditional, functional lines. A review of existing literature in the area of Business Process Reengineering and Information Management reveals a lack of consensus amongst researchers concerning the appropriate role for ISps during and after BPR. Opinion is divided as to whether IS professionals should reactively support BPR or whether IT/IS developments should be driving these initiatives. A questionnaire based ‘Descriptive Survey’ with 60 respondents is used as a first stage of primary data gathering. This is followed by follow-up interviews with 20 of the participating organisations to gather further information on their experiences. The final stage of data collection consists of further in-depth interview with four case study companies to provide an even richer picture of their experiences. The results of the questionnaire are analysed and displayed in the form of simple means, frequencies and bar graphs. The ‘NU-DIST’ computer based discourse analysis package was tried in relation to summarising the interview findings, but this proved cumbersome and a visual collation method is preferred. Overall, the researcher contends that the supposition outlined above is proven, and she concludes the research by suggesting the implications of these findings. In particular she offers a ‘Framework for Understanding and Action’ which is deemed to be relevant to both practitioners and future researchers.

Global optimisation of cold-formed steel sections

In this thesis, standard algorithms are used to carry out the optimisation of cold-formed steel purlins such as zed, channel and sigma sections, which are assumed to be simply supported and subjected to a gravity load. For zed, channel and sigma section, the local buckling, distortional buckling and lateral-torsional buckling are considered respectively herein. Currently, the local buckling is based on the BS 5950-5:1998 and EN 1993-1-3:2006. The distortional buckling is calculated by the direct strength method employing the elastic distortional buckling which is calculated by three available approaches such as Hancock (1995), Schafer and Pekoz (1998), Yu (2005). In the optimisation program, the lateral-torsional buckling based on BS 5950-5:1998, AISI and analytical model of Li (2004) are investigated. For the optimisation program, the programming codes are written for optimisation of channel, zed and sigma beam. The full study has been coded into a computer-based analysis program (MATLAB).

A study of the micro-mechanics of granular media

The development of more realistic constitutive models for granular media, such as sand, requires ingredients which take into account the internal micro-mechanical response to deformation. Unfortunately, at present, very little is known about these mechanisms and therefore it is instructive to find out more about the internal nature of granular samples by conducting suitable tests. In contrast to physical testing the method of investigation used in this study employs the Distinct Element Method. This is a computer based, iterative, time-dependent technique that allows the deformation of granular assemblies to be numerically simulated. By making assumptions regarding contact stiffnesses each individual contact force can be measured and by resolution particle centroid forces can be calculated. Then by dividing particle forces by their respective mass, particle centroid velocities and displacements are obtained by numerical integration. The Distinct Element Method is incorporated into a computer program 'Ball'. This program is effectively a numerical apparatus which forms a logical housing for this method and allows data input and output, and also provides testing control. By using this numerical apparatus tests have been carried out on disc assemblies and many new interesting observations regarding the micromechanical behaviour are revealed. In order to relate the observed microscopic mechanisms of deformation to the flow of the granular system two separate approaches have been used. Firstly a constitutive model has been developed which describes the yield function, flow rule and translation rule for regular assemblies of spheres and discs when subjected to coaxial deformation. Secondly statistical analyses have been carried out using data which was extracted from the simulation tests. These analyses define and quantify granular structure and then show how the force and velocity distributions use the structure to produce the corresponding stress and strain-rate tensors.

Development of an electric heat pump for domestic use

This thesis records the design and development of an electrically driven, air to water, vapour compression heat pump of nominally 6kW heat output, for residential space heating. The study was carried out on behalf of GEC Research Ltd through the Interdisciplinary Higher Degrees Scheme at Aston University. A computer based mathematical model of the vapour compression cycle was produced as a design aid, to enable the effects of component design changes or variations in operating conditions to be predicted. This model is supported by performance testing of the major components, which revealed that improvements in the compressor isentropic efficiency offer the greatest potential for further increases in cycle COPh. The evaporator was designed from first principles, and is based on wire-wound heat transfer tubing. Two evaporators, of air side area 10.27 and 16.24m2, were tested in a temperature and humidity controlled environment, demonstrating that the benefits of the large coil are greater heat pump heat output and lower noise levels. A systematic study of frost growth rates suggested that this problem is most severe at the conditions of saturated air at 0oC combined with low condenser water temperature. A dynamic simulation model was developed to predict the in-service performance of the heat pump. This study confirmed the importance of an adequate radiator area for heat pump installations. A prototype heat pump was designed and manufactured, consisting of a hermetic reciprocating compressor, a coaxial tube condenser and a helically coiled evaporator, using Refrigerant 22. The prototype was field tested in a domestic environment for one and a half years. The installation included a comprehensive monitoring system. Initial problems were encountered with defrosting and compressor noise, both of which were solved. The unit then operated throughout the 1985/86 heating season without further attention, producing a COPh of 2.34.

Expatriate managers adjustment and its impact on subordinates reactions: a cross cultural leadership study of Kenya and Ethiopia

Research on culture, leadership and adjustment shows that societal culture influences leadership in such a way that it can impact on expatriate managers' effectiveness and adjustment in a new culture. In previous research, cultural background, personality, motives or behaviour of expatriate managers and their followers' reactions to them have been investigated in Europe, America and Asia. However, little attention has been paid on research on expatriate managers in African cultures especially in Eastern Africa. The present study represents an attempt to address the gap by examining how societal culture, leadership and adjustment success are interrelated for expatriate managers in Kenya and Ethiopia. Questionnaire data were obtained from a) local middle managers (N=160) for studying societal culture and leadership in Kenya and Ethiopia, b) expatriate managers in non-governmental organizations - NGOs (N=28) for studying expatriate managers' personality, motives and adjustment success and c) their immediate subordinates (N=125) for studying the expatriate managers' behaviours and their subordinates' reactions to them. Additionally, expatriate managers were interviewed and responses were coded for implicit motives, experiences and adjustment. SPSS was used to analyse data from questionnaires to obtain cultural and leadership dimensions, leader behaviour and subordinate reactions. The NVIVO computer based disclosure analysis package was used to analyse interview data. Findings indicate that societal culture influences leadership behaviours and leadership perceptions while the expatriate managers' motives, behaviours, personality and the cross cultural training they received prior to their assignment impact on the expatriates' adjustment success and on subordinates' reactions to them. The cultural fit between expatriate managers' home country (19 countries) and the target country (Kenya or Ethiopia) had no significant association with adjustment success but was positively related to expatriate behaviour and negatively associated with subordinates reactions. However, some particular societal practices - obviously adopted by expatriates and transferred to their target country - did predict subordinates' commitment, motivation and job satisfaction. Furthermore, expatriates' responsibility motivation was positively related to their adjustment success. Regarding leadership behaviours and effectiveness, expatriate' supportive behaviours predicted subordinates' job satisfaction most strongly. Expatriate managers expressing their management philosophies and experience shed light on the various aspects of adjustment and management of NGOs. In addition, review of Kenyan and Ethiopian cultures and the NGO context in these countries offers valuable information for expatriate managers. This study's general imphcation for Cross Cultural Management and lnternational Human Resources Management is that the combination of culture general and culture specific knowledge and reflections on Eastern Africa countries can inform senior management and international HR staff about the critical issue of what to include in training, coaching, and actual experience in a particular host country in order to ensure effective leadership. Furthennore, this knowledge is expected to influence expatriate managers' behaviour modification to enhance positive subordinate reactions. Questions about how to prepare expatriate managers and subordinates to work more competently and sensitively across cultures are addressed. Further theoretical implications, limitations of the study and directions for future research are also addressed.

Modelling human performance within manufacturing systems design:from a theoretical towards a practical framework

Computer-based simulation is frequently used to evaluate the capabilities of proposed manufacturing system designs. Unfortunately, the real systems are often found to perform quite differently from simulation predictions and one possible reason for this is an over-simplistic representation of workers' behaviour within current simulation techniques. The accuracy of design predictions could be improved through a modelling tool that integrates with computer-based simulation and incorporates the factors and relationships that determine workers' performance. This paper explores the viability of developing a similar tool based on our previously published theoretical modelling framework. It focuses on evolving this purely theoretical framework towards a practical modelling tool that can actually be used to expand the capabilities of current simulation techniques. Based on an industrial study, the paper investigates how the theoretical framework works in practice, analyses strengths and weaknesses in its formulation, and proposes developments that can contribute towards enabling human performance modelling in a practical way.

Humans:the missing link in manufacturing simulation?

Computer based discrete event simulation (DES) is one of the most commonly used aids for the design of automotive manufacturing systems. However, DES tools represent machines in extensive detail, while only representing workers as simple resources. This presents a problem when modelling systems with a highly manual work content, such as an assembly line. This paper describes research at Cranfield University, in collaboration with the Ford Motor Company, founded on the assumption that human variation is the cause of a large percentage of the disparity between simulation predictions and real world performance. The research aims to improve the accuracy and reliability of simulation prediction by including models of human factors.