Biological and environmental determinants

This chapter describes biological and environmental determinants of the health of Australians, providing a background to the development of successful public health activity. You will recall from the introduction to Section 2 that health determinants are the biomedical, genetic, behavioural, socioeconomic and environmental factors that impact on health and wellbeing. These determinants can be influenced by interventions and by resources and systems (Australian Institute of Health and Welfare (AIHW) AIHW 2012a). Many factors combine to affect the health of individuals and communities. People’s circumstances and the environment determine whether a population is healthy or not. Factors such as where people live, the state of their environment, genetics, their education level and income, and their relationships with friends and family are all likely to impact on their health. The determinants of population health reflect the context of people’s lives; however, people have limited control over many of these determinants (WHO 2007).

Measurements of adequacy of anesthesia and level of consciousness during surgery and intensive care

The adequacy of anesthesia has been studied since the introduction of balanced general anesthesia. Commercial monitors based on electroencephalographic (EEG) signal analysis have been available for monitoring the hypnotic component of anesthesia from the beginning of the 1990s. Monitors measuring the depth of anesthesia assess the cortical function of the brain, and have gained acceptance during surgical anesthesia with most of the anesthetic agents used. However, due to frequent artifacts, they are considered unsuitable for monitoring consciousness in intensive care patients. The assessment of analgesia is one of the cornerstones of general anesthesia. Prolonged surgical stress may lead to increased morbidity and delayed postoperative recovery. However, no validated monitoring method is currently available for evaluating analgesia during general anesthesia. Awareness during anesthesia is caused by an inadequate level of hypnosis. This rare but severe complication of general anesthesia may lead to marked emotional stress and possibly posttraumatic stress disorder. In the present series of studies, the incidence of awareness and recall during outpatient anesthesia was evaluated and compared with that of in inpatient anesthesia. A total of 1500 outpatients and 2343 inpatients underwent a structured interview. Clear intraoperative recollections were rare the incidence being 0.07% in outpatients and 0.13% in inpatients. No significant differences emerged between outpatients and inpatients. However, significantly smaller doses of sevoflurane were administered to outpatients with awareness than those without recollections (p<0.05). EEG artifacts in 16 brain-dead organ donors were evaluated during organ harvest surgery in a prospective, open, nonselective study. The source of the frontotemporal biosignals in brain-dead subjects was studied, and the resistance of bispectral index (BIS) and Entropy to the signal artifacts was compared. The hypothesis was that in brain-dead subjects, most of the biosignals recorded from the forehead would consist of artifacts. The original EEG was recorded and State Entropy (SE), Response Entropy (RE), and BIS were calculated and monitored during solid organ harvest. SE differed from zero (inactive EEG) in 28%, RE in 29%, and BIS in 68% of the total recording time (p<0.0001 for all). The median values during the operation were SE 0.0, RE 0.0, and BIS 3.0. In four of the 16 organ donors, EEG was not inactive, and unphysiologically distributed, nonreactive rhythmic theta activity was present in the original EEG signal. After the results from subjects with persistent residual EEG activity were excluded, SE, RE, and BIS differed from zero in 17%, 18%, and 62% of the recorded time, respectively (p<0.0001 for all). Due to various artifacts, the highest readings in all indices were recorded without neuromuscular blockade. The main sources of artifacts were electrocauterization, electromyography (EMG), 50-Hz artifact, handling of the donor, ballistocardiography, and electrocardiography. In a prospective, randomized study of 26 patients, the ability of Surgical Stress Index (SSI) to differentiate patients with two clinically different analgesic levels during shoulder surgery was evaluated. SSI values were lower in patients with an interscalene brachial plexus block than in patients without an additional plexus block. In all patients, anesthesia was maintained with desflurane, the concentration of which was targeted to maintain SE at 50. Increased blood pressure or heart rate (HR), movement, and coughing were considered signs of intraoperative nociception and treated with alfentanil. Photoplethysmographic waveforms were collected from the contralateral arm to the operated side, and SSI was calculated offline. Two minutes after skin incision, SSI was not increased in the brachial plexus block group and was lower (38 ± 13) than in the control group (58 ± 13, p<0.005). Among the controls, one minute prior to alfentanil administration, SSI value was higher than during periods of adequate antinociception, 59 ± 11 vs. 39 ± 12 (p<0.01). The total cumulative need for alfentanil was higher in controls (2.7 ± 1.2 mg) than in the brachial plexus block group (1.6 ± 0.5 mg, p=0.008). Tetanic stimulation to the ulnar region of the hand increased SSI significantly only among patients with a brachial plexus block not covering the site of stimulation. Prognostic value of EEG-derived indices was evaluated and compared with Transcranial Doppler Ultrasonography (TCD), serum neuron-specific enolase (NSE) and S-100B after cardiac arrest. Thirty patients resuscitated from out-of-hospital arrest and treated with induced mild hypothermia for 24 h were included. Original EEG signal was recorded, and burst suppression ratio (BSR), RE, SE, and wavelet subband entropy (WSE) were calculated. Neurological outcome during the six-month period after arrest was assessed with the Glasgow-Pittsburgh Cerebral Performance Categories (CPC). Twenty patients had a CPC of 1-2, one patient had a CPC of 3, and nine patients died (CPC 5). BSR, RE, and SE differed between good (CPC 1-2) and poor (CPC 3-5) outcome groups (p=0.011, p=0.011, p=0.008, respectively) during the first 24 h after arrest. WSE was borderline higher in the good outcome group between 24 and 48 h after arrest (p=0.050). All patients with status epilepticus died, and their WSE values were lower (p=0.022). S-100B was lower in the good outcome group upon arrival at the intensive care unit (p=0.010). After hypothermia treatment, NSE and S-100B values were lower (p=0.002 for both) in the good outcome group. The pulsatile index was also lower in the good outcome group (p=0.004). In conclusion, the incidence of awareness in outpatient anesthesia did not differ from that in inpatient anesthesia. Outpatients are not at increased risk for intraoperative awareness relative to inpatients undergoing general anesthesia. SE, RE, and BIS showed non-zero values that normally indicate cortical neuronal function, but were in these subjects mostly due to artifacts after clinical brain death diagnosis. Entropy was more resistant to artifacts than BIS. During general anesthesia and surgery, SSI values were lower in patients with interscalene brachial plexus block covering the sites of nociceptive stimuli. In detecting nociceptive stimuli, SSI performed better than HR, blood pressure, or RE. BSR, RE, and SE differed between the good and poor neurological outcome groups during the first 24 h after cardiac arrest, and they may be an aid in differentiating patients with good neurological outcomes from those with poor outcomes after out-of-hospital cardiac arrest.

Ideaalin ja todellisuuden välimaastossa - katoavatko perheateriat?

Aims: The recent conversations about disappearing family meals, mental problems of the youngsters and family meals´ protective effect on youngsters problems have been the base of this study. The main aim of this study is to find out, what kind of position family meals do have in the youngsters´lives. Study questions are: 1. What kind of conceptions youngsters have of family meals? 2. What kind of hands-on experience youngsters have about family meals? 3. How youngsters feel family meals on a emotional level? a. Are meals positive moments with the family or do they just limit timetables? b. Do the youngsters need family meals if they do not have those in their families? Why? Why not? Methods: The data was collected using stimulated recall -interviews and basic themed interviews. The data was collected from thirteen 8th graders from Pirkanmaa and Kanta-Häme. The interviews were analyzed with the qualitative content analysis. Results and conclusion: The youngsters´ consepts of the meals and the family meals were quite traditional, assuming that those are warm, varied and eaten with company. The situation of the family meals was good and those were eaten nearly every day in the most of the families. The youngsters thought that the family meals were important social moments with the family and they were able to talk about important things with the family during the meals. They also felt that the daily eating rythm was good and they did not felt that the meals would have been somehow restrictive. Even so that the pupils felt the family meals were important, the pupil whose family did not eat family meals did not long those meals. He felt that he was able to share his thoughts and experiences also in other ways. It is important that youngsters have this channel of communication.

High-quality annotation of promoter regions for 913 bacterial genomes

Motivation: The number of bacterial genomes being sequenced is increasing very rapidly and hence, it is crucial to have procedures for rapid and reliable annotation of their functional elements such as promoter regions, which control the expression of each gene or each transcription unit of the genome. The present work addresses this requirement and presents a generic method applicable across organisms. Results: Relative stability of the DNA double helical sequences has been used to discriminate promoter regions from non-promoter regions. Based on the difference in stability between neighboring regions, an algorithm has been implemented to predict promoter regions on a large scale over 913 microbial genome sequences. The average free energy values for the promoter regions as well as their downstream regions are found to differ, depending on their GC content. Threshold values to identify promoter regions have been derived using sequences flanking a subset of translation start sites from all microbial genomes and then used to predict promoters over the complete genome sequences. An average recall value of 72% (which indicates the percentage of protein and RNA coding genes with predicted promoter regions assigned to them) and precision of 56% is achieved over the 913 microbial genome dataset.

Guessers for Finite-State Transducer Lexicons

Language software applications encounter new words, e.g., acronyms, technical terminology, names or compounds of such words. In order to add new words to a lexicon, we need to indicate their inflectional paradigm. We present a new generally applicable method for creating an entry generator, i.e. a paradigm guesser, for finite-state transducer lexicons. As a guesser tends to produce numerous suggestions, it is important that the correct suggestions be among the first few candidates. We prove some formal properties of the method and evaluate it on Finnish, English and Swedish full-scale transducer lexicons. We use the open-source Helsinki Finite-State Technology to create finitestate transducer lexicons from existing lexical resources and automatically derive guessers for unknown words. The method has a recall of 82-87 % and a precision of 71-76 % for the three test languages. The model needs no external corpus and can therefore serve as a baseline.

Neural network modeling of associative memory: Beyond the Hopfield model

A number of neural network models, in which fixed-point and limit-cycle attractors of the underlying dynamics are used to store and associatively recall information, are described. In the first class of models, a hierarchical structure is used to store an exponentially large number of strongly correlated memories. The second class of models uses limit cycles to store and retrieve individual memories. A neurobiologically plausible network that generates low-amplitude periodic variations of activity, similar to the oscillations observed in electroencephalographic recordings, is also described. Results obtained from analytic and numerical studies of the properties of these networks are discussed.

DNA Free Energy-Based Promoter Prediction and Comparative Analysis of Arabidopsis and Rice Genomes

The cis-regulatory regions on DNA serve as binding sites for proteins such as transcription factors and RNA polymerase. The combinatorial interaction of these proteins plays a crucial role in transcription initiation, which is an important point of control in the regulation of gene expression. We present here an analysis of the performance of an in silico method for predicting cis-regulatory regions in the plant genomes of Arabidopsis (Arabidopsis thaliana) and rice (Oryza sativa) on the basis of free energy of DNA melting. For protein-coding genes, we achieve recall and precision of 96% and 42% for Arabidopsis and 97% and 31% for rice, respectively. For noncoding RNA genes, the program gives recall and precision of 94% and 75% for Arabidopsis and 95% and 90% for rice, respectively. Moreover, 96% of the false-positive predictions were located in noncoding regions of primary transcripts, out of which 20% were found in the first intron alone, indicating possible regulatory roles. The predictions for orthologous genes from the two genomes showed a good correlation with respect to prediction scores and promoter organization. Comparison of our results with an existing program for promoter prediction in plant genomes indicates that our method shows improved prediction capability.

Trans-saccadic processing of visual and motor planning during sequential eye movements

How the brain maintains perceptual continuity across eye movements that yield discontinuous snapshots of the world is still poorly understood. In this study, we adapted a framework from the dual-task paradigm, well suited to reveal bottlenecks in mental processing, to study how information is processed across sequential saccades. The pattern of RTs allowed us to distinguish among three forms of trans-saccadic processing (no trans-saccadic processing, trans-saccadic visual processing and trans-saccadic visual processing and saccade planning models). Using a cued double-step saccade task, we show that even though saccade execution is a processing bottleneck, limiting access to incoming visual information, partial visual and motor processing that occur prior to saccade execution is used to guide the next eye movement. These results provide insights into how the oculomotor system is designed to process information across multiple fixations that occur during natural scanning.

Characterization of structural and free energy properties of promoters associated with Primary and Operon TSS in Helicobacter pylori genome and their orthologs

Promoter regions in the genomes of all domains of life show similar trends in several structural properties such as stability, bendability, curvature, etc. In current study we analysed the stability and bendability of various classes of promoter regions (based on the recent identification of different classes of transcription start sites) of Helicobacter pylori 26695 strain. It is found that primary TSS and operon-associated TSS promoters show significantly strong features in their promoter regions. DNA free-energy-based promoter prediction tool PromPredict was used to annotate promoters of different classes, and very high recall values (similar to 80%) are obtained for primary TSS. Orthologous genes from other strains of H. pylori show conservation of structural properties in promoter regions as well as coding regions. PromPredict annotates promoters of orthologous genes with very high recall and precision.

Multi-script and multi-oriented text localization from scene images

This paper describes a new method of color text localization from generic scene images containing text of different scripts and with arbitrary orientations. A representative set of colors is first identified using the edge information to initiate an unsupervised clustering algorithm. Text components are identified from each color layer using a combination of a support vector machine and a neural network classifier trained on a set of low-level features derived from the geometric, boundary, stroke and gradient information. Experiments on camera-captured images that contain variable fonts, size, color, irregular layout, non-uniform illumination and multiple scripts illustrate the robustness of the method. The proposed method yields precision and recall of 0.8 and 0.86 respectively on a database of 100 images. The method is also compared with others in the literature using the ICDAR 2003 robust reading competition dataset.

OTCYMIST: Otsu-Canny minimal spanning tree for born-digital images

Text segmentation and localization algorithms are proposed for the born-digital image dataset. Binarization and edge detection are separately carried out on the three colour planes of the image. Connected components (CC's) obtained from the binarized image are thresholded based on their area and aspect ratio. CC's which contain sufficient edge pixels are retained. A novel approach is presented, where the text components are represented as nodes of a graph. Nodes correspond to the centroids of the individual CC's. Long edges are broken from the minimum spanning tree of the graph. Pair wise height ratio is also used to remove likely non-text components. A new minimum spanning tree is created from the remaining nodes. Horizontal grouping is performed on the CC's to generate bounding boxes of text strings. Overlapping bounding boxes are removed using an overlap area threshold. Non-overlapping and minimally overlapping bounding boxes are used for text segmentation. Vertical splitting is applied to generate bounding boxes at the word level. The proposed method is applied on all the images of the test dataset and values of precision, recall and H-mean are obtained using different approaches.

Evaluation of document binarization using eigen value decomposition

A necessary step for the recognition of scanned documents is binarization, which is essentially the segmentation of the document. In order to binarize a scanned document, we can find several algorithms in the literature. What is the best binarization result for a given document image? To answer this question, a user needs to check different binarization algorithms for suitability, since different algorithms may work better for different type of documents. Manually choosing the best from a set of binarized documents is time consuming. To automate the selection of the best segmented document, either we need to use ground-truth of the document or propose an evaluation metric. If ground-truth is available, then precision and recall can be used to choose the best binarized document. What is the case, when ground-truth is not available? Can we come up with a metric which evaluates these binarized documents? Hence, we propose a metric to evaluate binarized document images using eigen value decomposition. We have evaluated this measure on DIBCO and H-DIBCO datasets. The proposed method chooses the best binarized document that is close to the ground-truth of the document.

A context aware collaborative service provisioning system for mobile-commerce

In the process of service provisioning, providing required service to the user without user intervention, with reduction of the cognitive over loading is a real challenge. In this paper we propose a user centred context aware collaborative service provisioning system, which make use of context along with collaboration to provide the required service to the user dynamically. The system uses a novel approach of query expansion along with interactive and rating matrix based collaboration. Performance of the system is evaluated in Mobile-Commerce environment. The results show that the system is time efficient and perform with better precision and recall in comparison with context aware system.

A reexamination of some puzzling results in linearized elasticity

In this paper, we analyse three commonly discussed `flaws' of linearized elasticity theory and attempt to resolve them. The first `flaw' concerns cylindrically orthotropic material models. Since the work of Lekhnitskii (1968), there has been a growing body of work that continues to this day, that shows that infinite stresses arise with the use of a cylindrically orthotropic material model even in the case of linearized elasticity. Besides infinite stresses, interpenetration of matter is also shown to occur. These infinite stresses and interpenetration occur when the ratio of the circumferential Young modulus to the radial Young modulus is less than one. If the ratio is greater than one, then the stresses at the center of a spinning disk are found to be zero (recall that for an isotropic material model, the stresses are maximum at the center). Thus, the stresses go abruptly from a maximum value to a value of zero as the ratio is increased to a value even slightly above one! One of the explanations provided for this extremely anomalous behaviour is the failure of linearized elasticity to satisfy material frame-indifference. However, if this is the true cause, then the anomalous behaviour should also occur with the use of an isotropic material model, where, no such anomalies are observed. We show that the real cause of the problem is elsewhere and also show how these anomalies can be resolved. We also discuss how the formulation of linearized elastodynamics in the case of small deformations superposed on a rigid motion can be given in a succinct manner. Finally, we show how the long-standing problem of devising three compatibility relations instead of six can be resolved.

Using Relationships for Matching Textual Domain Models with Existing Code

We address the task of mapping a given textual domain model (e.g., an industry-standard reference model) for a given domain (e.g., ERP), with the source code of an independently developed application in the same domain. This has applications in improving the understandability of an existing application, migrating it to a more flexible architecture, or integrating it with other related applications. We use the vector-space model to abstractly represent domain model elements as well as source-code artifacts. The key novelty in our approach is to leverage the relationships between source-code artifacts in a principled way to improve the mapping process. We describe experiments wherein we apply our approach to the task of matching two real, open-source applications to corresponding industry-standard domain models. We demonstrate the overall usefulness of our approach, as well as the role of our propagation techniques in improving the precision and recall of the mapping task.