A 2-hour diagnostic protocol for possible cardiac chest pain in the emergency department: A randomized clinical trial

IMPORTANCE Patients with chest pain represent a high health care burden, but it may be possible to identify a patient group with a low short-term risk of adverse cardiac events who are suitable for early discharge. OBJECTIVE To compare the effectiveness of a rapid diagnostic pathway with a standard-care diagnostic pathway for the assessment of patients with possible cardiac chest pain in a usual clinical practice setting. DESIGN, SETTING, AND PARTICIPANTS A single-center, randomized parallel-group trial with blinded outcome assessments was conducted in an academic general and tertiary hospital. Participants included adults with acute chest pain consistent with acute coronary syndrome for whom the attending physician planned further observation and troponin testing. Patient recruitment occurred from October 11, 2010, to July 4, 2012, with a 30-day follow-up. INTERVENTIONS An experimental pathway using an accelerated diagnostic protocol (Thrombolysis in Myocardial Infarction score, 0; electrocardiography; and 0- and 2-hour troponin tests) or a standard-care pathway (troponin test on arrival at hospital, prolonged observation, and a second troponin test 6-12 hours after onset of pain) serving as the control. MAIN OUTCOMES AND MEASURES Discharge from the hospital within 6 hours without a major adverse cardiac event occurring within 30 days. RESULTS Fifty-two of 270 patients in the experimental group were successfully discharged within 6 hours compared with 30 of 272 patients in the control group (19.3% vs 11.0%; odds ratio, 1.92; 95% CI, 1.18-3.13; P = .008). It required 20 hours to discharge the same proportion of patients from the control group as achieved in the experimental group within 6 hours. In the experimental group, 35 additional patients (12.9%) were classified as low risk but admitted to an inpatient ward for cardiac investigation. None of the 35 patients received a diagnosis of acute coronary syndrome after inpatient evaluation. CONCLUSIONS AND RELEVANCE Using the accelerated diagnostic protocol in the experimental pathway almost doubled the proportion of patients with chest pain discharged early. Clinicians could discharge approximately 1 of 5 patients with chest pain to outpatient follow-up monitoring in less than 6 hours. This diagnostic strategy could be easily replicated in other centers because no extra resources are required.

No-reference image quality assessment using modified extreme learning machine classifier

In this paper, we present a machine learning approach to measure the visual quality of JPEG-coded images. The features for predicting the perceived image quality are extracted by considering key human visual sensitivity (HVS) factors such as edge amplitude, edge length, background activity and background luminance. Image quality assessment involves estimating the functional relationship between HVS features and subjective test scores. The quality of the compressed images are obtained without referring to their original images ('No Reference' metric). Here, the problem of quality estimation is transformed to a classification problem and solved using extreme learning machine (ELM) algorithm. In ELM, the input weights and the bias values are randomly chosen and the output weights are analytically calculated. The generalization performance of the ELM algorithm for classification problems with imbalance in the number of samples per quality class depends critically on the input weights and the bias values. Hence, we propose two schemes, namely the k-fold selection scheme (KS-ELM) and the real-coded genetic algorithm (RCGA-ELM) to select the input weights and the bias values such that the generalization performance of the classifier is a maximum. Results indicate that the proposed schemes significantly improve the performance of ELM classifier under imbalance condition for image quality assessment. The experimental results prove that the estimated visual quality of the proposed RCGA-ELM emulates the mean opinion score very well. The experimental results are compared with the existing JPEG no-reference image quality metric and full-reference structural similarity image quality metric.

Helium Gas Purity Monitor based on Low Frequency Acoustic Resonance

Monitoring gas purity is an important aspect of gas recovery stations where air is usually one of the major impurities. Purity monitors of Katherometric type ate commercially available for this purpose. Alternatively, we discuss here a helium gas purity monitor based on acoustic resonance of a cavity at audio frequencies. It measures the purity by monitoring the resonant frequency of a cylindrical cavity filled with the gas under test and excited by conventional telephone transducers fixed at the ends. The use of the latter simplifies the design considerably. The paper discusses the details of the resonant cavity and the electronic circuit along with temperature compensation. The unit has been calibrated with helium gas of known purities. The unit has a response time of the order of 10 minutes and measures the gas purity to an accuracy of 0.02%. The unit has been installed in our helium recovery system and is found to perform satisfactorily.

Analysing industry needs to fine tune IPM project activities

As a first step to better targeting the activities of a project for improving management of western flower thrips, Frankliniella occidentialis, (WFT) in field grown vegetable crops, we surveyed growers, consultants and other agribusiness personnel in two regions of Queensland. Using face-to-face interviews, we collected data on key pests and measures used to manage them, the importance of WFT and associated viral diseases, sources of pest management information and additional skills and knowledge needed by growers and industry. Responses were similar in the two regions. While capsicum growers in one northern Queensland district had suffered serious losses from WFT damage in 2002, in general the pest was not seen as a major problem. In cucurbit crops, the silverleaf whitefly (Bemisia tabaci biotype B) was considered the most difficult insect pest to manage. Pest control tactics were largely based on pesticides although many respondents mentioned non-chemical methods such as good farm hygiene practices, control of weed hosts and regular crop monitoring, particularly when prompted. Respondents wanted to know more about pest identification, biology and damage, spray application and the best use of insecticides. Natural enemies were mentioned infrequently. Keeping up to date with available pesticide options, availability of new chemicals and options for a district-wide approach to managing pests emerged as key issues. Growers identified agricultural distributors, consultants, Queensland Department of Primary Industries staff, other growers and their own experience as important sources of information. Field days, workshops and seminars did not rank highly. Busy vegetable growers wanted these activities to be short and relevant, and preferred to be contacted by post and facsimile rather than email. In response to these results, we are focusing on three core, interrelated project extension strategies: (i) short workshops, seminars and farm walks to provide opportunities for discussion, training and information sharing with growers and their agribusiness advisors; (ii) communication via newsletters and information leaflets; (iii) support for commercialisation of services.

A systems evaluation of high-input management using fortified molasses for beef production in Australia's dry tropics

The potential of beef producers to profitably produce 500-kg steers at 2.5 years of age in northern Australia's dry tropics to meet specifications of high-value markets, using a high-input management (HIM) system was examined. HIM included targeted high levels of fortified molasses supplementation, short seasonal mating and the use of growth promotants. Using herds of 300-400 females plus steer progeny at three sites, HIM was compared at a business level to prevailing best-practice, strategic low-input management (SLIM) in which there is a relatively low usage of energy concentrates to supplement pasture intake. The data presented for each breeding-age cohort within management system at each site includes: annual pregnancy rates (range: 14-99%), time of conception, mortalities (range: 0-10%), progeny losses between confirmed pregnancy and weaning (range: 0-29%), and weaning rates (range: 14-92%) over the 2-year observation. Annual changes in weight and relative net worth were calculated for all breeding and non-breeding cohorts. Reasons for outcomes are discussed. Compared with SLIM herds, both weaning weights and annual growth were >= 30 kg higher, enabling 86-100% of HIM steers to exceed 500 kg at 2.5 years of age. Very few contemporary SLIM steers reached this target. HIM was most profitably applied to steers. Where HIM was able to achieve high pregnancy rates in yearlings, its application was recommended in females. Well managed, appropriate HIM systems increased profits by around $15/adult equivalent at prevailing beef and supplement prices. However, a 20% supplement price rise without a commensurate increase in values for young slaughter steers would generally eliminate this advantage. This study demonstrated the complexity of pro. table application of research outcomes to commercial business, even when component research suggests that specific strategies may increase growth and reproductive efficiency and/or be more pro. table. Because of the higher level of management required, higher costs and returns, and higher susceptibility to market changes and disease, HIM systems should only be applied after SLIM systems are well developed. To increase profitability, any strategy must ultimately either increase steer growth and sale values and/or enable a shift to high pregnancy rates in yearling heifers.

Educational attainment: A genome wide association study in 9538 Australians

BACKGROUND Correlations between Educational Attainment (EA) and measures of cognitive performance are as high as 0.8. This makes EA an attractive alternative phenotype for studies wishing to map genes affecting cognition due to the ease of collecting EA data compared to other cognitive phenotypes such as IQ. METHODOLOGY In an Australian family sample of 9538 individuals we performed a genome-wide association scan (GWAS) using the imputed genotypes of approximately 2.4 million single nucleotide polymorphisms (SNP) for a 6-point scale measure of EA. Top hits were checked for replication in an independent sample of 968 individuals. A gene-based test of association was then applied to the GWAS results. Additionally we performed prediction analyses using the GWAS results from our discovery sample to assess the percentage of EA and full scale IQ variance explained by the predicted scores. RESULTS The best SNP fell short of having a genome-wide significant p-value (p = 9.77x10(-7)). In our independent replication sample six SNPs among the top 50 hits pruned for linkage disequilibrium (r(2)<0.8) had a p-value<0.05 but only one of these SNPs survived correction for multiple testing--rs7106258 (p = 9.7*10(-4)) located in an intergenic region of chromosome 11q14.1. The gene based test results were non-significant and our prediction analyses show that the predicted scores explained little variance in EA in our replication sample. CONCLUSION While we have identified a polymorphism chromosome 11q14.1 associated with EA, further replication is warranted. Overall, the absence of genome-wide significant p-values in our large discovery sample confirmed the high polygenic architecture of EA. Only the assembly of large samples or meta-analytic efforts will be able to assess the implication of common DNA polymorphisms in the etiology of EA.

Assessing the potential of the rust fungus Puccinia spegazzinii as a classical biological control agent for the invasive weed Mikania micrantha in Papua New Guinea

The rust fungus Puccinia spegazzinii was introduced into Papua New Guinea (PNG) in 2008 as a classical biological control agent of the invasive weed Mikania micrantha (Asteraceae), following its earlier release in India, mainland China and Taiwan. Prior to implementing field releases in PNG, assessments were conducted to determine the most suitable rust pathotype for the country, potential for damage to non-target species, most efficient culturing method and potential impact to M. micrantha. The pathotype from eastern Ecuador was selected from the seven pathotypes tested, since all the plant populations evaluated from PNG were highly susceptible to it. None of the 11 plant species (representing eight families) tested to confirm host specificity showed symptoms of infection, supporting previous host range determination. A method of mass-producing inoculum of the rust fungus, using a simple technology which can be readily replicated in other countries, was developed. Comparative growth trials over one rust generation showed that M. micrantha plants infected with the rust generally had both lower growth rates and lower final dry weights, and produced fewer nodes than uninfected plants. There were significant correlations between the number of pustules and (a) the growth rate, (b) number of new nodes and (c) final total dry weight of single-stemmed plants placed in open sunlight and between the number of pustules and number of new nodes of multi-stemmed plants placed under cocoa trees. The trials suggest that field densities of M. micrantha could be reduced if the rust populations are sufficiently high. Crown Copyright (C) 2013 Published by Elsevier Inc. All rights reserved.

Assessing the effectiveness of High Intensity Interval Training (HIIT) for smoking cessation in women: HIIT to quit study protocol

Background: Smoking and physical inactivity are major risk factors for heart disease. Linking strategies that promote improvements in fitness and assist quitting smoking has potential to address both these risk factors simultaneously. The objective of this study is to compare the effects of two exercise interventions (high intensity interval training (HIIT) and lifestyle physical activity) on smoking cessation in female smokers. Method/design: This study will use a randomised controlled trial design. Participants: Women aged 18–55 years who smoke ≥ 5 cigarettes/day, and want to quit smoking. Intervention: all participants will receive usual care for quitting smoking. Group 1 - will complete two gym-based supervised HIIT sessions/week and one home-based HIIT session/week. At each training session participants will be asked to complete four 4-min (4 × 4 min) intervals at approximately 90 % of maximum heart rate interspersed with 3- min recovery periods. Group 2 - participants will receive a resource pack and pedometer, and will be asked to use the 10,000 steps log book to record steps and other physical activities. The aim will be to increase daily steps to 10,000 steps/day. Analysis will be intention to treat and measures will include smoking cessation, withdrawal and cravings, fitness, physical activity, and well-being. Discussion: The study builds on previous research suggesting that exercise intensity may influence the efficacy of exercise as a smoking cessation intervention. The hypothesis is that HIIT will improve fitness and assist women to quit smoking.

Tannakian Formalism Applied to the Category of Mixed Hodge Structures

Many problems in analysis have been solved using the theory of Hodge structures. P. Deligne started to treat these structures in a categorical way. Following him, we introduce the categories of mixed real and complex Hodge structures. Category of mixed Hodge structures over the field of real or complex numbers is a rigid abelian tensor category, and in fact, a neutral Tannakian category. Therefore it is equivalent to the category of representations of an affine group scheme. The direct sums of pure Hodge structures of different weights over real or complex numbers can be realized as a representation of the torus group, whose complex points is the Cartesian product of two punctured complex planes. Mixed Hodge structures turn out to consist of information of a direct sum of pure Hodge structures of different weights and a nilpotent automorphism. Therefore mixed Hodge structures correspond to the representations of certain semidirect product of a nilpotent group and the torus group acting on it.

Performance of Ajax Applications on Mobile Devices

The Ajax approach has outgrown its origin as shorthand for "Asynchronous JavaScript + XML". Three years after its naming, Ajax has become widely adopted by web applications. Therefore, there exists a growing interest in using those applications with mobile devices. This thesis evaluates the presentational capability and measures the performance of five mobile browsers on the Apple iPhone and Nokia models N95 and N800. Performance is benchmarked through user-experienced response times as measured with a stopwatch. 12 Ajax toolkit examples and 8 production-quality applications are targeted, all except one in their real environments. In total, over 1750 observations are analyzed and included in the appendix. Communication delays are not considered; the network connection type is WLAN. Results indicate that the initial loading time of an Ajax application can often exceed 20 seconds. Content reordering may be used to partially overcome this limitation. Proper testing is the key for success: the selected browsers are capable of presenting Ajax applications if their differing implementations are overcome, perhaps using a suitable toolkit.

Evidence of Partisan Emphasis on EMU during 1994–1999 : Comparing Finnish Parties

This study explores the EMU stand taken by the major Finnish political parties from 1994 to 1999. The starting point is the empirical evidence showing that party responses to European integration are shaped by a mix of national and cross-national factors, with national factors having more explanatory value. The study is the first to produce evidence that classified party documents such as protocols, manifestos and authoritative policy summaries may describe the EMU policy emphasis. In fact, as the literature review demonstrates, it has been unclear so far what kind of stand the three major Finnish political parties took during 1994–1999. Consequently, this study makes a substantive contribution to understanding the factors that shaped EMU party policies, and eventually, the national EMU policy during the 1990s. The research questions addressed are the following: What are the main factors that shaped partisan standpoints on EMU during 1994–1999? To what extent did the policy debate and themes change in the political parties? How far were the policies of the Social Democratic Party, the Centre Party and the National Coalition Party shaped by factors unique to their own national contexts? Furthermore, to what extent were they determined by cross-national influences from abroad, and especially from countries with which Finland has a special relationship, such as Sweden? The theoretical background of the study is in the area of party politics and approaches to EU policies, and party change, developed mainly by Kevin Featherstone, Peter Mair and Richard Katz. At the same time, it puts forward generic hypotheses that help to explain party standpoints on EMU. It incorporates a large quantity of classified new material based on primary research through content analysis and interviews. Quantitative and qualitative methods are used sequentially in order to overcome possible limitations. Established content-analysis techniques improve the reliability of the data. The coding frame is based on the salience theory of party competition. Interviews with eight party leaders and one independent expert civil servant provided additional insights and improve the validity of the data. Public-opinion surveys and media coverage are also used to complete the research path. Four major conclusions are drawn from the research findings. First, the quantitative and the interview data reveal the importance of the internal influences within the parties that most noticeably shaped their EMU policies during the 1990s. In contrast, international events play a minor role. The most striking feature turned out to be the strong emphasis by all of the parties on economic goals. However, it is important to note that the factors manifest differences between economic, democratic and international issues across the three major parties. Secondly, it seems that the parties have transformed into centralised and professional organisations in terms of their EMU policy-making. The weight and direction of party EMU strategy rests within the leadership and a few administrative elites. This could imply changes in their institutional environment. Eventually, parties may appear generally less differentiated and more standardised in their policy-making. Thirdly, the case of the Social Democratic Party shows that traditional organisational links continue to exist between the left and the trade unions in terms of their EMU policy-making. Hence, it could be that the parties have not yet moved beyond their conventional affiliate organisations. Fourthly, parties tend to neglect citizen opinion and demands with regard to EMU, which could imply conflict between the changes in their strategic environment. They seem to give more attention to the demands of political competition (party-party relationships) than to public attitudes (party-voter relationships), which would imply that they have had to learn to be more flexible and responsive. Finally, three suggestions for institutional reform are offered, which could contribute to the emergence of legitimised policy-making: measures to bring more party members and voter groups into the policy-making process; measures to adopt new technologies in order to open up the policy-formation process in the early phase; and measures to involve all interest groups in the policy-making process.

Measuring tax efficiency: A tax optimality index

This paper introduces an index of tax optimality that measures the distance of some current tax structure from the optimal tax structure in the presence of public goods. This index is defined on the [0, 1] interval and measures the proportion of the optimal tax rates that will achieve the same welfare outcome as some arbitrarily given initial tax structure. We call this number the Tax Optimality Index. We also show how the basic methodology can be altered to derive a revenue equivalent uniform tax, which measures the tax burden implied by the public sector. A numerical example is used to illustrate the method developed, and extensions of the analysis to handle models with multiple households and nonlinear taxation structures are undertaken.

Novel fluorescence detection technique for non-contact temperature sensing in microchip PCR

DNA amplification using Polymerase Chain Reaction (PCR) in a small volume is used in Lab-on-a-chip systems involving DNA manipulation. For few microliters of volume of liquid, it becomes difficult to measure and monitor the thermal profile accurately and reproducibly, which is an essential requirement for successful amplification. Conventional temperature sensors are either not biocompatible or too large and hence positioned away from the liquid leading to calibration errors. In this work we present a fluorescence based detection technique that is completely biocompatible and measures directly the liquid temperature. PCR is demonstrated in a 3 ILL silicon-glass microfabricated device using non-contact induction heating whose temperature is controlled using fluorescence feedback from SYBR green I dye molecules intercalated within sensor DNA. The performance is compared with temperature feedback using a thermocouple sensor. Melting curve followed by gel electrophoresis is used to confirm product specificity after the PCR cycles. (c) 2007 Elsevier B.V. All rights reserved.

Optimal production resource reallocation for CO2 emissions reduction in manufacturing sectors

To mitigate the effects of climate change, countries worldwide are advancing technologies to reduce greenhouse gas emissions. This paper proposes and measures optimal production resource reallocation using data envelopment analysis. This research attempts to clarify the effect of optimal production resource reallocation on CO2 emissions reduction, focusing on regional and industrial characteristics. We use finance, energy, and CO2 emissions data from 13 industrial sectors in 39 countries from 1995 to 2009. The resulting emissions reduction potential is 2.54 Gt-CO2 in the year 2009, with former communist countries having the largest potential to reduce CO2 emissions in the manufacturing sectors. In particular, basic material industry including chemical and steel sectors has a lot of potential to reduce CO2 emissions.

Design of a compact wideband bandpass filter

This article presents the analysis and design of a compact multi-layer layer, high selectivity wideband bandpass filter using stub loaded and `U' shaped resonators over a slotted bottom ground plane. While the resonators with folded open circuit stub loadings create the desired bandpass characteristics. the IT shaped resonators reduce the size of filter. The slotted bottom ground plane is used to enhance the coupling to achieve the desired bandwidth. The proposed filter has been analyzed using circuit model, and the results were verified through full wave simulations and measurements. The fabricated filter is compact and measures a size of 18 mm x 25 mm x 1.6 MM. (C) 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52: 1387-1389, 2010: Published online in Wiley InterScience (www.interscience.wiley.com).