Ventilation/perfusion SPECT/CT in patients with pulmonary emphysema. Evaluation of software-based analysing

UNLABELLED The purpose of this study was to evaluate the reproducibility of a new software based analysing system for ventilation/perfusion single-photon emission computed tomography/computed tomography (V/P SPECT/CT) in patients with pulmonary emphysema and to compare it to the visual interpretation. PATIENTS, MATERIAL AND METHODS 19 patients (mean age: 68.1 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. Data were analysed by two independent observers in visual interpretation (VI) and by software based analysis system (SBAS). SBAS PMOD version 3.4 (Technologies Ltd, Zurich, Switzerland) was used to assess counts and volume per lung lobe/per lung and to calculate the count density per lung, lobe ratio of counts and ratio of count density. VI was performed using a visual scale to assess the mean counts per lung lobe. Interobserver variability and association for SBAS and VI were analysed using Spearman's rho correlation coefficient. RESULTS Interobserver agreement correlated highly in perfusion (rho: 0.982, 0.957, 0.90, 0.979) and ventilation (rho: 0.972, 0.924, 0.941, 0.936) for count/count density per lobe and ratio of counts/count density in SBAS. Interobserver agreement correlated clearly for perfusion (rho: 0.655) and weakly for ventilation (rho: 0.458) in VI. CONCLUSIONS SBAS provides more reproducible measures than VI for the relative tracer uptake in V/P SPECT/CTs in patients with pulmonary emphysema. However, SBAS has to be improved for routine clinical use.

Survey of VFC provider knowledge of catch-up regimens and contraindications to vaccination in Houston, Texas

In 2004, Houston had one of the lowest childhood immunization levels among major metropolitan cities in the United States at 65% for the 4:3:1:3:3 vaccination series. Delays in the receipt of scheduled vaccinations may be related to missed opportunities due to health care provider lack of knowledge about catch-up regimens and contraindications for pediatric vaccination. The objectives of this study are to identify, measure, and report on VFC provider-practice characteristics, knowledge of catch-up regimens and contraindications, and use of Reminder recall (R/R) and moved or gone elsewhere (MOGE) practices among providers with high (>80%) and low (<70%) immunization coverage among 19-35 month old children. The sampling frame consists of 187 Vaccines for Children (VFC) providers with 2004 clinic assessment software application (CASA) scores. Data were collected by personal interview with each participating practice provider. Only ten VFC providers were successful at maximizing vaccinations for every vignette and no provider administered the maximum possible number of vaccinations at visit 2 for all six vignettes. Both coverage groups administered polio conjugate vaccine (PCV), haemophilus influenza type b (Hib), and diphtheria, tetanus and acellular pertussis (DTaP) most frequently and omitted most frequently varicella zoster vaccine (VZV) and measles, mumps, and rubella (MMR) vaccine. ^

Hearing aid use and adherence: A systematic review of the literature concerning the socioeconomic and psychological influences on hearing aid use and barriers to use

The current hearing health situation in the United States does not provide adequate support to individuals with hearing loss. More research is needed to give more support to these individuals. By conducting a systematic review of relevant literature from 1990 to present, I identified many factors that influence an individual's use of hearing aids. There are two research questions in this study: 1. Does the provision of screening and access to hearing aids decrease the negative effects of hearing loss? 2. Why is it difficult for people with hearing loss to adapt to and use hearing aids? The population of interest was adults (>18 years old) with hearing loss. Factors that influenced use of hearing aids for this population included age, gender, socioeconomic status, education, perceived severity of hearing loss, cost of hearing aids, screening, perceived benefit, stigmatization, perceived control, cognitive capability, personality, and social support. Research suggests that more efficient screening of at-risk individuals and the provision of better access to these individuals would prevent many of the negative effects of hearing loss.^

Use of Echogenic Immunoliposomes for Delivery of both Drug and Stem Cells for Inhibition of Atheroma Progression

Use of Echogenic Immunoliposomes for Delivery of both Drug and Stem Cells for Inhibition of Atheroma Progression By Ali K. Naji B.S. Advisor: Dr. Melvin E. Klegerman PhD Background and significance: Echogenic liposomes can be used as drug and cell delivery vehicles that reduce atheroma progression. Vascular endothelial growth factor (VEGF) is a signal protein that induces vasculogenesis and angiogenesis. VEGF functionally induces migration and proliferation of endothelial cells and increases intracellular vascular permeability. VEGF activates angiogenic transduction factors through VEGF tyrosine kinase domains in high-affinity receptors of endothelial cells. Bevacizumab is a humanized monoclonal antibody specific for VEGF-A which was developed as an anti-tumor agent. Often, anti-VEGF agents result in regression of existing microvessels, inhibiting tumor growth and possibly causing tumor shrinkage with time. During atheroma progression neovasculation in the arterial adventitia is mediated by VEGF. Therefore, bevacizumab may be effective in inhibiting atheroma progression. Stem cells show an ability to inhibit atheroma progression. We have previously demonstrated that monocyte derived CD-34+ stem cells that can be delivered to atheroma by bifunctional-ELIP ( BF-ELIP) targeted to Intercellular Adhesion Molecule-1 (ICAM-1) and CD-34. Adhesion molecules such as ICAM-1 and vascular cell adhesion molecule-1 (VCAM-1) are expressed by endothelial cells under inflammatory conditions. Ultrasound enhanced liposomal targeting provides a method for stem cell delivery into atheroma and encapsulated drug release. This project is designed to examine the ability of echogenic liposomes to deliver bevacizumab and stem cells to inhibit atheroma progression and neovasculation with and without ultrasound in vitro and optimize the ultrasound parameters for delivery of bevacizumab and stem cells to atheroma. V Hypotheses: Previous studies showed that endothelial cell VEGF expression may relate to atherosclerosis progression and atheroma formation in the cardiovascular system. Bevacizumab-loaded ELIP will inhibit endothelial cell VEGF expression in vitro. Bevacizumab activity can be enhanced by pulsed Doppler ultrasound treatment of BEV-ELIP. I will also test the hypothesis that the transwell culture system can serve as an in vitro model for study of US-enhanced targeted delivery of stem cells to atheroma. Monocyte preparations will serve as a source of CD34+ stem cells. Specific Aims: Induce VEGF expression using PKA and PKC activation factors to endothelial cell cultures and use western blot and ELISA techniques to detect the expressed VEGF.  Characterize the relationship between endothelial cell proliferation and VEGF expression to develop a specific EC culture based system to demonstrate BEV-ELIP activity as an anti-VEGF agent. Design a cell-based assay for in vitro assessment of ultrasound-enhanced bevacizumab release from echogenic liposomes.  Demonstrate ultrasound delivery enhancement of stem cells by applying different types of liposomes on transwell EC culture using fluorescently labeled monocytes and detect the effect on migration and attachment rate of these echogenic liposomes with and without ultrasound in vitro.

Usability-Oriented Software Development Process

Usability is the capability of the software product to be understood, learned, used and attractive to the user, when used under specified conditions. Many studies demonstrate the benefits of usability, yet to this day software products continue to exhibit consistently low levels of this quality attribute. Furthermore, poor usability in software systems contributes largely to software failing in actual use. One of the main disciplines involved in usability is that of Human-Computer Interaction (HCI). Over the past two decades the HCI community has proposed specific features that should be present in applications to improve their usability, yet incorporating them into software continues to be far from trivial for software developers. These difficulties are due to multiple factors, including the high level of abstraction at which these HCI recommendations are made and how far removed they are from actual software implementation. In order to bridge this gap, the Software Engineering community has long proposed software design solutions to help developers include usability features into software, however, the problem remains an open research question. This doctoral thesis addresses the problem of helping software developers include specific usability features into their applications by providing them with a structured and tangible guidance in the form of a process, which we have termed the Usability-Oriented Software Development Process. This process is supported by a set of Software Usability Guidelines that help developers to incorporate a set of eleven usability features with high impact on software design. After developing the Usability-oriented Software Development Process and the Software Usability Guidelines, they have been validated across multiple academic projects and proven to help software developers to include such usability features into their software applications. In doing so, their use significantly reduced development time and improved the quality of the resulting designs of these projects. Furthermore, in this work we propose a software tool to automate the application of the proposed process. In sum, this work contributes to the integration of the Software Engineering and HCI disciplines providing a framework that helps software developers to create usable applications in an efficient way.

Software Design Guidelines for Usability

For years, the Human Computer Interaction (HCI) community has crafted usability guidelines that clearly define what characteristics a software system should have in order to be easy to use. However, in the Software Engineering (SE) community keep falling short of successfully incorporating these recommendations into software projects. From a SE perspective, the process of incorporating usability features into software is not always straightforward, as a large number of these features have heavy implications in the underlying software architecture. For example, successfully including an “undo” feature in an application requires the design and implementation of many complex interrelated data structures and functionalities. Our work is focused upon providing developers with a set of software design patterns to assist them in the process of designing more usable software. This would contribute to the proper inclusion of specific usability features with high impact on the software design. Preliminary validation data show that usage of the guidelines also has positive effects on development time and overall software design quality.

A Model-based Repository for Open Source Service and Component Integration.

Open source is a software development paradigm that has seen a huge rise in recent years. It reduces IT costs and time to market, while increasing security and reliability. However, the difficulty in integrating developments from different communities and stakeholders prevents this model from reaching its full potential. This is mainly due to the challenge of determining and locating the correct dependencies for a given software artifact. To solve this problem we propose the development of an extensible software component repository based upon models. This repository should be capable of solving the dependencies between several components and work with already existing repositories to access the needed artifacts transparently. This repository will also be easily expandable, enabling the creation of modules that support new kinds of dependencies or other existing repository technologies. The proposed solution will work with OSGi components and use OSGi itself.

Reusable Knowledge-based Components for Building Software Applications: A Knowledge Modelling Approach

In computer science, different types of reusable components for building software applications were proposed as a direct consequence of the emergence of new software programming paradigms. The success of these components for building applications depends on factors such as the flexibility in their combination or the facility for their selection in centralised or distributed environments such as internet. In this article, we propose a general type of reusable component, called primitive of representation, inspired by a knowledge-based approach that can promote reusability. The proposal can be understood as a generalisation of existing partial solutions that is applicable to both software and knowledge engineering for the development of hybrid applications that integrate conventional and knowledge based techniques. The article presents the structure and use of the component and describes our recent experience in the development of real-world applications based on this approach.

Balancing software engineering education and industrial needs

In the world of information and communications technologies the demand for professionals with software engineering skills grows at an exponential rate. On this ground, we have conducted a study to help both academia and the software industry form a picture of the relationship between the competences of recent graduates of undergraduate and graduate software engineering programmes and the tasks that these professionals are to perform as part of their jobs in industry. Thanks to this study, academia will be able to observe which skills demanded by industry the software engineering curricula do or do not cater for, and industry will be able to ascertain which tasks a recent software engineering programme graduate is well qualified to perform. The study focuses on the software engineering knowledge guidelines provided in SE2004 and GSwE2009, and the job profiles identified by Career Space.

HERMES: Towards an Integrated Toolbox to Characterize Functional and Effective Brain Connectivity

The analysis of the interdependence between time series has become an important field of research in the last years, mainly as a result of advances in the characterization of dynamical systems from the signals they produce, the introduction of concepts such as generalized and phase synchronization and the application of information theory to time series analysis. In neurophysiology, different analytical tools stemming from these concepts have added to the ‘traditional’ set of linear methods, which includes the cross-correlation and the coherency function in the time and frequency domain, respectively, or more elaborated tools such as Granger Causality. This increase in the number of approaches to tackle the existence of functional (FC) or effective connectivity (EC) between two (or among many) neural networks, along with the mathematical complexity of the corresponding time series analysis tools, makes it desirable to arrange them into a unified-easy-to-use software package. The goal is to allow neuroscientists, neurophysiologists and researchers from related fields to easily access and make use of these analysis methods from a single integrated toolbox. Here we present HERMES (http://hermes.ctb.upm.es), a toolbox for the Matlab® environment (The Mathworks, Inc), which is designed to study functional and effective brain connectivity from neurophysiological data such as multivariate EEG and/or MEG records. It includes also visualization tools and statistical methods to address the problem of multiple comparisons. We believe that this toolbox will be very helpful to all the researchers working in the emerging field of brain connectivity analysis.

HERMES: towards an integrated toolbox to characterize functional and effective brain connectivity

The analysis of the interdependence between time series has become an important field of research in the last years, mainly as a result of advances in the characterization of dynamical systems from the signals they produce, the introduction of concepts such as generalized and phase synchronization and the application of information theory to time series analysis. In neurophysiology, different analytical tools stemming from these concepts have added to the ?traditional? set of linear methods, which includes the cross-correlation and the coherency function in the time and frequency domain, respectively, or more elaborated tools such as Granger Causality. This increase in the number of approaches to tackle the existence of functional (FC) or effective connectivity (EC) between two (or among many) neural networks, along with the mathematical complexity of the corresponding time series analysis tools, makes it desirable to arrange them into a unified, easy-to-use software package. The goal is to allow neuroscientists, neurophysiologists and researchers from related fields to easily access and make use of these analysis methods from a single integrated toolbox. Here we present HERMES (http://hermes.ctb.upm.es), a toolbox for the Matlab® environment (The Mathworks, Inc), which is designed to study functional and effective brain connectivity from neurophysiological data such as multivariate EEG and/or MEG records. It includes also visualization tools and statistical methods to address the problem of multiple comparisons. We believe that this toolbox will be very helpful to all the researchers working in the emerging field of brain connectivity analysis.

Analysis and Modelling of the Structural Components of the Elbow Joint

A recent application of computer simulation is its use for the human body, which resembles a mechanism that is complemented by torques in the joints that are caused by the action of muscles and tendons. Among others, the application can be used to provide training in surgical procedures or to learn how the body works. Some of the other applications are to make a biped walk upright, to build robots that are designed on the human body or to make prostheses or robot arms to perform specific tasks. One of the uses of simulation is to optimise the movement of the human body by examining which muscles are activated and which should or should not be activated in order to improve a person?s movements. This work presents a model of the elbow joint, and by analysing the constraint equations using classic methods we go on to model the bones, muscles and tendons as well as the logic linked to the force developed by them when faced with a specific movement. To do this, we analyse the reference bibliography and the software available to perform the validation.

Reliability and reproductibility of skin temperature of overweight subjects by an infrared thermograpy software designed for human beings

The technical improvement and new applications of Infrared Thermography (IRT) with healthy subjects should be accompanied by results about the reproducibility of IRT measurements in different popula-tion groups. In addition, there is a remarkable necessity of a larger supply on software to analyze IRT images of human beings. Therefore, the objectives of this study were: firstly, to investigate the reproducibility of skin temperature (Tsk) on overweight and obese subjects using IRT in different Regions of Interest (ROI), moments and side-to-side differences (?T); and secondly, to check the reliability of a new software called Termotracker®, specialized on the analysis of IRT images of human beings. Methods: 22 overweight and obese males (11) and females (11) (age: 41,51±7,76 years; height: 1,65±0,09 m; weight: 82,41±11,81 Kg; BMI: 30,17±2,58 kg/m²) were assessed in two consecutive thermograms (5 seconds in-between) by the same observer, using an infrared camera (FLIR T335, Sweden) to get 4 IRT images from the whole body. 11 ROI were selected using Termotracker® to analyze its reproducibility and reliability through Intra-class Correlation Coefficient (ICC) and Coefficient of Variation (CV) values. Results: The reproducibility of the side-to-side differences (?T) between two consecutive thermograms was very high in all ROIs (Mean ICC = 0,989), and excellent between two computers (Mean ICC = 0,998). The re-liability of the software was very high in all the ROIs (Mean ICC = 0,999). Intraexaminer reliability analysing the same subjects in two consecutive thermograms was also very high (Mean ICC = 0,997). CV values of the different ROIs were around 2%. Conclusions: Skin temperature on overweight subjects had an excellent reproducibility for consecutive ther-mograms. The reproducibility of thermal asymmetries (?T) was also good but it had the influence of several factors that should be further investigated. Termotracker® reached excellent reliability results and it is a relia-ble and objective software to analyse IRT images of humans beings.

Gestión de configuración y línea de productos para mejorar el proceso experimental en ingeniería del software

La Ingeniería del Software (IS) Empírica adopta el método científico a la IS para facilitar la generación de conocimiento. Una de las técnicas empleadas, es la realización de experimentos. Para que el conocimiento obtenido experimentalmente adquiera el nivel de madurez necesario para su posterior uso, es necesario que los experimentos sean replicados. La existencia de múltiples replicaciones de un mismo experimento conlleva la existencia de numerosas versiones de los distintos productos generados durante la realización de cada replicación. Actualmente existe un gran descontrol sobre estos productos, ya que la administración se realiza de manera informal. Esto causa problemas a la hora de planificar nuevas replicaciones, o intentar obtener información sobre las replicaciones ya realizadas. Para conocer con detalle la dimensión del problema a resolver, se estudia el estado actual de la gestión de materiales experimentales y su uso en replicaciones, así como de las herramientas de gestión de materiales experimentales. El estudio concluye que ninguno de los enfoques estudiados proporciona una solución al problema planteado. Este trabajo persigue como objetivo mejorar la administración de los materiales experimentales y replicaciones de experimentos en IS para dar soporte a la replicación de experimentos. Para satisfacer este objetivo, se propone la adopción en experimentación de los paradigmas de Gestión de Configuración del Software (GCS) y Línea de Producto Software (LPS). Para desarrollar la propuesta se decide utilizar el método de investigación acción (en inglés action research). Para adoptar la GCS a experimentación, se comienza realizando un estudio del proceso experimental como transformación de productos; a continuación, se realiza una adopción de conceptos fundamentada en los procesos del desarrollo software y de experimentación; finalmente, se desarrollan un conjunto de instrumentos, que se incorporan a un Plan de Gestión de Configuración de Experimentos (PGCE). Para adoptar la LPS a experimentación, se comienza realizando un estudio de los conceptos, actividades y fases que fundamentan la LPS; a continuación, se realiza una adopción de los conceptos; finalmente, se desarrollan o adoptan las técnicas, simbología y modelos para dar soporte a las fases de la Línea de Producto para Experimentación (LPE). La propuesta se valida mediante la evaluación de su: viabilidad, flexibilidad, usabilidad y satisfacción. La viabilidad y flexibilidad se evalúan mediante la instanciación del PGCE y de la LPE en experimentos concretos en IS. La usabilidad se evalúa mediante el uso de la propuesta para la generación de las instancias del PGCE y de LPE. La satisfacción evalúa la información sobre el experimento que contiene el PGCE y la LPE. Los resultados de la validación de la propuesta muestran mejores resultados en los aspectos de usabilidad y satisfacción a los experimentadores. ABSTRACT Empirical software engineering adapts the scientific method to software engineering (SE) in order to facilitate knowledge generation. Experimentation is one of the techniques used. For the knowledge generated experimentally to acquire the level of maturity necessary for later use, the experiments have to be replicated. As the same experiment is replicated more than once, there are numerous versions of all the products generated during a replication. These products are generally administered informally without control. This is troublesome when it comes to planning new replications or trying to gather information on replications conducted in the past. In order to grasp the size of the problem to be solved, this research examines the current state of the art of the management and use of experimental materials in replications, as well as the tools managing experimental materials. The study concludes that none of the analysed approaches provides a solution to the stated problem. The aim of this research is to improve the administration of SE experimental materials and experimental replications in support of experiment replication. To do this, we propose the adaptation of software configuration management (SCM) and software product line (SPL) paradigms to experimentation. The action research method was selected in order to develop this proposal. The first step in the adaptation of the SCM to experimentation was to analyse the experimental process from the viewpoint of the transformation of products. The concepts were then adapted based on software development and experimentation processes. Finally, a set of instruments were developed and added to an experiment configuration management plan (ECMP). The first step in the adaptation of the SPL to experimentation is to analyse the concepts, activities and phases underlying the SPL. The concepts are then adapted. Finally, techniques, symbols and models are developed or adapted in support of the experimentation product line (EPL) phases. The proposal is validated by evaluating its feasibility, flexibility, usability and satisfaction. Feasibility and flexibility are evaluated by instantiating the ECMP and the EPL in specific SE experiments. Usability is evaluated by using the proposal to generate the instances of the ECMP and EPL. The results of the validation of the proposal show that the proposal performs better with respect to usability issues and experimenter satisfaction.

Metamodelo para la definición de metodologías de desarrollo software centradas en documentos y la mejora de la calidad de la documentación software

La documentación en los proyectos software presenta una serie de problemas que afectan a la calidad del producto y al proceso software. Con frecuencia, la documentación es considerada sólo como un volumen adicional de información disponible para la organización y el equipo de desarrollo, que ralentiza la ejecución del proyecto. En este sentido, el papel de la documentación en un proyecto se concibe como una de las actividades más costosas y que consumen más tiempo y que luego no se utiliza de forma extensiva. La documentación queda, en muchos casos, relegada a un segundo plano y es poco valorada frente a la comunicación cara a cara. Existe además una relación entre la calidad de la documentación y el proceso software. Se plantean dificultades en la adopción de buenas prácticas de proceso software y el impacto del exceso de documentación percibido por parte de los gestores de proyectos en los que se quiere abordad un programa de mejora del proceso software. Recordemos que la calidad de la documentación está muy relacionada con la utilización de la misma que puedan hacer los desarrolladores. Esta tesis aborda el problema planteando un cambio de punto de vista en el proceso software, en el que la documentación pasa de ser un sub producto de las actividades y tareas del proceso a ser el elemento que vertebra el propio proceso. En este nuevo punto de vista, la definición de los propios documentos, sus propiedades y relaciones permiten establecer y guiar procesos software de cualquier tipo. Para ello, desarrolla un metamodelo para definición de metodologías centradas en documentos. Este metamodelo se confronta con una serie atributos de calidad de la documentación software para comprobar que existe una mejora sobre estos, y, por consiguiente se mejora la calidad de la documentación software en general. Por último se utiliza este metamodelo centrado en documentos para describir una metodología ágil (Scrum) y validar la capacidad y flexibilidad del metamodelo utilizando el cambio de punto de vista sobre el proceso software planteado en esta tesis. ABSTRACT The documentation in software projects has a number of problems affecting the quality of the product and the software process. Often, documentation is considered only as an additional volume of information available to the organization and development team, which slows project execution. In this sense, the role of documentation in a project is conceived as one of the most expensive activities and more time-consuming and then not used extensively. The documentation is, in many cases, relegated to the background and is undervalued compared to face-to-face communication. There is also a relationship between the quality of the documentation and software process. There are difficulties in adopting good practices of software process and the impact of excess documentation perceived by project managers in Software Process Improvement activities. We have to remember that quality of the documentation is closely related to the use of it that can make developers. This thesis addresses the problem considering a change of view on the software process, in which the documentation happens to be a by-product of the activities and tasks of the process to be the element that structures the process itself. Through this new view, the definition of the documents themselves, their properties and relationships, allow us to establish processes and guidance for develop software of any kind. To achieve this target, a metamodel for defining document-centric methodologies has been developed. This metamodel confronts a number of quality attributes software documentation to prove that there is an improvement on these, and therefore the quality of the software documentation is improved. Finally this document-centric metamodel is used to describe an agile methodology (Scrum) to validate the capability and flexibility of the metamodel, using the proposed change of view on the software process described in this thesis.