Use of pulse transit time to distinguish respiratory events from tidal breathing in sleeping children

Study objectives: Currently, esophageal pressure monitoring is the "gold standard" measure for inspiratory efforts, hut its invasive nature necessitates a better tolerated and noninvasive method to be used on children. Pulse transit time (PTT) has demonstrated its potential as a noninvasive surrogate marker for inspiratory efforts. The principle velocity determinant of PTT is the change in stiffness of the arterial wall and is inversely correlated to BP. Moreover, PTT has been shown to identify changes in inspiratory effort via the BP fluctuations induced by negative pleural pressure swings. In this study, the capability of PTT to classify respiratory, events during sleep as either central or obstructive in nature was investigated. Setting and participants: PTT measure was used in adjunct to routine overnight polysomnographic studies performed on 33 children (26 boys and 7 girls; mean +/- SD age, 6.7 +/- 3.9 years). The accuracy of PTT measurements was then evaluated against scored corresponding respiratory events in the polysomnography recordings. Results: Three hundred thirty-four valid respiratory events occurred and were analyzed. One hundred twelve obstructive events (OEs) showed a decrease in mean PTT over a 10-sample window that had a probability of being correctly ranked below the baseline PTT during tidal breathing of 0.92 (p < 0.005); 222 central events (CEs) showed a decrease in the variance of PTT over a 10-sample window that had a probability of being ranked below the baseline PTT of 0.94 (p < 0.005). This indicates that, at a sensitivity of 0.90, OEs can be detected with a specificity of 0.82 and CEs can be detected with a specificity of 0.80. Conclusions: PTT is able to categorize CEs and OEs accordingly in the absence of motion artifacts, including hypopneas. Hence, PTT shows promise to differentiate respiratory, events accordingly and can be an important diagnostic tool in pediatric respiratory sleep studies.< 0.005); 222 central events (CEs) showed a decrease in the variance of PTT over a 10-sample window that had a probability of being ranked below the baseline PTT of 0.94 (p < 0.005). This indicates that, at a sensitivity of 0.90, OEs can be detected with a specificity of 0.82 and CEs can be detected with a specificity of 0.80. Conclusions: PTT is able to categorize CEs and OEs accordingly in the absence of motion artifacts, including hypopneas. Hence, PTT shows promise to differentiate respiratory, events accordingly and can be an important diagnostic tool in pediatric respiratory sleep studies.');"

Reliability and validity of a brief physical activity assessment for use by family doctors

Objective: To evaluate the reliability and validity of a brief physical activity assessment tool suitable for doctors to use to identify inactive patients in the primary care setting. Methods: Volunteer family doctors (n = 8) screened consenting patients (n = 75) for physical activity participation using a brief physical activity assessment tool. Inter-rater reliability was assessed within one week (n = 71). Validity was assessed against an objective physical activity monitor (computer science and applications accelerometer; n = 42). Results: The brief physical activity assessment tool produced repeatable estimates of sufficient total physical activity, correctly classifying over 76% of cases (kappa 0.53, 95% confidence interval (CI) 0.33 to 0.72). The validity coefficient was reasonable (kappa 0.40, 95% CI 0.12 to 0.69), with good percentage agreement (71%). Conclusions: The brief physical activity assessment tool is a reliable instrument, with validity similar to that of more detailed self report measures of physical activity. It is a tool that can be used efficiently in routine primary healthcare services to identify insufficiently active patients who may need physical activity advice.

Tool support for executable documentation of Java class hierarchies

While object-oriented programming offers great solutions for today's software developers, this success has created difficult problems in class documentation and testing. In Java, two tools provide assistance: Javadoc allows class interface documentation to be embedded as code comments and JUnit supports unit testing by providing assert constructs and a test framework. This paper describes JUnitDoc, an integration of Javadoc and JUnit, which provides better support for class documentation and testing. With JUnitDoc, test cases are embedded in Javadoc comments and used as both examples for documentation and test cases for quality assurance. JUnitDoc extracts the test cases for use in HTML files serving as class documentation and in JUnit drivers for class testing. To address the difficult problem of testing inheritance hierarchies, JUnitDoc provides a novel solution in the form of a parallel test hierarchy. A small controlled experiment compares the readability of JUnitDoc documentation to formal documentation written in Object-Z. Copyright (c) 2005 John Wiley & Sons, Ltd.

Potential misidentification of in situ archaeological tool-residues: starch and conidia

Microscopic identification of organic residues in situ on the surface of archaeological artefacts is an established procedure. Where soil components morphologically similar to use-residue types exist within the soil, however, there remains the possibility that these components may be misidentified as authentic residues. The present study investigates common soil components known as conidia, fungal spores which may be mistaken for starch grains. Conidia may exhibit the rotating extinction cross under cross-polarised light commonly diagnostic of starch, and may be morphologically indistinguishable from small starch grains, particularly at the limits of microscope resolution. Conidia were observed on stone and ceramic archaeological artefacts from Honduras, Palau and New Caledonia, as well as experimental artefacts from Papua New Guinea. The findings act as a caution that in situ analysis of residues, and especially of those less than 5 mu m in size, may be subject to misidentification. (c) 2005 Elsevier Ltd. All rights reserved.

Use of optical density as a measure of Claviceps africana conidial suspension concentration

Sorghum ergot, caused by Claviceps africana, has remained a major disease problem in Australia since it was first recorded in 1996, and is the focus of a range of biological and integrated management research. Artificial inoculation using conidial suspensions is an important tool in this research. Ergot infection is greatly influenced by environmental factors, so it is important to reduce controllable sources of variation such as inoculum concentration. The use of optical density was tested as a method of quantifying conidial suspensions of C. africana, as an alternative to haemocytometer counts. This method was found to be accurate and time efficient, with possible applications in other disease systems.

Use of regression equation of peripheral pulse timing characteristics to predict hypertension in children

Studies have shown that an increase in arterial stiffening can indicate the presence of cardiovascular diseases like hypertension. Current gold standard in clinical practice is by measuring the blood pressure of patients using a mercury sphygmomanometer. However, the nature of this technique is not suitable for prolonged monitoring. It has been established that pulse wave velocity is a direct measure of arterial stiffening. However, its usefulness is hampered by the absence of techniques to estimate it non-invasively. Pulse transit time (PTT) is a simple and non-intrusive method derived from pulse wave velocity. It has shown its capability in childhood respiratory sleep studies. Recently, regression equations that can predict PTT values for healthy Caucasian children were formulated. However, its usefulness to identify hypertensive children based on mean PTT values has not been investigated. This was a continual study where 3 more Caucasian male children with known clinical hypertension were recruited. Results indicated that the PTT predictive equations are able to identify hypertensive children from their normal counterparts in a significant manner (p < 0.05). Hence, PTT can be a useful diagnostic tool in identifying hypertension in children and shows potential to be a non-invasive continual monitor for arterial stiffening.

A tool for a formal pattern modeling language

This paper presents a formal but practical approach for defining and using design patterns. Initially we formalize the concepts commonly used in defining design patterns using Object-Z. We also formalize consistency constraints that must be satisfied when a pattern is deployed in a design model. Then we implement the pattern modeling language and its consistency constraints using an existing modeling framework, EMF, and incorporate the implementation as plug-ins to the Eclipse modeling environment. While the language is defined formally in terms of Object-Z definitions, the language is implemented in a practical environment. Using the plug-ins, users can develop precise pattern descriptions without knowing the underlying formalism, and can use the tool to check the validity of the pattern descriptions and pattern usage in design models. In this work, formalism brings precision to the pattern language definition and its implementation brings practicability to our pattern-based modeling approach.

Technology valuation within the context of transfer collaborations with Chinese machine tool companies

The point of departure for this study was a recognition of the differences in suppliers' and acquirers' judgements of the value of technology when transferred between the two, and the significant impacts of technology valuation on the establishment of technology partnerships and effectiveness of technology collaborations. The perceptions, transfer strategies and objectives, perceived benefits and assessed technology contributions as well as associated costs and risks of both suppliers and acquirers were seen to be the core to these differences. This study hypothesised that the capability embodied in technology to yield future returns makes technology valuation distinct from the process of valuing manufacturing products. The study hence has gone beyond the dimensions of cost calculation and price determination that have been discussed in the existing literature, by taking a broader view of how to achieve and share future added value from transferred technology. The core of technology valuation was argued as the evaluation of the 'quality' of the capability (technology) in generating future value and the effectiveness of the transfer arrangement for best use of such a capability. A dynamic approach comprising future value generation and realisation within the context of specific forms of collaboration was therefore adopted. The research investigations focused on the UK and China machine tool industries, where there are many technology transfer activities and the value issue has already been recognised in practice. Data were gathered from three groups: machine tool manufacturing technology suppliers in the UK and acquirers in China, and machine tool users in China. Data collecting methods included questionnaire surveys and case studies within all the three groups. The study has focused on identifying and examining the major factors affecting value as well as their interactive effects on technology valuation from both the supplier's and acquirer's point of view. The survey results showed the perceptions and the assessments of the owner's value and transfer value from the supplier's and acquirer's point of view respectively. Benefits, costs and risks related to the technology transfer were the major factors affecting the value of technology. The impacts of transfer payment on the value of technology by the sharing of financial benefits, costs and risks between partners were assessed. The close relationship between technology valuation and transfer arrangements was established by which technical requirements and strategic implications were considered. The case studies reflected the research propositions and revealed that benefits, costs and risks in the financial, technical and strategic dimensions interacted in the process of technology valuation within the context of technology collaboration. Further to the assessment of factors affecting value, a technology valuation framework was developed which suggests that technology attributes for the enhancement of contributory factors and their contributions to the realisation of transfer objectives need to be measured and compared with the associated costs and risks. The study concluded that technology valuation is a dynamic process including the generation and sharing of future value and the interactions between financial, technical and strategic achievements.

High speed DSC (hyper-DSC) as a tool to measure the solubility of a drug within a solid or semi-solid matrix

Conventional differential scanning calorimetry (DSC) techniques are commonly used to quantify the solubility of drugs within polymeric-controlled delivery systems. However, the nature of the DSC experiment, and in particular the relatively slow heating rates employed, limit its use to the measurement of drug solubility at the drug's melting temperature. Here, we describe the application of hyper-DSC (HDSC), a variant of DSC involving extremely rapid heating rates, to the calculation of the solubility of a model drug, metronidazole, in silicone elastomer, and demonstrate that the faster heating rates permit the solubility to be calculated under non-equilibrium conditions such that the solubility better approximates that at the temperature of use. At a heating rate of 400°C/min (HDSC), metronidazole solubility was calculated to be 2.16 mg/g compared with 6.16 mg/g at 20°C/min. © 2005 Elsevier B.V. All rights reserved.

A visual interactive modelling system as a learning tool

This paper presents a case study of the use of a visual interactive modelling system to investigate issues involved in the management of a hospital ward. Visual Interactive Modelling systems are seen to offer the learner the opportunity to explore operational management issues from a varied perspective and to provide an interactive system in which the learner receives feedback on the consequences of their actions. However to maximise the potential learning experience for a student requires the recognition that they require task structure which helps them to understand the concepts involved. These factors can be incorporated into the visual interactive model by providing an interface customised to guide the student through the experimentation. Recent developments of VIM systems in terms of their connectivity with the programming language Visual Basic facilitates this customisation.

Increasing the use of simulation in business

The nature of Discrete-Event Simulation (DES) and the use of DES in organisations is changing. Two important developments are the use of Visual Interactive Modelling systems and the use of DES in Business Process Management (BPM) projects. Survey research is presented that shows that despite these developments usage of DES remains relatively low due to a lack of knowledge of the benefits of the technique. This paper considers two factors that could lead to a greater achievement and appreciation of the full benefit of DES and thus lead to greater usage. Firstly in relation to using DES to investigate social systems, both in the process of undertaking a simulation project and in the interpretation of the findings a 'soft' approach may generate more knowledge from the DES intervention and thus increase its benefit to businesses. Secondly in order to assess the full range of outcomes of DES the technique could be considered from the perspective of an information processing tool within the organisation. This will allow outcomes to be considered under the three modes of organisational information use of sense making, knowledge creating and decision making which relate to the theoretical areas of knowledge management, organisational learning and decision making respectively. The association of DES with these popular techniques could further increase its usage in business.

Reliability management of machine tool technology: a case study of current practice

Considerable attention has been given in the literature to identifying and describing the effective elements which positively affect the improvement of product reliability. These have been perceived by many as the 'state of the art' in the manufacturing industry. The applicability, diffusion and effectiveness of such methods and philosophies, as a means of systematically improving the reliability of a product, come in the main from case studies and single and infra-industry empirical studies. These studies have both been carried out within the wider context of quality assurance and management, and taking reliability as a discipline in its own right. However, it is somewhat of a surprise that there are no recently published findings or research studies on the adoption of these methods by the machine tool industry. This may lead one to construct several hypothesised paradigms: (a) that machine tool manufacturers compared to other industries, are slow to respond to propositions given in the literature by theorists or (b) this may indicate that a large proportion of the manufacturers make little use of the reliability improvement techniques as described in the literature, with the overall perception that they will not lead to any significant improvements? On the other hand, it is evident that hypothetical verification of the operational and engineering methods of reliability achievement and improvement adopted in the machine tool industry is less widely researched. Therefore, research into this area is needed in order to explore the 'state of the art' practice in the machine tool industry. This is in terms of the status, structure and activities of the operation of the reliability function. This paper outlines a research programme being conducted with the co-operation of a leading machine tool manufacturer, whose UK manufacturing plant produces in the main Vertical Machining Centres (VMCs) and is continuously undergoing incremental transitions in product reliability improvement.

Tool support for integrating extended enterprises

A current EPSRC project, product introduction process: a simulation in the extended enterprise (PIPSEE) is discussed. PIPSEE attempts to improve the execution of the product introduction process (PIP) within an extended enterprise in the aerospace sector. The modus operandi for accomplishing this has been to develop process understanding amongst a core team, spanning four different companies, through process modelling, review and improvement recommendation. In parallel, a web-based simulation capability is being used to conduct simulation experiments, and to disseminate findings by training others in the lessons that have been learned. It is intended that the use of the PIPSEE simulator should encourage radical thinking about the ‘fuzzy front end’ of the PIP. This presents a topical, exciting and challenging research problem.

Analysis of computer communication systems by use of digital signal processing methods

Queueing theory is an effective tool in the analysis of canputer camrunication systems. Many results in queueing analysis have teen derived in the form of Laplace and z-transform expressions. Accurate inversion of these transforms is very important in the study of computer systems, but the inversion is very often difficult. In this thesis, methods for solving some of these queueing problems, by use of digital signal processing techniques, are presented. The z-transform of the queue length distribution for the Mj GY jl system is derived. Two numerical methods for the inversion of the transfom, together with the standard numerical technique for solving transforms with multiple queue-state dependence, are presented. Bilinear and Poisson transform sequences are presented as useful ways of representing continuous-time functions in numerical computations.

The use of lichen growth rings in lichenometry: some preliminary findings

Certain species of crustose lichens have concentrically zoned margins which probably represent yearly growth rings. These marginal growth rings offer an alternative method of studying annual growth fluctuations, establishing growth rate-size curves, and determining the age of thalli for certain crustose species. Hence, marginal growth rings represent a potentially valuable, unexploited, tool in lichenometry. In a preliminary study, we measured the widths of the successive marginal rings in 25 thalli of Ochrolechia parella (L.) Massal., growing at a maritime site in north Wales. Mean ring widths of all thalli varied from a minimum of 1.02 mm (the outermost ring) to a maximum of 2.06 mm (the third ring from the margin). There is some suggestion that marginal ring width and thallus size are positively correlated; and hence that growth rates increase in larger thalli in this small population. In a further study on recently exposed bedrock adjacent to Breidalon, SE Iceland, we examined the potential for using marginal growth rings to estimate thallus age of a lichen tentatively identified as a Rhizocarpon (possibly R. concentricum (Davies) Beltram.) and thus confirm the timing of surface exposure (c. 50 years). Collectively, these results suggest: 1) the measurement of marginal rings is a possible alternative method of studying the growth of crustose lichens; 2) O. parella may grow differently to other crustose species, exhibiting a rapidly increasing radial growth rate in thalli >40 mm; 3) where lichens with marginal rings grow on recently exposed surfaces (<60 yrs), minimum age estimates can be made using growth rings as an in situ indication of lichen growth rate; 4) it is suggested that this phenomenon could provide a valuable, previously unexploited, in situ lichenometric-dating tool in areas lacking calibration control.