Emergency department surge capacity : Recommendations of the Australasian surge strategy working group

Background For more than a decade emergency medicine organizations have produced guidelines, training and leadership for disaster management. However to date, there have been limited guidelines for emergency physicians needing to provide a rapid response to a surge in demand. The aim of this study is to identify strategies which may guide surge management in the Emergency Department. Method A working group of individuals experienced in disaster medicine from the Australasian College for Emergency Medicine Disaster Medicine Subcommittee (the Australasian Surge Strategy Working Group) was established to undertake this work. The Working Group used a modified Delphi technique to examine response actions in surge situations. The Working Group identified underlying assumptions from epidemiological and empirical understanding and then identified remedial strategies from literature and from personal experience and collated these within domains of space, staff, supplies, and system operation. Findings These recommendations detail 22 potential actions available to an emergency physician working in the context of surge. The Working Group also provides detailed guidance on surge recognition, triage, patient flow through the emergency department and clinical goals and practices. Discussion These strategies provide guidance to emergency physicians confronting the challenges of a surge in demand. The paper also identifies areas that merit future research including the measurement of surge capacity, constraints to strategy implementation, validation of surge strategies and measurement of strategy impacts on throughput, cost, and quality of care.

Towards an automatic road lane marks extraction based on ISODATA segmentation and shadow detection from large-scale aerial images

The automatic extraction of road features from remote sensed images has been a topic of great interest within the photogrammetric and remote sensing communities for over 3 decades. Although various techniques have been reported in the literature, it is still challenging to efficiently extract the road details with the increasing of image resolution as well as the requirement for accurate and up-to-date road data. In this paper, we will focus on the automatic detection of road lane markings, which are crucial for many applications, including lane level navigation and lane departure warning. The approach consists of four steps: i) data preprocessing, ii) image segmentation and road surface detection, iii) road lane marking extraction based on the generated road surface, and iv) testing and system evaluation. The proposed approach utilized the unsupervised ISODATA image segmentation algorithm, which segments the image into vegetation regions, and road surface based only on the Cb component of YCbCr color space. A shadow detection method based on YCbCr color space is also employed to detect and recover the shadows from the road surface casted by the vehicles and trees. Finally, the lane marking features are detected from the road surface using the histogram clustering. The experiments of applying the proposed method to the aerial imagery dataset of Gympie, Queensland demonstrate the efficiency of the approach.

Improvement to Chinese information retrieval by incorporating word segmentation and query expansion

The increasing diversity of the Internet has created a vast number of multilingual resources on the Web. A huge number of these documents are written in various languages other than English. Consequently, the demand for searching in non-English languages is growing exponentially. It is desirable that a search engine can search for information over collections of documents in other languages. This research investigates the techniques for developing high-quality Chinese information retrieval systems. A distinctive feature of Chinese text is that a Chinese document is a sequence of Chinese characters with no space or boundary between Chinese words. This feature makes Chinese information retrieval more difficult since a retrieved document which contains the query term as a sequence of Chinese characters may not be really relevant to the query since the query term (as a sequence Chinese characters) may not be a valid Chinese word in that documents. On the other hand, a document that is actually relevant may not be retrieved because it does not contain the query sequence but contains other relevant words. In this research, we propose two approaches to deal with the problems. In the first approach, we propose a hybrid Chinese information retrieval model by incorporating word-based techniques with the traditional character-based techniques. The aim of this approach is to investigate the influence of Chinese segmentation on the performance of Chinese information retrieval. Two ranking methods are proposed to rank retrieved documents based on the relevancy to the query calculated by combining character-based ranking and word-based ranking. Our experimental results show that Chinese segmentation can improve the performance of Chinese information retrieval, but the improvement is not significant if it incorporates only Chinese segmentation with the traditional character-based approach. In the second approach, we propose a novel query expansion method which applies text mining techniques in order to find the most relevant words to extend the query. Unlike most existing query expansion methods, which generally select the highly frequent indexing terms from the retrieved documents to expand the query. In our approach, we utilize text mining techniques to find patterns from the retrieved documents that highly correlate with the query term and then use the relevant words in the patterns to expand the original query. This research project develops and implements a Chinese information retrieval system for evaluating the proposed approaches. There are two stages in the experiments. The first stage is to investigate if high accuracy segmentation can make an improvement to Chinese information retrieval. In the second stage, a text mining based query expansion approach is implemented and a further experiment has been done to compare its performance with the standard Rocchio approach with the proposed text mining based query expansion method. The NTCIR5 Chinese collections are used in the experiments. The experiment results show that by incorporating the text mining based query expansion with the hybrid model, significant improvement has been achieved in both precision and recall assessments.

Improved GrabCut segmentation via GMM optimisation

Semi-automatic segmentation of still images has vast and varied practical applications. Recently, an approach "GrabCut" has managed to successfully build upon earlier approaches based on colour and gradient information in order to address the problem of efficient extraction of a foreground object in a complex environment. In this paper, we extend the GrabCut algorithm further by applying an unsupervised algorithm for modelling the Gaussian Mixtures that are used to define the foreground and background in the segmentation algorithm. We show examples where the optimisation of the GrabCut framework leads to further improvements in performance.

Three-dimensional hydrogen-bonded structures in the 1:1 proton-transfer compounds of L-tartaric acid with the associative-group monosubstituted pyridines 3-minopyridine, 3-carboxypyridine (nicotinic acid) and 2-carboxypyridine (picolinic acid).

The 1:1 proton-transfer compounds of L-tartaric acid with 3-aminopyridine [3-aminopyridinium hydrogen (2R,3R)-tartrate dihydrate, C5H7N2+·C4H5O6-·2H2O, (I)], pyridine-3-carboxylic acid (nicotinic acid) [anhydrous 3-carboxypyridinium hydrogen (2R,3R)-tartrate, C6H6NO2+·C4H5O6-, (II)] and pyridine-2-carboxylic acid [2-carboxypyridinium hydrogen (2R,3R)-tartrate monohydrate, C6H6NO2+·C4H5O6-·H2O, (III)] have been determined. In (I) and (II), there is a direct pyridinium-carboxyl N+-HO hydrogen-bonding interaction, four-centred in (II), giving conjoint cyclic R12(5) associations. In contrast, the N-HO association in (III) is with a water O-atom acceptor, which provides links to separate tartrate anions through Ohydroxy acceptors. All three compounds have the head-to-tail C(7) hydrogen-bonded chain substructures commonly associated with 1:1 proton-transfer hydrogen tartrate salts. These chains are extended into two-dimensional sheets which, in hydrates (I) and (III) additionally involve the solvent water molecules. Three-dimensional hydrogen-bonded structures are generated via crosslinking through the associative functional groups of the substituted pyridinium cations. In the sheet struture of (I), both water molecules act as donors and acceptors in interactions with separate carboxyl and hydroxy O-atom acceptors of the primary tartrate chains, closing conjoint cyclic R44(8), R34(11) and R33(12) associations. Also, in (II) and (III) there are strong cation carboxyl-carboxyl O-HO hydrogen bonds [OO = 2.5387 (17) Å in (II) and 2.441 (3) Å in (III)], which in (II) form part of a cyclic R22(6) inter-sheet association. This series of heteroaromatic Lewis base-hydrogen L-tartrate salts provides further examples of molecular assembly facilitated by the presence of the classical two-dimensional hydrogen-bonded hydrogen tartrate or hydrogen tartrate-water sheet substructures which are expanded into three-dimensional frameworks via peripheral cation bifunctional substituent-group crosslinking interactions.

Design of automatic vision-based inspection system for solder joint segmentation

Purpose: Computer vision has been widely used in the inspection of electronic components. This paper proposes a computer vision system for the automatic detection, localisation, and segmentation of solder joints on Printed Circuit Boards (PCBs) under different illumination conditions. Design/methodology/approach: An illumination normalization approach is applied to an image, which can effectively and efficiently eliminate the effect of uneven illumination while keeping the properties of the processed image the same as in the corresponding image under normal lighting conditions. Consequently special lighting and instrumental setup can be reduced in order to detect solder joints. These normalised images are insensitive to illumination variations and are used for the subsequent solder joint detection stages. In the segmentation approach, the PCB image is transformed from an RGB color space to a YIQ color space for the effective detection of solder joints from the background. Findings: The segmentation results show that the proposed approach improves the performance significantly for images under varying illumination conditions. Research limitations/implications: This paper proposes a front-end system for the automatic detection, localisation, and segmentation of solder joint defects. Further research is required to complete the full system including the classification of solder joint defects. Practical implications: The methodology presented in this paper can be an effective method to reduce cost and improve quality in production of PCBs in the manufacturing industry. Originality/value: This research proposes the automatic location, identification and segmentation of solder joints under different illumination conditions.

Robust real time multi-layer foreground segmentation

Many surveillance applications (object tracking, abandoned object detection) rely on detecting changes in a scene. Foreground segmentation is an effective way to extract the foreground from the scene, but these techniques cannot discriminate between objects that have temporarily stopped and those that are moving. We propose a series of modifications to an existing foreground segmentation system\cite{Butler2003} so that the foreground is further segmented into two or more layers. This yields an active layer of objects currently in motion and a passive layer of objects that have temporarily ceased motion which can itself be decomposed into multiple static layers. We also propose a variable threshold to cope with variable illumination, a feedback mechanism that allows an external process (i.e. surveillance system) to alter the motion detectors state, and a lighting compensation process and a shadow detector to reduce errors caused by lighting inconsistencies. The technique is demonstrated using outdoor surveillance footage, and is shown to be able to effectively deal with real world lighting conditions and overlapping objects.

Extraction of road lanes from high-resolution stereo aerial imagery based on maximum likelihood segmentation and texture enhancement

Accurate road lane information is crucial for advanced vehicle navigation and safety applications. With the increasing of very high resolution (VHR) imagery of astonishing quality provided by digital airborne sources, it will greatly facilitate the data acquisition and also significantly reduce the cost of data collection and updates if the road details can be automatically extracted from the aerial images. In this paper, we proposed an effective approach to detect road lanes from aerial images with employment of the image analysis procedures. This algorithm starts with constructing the (Digital Surface Model) DSM and true orthophotos from the stereo images. Next, a maximum likelihood clustering algorithm is used to separate road from other ground objects. After the detection of road surface, the road traffic and lane lines are further detected using texture enhancement and morphological operations. Finally, the generated road network is evaluated to test the performance of the proposed approach, in which the datasets provided by Queensland department of Main Roads are used. The experiment result proves the effectiveness of our approach.

Accurate silhouette segmentation using motion detection and graph cuts

Acquiring accurate silhouettes has many applications in computer vision. This is usually done through motion detection, or a simple background subtraction under highly controlled environments (i.e. chroma-key backgrounds). Lighting and contrast issues in typical outdoor or office environments make accurate segmentation very difficult in these scenes. In this paper, gradients are used in conjunction with intensity and colour to provide a robust segmentation of motion, after which graph cuts are utilised to refine the segmentation. The results presented using the ETISEO database demonstrate that an improved segmentation is achieved through the combined use of motion detection and graph cuts, particularly in complex scenes.

Fusing shrinking and expanding active contour models for robust IRIS segmentation

The performance of iris recognition systems is significantly affected by the segmentation accuracy, especially in non- ideal iris images. This paper proposes an improved method to localise non-circular iris images quickly and accurately. Shrinking and expanding active contour methods are consolidated when localising inner and outer iris boundaries. First, the pupil region is roughly estimated based on histogram thresholding and morphological operations. There- after, a shrinking active contour model is used to precisely locate the inner iris boundary. Finally, the estimated inner iris boundary is used as an initial contour for an expanding active contour scheme to find the outer iris boundary. The proposed scheme is robust in finding exact the iris boundaries of non-circular and off-angle irises. In addition, occlusions of the iris images from eyelids and eyelashes are automatically excluded from the detected iris region. Experimental results on CASIA v3.0 iris databases indicate the accuracy of proposed technique.

Mechanisms of change in negative thinking and urinary monoamines in depressed patients during acute treatment with group cognitive behavior therapy and antidepressant medication

This naturalistic study investigated the mechanisms of change in measures of negative thinking and in 24-h urinary metabolites of noradrenaline (norepinephrine), dopamine and serotonin in a sample of 43 depressed hospital patients attending an eight-session group cognitive behavior therapy program. Most participants (91%) were taking antidepressant medication throughout the therapy period according to their treating Psychiatrists' prescriptions. The sample was divided into outcome categories (19 Responders and 24 Non-responders) on the basis of a clinically reliable change index [Jacobson, N.S., & Truax, P., 1991. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.] applied to the Beck Depression Inventory scores at the end of the therapy. Results of repeated measures analysis of variance [ANOVA] analyses of variance indicated that all measures of negative thinking improved significantly during therapy, and significantly more so in the Responders as expected. The treatment had a significant impact on urinary adrenaline and metadrenaline excretion however, these changes occurred in both Responders and Non-responders. Acute treatment did not significantly influence the six other monoamine metabolites. In summary, changes in urinary monoamine levels during combined treatment for depression were not associated with self-reported changes in mood symptoms.

Skydweller and representations of the adolescent crisis : group identity versus alienation

This document contains a creative work – the text of a young adult novel, Skydweller – and an exegesis discussing the ways in which identity and the adolescent crisis of group identity versus alienation are represented in young adult science fiction/fantasy novels.

A peptidomimetic inhibitor of matrix metalloproteinases containing a tetherable linker group

Successful wound repair and normal turnover of the extracellular matrix relies on a balance between matrix metalloproteinases (MMPs) and their natural inhibitors (the TIMPs). When over-expression of MMPs and abnormally high levels of activation or low expression of TIMPs are encountered, excessive degradation of connective tissue and the formation of chronic ulcers can occur. One strategy to rebalance MMPs and TIMPs is to use inhibitors. We have designed a synthetic pseudopeptide inhibitor with an amine linker group based on a known high-affinity peptidomimetic MMP inhibitor have demonstrated inhibition of MMP-1, -2, -3 and -9 activity in standard solutions. The inhibitor was also tethered to a polyethylene glycol hydrogel using a facile reaction between the linker unit on the inhibitor and the hydrogel precursors. After tethering, we observed inhibition of the MMPs although there was an increase in the IC50s which was attributed to poor diffusion of the MMPs into the hydrogels, reduced activity of the tethered inhibitor or incomplete incorporation of the inhibitor into the hydrogels. When the tethered inhibitors were tested against chronic wound fluid we observed significant inhibition in proteolytic activity suggesting our approach may prove useful in rebalancing MMPs within chronic wounds.