Caveat Anicula! Beware of the Quiet Little Old Ladies : Demographics, Pharmacotherapy, Survival and Readmissions in a 10 Year Cohort of Heart Failure Patients with Preserved Systolic Function

Objective--To determine whether heart failure with preserved systolic function (HFPSF) has different natural history from left ventricular systolic dysfunction (LVSD). Design and setting--A retrospective analysis of 10 years of data (for patients admitted between 1 July 1994 and 30 June 2004, and with a study census date of 30 June 2005) routinely collected as part of clinical practice in a large tertiary referral hospital.Main outcome measures-- Sociodemographic characteristics, diagnostic features, comorbid conditions, pharmacotherapies, readmission rates and survival.Results--Of the 2961 patients admitted with chronic heart failure, 753 had echocardiograms available for this analysis. Of these, 189 (25%) had normal left ventricular size and systolic function. In comparison to patients with LVSD, those with HFPSF were more often female (62.4% v 38.5%; P = 0.001), had less social support, and were more likely to live in nursing homes (17.9% v 7.6%; P < 0.001), and had a greater prevalence of renal impairment (86.7% v 6.2%; P = 0.004), anaemia (34.3% v 6.3%; P = 0.013) and atrial fibrillation (51.3% v 47.1%; P = 0.008), but significantly less ischaemic heart disease (53.4% v 81.2%; P = 0.001). Patients with HFPSF were less likely to be prescribed an angiotensin-converting enzyme inhibitor (61.9% v 72.5%; P = 0.008); carvedilol was used more frequently in LVSD (1.5% v 8.8%; P < 0.001). Readmission rates were higher in the HFPSF group (median, 2 v 1.5 admissions; P = 0.032), particularly for malignancy (4.2% v 1.8%; P < 0.001) and anaemia (3.9% v 2.3%; P < 0.001). Both groups had the same poor survival rate (P = 0.912). Conclusions--Patients with HFPSF were predominantly older women with less social support and higher readmission rates for associated comorbid illnesses. We therefore propose that reduced survival in HFPSF may relate more to comorbid conditions than suboptimal cardiac management.

Differences in Treatment and Management of Indigenous and Non-Indigenous Patients Presenting with Chest Pain: Results of the Heart Protection Partnership (HPP) Study

BACKGROUND: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain. METHODS: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain. Patients were identified as Indigenous or non-Indigenous, and time to presentation and cardiac investigations as well as rates of cardiac investigations and procedures were compared between the two groups. RESULTS: Of the 2380 patients included, 199 (8.4%) identified as Indigenous, and 2174 (91.6%) as non-Indigenous. Indigenous patients were younger, had higher rates hyperlipidaemia, diabetes, smoking, known coronary artery disease and a lower rate of prior PCI; and were significantly less likely to have private health insurance, be admitted to an interventional facility or to have a cardiologist as primary physician. Following adjustment for difference in baseline characteristics, Indigenous patients had comparable rates of cardiac investigations and delay times to presentation and investigations. CONCLUSIONS: Although the Indigenous population was identified as a high-risk group, in this analysis of selected Australian hospitals there were no significant differences in treatment or management of Indigenous patients in comparison to non-Indigenous.

An analysis of the Brisbane residential property market and the global financial crisis

The period from 2007 to 2009 covered the residential property boom from early 2000, to the property recession following the Global Financial Crisis. Since late 2008, a number of residential property markets have suffered significant falls in house prices, buth this has not been consistent across all market sectors. This paper will analyze the housing market in Brisbane Australia to determine the impact, similarities and differences that the4 GFC had on range of residential sectors across a divesified property market. Data analysis will provide an overview of residential property prices, sales and listing volumes over the study period and will provide a comparison of median house price performance across the geographic and socio-economic areas of Brisbane.

‘You’re a bad driver but I just made a mistake’ : attribution differences between the ‘victims’ and ‘perpetrators’ of scenario-based aggressive driving incidents

Driver aggression is an increasing concern for motorists, with some research suggesting that drivers who behave aggressively perceive their actions as justified by the poor driving of others. Thus attributions may play an important role in understanding driver aggression. A convenience sample of 193 drivers (aged 17-36) randomly assigned to two separate roles (‘perpetrators’ and ‘victims’) responded to eight scenarios of driver aggression. Drivers also completed the Aggression Questionnaire and Driving Anger Scale. Consistent with the actor-observer bias, ‘victims’ (or recipients) in this study were significantly more likely than ‘perpetrators’ (or instigators) to endorse inadequacies in the instigator’s driving skills as the cause of driver aggression. Instigators were significantly more likely attribute the depicted behaviours to external but temporary causes (lapses in judgement or errors) rather than stable causes. This suggests that instigators recognised drivers as responsible for driving aggressively but downplayed this somewhat in comparison to ‘victims’/recipients. Recipients and instigators agreed that the behaviours were examples of aggressive driving but instigators appeared to focus on the degree of intentionality of the driver in making their assessments while recipients appeared to focus on the safety implications. Contrary to expectations, instigators gave mean ratings of the emotional impact of driving aggression on recipients that were higher in all cases than the mean ratings given by the recipients. Drivers appear to perceive aggressive behaviours as modifiable, with the implication that interventions could appeal to drivers’ sense of self-efficacy to suggest strategies for overcoming plausible and modifiable attributions (e.g. lapses in judgement; errors) underpinning behaviours perceived as aggressive.

A regional construction R&D evaluation system for China

Expenditure on R&D in the China construction industry has been relatively low in comparison with many developed countries for a number of years – a situation considered to be a major barrier to the industry’s competitiveness in general and unsatisfactory industry development of the 31 regions involved. A major problem with this is the lack of a sufficiently sophisticated method of objectively evaluating R&D activity in what are quite complex circumstances considering the size and regional differences that exist in this part of the world. A regional construction R&D evaluation system (RCRES) is presented aimed at rectifying the situation. This is based on 12 indicators drawn from the Chinese Government’s R&D Inventory of Resources in consultation with a small group of experts in the field, and further factor analysed into three groups. From this, the required evaluation is obtained by a simple formula. Examination of the results provides a ranking list of the R&D performance of each of the 31 regions, indicating a general disproportion between coastal and inland regions and highlighting regions receiving special emphasis or currently lacking in development. The understanding on this is vital for the future of China’s construction industry.

Conceptual models of satisfaction level in construction

It is recognized that, in general, the performance of construction projects does not meet optimal expectations. One aspect of this is the performance of each participant, which is interdependent and makes a significance impact on overall project outcomes. Of these, the client is traditionally the owner of the project, the architect or engineer is engaged as the lead designer and a contractor is selected to construct the facilities. Generally, the performance of the participants is gauged by considering three main factors, namely time, cost and quality. As the level of satisfaction is a subjective measurement, it is rarely used in the performance evaluation of construction work. Recently, various approaches to the measurement of satisfaction have been made in attempting to determine the performance of construction project outcomes – for instance client satisfaction, consultant satisfaction, contractor satisfaction, customer satisfaction and home buyer satisfaction. These not only identify the performance of the construction project, but are also used to improve and maintain relationships. In addition, these assessments are necessary for continuous improvement and enhanced cooperation between participants. The measurement of satisfaction levels primarily involves expectations and perceptions. An expectation can be regarded as a comparison standard of different needs, motives and beliefs, while a perception is a subjective interpretation that is influenced by moods, experiences and values. This suggests that the disparity between perceptions and expectations may be used to represent different levels of satisfaction. However, this concept is rather new and in need of further investigation. This paper examines the current methods commonly practiced in measuring satisfaction level and the advantages of promoting these methods. The results provided are a preliminary review of the advantages of satisfaction measurement in the construction industry and recommendations are made concerning the most appropriate methods for use in identifying the performance of project outcomes.

Fast and accurate phonetic spoken term detection

For the first time in human history, large volumes of spoken audio are being broadcast, made available on the internet, archived, and monitored for surveillance every day. New technologies are urgently required to unlock these vast and powerful stores of information. Spoken Term Detection (STD) systems provide access to speech collections by detecting individual occurrences of specified search terms. The aim of this work is to develop improved STD solutions based on phonetic indexing. In particular, this work aims to develop phonetic STD systems for applications that require open-vocabulary search, fast indexing and search speeds, and accurate term detection. Within this scope, novel contributions are made within two research themes, that is, accommodating phone recognition errors and, secondly, modelling uncertainty with probabilistic scores. A state-of-the-art Dynamic Match Lattice Spotting (DMLS) system is used to address the problem of accommodating phone recognition errors with approximate phone sequence matching. Extensive experimentation on the use of DMLS is carried out and a number of novel enhancements are developed that provide for faster indexing, faster search, and improved accuracy. Firstly, a novel comparison of methods for deriving a phone error cost model is presented to improve STD accuracy, resulting in up to a 33% improvement in the Figure of Merit. A method is also presented for drastically increasing the speed of DMLS search by at least an order of magnitude with no loss in search accuracy. An investigation is then presented of the effects of increasing indexing speed for DMLS, by using simpler modelling during phone decoding, with results highlighting the trade-off between indexing speed, search speed and search accuracy. The Figure of Merit is further improved by up to 25% using a novel proposal to utilise word-level language modelling during DMLS indexing. Analysis shows that this use of language modelling can, however, be unhelpful or even disadvantageous for terms with a very low language model probability. The DMLS approach to STD involves generating an index of phone sequences using phone recognition. An alternative approach to phonetic STD is also investigated that instead indexes probabilistic acoustic scores in the form of a posterior-feature matrix. A state-of-the-art system is described and its use for STD is explored through several experiments on spontaneous conversational telephone speech. A novel technique and framework is proposed for discriminatively training such a system to directly maximise the Figure of Merit. This results in a 13% improvement in the Figure of Merit on held-out data. The framework is also found to be particularly useful for index compression in conjunction with the proposed optimisation technique, providing for a substantial index compression factor in addition to an overall gain in the Figure of Merit. These contributions significantly advance the state-of-the-art in phonetic STD, by improving the utility of such systems in a wide range of applications.

Three primary school students’ cognition about 3D rotation in a virtual reality learning environment

This paper reports on three primary school students’ explorations of 3D rotation in a virtual reality learning environment (VRLE) named VRMath. When asked to investigate if you would face the same direction when you turn right 45 degrees first then roll up 45 degrees, or when you roll up 45 degrees first then turn right 45 degrees, the students found that the different order of the two turns ended up with different directions in the VRLE. This was contrary to the students’ prior predictions based on using pen, paper and body movements. The findings of this study showed the difficulty young children have in perceiving and understanding the non-commutative nature of 3D rotation and the power of the computational VRLE in giving students experiences that they rarely have in real life with 3D manipulations and 3D mental movements.

A comparative review of quantitative VFM methodology for PPP infrastructure project in Indonesia and Australia

The Government of Indonesia (GoI) increasingly relies on the private sector financing to build and operate infrastructures through public private partnership (PPP) schemes. However, PPP does not automatically provide the solution for the financing scheme due to value for money (VFM) issues. The procurement authority must show whether a PPP proposal is the optimal solution that provides best VFM outcome. The paper presents a literature review of comparing quantitative VFM methodology for PPP infrastructure project procurement in Indonesia and Australia. Public Sector Comparator (PSC) is used to assess the potential project VFM quantitatively in Australia. In Indonesia, the PSC has not been applied, where the PPP procurement authority tends to utilize a common project evaluation method that ignores the issues of risk. Unlike the conventional price bid evaluation, the PSC enables a financial comparison including costs/gains and risks. Since the construction of PSC is primarily on risk management approach, it can facilitate risk negotiation processes between the involved parties. The study indicates that the quantitative VFM methodology of PSC is potentially applicable in Indonesia for water supply sector. Various supporting regulations are available that emphasize the importance of VFM and risk management in infrastructure investment. However, the study also reveals a number of challenges that need to be anticipated, such as the need of a more comprehensive PPP policy at both central and local government level, a more specific legal instrument for bidding evaluation method and the issue of institutional capacity development in PPP Units at the local level.

Improving the performance of model-order selection criteria by partial-model selection search

The traditional searching method for model-order selection in linear regression is a nested full-parameters-set searching procedure over the desired orders, which we call full-model order selection. On the other hand, a method for model-selection searches for the best sub-model within each order. In this paper, we propose using the model-selection searching method for model-order selection, which we call partial-model order selection. We show by simulations that the proposed searching method gives better accuracies than the traditional one, especially for low signal-to-noise ratios over a wide range of model-order selection criteria (both information theoretic based and bootstrap-based). Also, we show that for some models the performance of the bootstrap-based criterion improves significantly by using the proposed partial-model selection searching method. Index Terms— Model order estimation, model selection, information theoretic criteria, bootstrap 1. INTRODUCTION Several model-order selection criteria can be applied to find the optimal order. Some of the more commonly used information theoretic-based procedures include Akaike’s information criterion (AIC) [1], corrected Akaike (AICc) [2], minimum description length (MDL) [3], normalized maximum likelihood (NML) [4], Hannan-Quinn criterion (HQC) [5], conditional model-order estimation (CME) [6], and the efficient detection criterion (EDC) [7]. From a practical point of view, it is difficult to decide which model order selection criterion to use. Many of them perform reasonably well when the signal-to-noise ratio (SNR) is high. The discrepancies in their performance, however, become more evident when the SNR is low. In those situations, the performance of the given technique is not only determined by the model structure (say a polynomial trend versus a Fourier series) but, more importantly, by the relative values of the parameters within the model. This makes the comparison between the model-order selection algorithms difficult as within the same model with a given order one could find an example for which one of the methods performs favourably well or fails [6, 8]. Our aim is to improve the performance of the model order selection criteria in cases where the SNR is low by considering a model-selection searching procedure that takes into account not only the full-model order search but also a partial model order search within the given model order. Understandably, the improvement in the performance of the model order estimation is at the expense of additional computational complexity.

Sensitivity of Dot-ELISA on Nitrocellulose Membranes in Comparison with ELISA on Polystyrene Plates for the Detection of Four Plant Viruses

ABSTR.4CT Senitivity of dot-immunobindinding ELf SA on nitrocellulose membrane (DotELISA)was compared with double-antibody sandwich ELISA (DAS-ELlSA) on polystyrene plates for the detection of bean yellow mosaic virus (BYMV), broad bean stain virus (WMV-2). Dot-ELISA was 2 and 1O times more sensitive than DAS-ELISA for the detection of BBSV and WMV-2, respectively, whereas DAS-ELISA was more sensitive than Dot-ELiSA for {he detection of BYMV. Both techniques were equally sensitive for the detection of BYDV. Using one day instead uf the two-day procedure, the four viruses were still detectable and the ralative sensitivity of both techniques remained the same.

Comparison of Nucleotide Sequences between Northern and Southern Philippine Isolates of Rice Grassy Stunt Virus Indicates Occurrence of Natural Genetic Reassortment

Rice grassy stunt virus is a member of the genus Tenuivirus, is persistently transmitted by a brown planthopper, and has occurred in rice plants in South, Southeast, and East Asia (similar to North and South America). We determined the complete nucleotide (nt) sequences of RNAs 1 (9760 nt), 2 (4069 nt), 3 (3127 nt), 4 (2909 nt), 5 (2704 nt), and 6 (2590 nt) of a southern Philippine isolate from South Cotabato and compared them with those of a northern Philippine isolate from Laguna (Toriyama et al., 1997, 1998). The numbers of nucleotides in the terminal untranslated regions and open reading frames were identical between the two isolates except for the 5′ untranslated region of the complementary strand of RNA 4. Overall nucleotide differences between the two isolates were only 0.08% in RNA 1, 0.58% in RNA 4, and 0.26% in RNA 5, whereas they were 2.19% in RNA 2, 8.38% in RNA 3, and 3.63% in RNA 6. In the intergenic regions, the two isolates differed by 9.12% in RNA 2, 11.6% in RNA 3, and 6.86% in RNA 6 with multiple consecutive nucleotide deletion/insertions, whereas they differed by only 0.78% in RNA 4 and 0.34% in RNA 5. The nucleotide variation in the intergenic region of RNA 6 within the South Cotabato isolate was only 0.33%. These differences in accumulation of mutations among individual RNA segments indicate that there was genetic reassortment in the two geographical isolates; RNAs 1, 4, and 5 of the two isolates came from a common ancestor, whereas RNAs 2, 3, and 6 were from two different ancestors.

Reference bias : presentation of extreme health states prior to EQ-VAS improves health-related quality of life scores. A randomised crossover trial.

Background: Clinical practice and clinical research has made a concerted effort to move beyond the use of clinical indicators alone and embrace patient focused care through the use of patient reported outcomes such as healthrelated quality of life. However, unless patients give consistent consideration to the health states that give meaning to measurement scales used to evaluate these constructs, longitudinal comparison of these measures may be invalid. This study aimed to investigate whether patients give consideration to a standard health state rating scale (EQ-VAS) and whether consideration of good and poor health state descriptors immediately changes their selfreport. Methods: A randomised crossover trial was implemented amongst hospitalised older adults (n = 151). Patients were asked to consider descriptions of extremely good (Description-A) and poor (Description-B) health states. The EQ-VAS was administered as a self-report at baseline, after the first descriptors (A or B), then again after the remaining descriptors (B or A respectively). At baseline patients were also asked if they had considered either EQVAS anchors. Results: Overall 106/151 (70%) participants changed their self-evaluation by ≥5 points on the 100 point VAS, with a mean (SD) change of +4.5 (12) points (p < 0.001). A total of 74/151 (49%) participants did not consider the best health VAS anchor, of the 77 who did 59 (77%) thought the good health descriptors were more extreme (better) then they had previously considered. Similarly 85/151 (66%) participants did not consider the worst health anchor of the 66 who did 63 (95%) thought the poor health descriptors were more extreme (worse) then they had previously considered. Conclusions: Health state self-reports may not be well considered. An immediate significant shift in response can be elicited by exposure to a mere description of an extreme health state despite no actual change in underlying health state occurring. Caution should be exercised in research and clinical settings when interpreting subjective patient reported outcomes that are dependent on brief anchors for meaning. Trial Registration: Australian and New Zealand Clinical Trials Registry (#ACTRN12607000606482) http://www.anzctr. org.au

How do we reach them? Comparing random samples from mobile and landline phones

Quantitative studies of nascent entrepreneurs such as GEM and PSED are required to generate their samples by screening the adult population, usually by phone in developed economies. Phone survey research has recently been challenged by shifting patterns of ownership and response rates of landline versus mobile (cell) phones, particularly for younger respondents. This challenge is acutely intense for entrepreneurship which is a strongly age-dependent phenomenon. Although shifting ownership rates have received some attention, shifting response rates have remained largely unexplored. For the Australian GEM 2010 adult population study we conducted a dual-frame approach that allows comparison between samples of mobile and landline phones. We find a substantial response bias towards younger, male and metropolitan respondents for mobile phones – far greater than explained by ownership rates. We also found these response rate differences significantly biases the estimates of the prevalence of early stage entrepreneurship by both samples, even when each sample is weighted to match the Australian population.

Theoretical analysis of serrated chip formation based on ideal models in high speed cutting

In this paper, two ideal formation models of serrated chips, the symmetric formation model and the unilateral right-angle formation model, have been established for the first time. Based on the ideal models and related adiabatic shear theory of serrated chip formation, the theoretical relationship among average tooth pitch, average tooth height and chip thickness are obtained. Further, the theoretical relation of the passivation coefficient of chip's sawtooth and the chip thickness compression ratio is deduced as well. The comparison between these theoretical prediction curves and experimental data shows good agreement, which well validates the robustness of the ideal chip formation models and the correctness of the theoretical deducing analysis. The proposed ideal models may have provided a simple but effective theoretical basis for succeeding research on serrated chip morphology. Finally, the influences of most principal cutting factors on serrated chip formation are discussed on the basis of a series of finite element simulation results for practical advices of controlling serrated chips in engineering application.