Design, construction and evaluation of systems to predict risk in obstetrics

We present a systematic, practical approach to developing risk prediction systems, suitable for use with large databases of medical information. An important part of this approach is a novel feature selection algorithm which uses the area under the receiver operating characteristic (ROC) curve to measure the expected discriminative power of different sets of predictor variables. We describe this algorithm and use it to select variables to predict risk of a specific adverse pregnancy outcome: failure to progress in labour. Neural network, logistic regression and hierarchical Bayesian risk prediction models are constructed, all of which achieve close to the limit of performance attainable on this prediction task. We show that better prediction performance requires more discriminative clinical information rather than improved modelling techniques. It is also shown that better diagnostic criteria in clinical records would greatly assist the development of systems to predict risk in pregnancy. We present a systematic, practical approach to developing risk prediction systems, suitable for use with large databases of medical information. An important part of this approach is a novel feature selection algorithm which uses the area under the receiver operating characteristic (ROC) curve to measure the expected discriminative power of different sets of predictor variables. We describe this algorithm and use it to select variables to predict risk of a specific adverse pregnancy outcome: failure to progress in labour. Neural network, logistic regression and hierarchical Bayesian risk prediction models are constructed, all of which achieve close to the limit of performance attainable on this prediction task. We show that better prediction performance requires more discriminative clinical information rather than improved modelling techniques. It is also shown that better diagnostic criteria in clinical records would greatly assist the development of systems to predict risk in pregnancy.

Spatial and temporal variability in a residual soil profile

It is well understood that that there is variation inherent in all testing techniques, and that all soil and rock materials also contain some degree of natural variability. Less consideration is normally given to variation associated with natural material heterogeneity within a site, or the relative condition of the material at the time of testing. This paper assesses the impact of spatial and temporal variability upon repeated insitu testing of a residual soil and rock profile present within a single residential site over a full calendar year, and thus range of seasonal conditions. From this repeated testing, the magnitude of spatial and temporal variation due to seasonal conditions has demonstrated that, depending on the selected location and moisture content of the subsurface at the time of testing, up to a 35% variation within the test results can be expected. The results have also demonstrated that the completed insitu test technique has a similarly large measurement and inherent variability error and, for the investigated site, up to a 60% variation in normalised results was observed. From these results, it is recommended that the frequency and timing of insitu tests should be considered when deriving geotechnical design parameters from a limited data set.

Using upper bounds on attainable discrimination to select discrete valued features

Selection of features that will permit accurate pattern classification is a difficult task. However, if a particular data set is represented by discrete valued features, it becomes possible to determine empirically the contribution that each feature makes to the discrimination between classes. This paper extends the discrimination bound method so that both the maximum and average discrimination expected on unseen test data can be estimated. These estimation techniques are the basis of a backwards elimination algorithm that can be use to rank features in order of their discriminative power. Two problems are used to demonstrate this feature selection process: classification of the Mushroom Database, and a real-world, pregnancy related medical risk prediction task - assessment of risk of perinatal death.

Is there a potential relationship between prior h amstring strain injury and increased risk for future a nterior cruciate ligament injury?

Hamstring strain injuries (HSIs) are the most prevalent injury in a number of sports, and while anterior cruciate ligament (ACL) injuries are less common, they are far more severe and have long-term implications, such as an increased risk of developing osteoarthritis later in life. Given the high incidence and severity of these injuries, they are key targets of injury preventive programs in elite sport. Evidence has shown that a previous severe knee injury (including ACL injury) increases the risk of HSI; however, whether the functional deficits that occur after HSI result in an increased risk of ACL injury has yet to be considered. In this clinical commentary, we present evidence that suggests that the link between previous HSI and increased risk of ACL injury requires further investigation by drawing parallels between deficits in hamstring function after HSI and in women athletes, who are more prone to ACL injury than men athletes. Comparisons between the neuromuscular function of the male and female hamstring has shown that women display lower hamstring-to-quadriceps strength ratios during isokinetic knee flexion and extension, increased activation of the quadriceps compared with the hamstrings during a stop-jump landing task, a greater time required to reach maximal isokinetic hamstring torque, and lower integrated myoelectrical hamstring activity during a sidestep cutting maneuver. Somewhat similarly, in athletes with a history of HSI, the previously injured limb, compared with the uninjured limb, displays lower eccentric knee flexor strength, a lower hamstrings-to-quadriceps strength ratio, lower voluntary myoelectrical activity during maximal knee flexor eccentric contraction, a lower knee flexor eccentric rate of torque development, and lower voluntary myoelectrical activity during the initial portion of eccentric contraction. Given that the medial and lateral hamstrings have different actions at the knee joint in the coronal plane, which hamstring head is previously injured might also be expected to influence the likelihood of future ACL. Whether the deficits in function after HSI, as seen in laboratory-based studies, translate to deficits in hamstring function during typical injurious tasks for ACL injury has yet to be determined but should be a consideration for future work.

Dynamic capabilities and performance : an empirical study of audiovisual producers in Europe

This study tests Teece’s conceptualization of dynamic capabilities in the context of small and medium sized firms competing in creative industries, i.e. the European audio-visual production industry. This industry is characterized by immature and evolving markets where firms’ dynamic capabilities are expected to lead to superior innovative performance. Using survey data from audio-visual producers in ten European countries we find that both sensing and seizing capabilities have a positive effect on firms' innovative performance. The effect however, is curvilinear and positive effects appear only when capabilities overcome a threshold level.

Impact of PV units in LV feeders on distribution system reliability

Re-supplying loads on outage through cross-connect from adjacent feeders in a distribution system may cause voltage drop and hence require load shedding. However, the surplus PV generated in some of the LV feeders can prevent load shedding, and improve reliability. In order to measure these effects, this paper proposes the application of Direct Load Flow method[1] in reliability evaluation of distribution systems with PV units. As part of this study, seasonal impacts on load consumption together with surplus PV output power injection to higher voltage networks are also considered. New indices are proposed to measure yearly expected energy export, from LV to MV and from MV to higher voltage network.

The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence

Background: The existence of an ecstasy dependence syndrome is controversial. We examined whether the acute after-effects of ecstasy use (i.e., the “come-down”) falsely lead to the identification of ecstasy withdrawal and the subsequent diagnosis of ecstasy dependence. Methods: The Structured Clinical Interview for DSM-IV-TR Disorders: Research Version (SCID-RV) was administered to 214 Australian ecstasy users. Ecstasy withdrawal was operationalized in three contrasting ways: (i) as per DSM-IV criteria; (ii) as the expected after effects of ecstasy (a regular come-down); or (iii) as a substantially greater or longer come-down than on first use (intense come-down). These definitions were validated against frequency of ecstasy use, readiness to change and ability to resist the urge to use ecstasy. Confirmatory factor analyses were used to see how they aligned with the overall dependence syndrome. Results: Come-down symptoms increased the prevalence of withdrawal from 1% (DSM-IV criterion) to 11% (intense come-downs) and 75% (regular come-downs). Past year ecstasy dependence remained at 31% when including the DSM-IV withdrawal criteria and was 32% with intense come-downs, but increased to 45% with regular come-downs. Intense come-downs were associated with lower ability to resist ecstasy use and loaded positively on the dependence syndrome. Regular come-downs did not load positively on the ecstasy dependence syndrome and were not related to other indices of dependence. Conclusion: The acute after-effects of ecstasy should be excluded when assessing ecstasy withdrawal as they can lead to a false diagnosis of ecstasy dependence. Worsening of the ecstasy come-down may be a marker for dependence.

Grateful fateful sunshine rain

Grateful Fateful Sunshine Rain is a permanent public artwork commissioned by Aria Property Group through a competitive process for the Austin apartment building in South Brisbane. Artist Statement: Residents of Brisbane have a complex relationship with weather. As the capital of the Sunshine State, weather is an integral part of the city’s cultural identity. Weather deeply affects the mood of the city – from the excitement of scantily clad partygoers on balmy December evenings and late February’s lethargy, to the deepening anxiety that emerges after 100 days of rain (or more commonly, 100 days without rain). With a brief nod to the city’s – now decommissioned – iconic MCL weather beacon, Grateful Fateful Sunshine Rain taps into this aspect of Brisbane’s psyche with poetic, illuminated visualisations of real-time weather forecasts issued by the Bureau of Meteorology. Each evening, the artwork downloads tomorrow’s forecast from the Bureau of Meteorology website. Data including, current local temperature, humidity, wind speed & direction, precipitation (rain, hail etc), are used to generate a lighting display that conveys how tomorrow will feel. The artwork’s background colour indicates the expected temperature – from cold blues through mild pastel pinks and blues to bright hot oranges and reds. White fluffy clouds roll across the artwork if cloud is predicted. The density of these clouds indicates the level of cover whilst movement indicates expected wind speed and direction. If rain is predicted, sparkles of white light will appear on top of whichever background colour is chosen for the next day’s temperature. Sparkles appear constantly before wet, drizzly days, and intermittently if scattered showers are predicted. Intermittent, but more intense sparkles appear before rain storms or thunderstorms. Research Contribution: The work has made contributions to the field in the way it rethinks approaches to the conceptualization, design and realization of illuminated urban media. This has led to new theorizations of urban media, which consider light and illumination can be used to convey meaningful data. The research has produced new methods for controlling illumination systems using tools and techniques typically employed in computation arts. It has also develop methods and processes for the design and production of illuminated urban media architectures that are connected to real time data sources, and do which not follow the assumed logics of screen based media and displays.

Development of a flexible design approach for the deflection zone behind road safety barriers

Flexible design practices broadly permit that design values outside the normal range can be accepted as appropriate for a site-specific context providing that the risk is evaluated and is tolerable. Execution of flexible design demands some evaluation of risk. In restoration projects, it may be the case that an immovable object exists within the zone of the expected deflection of a road safety barrier system. Only by design exception can the situation be determined to be acceptable. However, the notion of using flexible design for road safety barrier design is not well developed. The existence of a diminishing return relationship between safety benefits and provision of increased clear zone has been established previously. This paper proposes that a similar rationale might reasonably apply for the deflection zone behind road safety barriers and describes how the risk associated with road safety barriers might be quantified in order that defensible road safety barrier design can exist below the lower bounds of normal design standards. As such, the methodology described in this paper may provide some basis to enable road authorities to make informed design decisions, particularly for restoration, or “Brownfield”, projects.

The influence of injury cause, contact-sport participation, and personal knowledge on expectation of outcome from mild traumatic brain injury

Objective: This study investigated the influence of injury cause, contact-sport participation, and prior knowledge of mild traumatic brain injury (mTBI) on injury beliefs and chronic symptom expectations of mTBI. Method: A total of 185 non-contact-sport players (non-CSPs) and 59 contact-sport players (CSPs) with no history of mTBI were randomly allocated to one of two conditions in which they read either a vignette depicting a sport-related mTBI (mTBIsport) or a motor-vehicle-accident-related mTBI (mTBIMVA). The vignettes were otherwise standardized to convey the same injury parameters (e.g., duration of loss of consciousness). After reading a vignette, participants reported their injury beliefs (i.e., perceptions of injury undesirability, chronicity, and consequences) and their expectations of chronic postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms. Results: Non-CSPs held significantly more negative beliefs and expected greater PTSD symptomatology and greater PCS affective symptomatology from an mTBIMVA vignette thann mTBIsport vignette, but this difference was not found for CSPs. Unlike CSPs, non-CSPs who personally knew someone who had sustained an mTBI expected significantly less PCS symptomatology than those who did not. Despite these different results for non-CSPs and CSPs, overall, contact-sport participation did not significantly affect injury beliefs and symptom expectations from an mTBIsport. Conclusions: Expectations of persistent problems after an mTBI are influenced by factors such as injury cause even when injury parameters are held constant. Personal knowledge of mTBI, but not contact sport participation, may account for some variability in mTBI beliefs and expectations. These factors require consideration when assessing mTBI outcome.

The burden of cancer in member countries of the association of southeast asian nations (ASEAN)

This paper presents the most recent data on cancer rates and the burden of cancer in the ASEAN region. Epidemiological data were sourced from GLOBOCAN 2008 and disability adjusted life years (DALYs) lost were estimated using the standard methodology developed within the World Health Organization's Global Burden of Disease study. Overall, it was estimated there were over 700,000 new cases of cancer and 500,000 cancer deaths in ASEAN in the year 2008, leading to approximately 7.5 million DALYs lost in one year. The most commonly diagnosed cancers were lung (98,143), breast (86,842) and liver cancers (74,777). The most common causes of cancer death were lung cancer (85,772), liver cancer (69,115) and colorectal cancer (44,280). The burden of cancer in terms of DALYs lost was highest in Laos, Viet Nam and Myanmar and lowest in Brunei, Singapore and the Philippines. Significant differences in the patterns of cancer from country to country were observed. Another key finding was the major impact played by population age distribution on cancer incidence and mortality. Cancer rates in ASEAN are expected to increase with ageing of populations and changes in lifestyles associated with economic development. Therefore, ASEAN member countries are strongly encouraged to put in place cancer-control health carepolicies, focussed on strengthening the health systems to cope with projected increases in cancer prevention, treatment and management needs.

Osteoporosis and fragility fractures

The prevalence of osteoporosis is expected to increase with the ageing of the world’s population. This article reviews the epidemiology, risk factors and health burden of osteoporosis. In the Global Burden of Disease (GBD) Study 2005, osteoporosis is studied as a risk factor for fracture by considering the bone-mineral-density (BMD) measurement as the continuous exposure variable. We have performed a systematic review seeking population-based studies with BMD data measured by dual-X-ray absorptiometry (DXA). The femoral neck was selected as the unique location and all values were converted into Hologic® to enable inclusion of worldwide data for analysis. Provisional results on mean BMD values for different world regions are shown in age breakdowns for males and females 50 years or over, as well as mean T-scores using the young, white, female reference of National Health and Nutrition Examination Survey (NHANES) III. Results show remarkable geographical differences and a time trend towards improvement of the BMD values in Asian and European populations.

Protein Molecular Surface Mapped at Different Geometrical Resolutions

Many areas of biochemistry and molecular biology, both fundamental and applications-orientated, require an accurate construction, representation and understanding of the protein molecular surface and its interaction with other, usually small, molecules. There are however many situations when the protein molecular surface gets in physical contact with larger objects, either biological, such as membranes, or artificial, such as nanoparticles. The contribution presents a methodology for describing and quantifying the molecular properties of proteins, by geometrical and physico-chemical mapping of the molecular surfaces, with several analytical relationships being proposed for molecular surface properties. The relevance of the molecular surface-derived properties has been demonstrated through the calculation of the statistical strength of the prediction of protein adsorption. It is expected that the extension of this methodology to other phenomena involving proteins near solid surfaces, in particular the protein interaction with nanoparticles, will result in important benefits in the understanding and design of protein-specific solid surfaces. © 2013 Nicolau et al.

Facile dearomatisation of porphyrins using palladium-catalysed hydrazination: the 5,15-diiminoporphodimethenes and their redox products

The synthesis, electronic absorption and 1H NMR spectra of a suite of novel porphyrinoids derived from meso-bromoporphyrins by palladium-catalysed aminations using ethyl and tert-butylcarbazates are reported. Instead of the expected carbazate-substituted porphyrins, a facile oxidative dearomatisation of the porphyrin ring occurs in high yield, especially for the nickel(II) complexes, resulting in high yields of 5,15-diiminoporphodimethenes (DIPDs). The analogous zinc(II) and free base DIPDs were also characterised, the former by X-ray crystallography. The oxidation and reduction reactions of DIPDs and their precursor carbazate porphyrins were studied. Density Functional Theory (DFT) was used to calculate the optimised geometries and frontier molecular orbitals of DIPD Ni8c and bis(azocarboxylate) 19c, and Time Dependent DFT calculations allowed the prediction of electronic absorption spectra, whose characteristics corresponded well with those of the observed solution spectra. In the latter case, the calculated low-energy absorptions were unlike those of a typical porphyrin, due to the near-degeneracy of the highest filled frontier orbitals, and the wide energy separation between the unfilled orbitals. This feature was present in the observed spectrum.

Teaching Reflective Learning in Higher Education : A Systematic Approach Using Pedagogic Patterns

This book is about understanding the nature and application of reflection in higher education. It provides a theoretical model to guide the implementation of reflective learning and reflective practice across multiple disciplines and international contexts in higher education. The book presents research into the ways in which reflection is both considered and implemented in different ways across different professional disciplines, while maintaining a common purpose to transform and improve learning and/or practice. Readers will find this book innovative and new in three key ways. First, in its holistic theorisation of reflection within the pedagogic field of higher education; Secondly, in conceptualising reflection in different modes to achieve specific purposes in different disciplines; and finally, in providing conceptual guidance for embedding reflective learning and reflective practice in a systematic way across whole programmes, faculties or institutions in higher education. The book considers important contextual factors that influence the teaching of forms and methods of reflection. It provides a functional analysis of multiple modes of reflection, including written, oral, visual, auditory, and embodied forms. Empirical chapters analyse the application of these modes across disciplines and at different stages of a programme. The theoretical model accounts for students’ stage of development in the disciplinary field, along with progressive and cyclical levels of higher order thinking, and learning and professional practice that are expected within different disciplines and professional fields. The book provides: • A conceptual model for the application of reflection across disciplines in a variety of contexts. • Empirical examples of different modes and pedagogic patterns for reflection. • Guidance and support for embedding systemic pedagogical and curriculum change.