A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer

The purpose of this research was to estimate the cost-effectiveness of two rehabilitation interventions for breast cancer survivors, each compared to a population-based, non-intervention group (n = 208). The two services included an early home-based physiotherapy intervention (DAART, n = 36) and a group-based exercise and psychosocial intervention (STRETCH, n = 31). A societal perspective was taken and costs were included as those incurred by the health care system, the survivors and community. Health outcomes included: (a) 'rehabilitated cases' based on changes in health-related quality of life between 6 and 12 months post-diagnosis, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity (FACT-B+4) questionnaire, and (b) quality-adjusted life years (QALYs) using utility scores from the Subjective Health Estimation (SHE) scale. Data were collected using self-reported questionnaires, medical records and program budgets. A Monte-Carlo modelling approach was used to test for uncertainty in cost and outcome estimates. The proportion of rehabilitated cases was similar across the three groups. From a societal perspective compared with the non-intervention group, the DAART intervention appeared to be the most efficient option with an incremental cost of $1344 per QALY gained, whereas the incremental cost per QALY gained from the STRETCH program was $14,478. Both DAART and STRETCH are low-cost, low-technological health promoting programs representing excellent public health investments.

Constriction flows of monodisperse linear entangled polymers: Multiscale modeling and flow visualization

We explore both the rheology and complex flow behavior of monodisperse polymer melts. Adequate quantities of monodisperse polymer were synthesized in order that both the materials rheology and microprocessing behavior could be established. In parallel, we employ a molecular theory for the polymer rheology that is suitable for comparison with experimental rheometric data and numerical simulation for microprocessing flows. The model is capable of matching both shear and extensional data with minimal parameter fitting. Experimental data for the processing behavior of monodisperse polymers are presented for the first time as flow birefringence and pressure difference data obtained using a Multipass Rheometer with an 11:1 constriction entry and exit flow. Matching of experimental processing data was obtained using the constitutive equation with the Lagrangian numerical solver, FLOWSOLVE. The results show the direct coupling between molecular constitutive response and macroscopic processing behavior, and differentiate flow effects that arise separately from orientation and stretch. (c) 2005 The Society of Rheology.

Influence of the 23 October 2002 dust storm on the air quality of four Australian cities

Widespread drought and record maximum temperatures in eastern Australia produced a large dust storm on 23 October, 2002 which traversed a large proportion of eastern Australia and engulfed communities along a 2000 km stretch of coastline from south of Sydney ( NSW) to north of Mackay ( Queensland). This event provided an opportunity for a study of the impacts of rural dust upon the air quality of four Australian cities. A simple model is used to predict dust concentrations, dust deposition rates and particle size characteristics of the airborne dust in the cities. The total dust load of the plume was 3.35 to 4.85 million tones, and assuming a ( conservative) plume height of 1500 m, 62 - 90% of this dust load was deposited in-transit to the coast. It is conservatively estimated that 3.5, 12.0, 2.1 and 1.7 kilotonnes of dust were deposited during the event in Sydney, Brisbane, Gladstone and Mackay, respectively. In the South East Queensland region, this deposition is equivalent to 40% of the total annual TSP emissions for the region. The event increased TSP, PM10 and PM2.5 concentrations and reduced the visibility beyond the health and amenity guidelines in the four cities. For example, the 24-h average PM10 concentrations in Brisbane and Mackay, were 161 and 475 mu g m(-3) respectively, compared with the Australian national ambient air quality standard of 50 mu g m(-3). The 24-h average PM2.5 concentration in Brisbane was 42 mu g m(-3), compared with the national advisory standard of 25 mu g m(-3). These rural dusts significantly increased PM10/TSP ratios and decreased PM2.5/PM10 ratios, indicating that most of the particles were between PM2.5 and PM10.

Modeling hydrogen separation in high temperature silica membrane systems

In this work, a working model is proposed of molecular sieve silica (MSS) multistage membrane systems for CO cleanup at high temperatures (up to 500 degrees C) in a simulated fuel cell fuel processing system. Gases are described as having little interactions with each other relative to the pore walls due to low isosteric heat of adsorption on silica surfaces and high temperatures. The Arrhenius function for activated transport of pure gases was used to predict mixture concentration in the permeate and retentate streams. Simulation predicted CO could be reduced to levels below the required 50 ppmv for polymer electrolyte membrane fuel cell anodes at a stage H-2/CO selectivity of higher than 40 in 4 series membrane units. Experimental validation showed predicting mixture concentrations required only pure gas permeation data. This model has significant application for setting industrial stretch targets and as a robust basis for complex membrane model configurations. (c) 2006 American Institute of Chemical Engineers.

Summarizing level-two topological relations in large spatial datasets

Summarizing topological relations is fundamental to many spatial applications including spatial query optimization. In this article, we present several novel techniques to effectively construct cell density based spatial histograms for range (window) summarizations restricted to the four most important level-two topological relations: contains, contained, overlap, and disjoint. We first present a novel framework to construct a multiscale Euler histogram in 2D space with the guarantee of the exact summarization results for aligned windows in constant time. To minimize the storage space in such a multiscale Euler histogram, an approximate algorithm with the approximate ratio 19/12 is presented, while the problem is shown NP-hard generally. To conform to a limited storage space where a multiscale histogram may be allowed to have only k Euler histograms, an effective algorithm is presented to construct multiscale histograms to achieve high accuracy in approximately summarizing aligned windows. Then, we present a new approximate algorithm to query an Euler histogram that cannot guarantee the exact answers; it runs in constant time. We also investigate the problem of nonaligned windows and the problem of effectively partitioning the data space to support nonaligned window queries. Finally, we extend our techniques to 3D space. Our extensive experiments against both synthetic and real world datasets demonstrate that the approximate multiscale histogram techniques may improve the accuracy of the existing techniques by several orders of magnitude while retaining the cost efficiency, and the exact multiscale histogram technique requires only a storage space linearly proportional to the number of cells for many popular real datasets.

Toward efficient multifeature query processing

In many advanced applications, data are described by multiple high-dimensional features. Moreover, different queries may weight these features differently; some may not even specify all the features. In this paper, we propose our solution to support efficient query processing in these applications. We devise a novel representation that compactly captures f features into two components: The first component is a 2D vector that reflects a distance range ( minimum and maximum values) of the f features with respect to a reference point ( the center of the space) in a metric space and the second component is a bit signature, with two bits per dimension, obtained by analyzing each feature's descending energy histogram. This representation enables two levels of filtering: The first component prunes away points that do not share similar distance ranges, while the bit signature filters away points based on the dimensions of the relevant features. Moreover, the representation facilitates the use of a single index structure to further speed up processing. We employ the classical B+-tree for this purpose. We also propose a KNN search algorithm that exploits the access orders of critical dimensions of highly selective features and partial distances to prune the search space more effectively. Our extensive experiments on both real-life and synthetic data sets show that the proposed solution offers significant performance advantages over sequential scan and retrieval methods using single and multiple VA-files.

Proprioceptive neuromuscular facilitation stretching - Mechanisms and clinical implications

Proprioceptive neuromuscular facilitation (PNF) stretching techniques are commonly used in the athletic and clinical environments to enhance both active and passive range of motion (ROM) with a view to optimising motor performance and rehabilitation. PNF stretching is positioned in the literature as the most effective stretching technique when the aim is to increase ROM, particularly in respect to short-term changes in ROM. With due consideration of the heterogeneity across the applied PNF stretching research, a summary of the findings suggests that an 'active' PNF stretching technique achieves the greatest gains in ROM, e.g. utilising a shortening contraction of the opposing muscle to place the target muscle on stretch, followed by a static contraction of the target muscle. The inclusion of a shortening contraction of the opposing muscle appears to have the greatest impact on enhancing ROM. When including a static contraction of the target muscle, this needs to be held for approximately 3 seconds at no more than 20% of a maximum voluntary contraction. The greatest changes in ROM generally occur after the first repetition and in order to achieve more lasting changes in ROM, PNF stretching needs to be performed once or twice per week. The superior changes in ROM that PNF stretching often produces compared with other stretching techniques has traditionally been attributed to autogenic and/or reciprocal inhibition, although the literature does not support this hypothesis. Instead, and in the absence of a biomechanical explanation, the contemporary view proposes that PNF stretching influences the point at which stretch is perceived or tolerated. The mechanism(s) underpinning the change in stretch perception or tolerance are not known, although pain modulation has been suggested.

Multiphoton high-resolution 3D imaging of Langerhans cells and keratinocytes in the mouse skin model adopted for epidermal powdered immunization

Langerhans cells (LCs) can be targeted with DNA-coated gold micro-projectiles ("Gene Gun") to induce potent cellular and humoral immune responses. It is likely that the relative volumetric distribution of LCs and keratinocytes within the epidermis impacts on the efficacy of Gene Gun immunization protocols. This study quantified the three-dimensional (3D) distribution of LCs and keratinocytes in the mouse skin model with a near-infrared multiphoton laser-scanning microscope (NIR-MPLSM). Stratum corneum (SC) and viable epidermal thickness measured with MPLSM was found in close agreement with conventional histology. LCs were located in the vertical plane at a mean depth of 14.9 mum, less than 3 mum above the dermo-epidermal boundary and with a normal histogram distribution. This likely corresponds to the fact that LCs reside in the suprabasal layer (stratum germinativum). The nuclear volume of keratinocytes was found to be approximately 1.4 times larger than that of resident LCs (88.6 mum3). Importantly, the ratio of LCs to keratinocytes in mouse ear skin (1:15) is more than three times higher than that reported for human breast skin (1:53). Accordingly, cross-presentation may be more significant in clinical Gene Gun applications than in pre-clinical mouse studies. These interspecies differences should be considered in pre-clinical trials using mouse models.

A neural network based technique for automatic classification of road cracks

This paper presents a neural network based technique for the classification of segments of road images into cracks and normal images. The density and histogram features are extracted. The features are passed to a neural network for the classification of images into images with and without cracks. Once images are classified into cracks and non-cracks, they are passed to another neural network for the classification of a crack type after segmentation. Some experiments were conducted and promising results were obtained. The selected results and a comparative analysis are included in this paper.

Playing in continuous spaces: Some analysis and extension of population-based incremental learning

As an alternative to traditional evolutionary algorithms (EAs), population-based incremental learning (PBIL) maintains a probabilistic model of the best individual(s). Originally, PBIL was applied in binary search spaces. Recently, some work has been done to extend it to continuous spaces. In this paper, we review two such extensions of PBIL. An improved version of the PBIL based on Gaussian model is proposed that combines two main features: a new updating rule that takes into account all the individuals and their fitness values and a self-adaptive learning rate parameter. Furthermore, a new continuous PBIL employing a histogram probabilistic model is proposed. Some experiments results are presented that highlight the features of the new algorithms.

Multiscale histograms: Summarizing topological relations in large spatial datasets

Summarizing topological relations is fundamental to many spatial applications including spatial query optimization. In this paper, we present several novel techniques to eectively construct cell density based spatial histograms for range (window) summarizations restricted to the four most important topological relations: contains, contained, overlap, and disjoint. We rst present a novel framework to construct a multiscale histogram composed of multiple Euler histograms with the guarantee of the exact summarization results for aligned windows in constant time. Then we present an approximate algorithm, with the approximate ratio 19/12, to minimize the storage spaces of such multiscale Euler histograms, although the problem is generally NP-hard. To conform to a limited storage space where only k Euler histograms are allowed, an effective algorithm is presented to construct multiscale histograms to achieve high accuracy. Finally, we present a new approximate algorithm to query an Euler histogram that cannot guarantee the exact answers; it runs in constant time. Our extensive experiments against both synthetic and real world datasets demonstrated that the approximate mul- tiscale histogram techniques may improve the accuracy of the existing techniques by several orders of magnitude while retaining the cost effciency, and the exact multiscale histogram technique requires only a storage space linearly proportional to the number of cells for the real datasets.

Different routes to pure food allergens: extraction, recombinant techniques and total chemical synthesis for obtaining the plant-food pan-allergen LTP

La richiesta di allergeni puri è in continuo aumento per scopi diagnostici, come standard per metodi di rilevamento e di quantificazione, per l'immunoterapia e per lo studio a livello molecolare dei meccanismi delle reazioni allergiche, al fine di facilitare lo sviluppo di possibili cure. In questa tesi di dottorato sono descritte diverse strategie per l’ottenimento di forme pure di non-specific Lipid Transfer Proteins (nsLTPs), le quali sono state riconosciute essere rilevanti allergeni alimentari in molti frutti e verdure comunemente consumati e sono state definite come modello di veri allergeni alimentari. Una LTP potenzialmente allergenica, non nota in precedenza, è stata isolata dalle mandorle, mentre una LTP dall’allergenicità nota contenuta nelle noci è stata prodotta mediante tecniche di DNA ricombinante. Oltre a questi approcci classici, metodi per la sintesi chimica totale di proteine sono stati applicati per la prima volta alla produzione di un allergene, utilizzando Pru p 3, la LTP prototipica e principale allergene della pesca nell'area mediterranea, come modello. La sintesi chimica totale di proteinepermette di controllarne completamente la sequenza e di studiare la loro funzione a livello atomico. La sua applicazione alla produzione di allergeni costituisce perciò un importante passo avanti nel campo della ricerca sulle allergie alimentari. La proteina Pru p 3 è stata prodotta nella sua intera lunghezza e sono necessari solo due passaggi finali di deprotezione per ottenere il target nella sua forma nativa. Le condizioni sperimentali per tali deprotezioni sono state messe a punto durante la produzione dei peptidi sPru p 3 (1-37) e sPru p 3 (38-91), componenti insieme l'intera proteina. Tecniche avanzate di spettrometria di massa sono state usate per caratterizzare tutti i composti ottenuti, mentre la loro allergenicità è stata studiata attraverso test immunologici o approcci in silico.

A METÁFORA DO CORPO NA I CARTA DE CLEMENTE DE ROMA AOS CORÍNTIOS (37.5-38.1): Uma análise dialógica

A I Carta de Clemente de Roma aos Coríntios faz parte de uma coleção de escritos cristãos antigos intitulados Pais Apostólicos. Esse texto é uma autêntica correspondência enviada da comunidade cristã de Roma para a comunidade cristã de Corinto, escrita pelo seu secretário Clemente. Esta pesquisa, em contraposição às desenvolvidas pela disciplina teológica chamada patrologia , analisa a carta a partir das teorias de Mikhail M. Bakhtin e seu círculo e da micro-história assumidamente relacionada com as teorias do mesmo autor delimitando o trecho 37.5-38.1, onde se encontra a metáfora do corpo.

ANÁLISE DA DENSIDADE ÓPTICA DA SUTURA PALATINA MEDIANA APÓS A EXPANSÃO RÁPIDA DA MAXILA ASSISTIDA CIRURGICAMENTE

A Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC) é um recurso ortodôntico-cirúrgico utilizado no tratamento das más oclusões com deficiência transversal da maxila em pacientes adultos que apresentam a consolidação da sutura palatina mediana. A proposta neste estudo foi a de avaliar as densidades ópticas da sutura palatina mediana antes da ERMAC (fase I), após o fechamento do parafuso expansor (fase II), após 3 meses do fechamento do parafuso expansor (fase III) e após 6 meses do procedimento cirúrgico. A amostra deste estudo foi constituída por 64 radiografias oclusais de 16 pacientes na faixa etária de 18 a 40 anos, sendo 6 do sexo masculino e 10 do sexo feminino que necessitavam submeter-se à Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC) e com atresia maxilar superior a 5 mm. Foram obtidas as radiografias oclusais e as imagens digitalizadas das quatro fases do estudo. Duas áreas de interesse foram demarcadas nas imagens digitalizadas, uma entre os incisivos centrais superiores e outra após o término do parafuso expansor. Procedeu-se às leituras das densidades ópticas pelo programa Image Tool for Windows por meio do Histograma. Após a análise estatística dos valores obtidos de densidade óptica das regiões analisadas pela Análise de Variâncias (ANOVA) e comparações múltiplas de Bonferroni (complemento da ANOVA), pode-se concluir que: a densidade óptica na região da sutura palatina mediana nas 4 fases estudadas, apresentou grande variação, compatível com a abertura da referida sutura e posterior neoformação óssea no período pós-operatório; foi observado valor decrescente para as densidades ópticas após o fechamento do parafuso expansor nas regiões A e B ; foi observado que após 3 meses do fechamento do parafuso expansor, as densidades ópticas aumentaram nas regiões A e B . Isso sugeriu neoformação óssea na região da sutura palatina mediana; foi observado que após 6 meses do procedimento cirúrgico, as densidades ópticas aumentaram em relação à fase anterior. Na região A , observou-se que os valores das densidades ópticas não retornaram aos valores pré-tratamento, ou seja, antes da Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC). Já os valores das densidades ópticas médias da região B retornaram aos valores iniciais, antes da ERMAC. A análise estatística revelou que após 6 meses do procedimento cirúrgico, houve diferença estatisticamente significante ao se avaliar a região A comparando as fases entre si, porém ao se avaliar a região B não houve diferença estatisticamente significante ao se comparar as fases I e IV.

Blood type classification using computer vision and machine learning

In emergency situations, where time for blood transfusion is reduced, the O negative blood type (the universal donor) is administrated. However, sometimes even the universal donor can cause transfusion reactions that can be fatal to the patient. As commercial systems do not allow fast results and are not suitable for emergency situations, this paper presents the steps considered for the development and validation of a prototype, able to determine blood type compatibilities, even in emergency situations. Thus it is possible, using the developed system, to administer a compatible blood type, since the first blood unit transfused. In order to increase the system’s reliability, this prototype uses different approaches to classify blood types, the first of which is based on Decision Trees and the second one based on support vector machines. The features used to evaluate these classifiers are the standard deviation values, histogram, Histogram of Oriented Gradients and fast Fourier transform, computed on different regions of interest. The main characteristics of the presented prototype are small size, lightweight, easy transportation, ease of use, fast results, high reliability and low cost. These features are perfectly suited for emergency scenarios, where the prototype is expected to be used.