Interobserver agreement of the Gross Motor Function Classification System in an ambulant population of children with cerebral palsy

Gross Motor Function Classification System (GMFCS) level was reported by three independent assessors in a population of children with cerebral palsy (CP) aged between 4 and 18 years (n=184; 112 males, 72 females; mean age 10y 10mo [SD 3y 7mo]). A software algorithm also provided a computed GMFCS level from a regional CP registry. Participants had clinical diagnoses of unilateral (n=94) and bilateral (n=84) spastic CP, ataxia (n=4), dyskinesia (n=1), and hypotonia (n=1), and could walk independently with or without the use of an aid (GMFCS Levels I-IV). Research physiotherapist (n=184) and parent/guardian data (n=178) were collected in a research environment. Data from the child's community physiotherapist (n=143) were obtained by postal questionnaire. Results, using the kappa statistic with linear weighting (?1w), showed good agreement between the parent/guardian and research physiotherapist (?1w=0.75) with more moderate levels of agreement between the clinical physiotherapist and researcher (?1w=0.64) and the clinical physiotherapist and parent/guardian (?1w=0.57). Agreement was consistently better for older children (>2y). This study has shown that agreement with parent report increases with therapists'experience of the GMFCS and knowledge of the child at the time of grading. Substantial agreement between a computed GMFCS and an experienced therapist (?1w=0.74) also demonstrates the potential for extrapolation of GMFCS rating from an existing CP registry, providing the latter has sufficient data on locomotor ability.

Turbo channel estimation and equalisation for a superposition-based cooperative system

This study investigates the superposition-based cooperative transmission system. In this system, a key point is for the relay node to detect data transmitted from the source node. This issued was less considered in the existing literature as the channel is usually assumed to be flat fading and a priori known. In practice, however, the channel is not only a priori unknown but subject to frequency selective fading. Channel estimation is thus necessary. Of particular interest is the channel estimation at the relay node which imposes extra requirement for the system resources. The authors propose a novel turbo least-square channel estimator by exploring the superposition structure of the transmission data. The proposed channel estimator not only requires no pilot symbols but also has significantly better performance than the classic approach. The soft-in-soft-out minimum mean square error (MMSE) equaliser is also re-derived to match the superimposed data structure. Finally computer simulation results are shown to verify the proposed algorithm.

TRARESA: a tissue microarray-based hospital system for biomarker validation and discovery

Formalin fixed and paraffin embedded tissue (FFPE) collections in pathology departments are the largest resource for retrospective biomedical research studies. Based on the literature analysis of FFPE related research, as well as our own technical validation, we present the Translational Research Arrays (TRARESA), a tissue microarray centred, hospital based, translational research conceptual framework for both validation and/or discovery of novel biomarkers. TRARESA incorporates the analysis of protein, DNA and RNA in the same samples, correlating with clinical and pathological parameters from each case, and allowing (a) the confirmation of new biomarkers, disease hypotheses and drug targets, and (b) the postulation of novel hypotheses on disease mechanisms and drug targets based on known biomarkers. While presenting TRARESA, we illustrate the use of such a comprehensive approach. The conceptualisation of the role of FFPE-based studies in translational research allows the utilisation of this commodity, and adds to the hypothesis-generating armamentarium of existing high-throughput technologies.

Evolutionary Requirements for Next-Generation Dataflow-Based FPGA System Design

The use of dataflow digital signal processing system modelling
and synthesis techniques has been a fruitful research theme for many years and has yielded many powerful rapid system synthesis and optimisation capabilities. However, recent years have seen the spectrum of languages and techniques splinter in an application specific manner, resulting in an ad-hoc design process which is increasingly dependent on the particular application under development. This poses a major problem for automated toolflows attempting to provide rapid system synthesis for a wide ranges of applications. By analysing a number of dataflow FPGA implementation case studies, this paper shows that despit ethis common traits may be found in current techniques, which fall largely into three classes. Further, it exposes limitations pertaining to their ability to adapt algorith models to implementations for different operating environments and target platforms.

A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists

Background: One way to tackle health inequalities in resource-poor settings is to establish links between doctors and health professionals there and specialists elsewhere using web-based telemedicine. One such system run by the Swinfen Charitable Trust has been in existence for 13 years which is an unusually long time for such systems.

Objective: We wanted to gain some insights into whether and how this system might be improved.

Methods: We carried out a survey by questionnaire of referrers and specialists over a six months period.

Results: During the study period, a total of 111 cases were referred from 35 different practitioners, of whom 24% were not doctors. Survey replies were received concerning 67 cases, a response rate of 61 per cent. Eighty-seven per cent of the responding referrers found the telemedicine advice useful, and 78% were able to follow the advice provided. As a result of the advice received, the diagnosis was changed in 22% of all cases and confirmed in a further 18 per cent. Patient management was changed in 33 per cent. There was no substantial difference between doctors and non-doctors. During the study period, the 111 cases were responded to by 148 specialists, from whom 108 replies to the questionnaire were received, a response rate of 73 per cent. About half of the specialists (47%) felt that their advice had improved the management of the patients. There were 62 cases where it was possible to match up the opinions of the referrer and the consultants about the value of a specific teleconsultation. In 34 cases (55%) the referrers and specialists agreed about the value. However, in 28 cases (45%) they did not: specialists markedly underestimated the value of a consultation compared to referrers. Both referrers and specialist were extremely positive about the system which appears to be working well. Minor changes such as a clearer referral template and an improved web interface for specialists may improve it.

Analysis of VSC-based HVDC System under DC Faults

This paper analyzes the behavior of a Voltage Source Converter Based HVDC system under DC cable fault conditions. The behavior of the HVDC system during a permanent line-to-earth fault is analyzed, outlining the systems configuration and behavior at each stage of the fault timeline. Operation of the proposed system under a single earthing configurations i.e. Converter (solid) earthed/AC transformer unearthed, was analyzed and simulated, with particular attention paid to the converters operation. It was observed that the development of potential earth loops within the system as a result of DC line- toearth faults leads to substantial overcurrent and results in system configuration oscillation.