Morning glory disc anomaly and moyamoya vessels

In the health care system, good communication is of vital importance for correct information, diagnosis and treatment. When the health care worker and the patient have no common language, an interpreter is needed. In a small population the patient and the interpreter will often be acquainted. In small, local communities few professional interpreters are available. These communities can be served by offering a telephone interpreter, thus providing foreign citizens with a better health service. The presence of an interpreter reduces the possibility of being anonymous. The patient may withhold important information, or give incorrect information. By using a telephone interpreter, neither the patient nor the interpreter needs to know who the other person is. We found this to be a very good alternative in most cases, and sometimes a better solution. A good, loud-speaking telephone was needed. The interpreters were not as satisfied as the doctors and patients. Further development of the service is therefore required.     

Potential risk factors for vertical HIV-1 transmission in Catalonia, Spain: the protective role of cesarean section. The Working Group on HIV-1 Vertical Transmission in Catalonia

OBJECTIVE: To evaluate the roles of certain potential risk factors on the vertical transmission of HIV-1. DESIGN: Prospective registry of infants born to HIV-1-infected women in Catalonia (north-east Spain) from 1987 to 1992. METHODS: A total of 599 infants, born in Catalan hospitals to 520 women who were identified as being HIV-1-infected during gestation or at delivery, were included. Data on mode of delivery, birth weight, gestational age and breast-feeding as well as the mother's age, her route of HIV-1 infection, clinical stage and p24 antigenaemia, were recorded. HIV-1 infection status of 489 (82%) of the infants was determined according to the criteria of the US Centers for Disease Control and Prevention. Risk estimates and odds ratio (OR) were calculated and logistic regression was performed. RESULTS: The overall rate of vertical transmission was 18.6% (95% confidence interval, 15.2-22.0%). Multivariate analyses revealed that Cesarean section was associated with a lower rate of vertical transmission (OR = 0.3; P = 0.001), as was maternal HIV-1 infection via injecting drug use (OR = 0.44; P = 0.02). Breast-feeding (OR = 6.9; P = 0.001), very low birth weight (< 1500 g; OR = 6.3; P = 0.001) and p24 antigenaemia (OR = 4.6; P = 0.04) were all related to increased risk. The crude rate of HIV-1 transmission was 6% among Cesarean births compared with 21% for infants born via vaginal deliveries. The population-attributable risk for vaginal deliveries was 61.7%. CONCLUSIONS: The results show a protective effect of Cesarean section in the absence of zidovudine prophylaxis. However, current research should be directed towards the individual and combined effects that antiretroviral agents and Cesarean section may have on mother-to-child HIV-1 infection.     

Computer recognition of textual keyboard inputs from naive users

The case for interactive computer dialogues for naive users to be based upon textual keyboard inputs is supported. A number of problems associated with this approach are highlighted relating to the fact that a single input may be entered in a variety of ways. A computer procedure, called TEX, is proposed which is designed to tolerate this variance and to successfully recognize textual inputs.     

A class of mobile motion prediction algorithms for wireless mobile computing and communications

This paper describes a class of novel mobile motion prediction algorithms for supporting global mobile data accessing. Traditionally, mobility and routing management includes functions to passively keep track of the location of the users/terminals and to maintain connections to the terminals belonging to the system. To maintain uninterrupted high-quality service for distributed applications, it is important that a mobile system be more intelligent and can anticipate the change of the location of its user. We propose an aggressive mobility and routing management scheme, called predictive mobility management. A class of mobile motion prediction algorithms predicts the future location of a mobile user according to the user's movement history, i.e., previous movement patterns. By combining this scheme with mobility agent functions, the service and user routing data are actually pre-connected and pre-assigned at the locations to which the user is moving. Thus, the user can immediately receive service or data with virtually the same efficiency as at the previous location, i.e., without encountering a large data structure handover delay before service or data is available.     

Usability of Geographic Information: Current challenges and future directions

The use of Geographic Information or GI, has grown rapidly in recent years. Previous research has identified the importance of usability and user centred design in enabling the proliferation and exploitation of GI. However, the design and development of usable GI is not simply a matter of applying the tried and tested usability methods that have been developed for software and web design. Dealing with data and specifically GI brings with it a number of issues that change the way usability and user centred design can be applied. This paper describes the outcomes of a workshop held in March 2010 exploring the core issues relating to GI usability. The workshop brought together an international group of twenty experts in both human factors and GI, from a wide range of academic and industrial backgrounds. These experts considered three key issues, the stakeholders in GI, key challenges applying usability to GI and the usability methods that can be successfully applied to GI. The result of this workshop was to identify some areas for future research, such as the production of meaningful metadata and the implications of blurring of the line between data producers and data consumers.     

Using simulation-based system dynamics and genetic algorithms to reduce the cash flow bullwhip in the supply chain

The bullwhip effect (BWE) is a phenomenon, which is caused by ineffective inventory decisions made by supply chain members. In addition to known inefficiencies caused by the bullwhip effect within a supply chain product flow, such as excessive inventory, it can also lead to inefficiencies in cash flow such as the cash flow bullwhip (CFB). The CFB reduces the efficiency of the supply chain (SC) through heterogeneous distribution of cash among supply chain members. This paper aims to decrease both the BWE and the CFB across a SC through applying a simulation-based optimisation approach, which integrates system dynamics (SD) simulation and genetic algorithms. For this purpose, cash flow modelling is incorporated into the SD structure of the beer distribution game (BG) to develop the CFB function. A multi objective optimisation model is then integrated with the SD-BG simulation model. Finally, a genetic algorithm (GA) is applied to determine the optimal values for the inventory, supply line, and financial decision parameters. Results show that the proposed integrated framework leads to efficient liquidity management in the SC in addition to cost management.     

Estimation of vaccine efficacy in a repeated measures study under heterogeneity of exposure or susceptibility to infection

Vaccine efficacy (VE) is commonly estimated through proportional hazards modelling of the time to first infection or disease, even when the event of interest can recur. These methods can result in biased estimates when VE is heterogeneous across levels of exposure and susceptibility in subjects. These two factors are important sources of unmeasured heterogeneity, since they vary within and across areas, and often cannot be individually quantified. We propose an estimator of VE per exposure that accounts for heterogeneous susceptibility and exposure for a repeated measures study with binary recurrent outcomes. The estimator requires only information about the probability distribution of environmental exposures. Through simulation studies, we compare the properties of this estimator with proportional hazards estimation under the heterogeneity of exposure. The methods are applied to a reanalysis of a malaria vaccine trial in Brazil.     

Reducing the negative effects of sales promotions in supply chains using genetic algorithms

This paper considers the detrimental effect of promotions on the supply chain (SC), one of the main causes of the bullwhip effect. A genetic algorithm (GA) is proposed to reduce these negative effects. In order to validate the GA, it is used to determine the optimal ordering policy in an online version of the MIT beer distribution game. Subsequently, the GA is applied in a number of experiments involving deterministic and random demand and lead times combined with sales promotions. It is shown how GAs can be used to dampen the impact of the bullwhip effect and can be used to assist supply managers in predicting reorder quantities along the supply chain.     

Identification of Apolipoprotein AI as a serum biomarker of chronic kidney disease in liver transplant recipients, using proteomic techniques

Chronic kidney disease (CKD) is a common complication post‐orthotopic liver transplantation (OLT). Development of CKD is detected by monitoring serum urea and creatinine, however disease can occasionally be at an advanced stage before they become abnormal. Therefore, more accurate parameters are required. In order to identify novel biomarkers of CKD, serum was obtained from 47 OLT recipients with CKD (glomerular filtration rate <60 mL/min) and 23 with normal renal function (glomerular filtration rate >90 mL/min). Using the proteomic technique SELDI‐TOF‐MS, three protein biomarkers (55.6 kDa, 9.5 kDa and 11.4 kDa) were identified that, together, could stratify patients into cases or controls with a sensitivity and specificity of 93.6 and 91.3%, respectively. The area under the curve was 0.94. The primary splitter of the groups at 55.6 kDa was an alternative version of a molecule at 27.8 kDa, which was subsequently identified by 1‐D SDS‐PAGE and LC‐ESI‐MS/MS to be Apolipoprotein AI. Protein expression was shown to be reduced in CKD, by both ELISA (p = 0.057) and Western blot analysis (p = 0.003). Apolipoprotein AI is a novel, accurate marker of CKD post‐OLT. It does require further validation in a large, more diverse patient population but could potentially improve detection of CKD.