Assessment of the nutritional state of dialysis patients

Obstructive sleep apnea syndrome (OSAS) has been associated with a higher than normal cardiovascular morbidity and mortality. Some OSAS patients lack the sleep-related, nocturnal decrease, or "dip," in blood pressure which is seen in normal individuals. These subjects, called "non-dippers," may be at greater risk for cardiovascular problems. We studied 40 OSAS patients (including 3 women) and 6 control subjects, all identified by polysomnography, for nocturnal blood pressure "dipping." We performed a second nocturnal polysomnogram to determine their apnea and hypopnea indices, (A + H)I, and oxygen saturation levels at the beginning of the study and then initiated 48 hours of ambulatory blood pressure monitoring, with data points collected every 30 minutes. Controls, which included one hypertensive subject, were all dippers. Nineteen OSAS subjects (48% of OSAS individuals) were systolic non-dippers and only 9 of them (22.5%) were diastolic non-dippers. We considered the following clinical variables as potential predictors of non-dipping: age, body mass index, respiratory disturbance index, years of reported loud snoring by bed partners, lowest oxygen saturation during nocturnal sleep, and percentage of sleep time spent with oxygen saturation below 90%. Multiple regression analyses indicated respiratory disturbance index as the only significant variable for systolic (p = 0.04) and diastolic (p = 0.03) blood pressure non-dipping. When we forced the following two nonsignificant variables into the model, they showed a very meager impact: number of years with reported loud snoring (p = 0.4 and p = 0.5, respectively for systolic and diastolic blood pressure non-dipping) and age (p = 0.5 and p = 0.6). The calculated model explained only a low percentage of the variance with an r2 of 0.25 and 0.26 for systolic and diastolic blood pressure non-dipping, respectively. Analysis of hypertension/normotension and dipping/non-dipping failed to show a significant relationship in the studied population. Fifty percent of the normotensive OSAS subjects were non-dippers and 43% of the hypertensive OSAS subjects were also non-dippers. We found a relationship between increasing respiratory disturbance index and increasing average 24-hour systolic blood pressure only when OSAS subjects were non-dippers and hypertensive.     

Iterative optimization of high-affinity proteases inhibitors using phage display. 1. Plasmin

We generated a series of libraries having variants of the first Kunitz domain of human lipoprotein-associated coagulation inhibitor (LACI-D1, also known as tissue-factor pathway inhibitor-I) displayed on bacteriophage M13 as pIII-fusions. We varied LACI-DI iteratively in two regions: the P1 region (positions 10-21) and the "second loop", (positions 31-39), which together form one end of the domain. Display-phage library Lib#1 allows 31 200 amino-acid sequences in P1 region (residues 13, 16-19). Preliminary, we screened Lib#1 against human plasmin (PLA, EC 3.4.21.7) immobolized on agarose to enrich for phage displaying variants with PLA affinity. We introduced a 1600-fold increase in second-loop diversity (residues 31, 32, 34, 39) into the population of selectants from Lib#1, yielding Lib#2. Lib#2 (allowing approximately 50 million amino-acid sequences) was screened against PLA-agarose to isolate highest affinity binders. Protein EPI-P211, derived from the best isolate of Lib#2, inhibits PLA with Ki = 2 nM (at least 500-fold better than LACI-D1) and with high specificity. We used amino-acid sequences of PLA-binding selectants to design a PLA-biased library (Lib#3) which we screened against PLA. The protein EPI-P302 (derived from the best binder obtained from Lib#3) has Ki for PLA inhibition of 87 pM, which is 25-fold better than the first-round best binder and > or = 12 500-fold better than LACI-D1. EPI-P302 also shows very high specificity for PLA vs other human proteases and is resistant to inactivation by oxidants and extremes of temperature or pH. Thus, one can use selectants from one library to design target-tailored combinatorial libraries and obtain quite stable, highly specific, very high-affinity binding molecules while maintaining an essentially human framework.     

A job grouping approach for planning container transfers at automated seaport container terminals

This paper proposes a practical job grouping approach, which aims to enhance the time related performance metrics of container transfers in the Patrick AutoStrad container terminal, located in Brisbane, Australia. It first formulates a mathematical model of the automated container transfers in a relatively complex environment. Apart from the consideration on collision avoidance of a fleet of large vehicles in a confined area, it also deals with many other difficult practical challenges such as the presence of multiple levels of container stacking and sequencing, variable container orientations, and vehicular dynamics that require finite acceleration and deceleration times. The proposed job grouping approach aims to improve the makespan of the schedule for yard jobs, while reducing straddle carrier waiting time by grouping jobs using a guiding function. The performance of the current sequential job allocation method and the proposed job grouping approach are evaluated and compared statistically using a pooled t-test for 30 randomly generated yard configurations. The experimental results show that the job grouping approach can effectively improve the schedule makespan and reduce the total straddle carrier waiting time.     

A Visualization Based Approach for Digital Signature Authentication

We propose a visualization based approach for digital signature authentication. Using our method, the speed and pressure aspects of a digital signature process can be clearly and intuitively conveyed to the user for digital signature authentication. Our design takes into account both the expressiveness and aesthetics of the derived visual patterns. With the visual aid provided by our method, digital signatures can be authenticated with better accuracy than using existing methods—even novices can examine the authenticity of a digital signature in most situations using our method. To validate the effectiveness of our method, we conducted a comprehensive user study which confirms positively the advantages of our approach. Our method can be employed as a new security enhancement measure for a range of business and legal applications in reality which involve digital signature authorization and authentication.     

Immunity-based hybrid evolutionary algorithm for multi-objective optimization in global container repositioning

The development of evolutionary algorithms for optimization has always been a stimulating and growing research area with an increasing demand in using them to solve complex industrial optimization problems. A novel immunity-based hybrid evolutionary algorithm known as Hybrid Artificial Immune Systems (HAIS) for solving both unconstrained and constrained multi-objective optimization problems is developed in this research. The algorithm adopts the clonal selection and immune suppression theories, with a sorting scheme featuring uniform crossover, multi-point mutation, non-dominance and crowding distance sorting to attain the Pareto optimal front in an efficient manner. The proposed algorithm was verified with nine benchmarking functions on its global optimal search ability as well as compared with four optimization algorithms to assess its diversity and spread. Sensitivity analysis was also carried out to investigate the selection of key parameters of the algorithm. It is found that the developed immunity-based hybrid evolutionary algorithm provides a useful means for solving optimization problems and has successfully applied to the problem of global repositioning of containers, which is one of a constrained multi-objective optimization problem. The developed HAIS will assist shipping liners on timely decision making and planning of container repositioning operations in global container transportation business in an optimized and cost effective manner.     

On detecting faults for Boolean expressions

Fault based testing aims at detecting hypothesized faults based on specifications or program source. There are some fault based techniques for testing Boolean expressions which are commonly used to model conditions in specifications as well as logical decisions in program source. The MUMCUT strategy has been proposed to generate test cases from Boolean expressions. Moreover, it detects eight common types of hypothesized faults provided that the original expression is in irredundant disjunctive normal form, IDNF. Software practitioners are more likely to write the conditions and logical decisions in general form rather than IDNF. Hence, it is interesting to investigate the fault detecting capability of the MUMCUT strategy with respect to general form Boolean expressions. In this article, we perform empirical studies to investigate the fault detection capability of the MUMCUT strategy with respect to general form Boolean expressions as well as mutated expressions. A mutated expression can be obtained from the original given Boolean expression by making a syntactic change based on a particular type of fault.

Situation awareness acquired from monitoring process plants – the Process Overview concept and measure

We introduce Process Overview, a situation awareness characterisation of the knowledge derived from monitoring process plants. Process Overview is based on observational studies of process control work in the literature. The characterisation is applied to develop a query-based measure called the Process Overview Measure. The goal of the measure is to improve coupling between situation and awareness according to process plant properties and operator cognitive work. A companion article presents the empirical evaluation of the Process Overview Measure in a realistic process control setting. The Process Overview Measure demonstrated sensitivity and validity by revealing significant effects of experimental manipulations that corroborated with other empirical results. The measure also demonstrated adequate inter-rater reliability and practicality for measuring SA based on data collected by process experts.

Practitioner Summary: The Process Overview Measure is a query-based measure for assessing operator situation awareness from monitoring process plants in representative settings.     

The course of geriatric depression with "reversible dementia": a controlled study

OBJECTIVE: The goals of this longitudinal investigation were 1) to study the rate of development of irreversible dementia in elderly depressed patients with a dementia syndrome that subsided after improvement of depression and 2) to compare it with that of depressed, never-demented patients. METHOD: The subjects were 57 elderly patients consecutively hospitalized for major depression. At entry into the study, 23 subjects also met criteria for "reversible dementia," while 34 were without dementia. After a systematic clinical evaluation, the subjects were followed up at approximately yearly intervals for an average of 33.8 months. RESULTS: Irreversible dementia developed significantly more frequently in the depressed group with reversible dementia (43%) than in the group with depression alone (12%). Survival analysis showed that the group with reversible dementia had a 4.69-times higher chance of having developed dementia at follow-up than the patients with depression alone. No clinical characteristics at entry into the study were found to discriminate the subjects who developed irreversible dementia during the follow-up period from those who remained nondemented. CONCLUSIONS: These findings suggest that geriatric depression with reversible dementia is a clinical entity that includes a group of patients with early-stage dementing disorders. Therefore, identification of a reversible dementia syndrome is an indication for a thorough diagnostic workup and frequent follow-ups in order to identify treatable neurological disorders.     

CyberWalk: a web-based distributed virtual walkthrough environment

A distributed virtual walkthrough environment allows users connected to the geometry server to walk through a specific place of interest, without having to travel physically. This place of interest may be a virtual museum, virtual library or virtual university. There are two basic approaches to distribute the virtual environment from the geometry server to the clients, complete replication and on-demand transmission. Although the on-demand transmission approach saves waiting time and optimizes network usage, many technical issues need to be addressed in order for the system to be interactive. CyberWalk is a web-based distributed virtual walkthrough system developed based on the on-demand transmission approach. It achieves the necessary performance with a multiresolution caching mechanism. First, it reduces the model transmission and rendering times by employing a progressive multiresolution modeling technique. Second, it reduces the Internet response time by providing a caching and prefetching mechanism. Third, it allows a client to continue to operate, at least partially, when the Internet is disconnected. The caching mechanism of CyberWalk tries to maintain at least a minimum resolution of the object models in order to provide at least a coarse view of the objects to the viewer. All these features allow CyberWalk to provide sufficient interactivity to the user for virtual walkthrough over the Internet environment. In this paper, we demonstrate the design and implementation of CyberWalk. We investigate the effectiveness of the multiresolution caching mechanism of CyberWalk in supporting virtual walkthrough applications in the Internet environment through numerous experiments, both on the simulation system and on the prototype system.     

User-centric content negotiation for effective adaptation service in mobile computing

We address the challenges of building a good content adaptation service for mobile devices and propose a decision engine that is user-centric with QoS awareness, which can automatically negotiate for the appropriate adaptation decision to use in the synthesis of an optimal adapted version. The QoS-sensitive approach complements the lossy nature of the transcoding operations. The decision engine will look for the best trade off among various parameters in order to reduce the loss of quality in various domains. Quantitative methods are suggested to measure the QoS of the content versions in various quality domains. Based on the particular user perception and other contextual information on the client capability, the network connection, and the requested content, the proposed negotiation algorithm will determine a content version with a good aggregate score. We have built a prototype document adaptation system for PDF documents to demonstrate the viability of our approach.