Modeling the glucose regulatory system in extreme preterm infants

Background

Premature infants represent a significant proportion of the neonatal intensive care population. Blood glucose homeostasis in this group is often disturbed by immaturity of endogenous regulatory systems and the stress of their condition. Hypo- and hyperglycemia are frequently reported in very low birth weight infants, and more mature infants often experience low levels of glycemia. A model capturing the unique fundamental dynamics of the neonatal glucose regulatory system could be used to develop better blood glucose control methods.

Methods

A metabolic system model is adapted from adult critical care to the unique physiological case of the neonate. Integral-based fitting methods were used to identify time-varying insulin sensitivity and non-insulin mediated glucose uptake profiles. The clinically important predictive ability of the model was assessed by assuming insulin sensitivity was constant over prediction intervals of 1, 2 and 4 h forward and comparing model-simulated versus actual clinical glucose values for all recorded interventions. The clinical data included 1091 glucose measurements over 3567 total patient hours, along with all associated insulin and nutritional infusion data, for N = 25 total cases. Ethics approval was obtained from the Upper South A Regional Ethics Committee for this study.

Results

The identified model had a median absolute percentage error of 2.4% [IQR: 0.9-4.8%] between model-fitted and clinical glucose values. Median absolute prediction errors at 1-, 2- and 4-h intervals were 5.2% [IQR: 2.5-10.3%], 9.4% [IQR: 4.5-18.4%] and 13.6% [IQR: 6.3-27.6%] respectively.

Conclusions

The model accurately captures and predicts the fundamental dynamic behaviors of the neonatal metabolism well enough for effective clinical decision support in glycemic control. The adaptation from adult to a neonatal case is based on the data from the literature. Low prediction errors and very low fitting errors indicate that the fundamental dynamics of glucose metabolism in both premature neonates and critical care adults can be described by similar mathematical models.     

Innovations in Individual Feature History Management—The Significance of Feature-based Temporal Model

A feature relies on three dimensions (space, theme, and time) for its representation. Even though spatiotemporal models have been proposed, they have principally focused on the spatial changes of a feature. In this paper, a feature-based temporal model is proposed to represent the changes of both space and theme independently. The proposed model modifies the ISO’s temporal schema and adds new explicit temporal relationship structure that stores temporal topological relationship with the ISO’s temporal primitives of a feature in order to keep track feature history. The explicit temporal relationship can enhance query performance on feature history by removing topological comparison during query process. Further, a prototype system has been developed to test a proposed feature-based temporal model by querying land parcel history in Athens, Georgia. The result of temporal query on individual feature history shows the efficiency of the explicit temporal relationship structure.

Quality through Managed Improvement and Measurement (QMIM): Towards a Phased Development and Implementation of a Quality Management System for a Software Company

The paper describes results of a longitudinal study of developments in the area of software product and process quality improvement within a Hungarian software company, IQSOFT Ltd. This company has been active in this area since 1993, trying to build, introduce and maintain an efficiently working quality management system which, e.g., fulfils the ISO 9001 requirements, allows steady software process improvement and, at the same time, conforms to company's own needs. Over the last eight years five phases could be distinguished. Each phase is described shortly, following the same structure, namely: basic starting points, key problem areas, literature consulted, activities and design executed, reflections on what happened and why. The lessons resulting from the analysis of this case have been formulated in terms of guidelines. We feel that these are applicable to any low maturity software development organisation embarking on a product or process quality improvement endeavour. These guidelines are developed around a framework containing the basic issues of software production (project management, technical processes and products). The guidelines advocate a careful step-by-step development of definitions, quality characteristics, and metrics related to these objects while at the same time developing and introducing the associated process.     

The influence of virtual presence: Effects on experienced cognitive load and learning outcomes in educational computer games

Does the immersive design of an educational gaming environment affect learners’ virtual presence and how much do they learn? Does virtual presence affect learning? This study tries to answer these questions by examining the differences in virtual presence and learning outcomes in two different computer-based multimedia environments: a gaming environment with high immersive design vs. hypertext learning environment with low immersive design. As the main focus, the effect of virtual presence on learning is also explained and tested. By identifying virtual presence as a variable that may determine learning, it is argued that computer gaming environments present a new challenge for researchers to investigate, particularly, the effects of virtual presence on the immersive design of games in order to help designers to predict which instructional configurations will maximize learning performance. In general, results revealed that the high-immersive gaming environment leads to the strongest form of virtual presence but also decreased learning. Although regression analyses indicate that virtual presence positively influences trivial- and non-trivial learning outcomes, learners who learned in a low-immersive environment outperformed the gaming group. A mediation analysis showed that the relation between virtual presence and non-trivial learning outcomes is partly mediated through increased cognitive load.     

Bringing Scheme programming to the iPhone—Experience

The iPhone SDK provides a powerful platform for the development of applications that make use of iPhone capabilities, such as sensors, GPS, Wi‐Fi, or Bluetooth connectivity. We observe that so far the development of iPhone applications has mostly been restricted to using Objective‐C. However, developing applications in plain Objective‐C on the iPhone OS suffers from limitations, such as the need for explicit memory management and lack of syntactic extension mechanism. Moreover, when developing distributed applications in Objective‐C, programmers have to manually deal with distribution concerns, such as service discovery, remote communication, and failure handling. In this paper, we discuss our experience in porting the Scheme programming language to the iPhone OS and how it can be used together with Objective‐C to develop iPhone applications. To support the interaction between Scheme programs and the underlying iPhone APIs, we have implemented a language symbiosis layer that enables programmers to access the iPhone SDK libraries from Scheme. In addition, we have designed high‐level distribution constructs to ease the development of distributed iPhone applications in an event‐driven style. We validate and discuss these constructs with a series of examples, including an iPod controller, a maps application, and a distributed multiplayer Scrabble‐like game. We discuss the lessons learned from this experience for other programming language ports to mobile platforms. Copyright © 2011 John Wiley & Sons, Ltd.     

Analysing quadratic effects of formative constructs by means of variance-based structural equation modelling

Together with the development of information systems research, there has also been increased interest in non-linear relationships between focal constructs. This article presents six Partial Least Squares-based approaches for estimating formative constructs’ quadratic effects. In addition, these approaches’ performance is tested by means of a complex Monte Carlo experiment. The experiment reveals significant and substantial differences between the approaches. In general, the performance of the hybrid approach as suggested by Wold (1982) is most convincing in terms of point estimate accuracy, statistical power, and prediction accuracy. The two-stage approach suggested by Chin et al (1996) showed almost the same performance; differences between it and the hybrid approach – although statistically significant – were unsubstantial. Based on these results, the article provides guidelines for the analysis of non-linear effects by means of variance-based structural equation modelling.     

Low temperature synthesis and characterisation of lecontite, (NH4)Na(SO4)·2H20

Lecontite, (NH₄)Na(SO₄).2H₂O, was synthesised at room temperature in high purity compared to earlier work with a minor impurity of mascagnite, (NH₄)₂SO₄. Rietveld refinement of the XRD results confirmed the crystal structure and unit cell dimensions as published earlier. Raman and Infrared spectroscopy, in conjunction with factor group analysis, resulted in a complex pattern of overlapping sulphate, NH and OH modes. The NH modes υ₁ was observed around 2880 cm⁻¹, υ₂ around 1700 cm⁻¹ overlapping with water OH-bending modes, υ₃ around 3300 cm⁻¹ overlapping with water OH-stretching modes around 3023, 3185 and 3422 cm⁻¹, and υ₄ around 1432, 1447 and 1462 cm⁻¹. The sulphate group in the crystal structure displays a decrease in symmetry from T_d as evidenced by the activation of the ν₁ mode at 982 cm⁻¹ and the ν₂ mode around 452 cm⁻¹ in the Infrared spectrum. The υ₃ mode shows clear splitting in the infrared spectra with a strong band at 1064 cm⁻¹ accompanied by two shoulders at 1107 and 1139 cm⁻¹. The Raman spectra show three weak bands at 1068, 1109 and 1135 cm⁻¹ with a shoulder at 1155 cm⁻¹. Similar splitting was observed for the υ₄ mode around 611 and 632 cm⁻¹ in the Infrared and Raman spectra, respectively.     

Observations of Aggressive Children During Peer Provocation and With a Best Friend.

Observational methods were used to examine aggressive children's peer relations in 2 contexts: when being teased by a peer and when interacting with a best friend. Because aggressive children may have more difficulty than nonaggressive children in both peer contexts, the authors also examined whether relations between behaviors across contexts varied as a function of aggression. Results indicated that aggression was related to children's behavior when provoked. Children's behavior when provoked was associated with fewer positive and more negative interactions with their best friend, particularly for aggressive children. Results are discussed with respect to social norms in middle childhood and informing interventions for aggressive children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The W-Process for Software Product Evaluation: A Method for Goal-Oriented Implementation of the ISO 14598 Standard

The importance of software product evaluations will grow with the awareness of the need for better software quality. The process to conduct such evaluations is crucial to get evaluation results that can be applied and meet customers' expectations. This paper reviews a well-known evaluation process: the ISO 14598 standard. The review focuses on the difficulties in selecting and evaluating the appropriate evaluation techniques. The review shows that the standard has problems in applying evaluation processes in practice due to insufficient attention to goal definition and to relationships between activities being implicit. Also, the standard ignores the trade-off between goals and resources and pays insufficient attention to feedback. To address these deficiencies, the W-process is proposed. It extends the standard through an improved process structure and additional guidelines.     

The Diffusible Signal Factor Family of Bacterial Cell?Cell Signals

Bacterial cell-to-cell signals of the diffusible signal factor (DSF) family are cis-2-unsaturated fatty acids that differ in their chain length and branching patterns. Signaling involving DSF family members occurs in diverse bacteria to include plant and human pathogens. In the majority of these organisms, the perception of DSF is linked to turnover of the second messenger cyclic di-GMP by one of two “core” pathways. Additional “accessory” signal transduction pathways can also be found, but are not widely conserved. DSF signaling acts to regulate diverse functions to include biofilm formation and architecture, antibiotic resistance, and the production of virulence factors in pathogens. DSF family signals can also participate in interspecies signaling with other bacteria and interkingdom signaling with the yeast Candida albicans. Such interactions may have importance in modifying microbial behavior during polymicrobial infections.