Talking with pictures: Exploring the possibilities of iconic communication

As multimedia computing becomes the order of the day, so there is a greater need to understand and to come to terms with the problems of visual presentation. This paper deals with iconic languages as a means of communicating ideas and concepts without words. Two example systems, developed respectively at the universities of Exeter and Brighton, are described. Both embody basic principles of the iconic communication which,, though not unique to learning technology, is forming an increasingly important part of user‐interfaces, including those in the area computer‐assisted learning

Cost-utility of transcatheter aortic valve implantation for inoperable patients with severe aortic stenosis treated by medical management: a UK cost-utility analysis based on patient-level data from the ADVANCE study.

OBJECTIVE: To use patient-level data from the ADVANCE study to evaluate the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared to medical management (MM) in patients with severe aortic stenosis from the perspective of the UK NHS. METHODS: A published decision-analytic model was adapted to include information on TAVI from the ADVANCE study. Patient-level data informed the choice as well as the form of mathematical functions that were used to model all-cause mortality, health-related quality of life and hospitalisations. TAVI-related resource use protocols were based on the ADVANCE study. MM was modelled on publicly available information from the PARTNER-B study. The outcome measures were incremental cost-effectiveness ratios (ICERs) estimated at a range of time horizons with benefits expressed as quality-adjusted life-years (QALY). Extensive sensitivity/subgroup analyses were undertaken to explore the impact of uncertainty in key clinical areas. RESULTS: Using a 5-year time horizon, the ICER for the comparison of all ADVANCE to all PARTNER-B patients was £13 943 per QALY gained. For the subset of ADVANCE patients classified as high risk (Logistic EuroSCORE >20%) the ICER was £17 718 per QALY gained). The ICER was below £30 000 per QALY gained in all sensitivity analyses relating to choice of MM data source and alternative modelling approaches for key parameters. When the time horizon was extended to 10 years, all ICERs generated in all analyses were below £20 000 per QALY gained. CONCLUSION: TAVI is highly likely to be a cost-effective treatment for patients with severe aortic stenosis

A STUDY OF PHAGOCYTOSIS IN AMOEBAE OF DICTYOSTELIUM DISCOIDEUM

A study has been made of the effects of various treatments on the phagocytosis of 14C-labelled E.coli by amoebae of Dictyostelium discoideum. An assay was also developed for the adhesion of amoebae to glass and the effects of a number of inhibitors on this process have been investigated. The phagocytosis of bacteria was inhibited by chelating agents at millimolar concentrations. The effect of chelators was not apparent in the presence of added divalent cations. However, only a small reduction in cell-glass adhesion was seen with EDTA concentrations that caused large reductions in phagocytosis. The calcium ionophore, A23187 abolished phagocytosis at 40 ug/ml. Pretreatment of amoebae with lanthanum ions completely inhibited both phagocytosis and cell-glass adhesion at low concentrations. Both phagocytosis and adhesion to glass are also strongly inhibited by calmodulin antagonists. Neither cytochalasin B or colchicine affected phagocytosis. Concanavalin A strongly inhibited phagocytosis presumably due to a direct interaction with cell surface glycoproteins, since the effect did not occur in the presence of alpha-methyl mannoside. Both phagocytosis and adhesion to glass were greatly reduced on treatment of the amoebae with tunicamycin, again suggesting glycoprotein involvement. Pretreatment of amoebae for 30 min with 1 mg/ml trypsin or pronase had no effect on phagocytosis, although pretreatment with papain at the same concentration caused some reduction. However, phagocytosis became pronase sensitive on exposure to tunicamycin. Beta-glucosidase also caused a small but consistent reduction in phagocytosis and cell-glass adhesion. Phagosomes were isolated from amoebae by two procedures. In the first, cells were allowed to phagocytose 1 um diameter polystyrene beads. The endocytosed beads were then isolated by flotation on a discontinuous sucrose density gradient. In a second procedure, devised during the course of this work, an attempt was made to isolate phagosomes from ingested glutaraldehyde-fixed E.coli. Analysis of these preparations by SDS-polyacrylamide gel electrophoresis showed a number of differences between them. A comparison of these preparations with "bulk" plasma membrane revealed a considerable similarity of the polypeptide profile with that isolated using fixed E. coli.The Institute of Marine and Environmental Research, Plymout

Cost-effectiveness analysis of cardiac resynchronization therapy in patients with NYHA I and NYHA II heart failure in Spain

Objectives: The aim of the study was to combine clinical results from the European Cohort of the REVERSE study and costs associated with the addition of cardiac resynchronization therapy (CRT) to optimal medical therapy (OMT) in patients with mild symptomatic (NYHA I-II) or asymptomatic left ventricular dysfunction and markers of cardiac dyssynchrony in Spain. Methods: A Markov model was developed with CRT + OMT (CRT-ON) versus OMT only (CRT-OFF) based on a retrospective cost-effectiveness analysis. Raw data was derived from literature and expert opinion, reflecting clinical and economic consequences of patient"s management in Spain. Time horizon was 10 years. Both costs (euro 2010) and effects were discounted at 3 percent per annum. Results: CRT-ON showed higher total costs than CRT-OFF; however, CRT reduced the length of hospitalization in ICU by 94 percent (0.006 versus 0.091 days) and general ward in by 34 percent (0.705 versus 1.076 days). Surviving CRT-ON patients (88.2 percent versus 77.5 percent) remained in better functional class longer, and they achieved an improvement of 0.9 life years (LYGs) and 0.77 years quality-adjusted life years (QALYs). CRT-ON proved to be cost-effective after 6 years, except for the 7th year due to battery depletion. At 10 years, the results were 18,431 per LYG and 21,500 per QALY gained. Probabilistic sensitivity analysis showed CRT-ON was cost-effective in 75.4 percent of the cases at 10 years. Conclusions: The use of CRT added to OMT represents an efficient use of resources in patients suffering from heart failure in NYHA functional classes I and II

Sons-of-Freedom Songs in English

Mark Mealing relate les grandes lignes de l’histoire dans Doukhobors du Canada et présente plusieurs de leurs chants en anglais, chants dont il a fait la collection en 1962 auprès des Fils de la Liberté lorsque ceux-ci faisaient du piquetage devant la Législature à Victoria. Au cours d’une visite à Agassis en 1964, il a enregistré des hymnes et il décrit les trois genres de chants des Doukhobors ainsi que leur façon de les chanter

Statistical approaches to the evaluation of the impact of vaccination programs : a case study exploring rotavirus vaccination in New South Wales

University of Technology Sydney. Faculty of Health.Vaccination programs can provide an effective means to control infectious diseases at a population level. Evaluating the impact of these programs after implementation can be complicated by limitations of routine surveillance systems and lack of routine testing to confirm diagnosis, as well as natural fluctuations in disease rates over time. This thesis provides a structured explanation of statistical methods and how they can be used to address the epidemiological challenges in assessing changes in burden of disease as a result of vaccination programs. It explores statistical approaches to the evaluation of vaccination programs at a population level, using rotavirus vaccination in New South Wales (NSW), Australia, as a case study. A summary of the key features that need to be considered when trying to detect any changes in the burden of infectious diseases due to vaccination is given. An assessment of the impact of the Australian rotavirus vaccination program, introduced in 2007, on hospitalisations and emergency department (ED) presentations of children aged under five years for all-cause gastroenteritis in NSW from July 2001 to June 2013 was conducted. Previously published methods that separate these hospitalisations and ED presentations into those due to rotavirus and those that are not are compared. A simulation study is used to explore these methods in controlled scenarios to determine the most appropriate method for these data. The Australian rotavirus vaccination program had an almost immediate impact and led to a fifty and sixteen percent reduction in the rate of hospitalisations and ED presentations for acute gastroenteritis within the first 2.5 years. These declines were mostly attributed to a decline in the size of the seasonal peak. The methods to determine rotavirus cases from all-cause gastroenteritis cases had different strengths and limitations and the derived estimates varied. No robust method was identified from the simulation study for our data. Each method that relied on using weekly counts of positive rotavirus laboratory tests to estimate rotavirus-attributable cases underestimated the true number of rotavirus cases when their assumptions held. The evaluation of the effectiveness of vaccination programs requires the use of rigorous statistical methods to ensure the robustness and validity of findings. Appropriate statistical methods that account for temporal trends are needed to provide a detailed understanding of any changes in disease burden observed. While this thesis focused on rotavirus disease burden in NSW, Australia, many of the concepts discussed are applicable to other infectious diseases

Simulating Burial Settings: Laboratory-Scale Forensic Bioreactor

Laboratory-scale forensic bioreactors can be beneficial for simulating and monitoring of burial settings by providing controlled environmental parameters (e.g. temperature, moisture, and others) applicable to a wide range of environments. The objectives of this study were to design and build forensic bioreactor, define parameters that are relevant to burial settings and suitable for laboratory simulation in the bioreactor, and verify the performance of the bioreactor. The laboratory-scale forensic bioreactor consisted of housing with individual soil chambers, temperature sensors with signal controls, soil moisture sensors, and a computer with software. The forensic bioreactor was capable of simulating burial settings. Two soil types with different soil pH levels and soil moisture within a udic moisture regime (\u3e10% VWC) were placed in the bioreactor along with sensors and signal controls to maintain a thermic temperature regime (15 –22° C). The temperature parameters remained stable within the thermic temperature regime (15 – 22° C) and toggled between 18.8° C (minimum temperature) and 20.2° C (maximum temperature). The soil moisture parameters declined slowly throughout the test period but remained within a udic moisture regime, averaging 22.0%, 17.6%, and 23.2% in the control, Ultisol, and Mollisol, respectively. The laboratory-scale forensic bioreactor was built with readily-available, inexpensive materials, and can be easily reproduced for use in forensic research. This research introduces a new technological system, the forensic bioreactor, in order to provide controlled and reproducible environments for forensic science