Edith Cowan University

BACKGROUND: The order and magnitude of pathologic processes in Alzheimer's disease are not well understood, partly because the disease develops over many years. Autosomal dominant Alzheimer's disease has a predictable age at onset and provides an opportunity to determine the sequence and magnitude of pathologic changes that culminate in symptomatic disease. METHODS: In this prospective, longitudinal study, we analyzed data from 128 participants who underwent baseline clinical and cognitive assessments, brain imaging, and cerebrospinal fluid (CSF) and blood tests. We used the participant's age at baseline assessment and the parent's age at the onset of symptoms of Alzheimer's disease to calculate the estimated years from expected symptom onset (age of the participant minus parent's age at symptom onset). We conducted cross-sectional analyses of baseline data in relation to estimated years from expected symptom onset in order to determine the relative order and magnitude of pathophysiological changes. RESULTS: Concentrations of amyloid-beta (Aβ)(42) in the CSF appeared to decline 25 years before expected symptom onset. Aβ deposition, as measured by positron-emission tomography with the use of Pittsburgh compound B, was detected 15 years before expected symptom onset. Increased concentrations of tau protein in the CSF and an increase in brain atrophy were detected 15 years before expected symptom onset. Cerebral hypometabolism and impaired episodic memory were observed 10 years before expected symptom onset. Global cognitive impairment, as measured by the Mini-Mental State Examination and the Clinical Dementia Rating scale, was detected 5 years before expected symptom onset, and patients met diagnostic criteria for dementia at an average of 3 years after expected symptom onset. CONCLUSIONS: We found that autosomal dominant Alzheimer's disease was associated with a series of pathophysiological changes over decades in CSF biochemical markers of Alzheimer's disease, brain amyloid deposition, and brain metabolism as well as progressive cognitive impairment. Our results require confirmation with the use of longitudinal data and may not apply to patients with sporadic Alzheimer's disease. (Funded by the National Institute on Aging and others; DIAN ClinicalTrials.gov number, NCT00869817.).

Research that combines all available studies of biological responses to regional and global climate change shows that 81–83% of all observations were consistent with the expected impacts of climate change. These findings were replicated across taxa and oceanic basins. Past meta-analyses of the response of marine organisms to climate change have examined a limited range of locations1,2, taxonomic groups2,3,4 and/or biological responses5,6. This has precluded a robust overview of the effect of climate change in the global ocean. Here, we synthesized all available studies of the consistency of marine ecological observations with expectations under climate change. This yielded a meta-database of 1,735 marine biological responses for which either regional or global climate change was considered as a driver. Included were instances of marine taxa responding as expected, in a manner inconsistent with expectations, and taxa demonstrating no response. From this database, 81–83% of all observations for distribution, phenology, community composition, abundance, demography and calcification across taxa and ocean basins were consistent with the expected impacts of climate change. Of the species responding to climate change, rates of distribution shifts were, on average, consistent with those required to track ocean surface temperature changes. Conversely, we did not find a relationship between regional shifts in spring phenology and the seasonality of temperature. Rates of observed shifts in species’ distributions and phenology are comparable to, or greater, than those for terrestrial systems.

When attempting to better understand the strengths and weaknesses of an algorithm, it is important to have a strong understanding of the problem at hand. This is true for the field of multiobjective evolutionary algorithms (EAs) as it is for any other field. Many of the multiobjective test problems employed in the EA literature have not been rigorously analyzed, which makes it difficult to draw accurate conclusions about the strengths and weaknesses of the algorithms tested on them. In this paper, we systematically review and analyze many problems from the EA literature, each belonging to the important class of real-valued, unconstrained, multiobjective test problems. To support this, we first introduce a set of test problem criteria, which are in turn supported by a set of definitions. Our analysis of test problems highlights a number of areas requiring attention. Not only are many test problems poorly constructed but also the important class of nonseparable problems, particularly nonseparable multimodal problems, is poorly represented. Motivated by these findings, we present a flexible toolkit for constructing well-designed test problems. We also present empirical results demonstrating how the toolkit can be used to test an optimizer in ways that existing test suites do not

BACKGROUND: The programmed death 1 (PD-1) inhibitor pembrolizumab has been found to prolong progression-free and overall survival among patients with advanced melanoma. We conducted a phase 3 double-blind trial to evaluate pembrolizumab as adjuvant therapy in patients with resected, high-risk stage III melanoma. METHODS: Patients with completely resected stage III melanoma were randomly assigned (with stratification according to cancer stage and geographic region) to receive 200 mg of pembrolizumab (514 patients) or placebo (505 patients) intravenously every 3 weeks for a total of 18 doses (approximately 1 year) or until disease recurrence or unacceptable toxic effects occurred. Recurrence-free survival in the overall intention-to-treat population and in the subgroup of patients with cancer that was positive for the PD-1 ligand (PD-L1) were the primary end points. Safety was also evaluated. RESULTS: At a median follow-up of 15 months, pembrolizumab was associated with significantly longer recurrence-free survival than placebo in the overall intention-to-treat population (1-year rate of recurrence-free survival, 75.4% [95% confidence interval {CI}, 71.3 to 78.9] vs. 61.0% [95% CI, 56.5 to 65.1]; hazard ratio for recurrence or death, 0.57; 98.4% CI, 0.43 to 0.74; P<0.001) and in the subgroup of 853 patients with PD-L1-positive tumors (1-year rate of recurrence-free survival, 77.1% [95% CI, 72.7 to 80.9] in the pembrolizumab group and 62.6% [95% CI, 57.7 to 67.0] in the placebo group; hazard ratio, 0.54; 95% CI, 0.42 to 0.69; P<0.001). Adverse events of grades 3 to 5 that were related to the trial regimen were reported in 14.7% of the patients in the pembrolizumab group and in 3.4% of patients in the placebo group. There was one treatment-related death due to myositis in the pembrolizumab group. CONCLUSIONS: As adjuvant therapy for high-risk stage III melanoma, 200 mg of pembrolizumab administered every 3 weeks for up to 1 year resulted in significantly longer recurrence-free survival than placebo, with no new toxic effects identified. (Funded by Merck; ClinicalTrials.gov number, NCT02362594 ; EudraCT number, 2014-004944-37 .).

, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.

The k-means clustering algorithm is considered one of the most powerful and popular data mining algorithms in the research community. However, despite its popularity, the algorithm has certain limitations, including problems associated with random initialization of the centroids which leads to unexpected convergence. Additionally, such a clustering algorithm requires the number of clusters to be defined beforehand, which is responsible for different cluster shapes and outlier effects. A fundamental problem of the k-means algorithm is its inability to handle various data types. This paper provides a structured and synoptic overview of research conducted on the k-means algorithm to overcome such shortcomings. Variants of the k-means algorithms including their recent developments are discussed, where their effectiveness is investigated based on the experimental analysis of a variety of datasets. The detailed experimental analysis along with a thorough comparison among different k-means clustering algorithms differentiates our work compared to other existing survey papers. Furthermore, it outlines a clear and thorough understanding of the k-means algorithm along with its different research directions.

A cohort of 2270 white women, aged 40-69 years at baseline, were followed for an average of 8.5 years in the Lipid Research Clinics Program Follow-up Study. There were 44 deaths due to cardiovascular disease among the 1677 nonusers of estrogens and six cardiovascular disease deaths among the 593 estrogen users. The age-adjusted relative risk (RR) of cardiovascular disease deaths in users compared with nonusers was 0.34 (95% confidence limits 0.12 to 0.81). After multivariable adjustment for potential confounding factors (age, blood pressure, and smoking), the estimated RR for estrogen use was 0.37 (95% confidence limits 0.16 to 0.88). Analyses were done to explore whether these results could be due to selection bias for estrogen use. However, the prevalence of cardiovascular disease at baseline was slightly higher in estrogen users (12%) than in nonusers (10%); furthermore, the exclusion of all women with prevalent cardiovascular disease at baseline did not alter the apparent protective effect of estrogen use on cardiovascular disease mortality (RR = 0.42, 95% confidence limits 0.13 to 1.10). Additional analyses examining the complex association between estrogen use, lipoprotein levels, and cardiovascular disease mortality suggest that the protective effect of estrogen is substantially mediated through increased high-density lipoprotein levels.

Climate change challenges organisms to adapt or move to track changes in environments in space and time. We used two measures of thermal shifts from analyses of global temperatures over the past 50 years to describe the pace of climate change that species should track: the velocity of climate change (geographic shifts of isotherms over time) and the shift in seasonal timing of temperatures. Both measures are higher in the ocean than on land at some latitudes, despite slower ocean warming. These indices give a complex mosaic of predicted range shifts and phenology changes that deviate from simple poleward migration and earlier springs or later falls. They also emphasize potential conservation concerns, because areas of high marine biodiversity often have greater velocities of climate change and seasonal shifts.

The evaluation of rate of force development during rapid contractions has recently become quite popular for characterising explosive strength of athletes, elderly individuals and patients. The main aims of this narrative review are to describe the neuromuscular determinants of rate of force development and to discuss various methodological considerations inherent to its evaluation for research and clinical purposes. Rate of force development (1) seems to be mainly determined by the capacity to produce maximal voluntary activation in the early phase of an explosive contraction (first 50-75 ms), particularly as a result of increased motor unit discharge rate; (2) can be improved by both explosive-type and heavy-resistance strength training in different subject populations, mainly through an improvement in rapid muscle activation; (3) is quite difficult to evaluate in a valid and reliable way. Therefore, we provide evidence-based practical recommendations for rational quantification of rate of force development in both laboratory and clinical settings.

ConspectusCatalytic processes have remarkably boosted the rapid industrializations in chemical production, energy conversion, and environmental remediation. As one of the emerging applications of carbocatalysis, metal-free nanocarbons have demonstrated promise as catalysts for green remediation technologies to overcome the poor stability and undesirable metal leaching in metal-based advanced oxidation processes (AOPs). Since our reports of heterogeneous activation of persulfates with low-dimensional nanocarbons, the novel oxidative system has raised tremendous interest for degradation of organic contaminants in wastewater without secondary contamination. In this Account, we showcase our recent contributions to metal-free catalysis in advanced oxidation, including design of nanocarbon catalysts, exploration of intrinsic active sites, and identification of reactive species and reaction pathways, and we offer perspectives on carbocatalysis for future environmental applications.The journey starts with the discovery of peroxymonosulfate (PMS) and peroxydisulfate (PDS) activation by graphene-based materials. With the systematic investigations on most carbon allotropes, for the first time the carbocatalysis for PMS or PDS activation was correlated with the pristine carbon configuration, oxygen functionality (ketonic groups), defect degree (exposed edge sites and vacancies), and dimensional structure. Moreover, an intrinsic difference in catalytic oxidation does exist between PMS and PDS activation. For example, the PMS/carbon reaction is dominated by free radicals, while PDS/carbon catalysis was unveiled as a singlet oxygen- or nonradical-based process in which the surface-activated PDS complex directly degrades the organic pollutants without relying on the generation of free radicals. Nitrogen doping significantly enhances the carbocatalysis because of the positively charged carbon domains, which strongly bind with persulfates to form reactive intermediates toward organic reactions. More importantly, N doping substantially alters the catalytic oxidation from a radical process to a nonradical pathway in PMS activation. Codoping of sulfur or boron with nitrogen at a rational level will synergistically promote the catalysis as a result of the formation of more catalytic centers by improved charge/spin redistribution of the carbon framework. Furthermore, a structure–performance relationship was established for annealed nanodiamonds with a characteristic sp3/sp2 (core/shell) hybridization, where the catalytic pathways were intimately dependent on the thickness of the graphitic shells. Interestingly, the introduction of structural defects and N dopants into the well-defined graphitic carbon framework and alteration of graphene/diamond hybrids can transform the persulfate/carbon system from a radical oxidation pathway to a nonradical pathway. Encapsulation of metal nanoparticles within carbon layers further modulates the electronic states of the interacting carbon via charge transport to increase the electron density. Overall, this Account contributes to unveiling the mist of carbocatalysis in AOPs and to summarizing the achievements of metal-free remediation. We also present future research directions on underpinning the knowledge base to facilitate the applications of nanocarbons in sustainable catalysis and environmental chemistry.

Invasive species threaten biodiversity globally, and invasive mammalian predators are particularly damaging, having contributed to considerable species decline and extinction. We provide a global metaanalysis of these impacts and reveal their full extent. Invasive predators are implicated in 87 bird, 45 mammal, and 10 reptile species extinctions-58% of these groups' contemporary extinctions worldwide. These figures are likely underestimated because 23 critically endangered species that we assessed are classed as "possibly extinct." Invasive mammalian predators endanger a further 596 species at risk of extinction, with cats, rodents, dogs, and pigs threatening the most species overall. Species most at risk from predators have high evolutionary distinctiveness and inhabit insular environments. Invasive mammalian predators are therefore important drivers of irreversible loss of phylogenetic diversity worldwide. That most impacted species are insular indicates that management of invasive predators on islands should be a global conservation priority. Understanding and mitigating the impact of invasive mammalian predators is essential for reducing the rate of global biodiversity loss.

OBJECTIVE: Observational studies show breaking up prolonged sitting has beneficial associations with cardiometabolic risk markers, but intervention studies are required to investigate causality. We examined the acute effects on postprandial glucose and insulin levels of uninterrupted sitting compared with sitting interrupted by brief bouts of light- or moderate-intensity walking. RESEARCH DESIGN AND METHODS: Overweight/obese adults (n = 19), aged 45-65 years, were recruited for a randomized three-period, three-treatment acute crossover trial: 1) uninterrupted sitting; 2) seated with 2-min bouts of light-intensity walking every 20 min; and 3) seated with 2-min bouts of moderate-intensity walking every 20 min. A standardized test drink was provided after an initial 2-h period of uninterrupted sitting. The positive incremental area under curves (iAUC) for glucose and insulin (mean [95% CI]) for the 5 h after the test drink (75 g glucose, 50 g fat) were calculated for the respective treatments. RESULTS: The glucose iAUC (mmol/L) · h after both activity-break conditions was reduced (light: 5.2 [4.1-6.6]; moderate: 4.9 [3.8-6.1]; both P < 0.01) compared with uninterrupted sitting (6.9 [5.5-8.7]). Insulin iAUC (pmol/L) · h was also reduced with both activity-break conditions (light: 633.6 [552.4-727.1]; moderate: 637.6 [555.5-731.9], P < 0.0001) compared with uninterrupted sitting (828.6 [722.0-950.9]). CONCLUSIONS: Interrupting sitting time with short bouts of light- or moderate-intensity walking lowers postprandial glucose and insulin levels in overweight/obese adults. This may improve glucose metabolism and potentially be an important public health and clinical intervention strategy for reducing cardiovascular risk.

Abstract Policies aiming to preserve vegetated coastal ecosystems (VCE; tidal marshes, mangroves and seagrasses) to mitigate greenhouse gas emissions require national assessments of blue carbon resources. Here, we present organic carbon (C) storage in VCE across Australian climate regions and estimate potential annual CO 2 emission benefits of VCE conservation and restoration. Australia contributes 5–11% of the C stored in VCE globally (70–185 Tg C in aboveground biomass, and 1,055–1,540 Tg C in the upper 1 m of soils). Potential CO 2 emissions from current VCE losses are estimated at 2.1–3.1 Tg CO 2 -e yr -1 , increasing annual CO 2 emissions from land use change in Australia by 12–21%. This assessment, the most comprehensive for any nation to-date, demonstrates the potential of conservation and restoration of VCE to underpin national policy development for reducing greenhouse gas emissions.

Recycling of spent lithium-ion batteries (LIBs) has attracted significant attention in recent years due to the increasing demand for corresponding critical metals/materials and growing pressure on the environmental impact of solid waste disposal. A range of investigations have been carried out for recycling spent LIBs to obtain either battery materials or individual compounds. For the effective recovery of materials to be enhanced, physical pretreatment is usually applied to obtain different streams of waste materials ensuring efficient separation for further processing. Subsequently, a metallurgical process is used to extract metals or separate impurities from a specific waste stream so that the recycled materials or compounds can be further prepared by incorporating principles of materials engineering. In this review, the current status of spent LIB recycling is summarized in light of the whole recycling process, especially focusing on the hydrometallurgy. In addition to understanding different hydrometallurgical technologies including acidic leaching, alkaline leaching, chemical precipitation, and solvent extraction, the existing challenges for process optimization during the recycling are critically analyzed. Moreover, the energy consumption of different processes is evaluated and discussed. It is expected that this research could provide a guideline for improving spent LIB recycling, and this topic can be further stimulated for industrial realization.

We present an algorithm for calculating hypervolume exactly, the Hypervolume by Slicing Objectives (HSO) algorithm, that is faster than any that has previously been published. HSO processes objectives instead of points, an idea that has been considered before but that has never been properly evaluated in the literature. We show that both previously studied exact hypervolume algorithms are exponential in at least the number of objectives and that although HSO is also exponential in the number of objectives in the worst case, it runs in significantly less time, i.e., two to three orders of magnitude less for randomly generated and benchmark data in three to eight objectives. Thus, HSO increases the utility of hypervolume, both as a metric for general optimization algorithms and as a diversity mechanism for evolutionary algorithms.

Compared with stainless steel and Co–Cr‐based alloys, Ti and its alloys are widely used as biomedical implants due to many fascinating properties, such as superior mechanical properties, strong corrosion resistance, and excellent biocompatibility. After briefly introducing several most commonly used biomedical materials, this article reviews the recent development in Ti alloys and their biomedical applications, especially the low‐modulus β ‐type Ti alloys and their design methods. This review also systemically investigates the recently attractive progress in preparation of biomedical Ti alloys, including additive manufacturing, porous powder metallurgy, and severe plastic deformation, applied in the manufacturing and the influenced microstructures and properties. Nevertheless, there are still some problems with the long‐term performance of Ti alloys, and therefore several surface modification methods are reviewed to further improve their biological activity, wear resistance, and corrosion resistance. Finally, the biocompatibility of Ti and its alloys is concluded. Summarizing the findings from literature, future prediction is also conducted.

Climate change is driving changes in the physical and chemical properties of the ocean that have consequences for marine ecosystems. Here, we review evidence for the responses of marine life to recent climate change across ocean regions, from tropical seas to polar oceans. We consider observed changes in calcification rates, demography, abundance, distribution and phenology of marine species. We draw on a database of observed climate change impacts on marine species, supplemented with evidence in the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. We discuss factors that limit or facilitate species’ responses, such as fishing pressure, the availability of prey, habitat, light and other resources, and dispersal by ocean currents. We find that general trends in species responses are consistent with expectations from climate change, including poleward and deeper distributional shifts, advances in spring phenology, declines in calcification and increases in the abundance of warm-water species. The volume and type of evidence of species responses to climate change is variable across ocean regions and taxonomic groups, with much evidence derived from the heavily-studied north Atlantic Ocean. Most investigations of marine biological impacts of climate change are of the impacts of changing temperature, with few observations of effects of changing oxygen, wave climate, precipitation (coastal waters) or ocean acidification. Observations of species responses that have been linked to anthropogenic climate change are widespread, but are still lacking for some taxonomic groups (e.g., phytoplankton, benthic invertebrates, marine mammals).

PURPOSE: This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress. PATIENTS AND METHODS: Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and post-intervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a post-intervention satisfaction survey. RESULTS: Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81% reported that it had been or would be of help to their family. Post-intervention measures of suffering showed significant improvement (P = .023) and reduced depressive symptoms (P = .05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P = .000) and having a sense of purpose (r = 0.562; P = .000), accompanied by a lessened sense of suffering (r = 0.327; P = .001) and increased will to live (r = 0.387; P = .000). CONCLUSION: Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.

BACKGROUND: The Australian Imaging, Biomarkers and Lifestyle (AIBL) flagship study of aging aimed to recruit 1000 individuals aged over 60 to assist with prospective research into Alzheimer's disease (AD). This paper describes the recruitment of the cohort and gives information about the study methodology, baseline demography, diagnoses, medical comorbidities, medication use, and cognitive function of the participants. METHODS: Volunteers underwent a screening interview, had comprehensive cognitive testing, gave 80 ml of blood, and completed health and lifestyle questionnaires. One quarter of the sample also underwent amyloid PET brain imaging with Pittsburgh compound B (PiB PET) and MRI brain imaging, and a subgroup of 10% had ActiGraph activity monitoring and body composition scanning. RESULTS: A total of 1166 volunteers were recruited, 54 of whom were excluded from further study due to comorbid disorders which could affect cognition or because of withdrawal of consent. Participants with AD (211) had neuropsychological profiles which were consistent with AD, and were more impaired than participants with mild cognitive impairment (133) or healthy controls (768), who performed within expected norms for age on neuropsychological testing. PiB PET scans were performed on 287 participants, 100 had DEXA scans and 91 participated in ActiGraph monitoring. CONCLUSION: The participants comprising the AIBL cohort represent a group of highly motivated and well-characterized individuals who represent a unique resource for the study of AD. They will be reassessed at 18-month intervals in order to determine the predictive utility of various biomarkers, cognitive parameters and lifestyle factors as indicators of AD, and as predictors of future cognitive decline.

In this paper, a robust multi-input/multi-output (MIMO) terminal sliding mode control technique is developed for n-link rigid robotic manipulators. It is shown that an MIMO terminal switching plane variable vector is first defined, and the relationship between the terminal switching plane variable vector and system error dynamics is established. By using the MIMO terminal sliding mode technique and a few structural properties of rigid robotic manipulators, a robust controller can then be designed so that the output tracking error can converge to zero in a finite time, and strong robustness with respect to large uncertain dynamics can be guaranteed. It is also shown that the high gain of the terminal sliding mode controllers can be significantly reduced with respect to the one of the linear sliding mode controller where the sampling interval is nonzero.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>