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Objective To assess the use of silastic sling for genuine stress incontinence. Design Retrospective descriptive analysis. Setting Tertiary referral centre for urogynaecology. Subjects Eighty-eight women with urodynamically proven genuine stress incontinence, 10 had coexistent detrusor instability. In 74 women, the sling operation was for recurrent incontinence. Intervention A low Pfannenstiel incision was used and a suburethral tunnel dissected to insert the sling, which was attached under minimal tension with non-absorbable sutures to each ileopectineal ligament. Main outcome measures Clinical and urodynamic data were assessed between two and three months post-surgery; thereafter clinical assessment and pad testing were performed at yearly intervals for five years. Results The subjective cure at three months was 81% and the objective cure was 69 %. There was a fall in success rate with increasing number of continence operations, and this was statistically significant for women with three or more previous continence operations (P < 0.05). Neither age, parity nor menopausal status made a statistical difference to the cure rate. Twenty-three women had reached their fifth year follow up and the success rate using life table analysis was 71%. Post-operatively, 29 women had detrusor instability: 22 women developed detrusor instability de novo and seven had detrusor instability presurgery. Urodynamic findings post-surgery showed an increase (P < 0.001) in outflow resistance. Four women required removal of sling for voiding difficulties. Ten women developed sling erosions: five vaginal, four bladder erosions and one urethral erosion. After removal of the sling, seven women still remained continent. Conclusions A silastic sling operation for the treatment of genuine stress incontinence provides a good long term cure, considering that 45% of women had two or more previous failed continence operations. The high prevalence of detrusor instability and voiding difficulties post-surgery should be noted.

The predominance of unicast connectivity in the current Internet infrastructure sabotages the widespread deployment of video applications. As such overlay multicast networking has been proposed to accelerate the ubiquity of video streaming in the Internet. Based on an existing overlay multicast network architecture, this paper proposes a method which aims at improving the efficiency of the streaming scheme that is part of this architecture. Instead of sending multiple streams of the same data across the network, only the essential video signals are sent in redundancy. Evaluation of the method generates promising results in preventing loss of the essential video data in burst losses of packets.

Examination of packet traces from the Internet reveals a significant number of multiple consecutive packet losses, which is detrimental to perceptual quality of Internet video. Capitalizing on the unordered-delivery property of Internet transport protocol (UDP) and the human visual system's insensitivity to the HF components of the video signals, a method has been proposed to attenuate the number of such burst losses by "transforming" them to singular isolated losses and to burst losses with fewer consecutive packets. With the use of an efficient layered coder the incoming video signals are segregated into base (essential) and enhancement (nonessential) data to be packetized in base and enhancement packets respectively. Using probability models, this paper presents analysis of the effectiveness of deliberately increasing the number of enhancement packets in order to protect critical video data from loss. Evaluation of the results from simulations as well as from probability models indicates that increasing the number of enhancement packets is indeed effective in reducing the number of base packets lost in a burst and that the number of isolated losses is increased

With the success of Uni-Speech chip designed for advance speech recognition system, there is an effort to develop a cost efficient version of the Uni-Speech chip targeted for mass consumer market speech-recognition related applications with special focus in improving power consumption. In this paper, a new low cost speech device called UniSpeech-Lite is described. The UniSpeech-Lite is an integrated SoC (system on chip), containing the speech functions for prompt, record, speaker-independent voice recognition, suitable for many applications such as portable speech related educational devices, toys, digital recorder, voice based remote control, etc. UniSpeech-Lite is specifically targeted for stable performance, low cost and low power-consumption. This chip will enable extensive deployment of applied speech technology in many fields and achieve favorable economic and social benefits.

To investigate the reasons for the high failure rates in introductory programming courses, this paper employs a case-study approach to explore the integration of context of learning, conceptions of learning, and approaches to study. Students' responses show that their approaches to study are directly related to the context and conceptions of learning. Five concepts of learning are illustrated through two models proposed by previous studies. These concepts are then used as benchmarks for comparing with the concepts of the case studies to investigate these students' approaches to learning. It is found that students with intrinsic interest and are academically orientated automatically adopt the deep approach to learning whilst academically orientated students with extrinsic interest can adopt the deep approach only with help from institutional context. Accordingly, this paper proposes a practical teaching / learning model to help students to attain the deep approach to study. Implemented this semester, to date the model has changed students' orientation to study, as well as encouraged some students towards the deep approach to study.

Purpose: The most often stated goal by persons with stroke is improved walking function, therefore it is important to understand the biomechanical mechanisms of gait and the factors that may improve its performance. The purpose of this study was to 1) describe three-dimensional (3-D) gait patterns, 2) examine the relationship between gait speed and kinematic/kinetic variables and 3) determine the effect of maximal strength training on walking performance, in addition to muscle strength and health-related quality of life, in chronic stroke survivors. Methods: Twenty individuals with chronic stroke (61.2 ± 8.4 years) were randomized into two six week (three times a week) training programs on the basis of age, sex, and time since onset of stroke (stratified randomization). An optoelectronic system and forceplates were used to generate 3-D kinematic and kinetic profiles during walking. The experimental group undertook maximal concentric isokinetic strength training o f the paretic lower limb flexors and extensors with the use of the Kin-Corn dynamometer. The control group received passive range of motion exercises using the same instrument. The Mann-Whitney LTest was used to compare the changes in score (posttraining-baseline) between the control and experimental groups: composite lower extremity strength score, walking speed (level and stair-walking) and health-related quality of life measure (SF-36). Correlations were used to assess the relationship between gait speed and biomechanical gait variables. Results: Twenty-five kinematic and twenty-five kinetic patterns were identified across three joints (hip, knee, ankle), three planes and two sides among the 20 participants. Kinetic, more so than kinematic variables were correlated with gait speed, particularly in the sagittal and frontal planes for both the paretic and non-paretic sides. No differences in the change of walking speed or SF-36 scores was found between groups despite the trend (p = 0.06) towards greater strength improvement in the experimental group following training. Conclusions: Strength training of the flexors/extensors of the paretic limb did not result in improvements in walking performance or health-related quality of life. The results of the biomechanical gait analysis suggest that in addition to these muscle groups, training programs that include hip abductors and the non-paretic limb may improve gait performance.

Real time audio and video applications, though sensitive to packet loss and delay, do not require absolute reliability for transmission. Thus, understanding packet loss characteristics in the Internet, as well as in the MBone, can provide network researchers with an ability to design improved protocols for error control/concealment. This paper presents an analysis of real traffic measurements from the Internet/MBone, giving details of loss rates and packet loss characteristics of different receivers from different geographical regions. The analysis reveals that some receivers experience very high loss rate, of above 25%, and that a high percentage of these packet losses are burst losses of several consecutive packets.

This paper investigates the efficacy of including redundant essential video data in methods for transforming burst packet losses to isolated. Critical video information is separated from non-critical video signals, assuming the availability of an efficient layered coder. Packets are interleaved and scrambled so as to spread out the loss of critical video information. In order to provide higher degree of key video signal protection, redundant packets of essential video data are included in the interleaved/scrambled packet sequence. Experiments were conducted on packet traces collected from the MBone. Results indicate that interleaving/scrambling significantly reduces burst losses. Furthermore, inclusion of essential redundant video data dramatically reduces the number of disjoint losses, as well as reducing the number of consecutive packet losses.

Because of an emphasis on academic discourse in tertiary-level courses, many adult ESL students discover that they need to adjust their strategies for learning ESL. Prior to attending university in English-speaking countries, these students tend to focus their ESL learning strategies on spoken English perhaps largely because they believe spoken English accounts for the bulk of ordinary people's communication time. When they begin studying at an English-speaking university, however, their participation shifts and the focus of their ESL learning strategies become written English. This paper reports a seven-week research project which involved six Korean adult ESL learners who, in an effort to improve their academic discourse competence, wrote reading logs about English newspaper articles. These logs mainly featured summaries and personal responses based on opinion articles such as editorials and columns. The research questions focused on exploring mainly the participants' self-reported benefits, difficulties and transfer of learning. The participants felt that the reading log strategy helped them detect and correct their ESL reading and writing weaknesses. They experienced a close relationship between reading comprehension and academic writing skills: They had difficulty writing their reading logs when they had a shaky grasp of content. They also felt that writing reading logs got them predisposed toward active or spirited oral discussion. Such research findings led to the conclusion that the reading log strategy is a good way to improve and integrate reading, writing and oral discussion skills for ESL learners. This paper might help educators gain insight into how adult ESL learners' academic discourse skills can be developed.