bluuebunny/crossref_metadata_2025 huggingface dataset:
Palliative care for advanced dementia: Knowledge and attitudes of long‐term care staff
Authors: Chen I‐Hui , Lin Kuan‐Yu , Hu Sophia H , Chuang Yeu‐Hui , Long Carol O , Chang Chia‐Chi , Liu Megan F
Published: October 2017

Aims and objectives

To investigate the knowledge of and attitudes towards palliative care for advanced dementia and their associations with demographics among nursing staff, including nurses and nursing assistants, in long‐term care settings.

Background

Nursing facilities are places where persons with dementia die; therefore, providing quality end‐of‐life care to residents with advanced dementia is crucial. To date, little attention has been paid to palliative care practice for patients with advanced dementia.

Design

A descriptive, cross‐sectional, survey design was used.

Methods

In total, a sample of 300 nurses (n = 125) and nursing assistants (n = 175) working in long‐term care settings in Taiwan participated in this study. Two instruments were administered: demographic characteristics and responses to the Questionnaire of Palliative Care for Advanced Dementia. Descriptive statistics and multiple regression were used for data analysis.

Results

Overall, the nurses and nursing assistants had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Additionally, nursing staff who were nurses with greater work experience and those who had received palliative care and hospice training had greater knowledge of palliative care. In addition, nursing staff who had received dementia care training and who had worked in nursing homes had higher levels of positive attitudes towards palliative care.

Conclusions

This study indicates the need to provide nurses and nursing assistants with more information about palliative care practice for people with advanced dementia. Particularly, providing education to those who are nursing assistants, who have less working experience, who have not received palliative and dementia care training, and who have not worked in nursing homes can improve overall nursing staff knowledge of and attitudes towards palliative care.

Relevance to clinical practice

Continuing education in principles of palliative care for advanced dementia is necessary for currently practicing nursing staff and should be developed according to their educational background and needs.
The impact of primary nursing care pattern: Results from a before–after study
Authors: Dal Molin Alberto , Gatta Claudia , Boggio Gilot Chiara , Ferrua Rachele , Cena Tiziana , Manthey Marie , Croso Antonella
Published: October 2017

Aims and objectives

To explore the effect of “Primary Nursing” on nursing‐sensitive patient outcomes, staff‐related outcomes and organisation‐related outcomes.

Background

Primary nursing is one example of a care pattern that has recently been implemented in many countries.

Design

Before–after study.

Methods

This study was conducted in an Italian hospital. We observed patient‐related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of primary nursing and in 3,169 inpatients after its implementation. Staff‐related outcomes (nursing competence and diagnostic thinking) and organisation‐related outcomes (empowerment and team climate) were collected from 369 nurses. From a subgroup of inpatients, we collected data regarding their satisfaction with the care provided.

Results

After the implementation of primary nursing, some nursing competencies and diagnostic thinking were improved, so were organisation‐related outcomes. Our data showed that the number of inpatients with urinary catheter infections (5.5% vs. 4.3%) and venous catheter infections (peripheral: 2.2% vs. 1%; central: 5.6% vs. 1%) was significantly decreased; also, the numbers of falls (2.4% vs. 1.9%) and pressure ulcers (4.8% vs. 4%) decreased, although these decreases were not statistically significant. Overall, the implementation of primary nursing increased patient satisfaction with nursing care (193.57 vs. 210.21).

Conclusions

Primary nursing improved staff‐related outcomes, nursing‐sensitive patient outcomes and organisation outcomes.

Relevance to clinical practice

Our results show that primary nursing has the potential to positively impact on inpatients, nurses and organisations. Moreover, the implementation of this care pattern is feasible.
Health literacy among caregivers of patients with heart failure: A multicentre cross‐sectional survey
Authors: Della Pelle Carlo , Orsatti Vincenzo , Cipollone Francesco , Cicolini Giancarlo
Published: October 2017

Aims and objectives

To assess the levels of health literacy of Italian caregivers of patients with heart failure.

Background

Health literacy is related to patients’ health outcomes. Low health literacy has been found in older people with heart failure, and less is known on the health literacy of caregivers whose patients are suffering from heart failure.

Design

Observational, multicentre, cross‐sectional study.

Methods

From July 2015–May 2016, caregivers were recruited in five hospitals from Central and Southern Italy. To assess health literacy, the Italian version of the Short Test of Functional Health Literacy tool was used.

Results

A total of 173 caregivers participated in the research, the majority being females (60.1%), aged between 46–60 years (52.6%) and 96 (55.5%) were from Central Italy. 33.5% of caregivers were patients’ children, and 16.2% were paid caregivers of foreign origins. The average level of health literacy was adequate; however, lower levels were found among patients’ spouses and those of older age.

Conclusion

Our results, in contrast with previous studies, showed adequate health literacy levels of caregivers. However, caregivers older in age and with a low education level showed the lowest health literacy, emphasising the need for healthcare workers, to check caregivers’ health literacy, before entrusting them with the care of patients.

Relevance to clinical practice

As this research gives, for the first time, an overview on Italian caregivers’ levels of health literacy, its results may be used to improve Italian healthcare professionals’ knowledge of caregivers’ health literacy, before entrusting them with the care of patients.
Benefits of the humidified low‐flow oxygen therapy in infants with mild–moderate bronchiolitis
Authors: Lorente Sánchez Sonia , Gimeno Rebeca , Losilla Josep‐Maria , Garzón Sandra , Vives Jaume
Published: October 2017

Aims and objectives

To investigate the clinical benefits of using humidification in low‐flow oxygen therapy. Specific objectives were to investigate via an assessment of the number of nasal lavages whether humidification can help to decrease the nasal mucus viscosity, to determine whether it can relieve feeding difficulties by comparing the weight gain in infants, to ascertain whether it can relieve respiratory distress by assessing the heart and respiratory rates and contribute to improved clinical outcomes, measured by the length of stay and oxygen requirements.

Background

There is no evidence to support the use of humidification in low‐flow oxygen therapy as a usual clinical practice in the management of bronchiolitis.

Design

A controlled quasi‐experimental study.

Methods

A total of 97 infants were included, aged ≤6 months, with bronchiolitis, low‐flow oxygen therapy and bronchodilators nebulised with hypertonic saline 3%. Data from the control group (nonhumidified) were gathered from 2010–2012 (49 infants), and data from the group with humidification from 2012–2014 (48 infants). Linear and Poisson regressions were performed adjusting for relevant characteristics of patients.

Results

Humidification was shown to be associated with significant reductions in the number of nasal lavages in infants with Sant Joan de Déu Bronchiolitis Scores of BROSJOD≤7, in the heart rate of infants with mixed bronchodilators treatment, and in the length of stay and oxygen requirements of infants with Score BROSJOD≤5. No differences in weight and respiratory rate were found.

Conclusions

Humidification in low‐flow oxygen therapy is an effective nursing intervention to improve the clinical outcomes of infants with mild–moderate bronchiolitis.

Relevance to clinical practice

Humidifying the nasal mucosa can help to reduce the need for professional procedures, oxygen requirements and hospitalisation length. Further research into the economic savings involved is recommended.
Registered nurses’ perceptions of safe care in overcrowded emergency departments
Authors: Eriksson Julia , Gellerstedt Linda , Hillerås Pernilla , Craftman Åsa G
Published: October 2017

Aims and objectives

To explore registered nurses’ perceptions of safe practice in care for patients with an extended length of stay in the emergency department.

Background

Extended length of stay and overcrowding in emergency departments are described internationally as one of the most comprehensive challenges of modern emergency care. An emergency department is not designed, equipped or staffed to provide care for prolonged periods of time. This context, combined with a high workload, poses a risk to patient safety, with additional medical errors and an increased number of adverse events. From this perspective, it is important to extend our knowledge and to describe registered nurses’ experiences of safe practice.

Design

A qualitative, inductive and descriptive study.

Methods

Qualitative interview study carried out in five emergency departments. Data were analysed using a qualitative content analysis with a latent approach.

Results

Patient safety meets obstacles in the clinical environment involving experiencing deficiencies regarding patient safety in the clinical setting and the impact of working procedures and routines. Moreover, nurses are challenged in their professional responsibilities involving balancing essential nursing care and actual workload; it is common to experience emotional reactions based on feelings of loss of control.

Conclusions

From the nurses’ perspective, a prolonged stay in the emergency department may lead to negative consequences for both patient safety and care as well as registered nurses’ psychosocial experiences. An extended length of stay significantly reduces the level of nursing and caring that registered nurses can perform in the emergency department.

Relevance to clinical practice

This study indicates that emergency departments should review their procedures to avoid both deviations from normal practice and moral stress among registered nurses. This can contribute to an increased understanding and insight about the challenge of patient safety in an emergency department setting.
Clinical leadership and nursing explored: A literature search
Authors: Stanley David , Stanley Karen
Published: October 2017

Aims and objectives

To explore what we know of the concept of clinical leadership and what the term means. Clues to the definition of clinical leadership, the attributes of effective and less effective clinical leaders, models of clinical leadership and the barriers that hinder clinical leadership development were explored.

Background

While nursing leadership and healthcare leadership are terms that have been evident in nursing and health industry literature for many decades, clinical leadership is a relatively new term and is may still be misunderstood.

Design

A search was undertaken of formal and informal literature using a library database and a range of search engines for the words “clinical leadership” and “clinical leadership in nursing.” In each case, the full search parameters were employed with searches between 1974–2016. Full‐text articles were requested, and English was the preferred language.

Results

In total, 3,259 publications were located through seven database search tools, although these included a large number of duplications. Following further informal searches and removing irrelevant material, 27 research or literature review focused papers were retained that included 17 qualitative studies, one quantitative study, one mixed method study, one Delphi study and two that compared other research studies. As well, five literature reviews were retained in the synthesis. The data synthesis resulted five categories: definitions of clinical leadership, characteristics most likely or least associated with clinical leadership, models applied to clinical leadership and limits to clinical leadership development.

Conclusion

Clinical leaders are recognised for having their values and beliefs parallel their actions and interventions. They are found across the spectrum of health organisations, often at the highest level for clinical interaction, but not commonly at the highest management level in a ward or unit team and they are seen in all clinical environments.

Relevance to clinical practice

Clinical Leadership and an understanding on how clinical leaders contribute to the health service is central to the application of values‐based practice and how clinical leaders impact on innovation, change and making care better.
Evaluation of a parent‐targeted video in Portuguese to improve pain management practices in neonates
Authors: Bueno Mariana , Costa Rebeca Nogueira , de Camargo Patrícia Ponce , Costa Taine , Harrison Denise
Published: October 2017

Aims and objectives

To assess parents' knowledge on breastfeeding, skin to skin care and sweet solutions as neonatal analgesic strategies, and to evaluate parents' perception on the feasibility, acceptability and usefulness of the Portuguese version of the “Be Sweet to Babies” video.

Background

Neonatal pain management during blood sampling is suboptimal, and knowledge translation strategies are needed to improve clinical practices. The “Be Sweet to Babies” video is a parent‐targeted knowledge translation tool that shows the effectiveness of breastfeeding, skin to skin contact and sweet solutions for procedural pain relief.

Design

Cross‐sectional study.

Methods

Parents of infants hospitalised in an intensive care unit watched the video during their infants' hospitalisation and then answered a survey. Descriptive analyses of the data were performed.

Results

Hundred parents were included. The majority did not know about the analgesic effects of breastfeeding (80%), skin to skin contact (69%) and sweet solutions (93%), and a limited number of parents stated their infants had received the strategies during painful procedures (7%, 11%, 2%, respectively). After watching the video, all (100%) parents intended to use or to advocate for one of the strategies; most (90%) of the parents would use any of the methods. All parents (100%) would recommend the video and considered the video useful, easy to understand, easy to apply in real scenarios. Length of the video was considered as ideal by 92%.

Conclusions

The Portuguese version of the “Be Sweet to Babies” video is feasible, acceptable and useful for parental education and is a persuasive knowledge translation tool. Further studies are needed to evaluate the effects of this parent‐targeted intervention on the implementation of the analgesic strategies during clinical care.

Relevance to clinical practice

This article highlights the importance of exploring evidence‐based knowledge translation tools for improving neonatal care and outcomes.
Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative
Authors: Ruff Jesley C. , Herndon Jill Boylston , Horton Roger A. , Lynch Julie , Mathwig Dawn C. , Leonard Audra , Aravamudhan Krishna
Published: October 2017

Objectives

Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children.

Methods

Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging “champions,” defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines.

Results

Registry eligibility is patients aged 0–17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence‐based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care.

Conclusions

The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels.
The mitochondrial membrane protein FgLetm1 regulates mitochondrial integrity, production of endogenous reactive oxygen species and mycotoxin biosynthesis in Fusarium graminearum
Authors: Tang Guangfei , Zhang Chengqi , Ju Zhenzhen , Zheng Shiyu , Wen Ziyue , Xu Sunde , Chen Yun , Ma Zhonghua
Published: October 2017

Deoxynivalenol (DON) is a mycotoxin produced in cereal crops infected with Fusarium graminearum. DON poses a serious threat to human and animal health, and is a critical virulence factor. Various environmental factors, including reactive oxygen species (ROS), have been shown to interfere with DON biosynthesis in this pathogen. The regulatory mechanisms of how ROS trigger DON production have been investigated extensively in F. graminearum. However, the role of the endogenous ROS‐generating system in DON biosynthesis is largely unknown. In this study, we genetically analysed the function of leucine zipper‐EF‐hand‐containing transmembrane 1 (LETM1) superfamily proteins and evaluated the role of the mitochondrial‐produced ROS in DON biosynthesis. Our results show that there are two Letm1 orthologues, FgLetm1 and FgLetm2, in F. graminearum. FgLetm1 is localized to the mitochondria and is essential for mitochondrial integrity, whereas FgLetm2 plays a minor role in the maintenance of mitochondrial integrity. The ΔFgLetm1 mutant demonstrated a vegetative growth defect, abnormal conidia and increased sensitivity to various stress agents. More importantly, the ΔFgLetm1 mutant showed significantly reduced levels of endogenous ROS, decreased DON biosynthesis and attenuated virulence in planta. To our knowledge, this is the first report showing that mitochondrial integrity and endogenous ROS production by mitochondria are important for DON production and virulence in Fusarium species.
Representative bureaucracy and unconscious bias: Exploring the unconscious dimension of active representation
Authors: Akram Sadiya
Published: October 2017

Representative bureaucracy theory explores the effects of representation on bureaucracies, but less attention has been paid to date as to how agents represent values or interests. Addressing this omission, this article highlights the unconscious dimension of active representation and, more specifically, the role of unconscious bias in representation. Unconscious bias has received limited attention to date in public administration, but has clear relevance for understanding how representation occurs at the individual level. This article proposes a framework for understanding unconscious bias. Drawing on Bourdieu's habitus, but making explicit its unconscious dimension, I argue that unconscious bias enhances our understanding of how active representation occurs in bureaucracies today. The article applies these insights to the case of unconscious gender bias as found in the Australian Public Service (APS) and concludes by exploring the methodological challenges involved in building a research agenda into tackling unconscious bias.
Rational Inference: The Lowest Bounds
Authors: Buckner Cameron
Published: October 2017

A surge of empirical research demonstrating flexible cognition in animals and young infants has raised interest in the possibility of rational decision‐making in the absence of language. A venerable position, which I here call “Classical Inferentialism”, holds that nonlinguistic agents are incapable of rational inferences. Against this position, I defend a model of nonlinguistic inferences that shows how they could be practically rational. This model vindicates the Lockean idea that we can intuitively grasp rational connections between thoughts by developing the Davidsonian idea that practical inferences are at bottom categorization judgments. From this perspective, we can see how similarity‐based categorization processes widely studied in human and animal psychology might count as practically rational. The solution involves a novel hybrid of internalism and externalism: intuitive inferences are psychologically rational (in the explanatory sense) given the intensional sensitivity of the similarity assessment to the internal structure of the agent's reasons for acting, but epistemically rational (in the justificatory sense) given an ecological fit between the features matched by that assessment and the structure of the agent's environment. The essay concludes by exploring empirical results that show how nonlinguistic agents can be sensitive to these similarity assessments in a way that grants them control over their opaque judgments.
Sports Diplomacy in the Australian Context: Theory into Strategy
Authors: Murray Stuart
Published: October 2017

These days, the study of soft power and public diplomacy is relatively advanced. The present article complements this growing body of work by focusing on the relationship between two institutions that are generally geared toward minimizing friction in international affairs: sport and diplomacy. Over the past five years, the study of “sports diplomacy” has grown but the same cannot be said about scholarship assessing its practice, that is, how theory is reconciled in practice. This is a gap this research seeks to overcome. It describes and critiques the efforts, challenges, and vicissitudes Australia's Department of Foreign Affairs and Trade faced when building and implementing the world's first Sports Diplomacy Strategy in 2015. The study finds that with appropriate ministerial support and innovative diplomats, both the theory and practice of sports diplomacy have a bright, promising future. Such analysis is useful because it encourages greater dialog between the ivory towers and the beltway of diplomacy.
Making Soft Power Work: Theory and Practice in Australia's International Education Policy
Authors: Laifer Natalie , Kitchen Nicholas
Published: October 2017

Policy makers around the world are increasingly concerned with the challenge of cultivating and capitalizing on soft power. Yet government efforts to increase others’ feelings of attraction toward their countries face conceptual and practical challenges. This article examines Australia's attempt to operationalize soft power in Asia through its international education strategy. Drawing on interviews with key officials, we show how the design of Australia's international education policy was consciously informed by multiple dimensions of soft power. Yet the nature of soft power means that whether the policy will achieve its soft power objectives is up to Asia, not Australia.
Science Diplomacy in the Indo‐Pacific Region: A Mixed but Promising Experience
Authors: Patman Robert G. , Davis Lloyd S.
Published: October 2017

Among other things, a globalizing world has challenged the old dichotomy between science and diplomacy and helped to facilitate the advent of Science Diplomacy. This term encompasses a particular form of public diplomacy and refers to the use of scientific collaborations among nations to tackle common challenges. Science Diplomacy operates on the assumption that many of today's problems—food, water, energy, climate, and health—cannot be solved by any single state and, more often than not, require international technical or scientific solutions. Does Science Diplomacy represent a major paradigm change or simply a minor adjustment in the making of foreign policy? In the Indo‐Pacific, the need for Science Diplomacy is clear, but at present there are mixed signals on whether states in the region are really prepared to develop its potential. On one hand, the Square Kilometre Array project—the construction of a large radio telescope in Australia and South Africa from 2018—represents a good example of a multilateral diplomatic effort to facilitate and extend scientific collaboration to dramatically improve human capabilities to survey the sky. On the other, science diplomacy has so far largely failed to live up to its potential to address climate change, the most significant threat to the future of the Indo‐Pacific region and the world beyond. However, successful efforts to make Ross Sea a global marine sanctuary also shows that, despite obstacles, Science Diplomacy can sometime have spillover effects into political decision making with positive outcomes. This mixed picture highlights a paradox. While the emergence of Science Diplomacy reflects a recognition by states that a growing number of national problems require international scientific solutions, such recognition remains patchy and somewhat uneven. Many states, particularly the most powerful ones, continue to be constrained in the international arena by the old Westphalian idea of unfettered state sovereignty.
The ecosystem as helix: an exploratory theory‐building study of regional co‐opetitive entrepreneurial ecosystems as Quadruple/Quintuple Helix Innovation Models
Authors: Carayannis Elias G. , Grigoroudis Evangelos , Campbell David F. J. , Meissner Dirk , Stamati Dimitra
Published: October 2017

Regions are increasingly being viewed as eco‐systemic agglomerations of organizational and institutional entities or stakeholders with socio‐technical, socio‐economic, and socio‐political conflicting as well as converging (co‐opetitive) goals, priorities, expectations, and behaviors that they pursue via entrepreneurial development, exploration, exploitation, and deployment actions, reactions and interactions. In this context, our paper aims to explore and profile the nature and dynamics of the Quadruple/Quintuple Helix Innovation System Model or Framework (government, university, industry, civil society, environment) as an enabler and enactor of regional co‐opetitive entrepreneurial ecosystems which we conceptualize as fractal, multi‐level, multi‐modal, multi‐nodal, and multi‐lateral configurations of dynamic tangible and intangible assets within the resource‐based view and the new theory of the growth of the firm. Co‐opetitive fractal innovation and entrepreneurship ecosystems are defined and discussed, and examples of regional innovation policies and programs are presented. Furthermore, the concept of multi‐level innovation systems is analyzed, taking into account the existence of knowledge clusters and innovation networks, while alternative aggregations of multi‐level innovation systems are proposed based on their spatial (geographical) and non‐spatial (research‐based) functional properties.
Straw preservation reduced total N2O emissions from a sugarcane field
Authors: Pitombo L. M. , Cantarella H. , Packer A. P. C. , Ramos N. P. , do Carmo J. B.
Published: October 2017

Post‐harvest biomass can be used as feedstock for energy production and alter N2O emissions from the soil, which is among the main issues determining bioethanol sustainability. To assess the effects of sugarcane straw return on gas emissions, we established a field experiment in which 0, 50, 75 or 100% (0, 5.65, 8.47 and 11.30 Mg/ha dry biomass, respectively) of the crop residues (straw) was left in the field during the first two ratoon crops. As fertilizer is applied in bands to sugarcane, we also investigated the contribution of different positions to the N2O emissions within the field. There was an interactive effect between straw and inorganic fertilizer, leading to a nonlinear effect of crop residues on the fertilizer emission factor (EF). However, straw consistently reduced N2O emissions from the field, acting mainly in the unfertilized areas in the field (P < 0.05). We observed that considering the typical EF used in the literature, the N2O‐N emissions attributed to fertilizer ranged from 0.19 to 0.79 kg/ha, while the total emissions ranged from 3.3 to 5.2 kg/ha, from the highest amount of straw to the lowest. We conclude that overall, the fertilizer EF is not as relevant as the total emissions, based on this and other studies. Consequently, management practices might be more effective in improving the GHG balance than changing inorganic fertilizer use. We conclude that keeping up to 11 Mg/ha of straw with a large C:N ratio (>100:1) on site might increase sugarcane production sustainability by reducing the greenhouse gas emissions from the field.
Cost‐effectiveness of liposomal amphotericin B in hospitalised patients with mucocutaneous leishmaniasis
Authors: Mistro Sóstenes , Gomes Bárbara , Rosa Lorena , Miranda Ligia , Camargo Marianne , Badaró Roberto
Published: October 2017

Objective

To compare the cost‐effectiveness of L‐AmB with that of SbV and AmB‐D, for the treatment of mucocutaneous leishmaniasis in a hospital in north‐east Brazil.

Methods

We developed an economic model based on retrospective data of 73 hospitalised patients in 2006–2012, from hospital and public health system perspectives.

Results

In the economic model, 82.2% of patients who started treatment with L‐AmB had completed it after 2 months, vs. 22.0% for the SbV and 19.9% for the AmB‐D groups. After 12 months of follow‐up, these proportions were 100% in the L‐AmB, 77.4% in the AmB‐D and 72.2% in the SbV group. Markov chain analyses showed that the group that started therapy with SbV had the lowest mean total cost (US$ 3782.38), followed by AmB‐D (US$ 5211.27) and L‐AmB (US$ 11 337.44). The incremental cost‐effectiveness ratio for L‐AmB was US$ 18 816.23 against SbV and US$ 24 504.65 against AmB‐D. In the sensitivity analysis, the drug acquisition cost of L‐AmB significantly influenced the results.

Conclusions

In the treatment of mucocutaneous leishmaniasis, L‐AmB is a cost‐effective alternative to SbV and AmB‐D owing to its higher effectiveness, safety and shorter course.
Tau directs intracellular trafficking by regulating the forces exerted by kinesin and dynein teams
Authors: Chaudhary Abdullah R. , Berger Florian , Berger Christopher L. , Hendricks Adam G.
Published: October 2017

Organelles, proteins, and mRNA are transported bidirectionally along microtubules by plus‐end directed kinesin and minus‐end directed dynein motors. Microtubules are decorated by microtubule‐associated proteins (MAPs) that organize the cytoskeleton, regulate microtubule dynamics and modulate the interaction between motor proteins and microtubules to direct intracellular transport. Tau is a neuronal MAP that stabilizes axonal microtubules and crosslinks them into bundles. Dysregulation of tau leads to a range of neurodegenerative diseases known as tauopathies including Alzheimer's disease (AD). Tau reduces the processivity of kinesin and dynein by acting as an obstacle on the microtubule. Single‐molecule assays indicate that kinesin‐1 is more strongly inhibited than kinesin‐2 or dynein, suggesting tau might act to spatially modulate the activity of specific motors. To investigate the role of tau in regulating bidirectional transport, we isolated phagosomes driven by kinesin‐1, kinesin‐2, and dynein and reconstituted their motility along microtubules. We find that tau biases bidirectional motility towards the microtubule minus‐end in a dose‐dependent manner. Optical trapping measurements show that tau increases the magnitude and frequency of forces exerted by dynein through inhibiting opposing kinesin motors. Mathematical modeling indicates that tau controls the directional bias of intracellular cargoes through differentially tuning the processivity of kinesin‐1, kinesin‐2, and dynein. Taken together, these results demonstrate that tau modulates motility in a motor‐specific manner to direct intracellular transport, and suggests that dysregulation of tau might contribute to neurodegeneration by disrupting the balance of plus‐ and minus‐end directed transport.
English language teaching in Uruguay
Authors: KAISER DJ
Published: October 2017

Uruguay is quickly emerging as one of the most innovative countries in the field of English Language Teaching (ELT) by delivering thousands of lessons weekly in public schools via interactive videoconference in a project called Ceibal en Inglés. This article provides a comprehensive look at the history of ELT practices in Uruguay that both necessitated this bold approach and provided the infrastructure to implement it nationally. Special focus is paid to the public school system with historical changes in ELT and teacher preparation. This overview article discusses the many challenges faced in ‘democratizing’ English language instruction in Uruguay and the new practices, policies, and proposals that support this new national objective.
Regional variation in the mechanical properties and fibre‐type composition of the rat extensor digitorum longus muscle
Authors: Kissane Roger W. P. , Egginton Stuart , Askew Graham N.
Published: October 2017

New Findings

What is the central question of this study?

Mammalian muscle is typically heterogeneous in fibre‐type distribution, with distinct regional variation in composition. The effects this might have on mechanical performance are largely unknown.

What is the main finding and its importance?

Contractile properties vary regionally within a heterogeneous muscle. The mixed extensor digitorum longus muscle has phenotypically distinct compartments that differ in their isometric twitch kinetics, the optimal cycle frequency for maximal power generation and fatigue resistance. The mechanisms underpinning the decline in performance during fatigue differ between compartments. Regional variation in mechanical performance suggests that regions of the extensor digitorum longus muscle might be differentially recruited during locomotion, depending upon functional demand.

Fibre‐type composition is heterogeneous, and distribution varies spatially in many muscles, indicating that there might be regional variation in recruitment and mechanical output. The rat extensor digitorum longus muscle is composed of predominantly fast‐twitch fibres and exhibits a gradient in phenotype, resulting in oxidative medial (areal composition 24.3% type I/IIa) and glycolytic lateral (92.4% type IIx/IIb) compartments. Here, we investigated the variation in mechanical performance between the medial and lateral compartments during isometric, isotonic and cyclical contractions. Isometric tetanic stress and force–velocity relationships were similar in both compartments, but isometric twitch kinetics were slower in the medial compared with the lateral compartment. The medial compartment also had a lower optimal cycle frequency for maximal net power generation (11 versus 15 Hz; P < 0.05) attributable to slower isometric kinetics, resulting in a lower level of activation and reduced net work generation at higher cycle frequencies, compared with the lateral compartment. The more oxidative, medial compartment had higher fatigue resistance, maintaining net power 26% longer than the lateral compartment. The predominant mechanisms underpinning the decrease in net power varied between the compartments, resulting from an increase in the work to extend the muscle and from a reduction in work during shortening in the medial and lateral compartments, respectively. Regional variation in mechanical performance and resistance to fatigue within a mixed muscle suggests that a differential recruitment pattern is likely during locomotion, with the medial compartment being used during slow‐speed locomotion and the lateral compartment during burst activities.
Improvement in Server Compute Performance Using Advanced Air Cooled Thermal Solutions
Authors: Kulkarni Devdatta , Ahuja Sandeep , Saha Sanjoy
Published: October 2017

Continuously increasing demand for higher compute performance is pushing for improved advanced thermal solutions. In high performance computing (HPC) area, most of the end users deploy some sort of direct or indirect liquid cooling thermal solutions. But for the users who have air cooled data centers and air cooled thermal solutions are challenged to cool next generation higher Thermal Design Power (TDP) processors in the same platform form factor without changing environmental boundary conditions. This paper presents several different advanced air cooled technologies developed to cool high TDP processors in the same form factor and within the same boundary conditions of current generation processor. Comparison of thermal performance using different cooling technologies such as Liquid Assist Air Cooling (LAAC) and Loop Heat Pipe (LHP) are presented in this paper. A case study of Intel’s Knights Landing (KNL) processor is presented to show case the increase in compute performance due to different advanced air cooling technologies.
The Mechanism of the Low-K Stress Reduction in Chip Assembly by Shorter Solder Bump Height
Authors: Matsumoto Keiji , Okamoto Keishi , Mori Hiroyuki
Published: October 2017

To solve the low-k delamination in chip assembly for high-end servers, our hypothesis is proposed that the low-k stress is determined by the bending moment and the stress relaxation of a joint. In our hypothesis, the low-k stress decreases as the joint height (SnAg bump height) becomes shorter, such as below 80μm, in 150μm-pitch joints. Our hypothesis is supported by simulation, in which the low-k stress is investigated as a function of the joint height, the joint material and also the joint width (the joint pitch). Finally, experiments are performed to evaluate the low-k delamination as a function of the joint height and our hypothesis is also supported by experiments.
Integrated Vapor Chamber Heat Spreader for Power Module Applications
Authors: Hose Clayton L. , Ibitayo Dimeji , Boteler Lauren M. , Weyant Jens , Richard Bradley
Published: October 2017

This work presents a demonstration of a coefficient of thermal expansion (CTE) matched, high heat flux vapor chamber directly integrated onto the backside of a direct bond copper (DBC) substrate to improve heat spreading and reduce thermal resistance of power electronics modules. Typical vapor chambers are designed to operate at heat fluxes > 25 W/cm2 with overall thermal resistances < 0.20 °C/W. Due to the rising demands for increased thermal performance in high power electronics modules, this vapor chamber has been designed as a passive, drop-in replacement for a standard heat spreader. In order to operate with device heat fluxes >500 W/cm2 while maintaining low thermal resistance, a planar vapor chamber is positioned onto the backside of the power substrate, which incorporates a specially designed wick directly beneath the active heat dissipating components to balance liquid return and vapor mass flow. In addition to the high heat flux capability, the vapor chamber is designed to be CTE matched to reduce thermally induced stresses. Modeling results showed effective thermal conductivities of up to 950 W/m-K, which is 5 times better than standard copper-molybdenum (CuMo) heat spreaders. Experimental results show a 43°C reduction in device temperature compared to a standard solid CuMo heat spreader at a heat flux of 520 W/cm2.
Steady State and Transient Thermal Characterization of Vertical GaN PIN Diodes
Authors: Pavlidis Georges , Dallas James , Choi Sukwon , Shen Shyh-Chiang , Graham Samuel
Published: October 2017

In this work, we investigate the thermal response of GaN PIN diodes grown on a sapphire substrate and compare the results to GaN PIN diodes grown on a free standing GaN substrate (FS-GaN). Until now, thermal characterization techniques have been developed to assess the temperature distribution across lateral devices. Raman thermometry has shown to accurately measure the temperature rise across the depth of the GaN layer. Implementing this technique to assess the temperature distribution across the depth of a vertical GaN device is more challenging since a volumetric depth average is measured. The use of TiO2 nanoparticles is shown to overcome this issue and reduce the uncertainty in the peak temperature by probing a surface temperature on top of the device. For the sapphire substrate, an additional temperature rise of about 15 K was seen on the surface of the PIN diode as compared to the average in the bulk. While the steady state thermal measurements show an accurate estimation of the device’s peak temperature, the PIN diodes are normally operated under pulsed conditions and the thermal response of these devices under periodic joule heating must be assessed. A recently developed transient thermoreflectance imaging technique (TTI) is used in this study to monitor transient temperature rise and decay of top metal contact. Under the same biasing conditions, the FS-GaN PIN diode is found to result in less than half the temperature rise obtained by the sapphire substrate diode. Extracting time constants, a longer rise and decay is also observed in the sapphire substrate diode.
Peel-and-Stick Sensors Powered by Directed RF Energy
Authors: Lalau-Keraly Christopher , Daniel George , Lee Joseph , Schwartz David
Published: October 2017

PARC, a Xerox Company, is developing a low-cost system of peel-and-stick wireless sensors that will enable widespread building environment sensor deployment with the potential to deliver up to 30% energy savings. The system is embodied by a set of RF hubs that provide power to automatically located sensor nodes, and relay data wirelessly to the building management system (BMS). The sensor nodes are flexible electronic labels powered by rectified RF energy transmitted by an RF hub and can contain multiple printed and conventional sensors. The system design overcomes limitations in wireless sensors related to power delivery, lifetime, and cost by eliminating batteries and photovoltaic devices. Sensor localization is performed automatically by the inclusion of a programmable multidirectional antenna array in the RF hub. Comparison of signal strengths while the RF beam is swept allows for sensor localization, reducing installation effort and enabling automatic recommissioning of sensors that have been relocated, overcoming a significant challenge in building operations. PARC has already demonstrated wireless power and temperature data transmission up to a distance of 20m with less than one minute between measurements, using power levels well within the FCC regulation limits in the 902–928 MHz ISM band. The sensor’s RF energy harvesting antenna achieves high performance with dimensions below 5cm × 9cm.
Investigation of the Heterogeneous Thermal Conductivity in Bulk CVD Diamond for Use in Electronics Thermal Management
Authors: Yates Luke , Cheaito Ramez , Sood Aditya , Cheng Zhe , Bougher Thomas , Asheghi Mehdi , Goodson Kenneth , Goorsky Mark , Faili Firooz , Twitchen Dan , Graham Samuel
Published: October 2017

From a materials perspective, diamond exhibits properties that are extremely well suited for use in the thermal management of high power and high heat flux electronic devices. While bulk diamond grown via chemical vapor deposition (CVD) has been demonstrated since the 1980s, and people have measured thermal conductivities ranging from 500–2000 W/m-K, these measurements have typically taken place over a large domain that encompasses numerous diamond grains. However, many of these techniques do not reveal the heterogenous nature of the diamond thermal conductivity which arises due to the local grain structure and orientation. The diamond sample investigated in this study contained a high level of boron doping on the order of 1021cm−3, giving rise to a reduced thermal conductivity measured as 714 W/m-K with a laser flash method. Similar bulk CVD diamond samples that are undoped show thermal conductivity values of greater than 1500 W/m-K with the same measurement technique.

Through the use of time-domain thermoreflectance (TDTR) we are able to measure the thermal conductivity of bulk CVD diamond at a spatial resolution smaller than the size of the columnar grains. This allows us to examine significant changes in thermal conductivity as a function of spatial location, which is of great significance when the thermal source from electronics is on the size scale of this variation. Using TDTR, we present an approach involving a variation in the laser spot size using multiple focusing objectives to yield the heterogeneous thermal conductivity in bulk CVD diamond. The data show variations in thermal conductivity near 40% over a diameter of 40 μm. Scanning Electron Microscopy (SEM) and electron backscatter diffraction (EBSD) data are presented which also show variation in microstructure over this length scale giving rise to the heterogeneity.