bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Technology to Facilitate Authentic Assessment of Bilingual Preschool Children
Authors: Kashinath Shubha , Pearman Aubrey , Canales Andrea
Published: April 2015

An increasing number of children in preschools and schools around the country are from culturally and linguistically diverse backgrounds and speak multiple languages. However, clinicians are often challenged in conducting least-biased assessments of bilingual children, which often results in over-referral or under- referral of these children to special education and related services. Utilizing naturalistic and authentic assessment of child language such as language sampling is a recommended approach to augment traditional assessments in clinical settings. The Language ENvironment Analysis (LENA) technology offers clinicians a time-and cost effective means to gathering representative language samples across home and school environments to help determine the presence of speech-language impairment in young bilingual children. We describe an exploratory study using the LENA with five Spanish-English bilingual children to identify the accuracy of traditionally transcribed child word counts as compared to the automated child vocalization analyses obtained through the LENA. Results indicate the need for more research to fully explore the clinical utility of this technology for assessment of bilingual children.
Stabilisation of directed cycle formations and application to two‐wheeled mobile robots
Authors: Park Myoung‐Chul , Ahn Hyo‐Sung
Published: April 2015

In this study, the authors deal with a formation of autonomous mobile agents in the distance‐based formation control setup, where the formation is represented by a directed cycle. They use gradient control law to stabilise the mobile agents and provide analysis of the behaviour of the agents under the given control law. Although a particular formation shape cannot be achieved by controlling only the inter‐agent distances with more than three agents in the plane, at least they can make the inter‐agent distances converge to the desired distances and stabilise the agents so that they converge. They found that there are invariant subsets where the agents may not achieve desired distances. However, they show that those invariant sets are not attractive. Simulation results and experimental results verifying their analysis are provided.
Symptoms of Sternal Nonunion Late after Cardiac Surgery
Authors: Rinta-Kiikka Irina , Tarkka Matti , Laurikka Jari , Hautalahti Juha
Published: April 2015

Background A cohort of patients having symptoms of sternal nonunion late after sternotomy was studied to find out whether the complaints were related to true sternal nonunion or decreased bone density.

Methods A survey was mailed to 2,053 cardiac surgical patients operated in our institution between July 2007 and June 2010. The patients were requested about symptoms referring to sternal instability. A group of symptomatic individuals as well as 1:1 age- and time-matched asymptomatic controls were examined with sternal palpation, ultrasound during standardized sternal pressure provocation, and computed tomography (CT).

Results The number of patients replied in the survey was 1,918 (93.4%); 2.3% (44 patients) reported sensation of movement or clicking in sternum during body movements and during coughing. Symptomatic patients living within 200 km to the hospital (21) and their asymptomatic controls (21) were selected for further clinical and imaging studies. Mean period between the initial operation and the examinations was 36 (22–56) months. Sternal palpation pain was significantly associated with reported symptoms suggestive of sternal nonunion (odds ratio [OR] 22.0; 95% confidence interval [CI] 2.5–195); however, none of the patients had clinically unstable sternum or nonunion in the sternal imaging. The symptoms of sternal instability were more frequent in patients whose bone mineralization rate (as measured with T-scores) was higher.

Conclusion Symptoms suggestive of sternal nonunion were experienced by 2.3%. However, their symptoms did not correlate with CT scans or provocation ultrasound although palpation pain was evident. Thus the pain is derived from nonmechanical etiologies. Higher bone mineralization rate correlated with abnormal symptoms of sternal wound.
Poloidal asymmetries in edge transport barriers
Authors: Churchill R. M. , Theiler C. , Lipschultz B. , Hutchinson I. H. , Reinke M. L. , Whyte D. , Hughes J. W. , Catto P. , Landreman M. , Ernst D. , Chang C. S. , Hager R. , Hubbard A. , Ennever P. , Walk J. R. ,   Alcator C-Mod Team
Published: April 2015

Measurements of impurities in Alcator C-Mod indicate that in the pedestal region, significant poloidal asymmetries can exist in the impurity density, ion temperature, and main ion density. In light of the observation that ion temperature and electrostatic potential are not constant on a flux surface [Theiler et al., Nucl. Fusion 54, 083017 (2014)], a technique based on total pressure conservation to align profiles measured at separate poloidal locations is presented and applied. Gyrokinetic neoclassical simulations with XGCa support the observed large poloidal variations in ion temperature and density, and that the total pressure is approximately constant on a flux surface. With the updated alignment technique, the observed in-out asymmetry in impurity density is reduced from previous publishing [Churchill et al., Nucl. Fusion 53, 122002 (2013)], but remains substantial (nz,H/nz,L∼6). Candidate asymmetry drivers are explored, showing that neither non-uniform impurity sources nor localized fluctuation-driven transport are able to explain satisfactorily the impurity density asymmetry. Since impurity density asymmetries are only present in plasmas with strong electron density gradients, and radial transport timescales become comparable to parallel transport timescales in the pedestal region, it is suggested that global transport effects relating to the strong electron density gradients in the pedestal are the main driver for the pedestal in-out impurity density asymmetry.
Curvature-induced changes in the magnetic energy of vortices and skyrmions in paraboloidal nanoparticles
Authors: Carvalho-Santos V. L. , Elias R. G. , Fonseca J. M. , Altbir D.
Published: April 2015

Curvature effects are important for a proper description of the properties of magnetic systems. In this paper, the exchange and dipolar energy of vortices on a paraboloidal shell is studied. Using analytical calculations, it is shown that the in-plane component of vortices has larger energy on a paraboloidal shell than in a planar disk with same thickness. On the other hand, the dipolar energy associated to the vortex core diminishes if the vortex core is on a paraboloidal surface. This reduction in the dipolar energy may cause a vortex pinning mechanism by a paraboloidal shaped defect in a planar nanomagnet. Regarding skyrmions, by using an in-plane anisotropy approximation to the dipolar energy, it is shown that the skyrmion must have its width shrunk in order to diminish the magnetostatic energy and satisfy geometrical constraints of the system.
Ab initio molecular dynamics studies of hydrogen bonded structure, molecular motion, and frequency fluctuations of water in the vicinity of azide ions
Authors: Karmakar Anwesa , Chandra Amalendu
Published: April 2015

First principles theoretical studies of vibrational spectral diffusion of the stretch modes of water and azide (N3−) ions are presented by means of ab initio molecular dynamics simulations for two different concentrations of the ions. The vibrational spectral diffusion of hydration shell water in a dilute solution containing a single azide ion is found to occur with three time scales while two time scales are found for the spectral diffusion in the solution of higher ion concentration. The frequency time correlation of the stretching vibration of azide ion is also found to have two time scales. The vibrational spectral diffusion of the stretching mode of azide ions in the concentrated solution is found to occur at a slightly faster rate while that of the water OD modes becomes slower with increase of ion concentration. The effects of dispersion interactions are also investigated by using a dispersion corrected density functional. The time constants of frequency correlations and dynamical spectral shifts are analyzed in terms of the relaxation of azide ion-water and water-water hydrogen bonds. The results of present theoretical calculations are compared with the available experimental and other theoretical results.
Disrupting the wall accumulation of human sperm cells by artificial corrugation
Authors: Guidobaldi H. A. , Jeyaram Y. , Condat C. A. , Oviedo M. , Berdakin I. , Moshchalkov V. V. , Giojalas L. C. , Silhanek A. V. , Marconi V. I.
Published: April 2015

Many self-propelled microorganisms are attracted to surfaces. This makes their dynamics in restricted geometries very different from that observed in the bulk. Swimming along walls is beneficial for directing and sorting cells, but may be detrimental if homogeneous populations are desired, such as in counting microchambers. In this work, we characterize the motion of human sperm cells ∼60 μm long, strongly confined to ∼25 μm shallow chambers. We investigate the nature of the cell trajectories between the confining surfaces and their accumulation near the borders. Observed cell trajectories are composed of a succession of quasi-circular and quasi-linear segments. This suggests that the cells follow a path of intermittent trappings near the top and bottom surfaces separated by stretches of quasi-free motion in between the two surfaces, as confirmed by depth resolved confocal microscopy studies. We show that the introduction of artificial petal-shaped corrugation in the lateral boundaries removes the tendency of cells to accumulate near the borders, an effect which we hypothesize may be valuable for microfluidic applications in biomedicine.
Performance of a prototype power transformer constructed by nanocrystalline Fe-Co-Si-B-P-Cu soft magnetic alloys
Authors: Takenaka Kana , Nishiyama Nobuyuki , Setyawan Albertus D. , Sharma Parmanand , Makino Akihiro
Published: April 2015

To clarify the feasibility and performance of Fe81.2Co4Si0.5B9.5P4Cu0.8 alloy (with trade name NANOMET®) for electrical power applications, a prototype transformer was constructed. After surface treatment, as-quenched ribbons with a constant width of 50 mm and a thickness of ∼30 μm were wound into a toroidal shape. Nanocrystallization of toroidal core was performed by immersing it in a salt at 673 K for 180 s. The transformer constructed in the present work exhibit low core loss similar to the transformer constructed by a commercial Fe-based amorphous alloy. In spite of issues related to the annealing/nano-crystallization of the core, the feasibility for commercialization of NANOMET in power transformer applications can be confirmed. We believe the potential of NANOMET as core material for next generation of power transformer seems to be huge.
Wireless power transfer and fault diagnosis of high-voltage power line via robotic bird
Authors: Liu Chunhua , Chau K. T. , Zhang Zhen , Qiu Chun , Li Wenlong , Ching T. W.
Published: April 2015

This paper presents a new idea of wireless power transfer (WPT) and fault diagnosis (FD) of high-voltage power line via robotic bird. The key is to present the conceptual robotic bird with WPT coupling coil for detecting and capturing the energy from the high-voltage power line. If the power line works in normal condition, the robotic bird is able to stand on the power line and extract energy from it. If fault occurs on the power line, the corresponding magnetic field distribution will become different from that in the normal situation. By analyzing the magnetic field distribution of the power line, the WPT to the robotic bird and the FD by the robotic bird are performed and verified.
Effect of natural mating or laparoscopic artificial insemination in superovulated Santa Inês ewes on superovulatory response, fertility and embryo viability
Authors: Lima J. T. M. , Fonseca J. F. , Balaro M. F. A. , Esteves L. V. , Ascoli F. O. , Leite C. R. , Ribeiro A. C. S. , Delgado K. F. , Souza-Fabjan J. M. G. , Filho R. A. Torres , Brandão F. Z.
Published: April 2015

This study evaluated the effect of two mating methods (GNM: natural mating or GAI: laparoscopic artificial insemination) on superovulatory response, fertility and embryo yield in superovulated ewes. Fifteen non-pregnant Santa Inês ewes were superovulated and either mated by GNM or GAI in a crossover design. Oestrus was synchronised using intravaginal progestagen sponges for 6 days and on Day 5, 300 IU eCG and 0.0375 mg d-cloprostenol were given. Twelve hours after sponge removal, 0.025 mg gonadotropin-releasing hormone was administered. Superovulation started 48 h after gonadotropin-releasing hormone treatment, using 5 IU/kg follicle-stimulating hormone (pFSH). At the first pFSH dose, new sponges were inserted. At the fifth dose, 0.0375 mg cloprostenol was administered and the sponges were removed. The GNM was mated with rams every 12 h, until the end of oestrus. The ewes of GAI were laparoscopic inseminated with frozen–thawed semen 36 and 48 h after sponge removal. Ultrasonography was performed every 24 h from the beginning of oestrus synchronisation treatment and every 12 h from the second sponge removal to 2 days after the last pFSH dose. Six to seven days after mating, the number of corpora lutea (CL) was evaluated by laparoscopy and the females with > 4 CL were subjected to embryo collection. The interval from sponge removal to ovulation was shorter (P < 0.05) in the GNM. The overall superovulatory response was 63.3% (19/30), with 60.0% and 66.7% in GNM and GAI, respectively (P > 0.05). The number of recovered structures (6.4 ± 2.4 vs 4.5 ± 3.0), recovery rate (74.0 ± 16.0 vs 52.3 ± 26.5%), number of transferable embryos (3.0 ± 2.9 vs 3.6 ± 2.0) and viability rate (47.2 ± 45.3 vs 77.4 ± 37.1%) did not differ between GAI and GNM (P > 0.05). However, the GAI group showed a higher (P < 0.05) number of unfertilised oocytes (3.1 ± 3.1) and a higher non-fertilisation rate (47.1 ± 45.3%) than the GNM (0.9 ± 2.1 and 11.5 ± 21.5%). The mating method did not affect the superovulatory response, and production of viable embryos although the non-fertilisation rate has been inferior for the AI group.
Emergence of homeostatic epithelial packing and stress dissipation through divisions oriented along the long cell axis
Authors: Wyatt Tom P. J. , Harris Andrew R. , Lam Maxine , Cheng Qian , Bellis Julien , Dimitracopoulos Andrea , Kabla Alexandre J. , Charras Guillaume T. , Baum Buzz
Published: April 2015

Significance

Animal cells undergo a remarkable series of shape changes as they pass through mitosis and divide. In an epithelial tissue, the impact of these morphogenetic processes depends strongly on the orientation of division. However, the cues orienting divisions remain poorly understood. Here, we combine live imaging and mechanical perturbations with computational modeling to investigate the effects of shape changes accompanying mitosis and division in stretched monolayers in the absence of neighbor exchange. We show that divisions orient with the long cell axis rather than with the stress direction, and show how oriented divisions contribute to the restoration of cell packing and stress relaxation. In doing so, we identify a clear role for oriented cell division in morphogenetically active tissues.
Integrating emerging technologies in teaching Ugandan traditional dances in K‐12 schools in New York City
Authors: Mabingo Alfdaniels
Published: April 2015

Schools in New York City have made attempts to embrace and support the strand of ‘making connections’, which is laid out in the New York City Department of Dance blueprint for teaching and learning in dance for grades PreK‐12. Accordingly, some schools have integrated Ugandan traditional dances into the dance curriculum, and dance teachers have employed emerging technologies as part of instructional methodologies in teaching these dances. Anchored in the theoretical framework of constructivism and the idea of concept and realisation in constructing dance knowledge, this article reveals how the author employed emerging technologies and online platforms such as ipads, smartboards, ipods, iphones, audio recorders, YouTube and wikispace in teaching Ugandan traditional dances to: reconcile contextual and content knowledge in the classroom; engage students in reflective and interpretive analyses and deconstruction of dance songs and movements; give feedback to and receive reflections from students; and explore issues relating to learning to dance, learning through dance, and learning about dance. The author further divulges how dilemmas that relate to re/presentation and appropriation of ephemerally, culturally and contextually celebrated, embodied and defined dances imposed limitations on execution of technologically mediated class activities.
Trends in Pediatric Pulmonary Hypertension–Related Hospitalizations in the United States from 2000–2009
Authors: Frank David B. , Crystal Matthew A. , Morales David L. S. , Gerald Ken , Hanna Brian D. , Mallory George B. , Rossano Joseph W.
Published: April 2015

There are few data on the epidemiology of pulmonary hypertension (PH)–related hospitalizations in children in the United States. Our aim was to determine hospital mortality, length of hospitalization, and hospital charges pertaining to PH‐related hospitalizations and also the effects of codiagnoses and comorbidities. A retrospective review of the Kids’ Inpatient Database during the years 2000, 2003, 2006, and 2009 was analyzed for patients ≤20 years of age with a diagnosis of PH by ICD‐9 (International Classification of Diseases, Ninth Revision) codes, along with associated diagnoses and comorbidities. Descriptive statistics, including Rao‐Scott χ2, ANOVA, and logistic regression models, were utilized on weighted values with survey analysis procedures. The number of PH‐related hospital admissions is rising, from an estimated 7,331 (95% confidence interval [CI]: 5,556–9,106) in 2000 to 10,792 (95% CI: 8,568–13,016) in 2009. While infant age and congenital heart disease were most commonly associated with PH‐related hospitalizations, they were not associated with mortality. Overall mortality for PH‐related hospitalizations was greater than that for hospitalizations not associated with PH, 5.7% versus 0.4% (odds ratio: 16.22 [95% CI: 14.78%–17.8%], P < 0.001), but mortality is decreasing over time. Sepsis, respiratory failure, acute renal failure, hepatic insufficiency, arrhythmias, and the use of extracorporeal membrane oxygenation are associated with mortality. The number of PH‐related hospitalizations is increasing in the United States. The demographics of PH in this study are evolving. Despite the increasing prevalence, mortality is improving.
Examples of factors which have no Cartan subalgebras
Authors: Isono Yusuke
Published: April 2015

We consider some conditions similar to Ozawa’s condition (AO) and prove that if a non-injective factor satisfies such a condition and has the

W
∗

C
B
A
P

\rm W^*CBAP

, then it has no Cartan subalgebras. As a corollary, we prove that

I

I
1

\rm II_1

factors of universal orthogonal and unitary discrete quantum groups have no Cartan subalgebras. We also prove that continuous cores of type

I
I

I
1

\rm III_1

factors with such a condition are semisolid as a

I

I
∞

\rm II_\infty

factor.
Representations of Banach algebras subordinate to topologically introverted spaces
Authors: Filali M. , Neufang M. , Sangani Monfared M.
Published: April 2015

Let

A
A

be a Banach algebra,

X
X

a closed subspace of

A
∗

A^*

,

Y
Y

a dual Banach space with predual

Y
∗

Y_*

, and

π
\pi

a continuous representation of

A
A

on

Y
Y

. We call

π
\pi

subordinate to

X
X

if each coordinate function

π

y
,
λ

∈
X

\pi _{y,\lambda }\in X

, for all

y
∈
Y
,
λ
∈

Y
∗

y\in Y, \lambda \in Y_*

. If

X
X

is topologically left (right) introverted and

Y
Y

is reflexive, we show the existence of a natural bijection between continuous representations of

A
A

on

Y
Y

subordinate to

X
X

, and normal representations of

X
∗

X^*

on

Y
Y

. We show that if

A
A

has a bounded approximate identity, then every weakly almost periodic functional on

A
A

is a coordinate function of a continuous representation of

A
A

subordinate to

W
A
P
(
A
)

WAP(A)

. We show that a function

f
f

on a locally compact group

G
G

is left uniformly continuous if and only if it is the coordinate function of the conjugate representation of

L
1

(
G
)

L^1(G)

, associated to some unitary representation of

G
G

. We generalize the latter result to an arbitrary Banach algebra with bounded right approximate identity. We prove the functionals in

L
U
C
(
A
)

LUC(A)

are all coordinate functions of some norm continuous representation of

A
A

on a dual Banach space.
Seasonal small-scale variation in distribution among depth zones in a coastal Baltic Sea fish assemblage
Authors: Mustamäki N. , Jokinen H. , Scheinin M. , Bonsdorff E. , Mattila J.
Published: April 2015

We studied seasonal and small-scale spatial variation in fish assemblage structure in the northern Baltic Proper archipelago. The study was conducted in a shallow coastal basin during three consecutive production-seasons. The structure of the fish assemblage changes significantly seasonally, from early summer (May–June) to late summer (August–September), and spatially over short distances (ca. 500 m) and small depth intervals (ca. 5 m) in an area without physical barriers. The magnitude of the seasonal variation was depth zone-specific, indicating that seasonal patterns from a given depth zone cannot be directly extrapolated to adjacent ones, let alone to a whole water body. In early summer, the adult fish displayed spawning aggregations, and their abundance was highest closest to the shoreline. In late summer, the adult fish were more evenly distributed and the assemblage was dominated by high abundances of juvenile fish. The results underline the importance of including several spatial and temporal scales into studies on fish distribution. The resulting patterns from such studies may appear idiosyncratic unless the nature and magnitude of seasonal variation and small-scale depth zone distribution are taken into account.
Essential medicines for palliative care
Authors: De Lima Liliana , Radbruch Lukas , Bruera Eduardo
Published: April 2015

The essential medicines concept developed by the World Health Organization (WHO), states that there is a list of minimum medicines for a basic health-care system, including the most efficacious, safe, and cost-effective ones for priority conditions. According to the WHO, essential medicines are those that satisfy the primary health-care needs of the population. Thus, they should always be available, affordable, and cost-effective. However, the vast majority of the global population does not have access to essential medicines. Many organizations have called on governments to adopt policies to improve availability of these essential medicines and developed programmes and projects to increase awareness and knowledge. This chapter describes two such projects developed by the International Association for Hospice and Palliative Care (IAHPC), based on the essential medicines concept to improve access to medicines and appropriate palliative care: the IAHPC List of Essential Medicines in Palliative Care and the Opioid Essential Prescription Package.
Palliative care in the nursing home
Authors: Phillips Jane L. , Hosie Annmarie , Davidson Patricia M.
Published: April 2015

Internationally, ageing, technological advances, evolving patterns of disease and disability, and changes in family structures have resulted in nursing homes becoming the final residence for many frailer older people. Much of the on-site assistance with activities of daily living in nursing homes is predominately provided by an unregulated or minimally trained carer workforce with registered nurse supervision, while professional nursing and medical care is provided either by on-site or visiting doctors, nurses, and allied health professionals from external services. This chapter details the palliative care needs of older people living in nursing homes and the challenges and opportunities to deliver better end-of-life care to this population, and proposes utilizing the Chronic Care Model as a framework for delivering the elements of a palliative approach to improve care outcomes for residents and their families.
Teaching and training in palliative medicine
Authors: Forbes Karen , Gibbins Jane
Published: April 2015

Patients die in almost all areas of medicine; it is therefore essential for doctors to be equipped with the knowledge, skills, attitudes, and behaviours necessary to look after patients who need care at the end of life. This chapter explores what the training needs of the various doctors caring for patients with palliative care needs are, how their curricula have developed, and the variety of ways training is delivered. It suggests that learners need to move out of the classroom to achieve exposure to real clinical experience with patients approaching the end of their lives with support from seniors who acknowledge patients’ needs, role model good communication and care, and facilitate their juniors’ reflection and learning from these encounters. However, the main challenge is to encourage and develop innovative clinical and research partnerships to design, deliver, and evaluate educational packages to demonstrate how education in palliative care best benefits patients and their families.
Genitourinary aspects of palliative care
Authors: Lee Olivia T. , Wu Jennifer N. , Meyers Frederick J. , Evans Christopher P.
Published: April 2015

Genitourinary tract diseases in the palliative care setting most commonly involve urinary tract obstruction, intractable bleeding, fistulae, and bladder-associated pain. Sources of obstruction in the lower urinary tract include benign prostatic hyperplasia, invasive prostate or bladder cancer, urethral stricture, or bladder neck contracture. Upper tract obstruction includes intraluminal or extraluminal blockage of the renal collecting system and ureters, such as transitional cell carcinoma, fibroepithelial polyps, stricture, stones, pelvic or retroperitoneal malignancy, fibrosis, or prior radiation. Untreated, obstructive uropathy leads to elevated bladder, ureter, and kidney pressures, bladder dysfunction, urolithiasis, renal failure, pyelonephritis, or urosepsis. Intractable haematuria can cause problematic anaemia, frequent transfusions, clot retention, haemorrhagic shock, and death. In addition, urinary tract fistulae such as vesicovaginal and vesicoenteric fistulae are common in patients who have had prior pelvic surgery or radiation especially in the setting of immunocompromise, poor nutrition, and infection. Untreated, these symptoms lead to rash, skin breakdown, ulcers, chronic infection, and sepsis. Lastly, pelvic and bladder pain, depending on aetiology can be treated with oral medications, intravesical therapies, or surgical therapies such as palliative resection or urinary diversion. Selection of tests and treatment modalities in the palliative care setting should be based on using the least invasive means to achieve the most relief in suffering. Some genitourinary conditions are potentially fatal, and in the acute or subacute setting, require re-evaluation of the end-of-life goals and wishes of the patient and family.
Pathophysiology of pain in cancer and other terminal illnesses
Authors: Gordon-Williams Richard M. , Dickenson Anthony H.
Published: April 2015

Cancer pain involves a myriad of peripheral changes in the function of tissue and nerves, at the site of the tumour growth, as well as a number of consequent changes in the processing of pain messages at the spinal cord level with implications for the pain experience at higher centres. This chapter reviews the changes in peripheral pain signalling, notes the likely prevalence of both inflammatory and neuropathic components, and describes the altered events at spinal levels that can come some way towards explaining ongoing pain, hyperalgesia, and allodynias that patients with cancer and other terminal illnesses such as HIV/AIDs experience. Finally, changes induced by cancer at the level of the brain are discussed. The mechanisms of action of therapies, both existing and potential novel approaches, are included at peripheral and central levels.
Withholding and withdrawing life-sustaining treatment (including artificial nutrition and hydration)
Authors: Ko Danielle N. , Blinderman Craig D.
Published: April 2015

Life-sustaining treatment (LST) is any treatment that serves to prolong life without reversing the underlying medical condition, and includes cardiopulmonary resuscitation, mechanical ventilation, haemodialysis, left ventricular assist devices, antibiotics, and artificial nutrition and hydration. The appropriate use of LST in seriously ill patients is a controversial topic that continues to generate intense debate amongst private citizens as well as health-care professionals, bioethicists, lawyers, governments, and religious institutions. This chapter sets out important questions clinicians ought to consider before making the decision to withhold or withdraw LST. This practical guide should enable clinicians to accurately identify the issues relevant to a given case and to make decisions that are both medically and ethically sound.
The oncologist’s role in delivering palliative care
Authors: Cherny Nathan I. , Kaasa Stein
Published: April 2015

The care of patients with cancer demands that oncologists have the means and skill necessary to address the suffering and distress of their patients. The effective provision of palliative care is, as a consequence, a core element of oncological practice. This is true for all oncological physicians be they surgeons, radiotherapists, or medical oncology. This chapter elaborates on the role of the oncologist and providing palliative care: how and where it is done, what it entails, what training is required to achieve adequate skill levels, and the coordination of care with palliative care specialty services.
Talking with families and children about the death of a parent
Authors: Muriel Anna C. , Rauch Paula K.
Published: April 2015

The untimely death of a parent is one of the most challenging events for families and the clinicians who care for them. This chapter discusses how a basic knowledge of child development and the ways that children understand illness and death can provide a template from which to engage families about how to help their children during this time and into bereavement. It addresses such topics as how children understand death at different ages, timing of discussions with children, decisions about the setting for end-of-life care in a family context, visits between ill parents and children, legacy leaving, and children’s participation in funerals and memorial services. When clinicians support honest, child-centred communication, and help families anticipate common situations and questions, surviving adults are able to use their own best resources to provide thoughtful care for the children.
The principles of evidence-based medicine
Authors: Abernethy Amy P.
Published: April 2015

Evidence-based medicine (EBM) has transformed clinicians’ approach to the practice of medicine. In most disciplines, EBM is the fundamental component of decision-making driving expectations of the care received by patients and families. To improve outcomes, EBM blends science and compassion to provide personalized, effective treatments, and consistent application of interventions. The ever-increasing demand for palliative care will continue unabated due to longer lifespans and a shift in the approach to disease from primarily acute illnesses to predominantly chronic conditions. The adoption of EBM by palliative care providers will advance the knowledge and practice base, elevating its position amongst other medical disciplines that have adopted EBM as the dominant paradigm. The framework of EBM informs a systematic and manageable approach to the overwhelming amount of available evidence. Patients will benefit from EBM practices when palliative care practitioners provide the most effective and personalized care tailored each patient’s needs, characteristics, and preferences.
Severe Hemolysis in a Patient With Erythrocytosis During Coupled Plasma Filtration Adsorption Therapy Was Prevented by Changing From Membrane-Based Technique to a Centrifuge-Based One
Authors: Fan Rong , Wu Buyun , Kong Ling , Gong Dehua
Published: April 2015

Coupled plasma filtration adsorption (CPFA) usually adopts membrane to separate plasma from blood. Here, we reported a case with erythrocytosis experienced severe hemolysis and membrane rupture during CPFA, which was avoided by changing from membrane-based technique to a centrifuge-based one. A 66-year-old man was to receive CPFA for severe hyperbilirubinemia (total bilirubin 922 μmol/L, direct bilirubin 638 μmol/L) caused by obstruction of biliary tract. He had erythrocytosis (hemoglobin 230 g/L, hematocrit 0.634) for years because of untreated tetralogy of Fallot. Severe hemolysis and membrane rupture occurred immediately after blood entering into the plasma separator even at a low flow rate (50 mL/min) and persisted after changing a new separator. Finally, centrifugal plasma separation technique was used for CPFA in this patient, and no hemolysis occurred. After 3 sessions of CPFA, total bilirubin level decreased to 199 μmol/L with an average decline by 35% per session. Thereafter, the patient received endoscopic biliary stent implantation, and total bilirubin level returned to nearly normal. Therefore, centrifugal-based plasma separation can also be used in CPFA and may be superior to a membrane-based one in patients with hyperviscosity.
Developing a Comprehensive Model of Intensive Care Unit Processes: Concept of Operations
Authors: Romig Mark , Tropello Steven P. , Dwyer Cindy , Wyskiel Rhonda M. , Ravitz Alan , Benson John , Gropper Michael A. , Pronovost Peter J. , Sapirstein Adam
Published: April 2015

Objectives

This study aimed to use a systems engineering approach to improve performance and stakeholder engagement in the intensive care unit to reduce several different patient harms.

Methods

We developed a conceptual framework or concept of operations (ConOps) to analyze different types of harm that included 4 steps as follows: risk assessment, appropriate therapies, monitoring and feedback, as well as patient and family communications. This framework used a transdisciplinary approach to inventory the tasks and work flows required to eliminate 7 common types of harm experienced by patients in the intensive care unit. The inventory gathered both implicit and explicit information about how the system works or should work and converted the information into a detailed specification that clinicians could understand and use.

Prototype ConOps to Eliminate Harm

Using the ConOps document, we created highly detailed work flow models to reduce harm and offer an example of its application to deep venous thrombosis. In the deep venous thrombosis model, we identified tasks that were synergistic across different types of harm. We will use a system of systems approach to integrate the variety of subsystems and coordinate processes across multiple types of harm to reduce the duplication of tasks. Through this process, we expect to improve efficiency and demonstrate synergistic interactions that ultimately can be applied across the spectrum of potential patient harms and patient locations.

Conclusions

Engineering health care to be highly reliable will first require an understanding of the processes and work flows that comprise patient care. The ConOps strategy provided a framework for building complex systems to reduce patient harm.
Sustained Improvement in Neonatal Intensive Care Unit Safety Attitudes After Teamwork Training
Authors: Murphy Thomas , Laptook Abbot , Bender Jesse
Published: April 2015

Objectives

This study aimed to measure safety attitudes in the neonatal intensive care unit (NICU) before and serially after a compulsory, multidisciplinary teamwork and communication training initiative and novel sustainment program.

Methods

Training was administered to NICU staff and subsequent sustainment efforts were directed at enculturating core principles over the following year. A modified Agency for Healthcare Research and Quality Survey on Patient Safety Culture was administered before as well as 3 and 12 months after training. Longitudinal survey results were compared with the national Agency for Healthcare Research and Quality survey data.

Results

Ninety-six percent of 350 NICU staff were trained over 2 months. Survey response rates were 84%, 71%, and 83% before, at 3 months, and at 12 months after training, respectively. Items with sustained improvement pertained to staff empowerment and patient hand-offs. The proportion of participants who agreed with the statement, “Staff feel free to question the decisions or actions of those with more authority” increased from 55% to 76% and 83% at 3 and 12 months, respectively (P < 0.0001). The proportion of participants who disagreed with the statement, “Things ‘fall between the cracks’ when transferring patients from one unit to another” increased from 36% to 48% and 52% at 3 and 12 months, respectively (P < 0.01). The only significant decline was for the statement, “We are actively doing things to improve patient safety.” The proportion of respondents who agreed dropped from 93% to 83% at 3 months (P = 0.02).

Conclusions

A novel sustainment program after teamwork and communication training measurably improved most staff safety attitudes over 1 year.
Dye-sensitized PS-
b
-P2VP-templated nickel oxide films for photoelectrochemical applications
Authors: Massin Julien , Bräutigam Maximilian , Kaeffer Nicolas , Queyriaux Nicolas , Field Martin J. , Schacher Felix H. , Popp Jürgen , Chavarot-Kerlidou Murielle , Dietzek Benjamin , Artero Vincent
Published: April 2015

Moving from homogeneous water-splitting photocatalytic systems to photoelectrochemical devices requires the preparation and evaluation of novel
p
-type transparent conductive photoelectrode substrates. We report here on the sensitization of polystyrene-
block
-poly-(2-vinylpyridine) (PS-
b
-P2VP) diblock copolymer-templated NiO films with an organic push–pull dye. The potential of these new templated NiO film preparations for photoelectrochemical applications is compared with NiO material templated by F108 triblock copolymers. We conclude that NiO films are promising materials for the construction of dye-sensitized photocathodes to be inserted into photoelectrochemical (PEC) cells. However, a combined effort at the interface between materials science and molecular chemistry, ideally funded within a Global Artificial Photosynthesis Project, is still needed to improve the overall performance of the photoelectrodes and progress towards economically viable PEC devices.
Bacillus caseinilyticus sp. nov., an alkali- and thermotolerant bacterium isolated from a soda lake
Authors: Vishnuvardhan Reddy Sultanpuram , Thirumala Mothe , Farooq Mohammed
Published: April 2015

A novel Gram-stain-positive, rod-shaped, motile, endospore-forming and proteolytic bacterial strain, SPT, was isolated from Lonar soda lake, in India. On the basis of 16S rRNA gene sequence analysis it was identified as belonging to the class Firmibacteria and was most closely related to Bacillus cellulosilyticus DSM 2522T (96.7  %) and other members of the genus Bacillus ( < 95.9  %). Strain SPT was catalase- and oxidase-positive. The cell-wall peptidoglycan of strain SPT contained meso-diaminopimelic acid. Polar lipids included diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, three phospholipids, two aminolipids and two unknown lipids. The predominant isoprenoid quinone was MK-7. Anteiso-C15 : 0 (26.8  %) was the predominant fatty acid and significant proportions (>5  %) of iso-C15 : 0 (20.9  %), C16 : 1ω7c alcohol (6.3  %), iso-C16 : 0 (6.3  %) and anteiso-C17 : 0 (5.3  %) were also detected in strain SPT. The DNA G+C content of strain SPT was 38.9 mol%. The results of phylogenetic, chemotaxonomic and biochemical tests allowed a clear differentiation of strain SPT from all other members of the genus Bacillus. Strain SPT represents a novel member of the genus Bacillus, for which the name Bacillus
caseinilyticus sp. nov. is proposed. The type strain is SPT ( = MCC 2612T = JCM 30246T).
Lysinibacillus alkaliphilus sp. nov., an extremely alkaliphilic bacterium, and emended description of genus Lysinibacillus
Authors: Zhao Fei , Feng Youzhi , Chen Ruirui , Zhang Jianwei , Lin Xiangui
Published: April 2015

A novel aerobic, alkaliphilic, Gram-staining-positive, endospore-forming bacterium, strain OMN17T, was isolated from a typical sandy loam soil under long-term OMN fertilization (half organic manure N plus half mineral N fertilizer) in northern China and was subjected to a polyphasic taxonomic study. The best growth was achieved at 30 °C and pH 8–10 in medium containing 0.5 % (w/v) NaCl. The cell-wall peptidoglycan of strain OMN17T was type A4α; (l
-Lys–Gly-d
-Asp) and the cell-wall sugars were ribose, traces of galactose and arabinose. The only respiratory quinone found in strain OMN17T was menaquinone 7 (MK-7). The major cellular fatty acids were iso-C15 : 0 and anteiso-C15 : 0. The major polar lipids were found to be phosphatidylethanolamine, phosphatidylglycerol and diphosphatidylglycerol. Phylogenetic analysis of strain OMN17T based on the 16S rRNA gene sequence showed that the strain was most closely related to Lysinibacillus halotolerans (97.8 %), Lysinibacillus sinduriensis (97.5 %), Lysinibacillus chungkukjangi (97.4 %) and Lysinibacillus xylanilyticus (97.0 %). The DNA–DNA hybridization results indicated that this strain was distinct from other species of the genus Lysinibacillus, the degree of relatedness being 21.8 ± 0.2 % with L. halotolerans, 45.6 ± 1.8 % with L. sinduriensis, 33.7 ± 1.2 % with L. chungkukjangi and 23.7 ± 0.7 % with L. xylanilyticus. The DNA G+C content of strain OMN17T was 38.1 mol%. The phenotypic, chemotaxonomic and genetic analyses identified strain OMN17T as a novel species of the genus Lysinibacillus, for which the name Lysinibacillus alkaliphilus sp. nov. is proposed. The type strain is OMN17T ( = DSM 28019T = CCTCC AB 2014073T). An emended description of the genus Lysinibacillus is also provided.
Not just what they want, but why they want it
Authors: Price Rebecca Anne , Wrigley Cara , Straker Karla
Published: April 2015

Purpose

– This paper aims to explore advantages and disadvantages of both traditional market research (TMR) and deep customer insight (DCI) methods to lay the platform for revealing how a relationship between these two domains could be optimised during firm-based innovation.

Design/methodology/approach

– The paper reports on an empirical research study conducted with 13 Australian-based firms engaged in a design-led approach to innovation. Firms were facilitated through a design-led approach where the process of gathering DCIs was isolated and investigated further in comparison to TMR methods.

Findings

– Results show that DCI methods are able to provide fresh, non-obvious ways of understanding customer needs, problems and behaviours that can become the foundation of new business opportunities. Findings concluded that DCI methods provide the critical layer to understand why customers do or do not engage with businesses. Revealing why was not accessible in TMR methods.

Research limitations/implications

– The theoretical outcome of this study is a complementary methods matrix, providing guidance on appropriate implementation of research methods in accordance with a project’s timeline to optimise the complementation of TMR methods with design-led customer engagement methods.

Practical implications

– DCI methods provide fresh, non-obvious ways of understanding customer needs, problems and behaviours that can become the foundation of new business opportunities. It is hoped that those in a position of data collection are encouraged to experiment and use DCI methods to connect with their customers on a meaningful level and translate these insights into value.

Originality/value

– This paper provides original value to a new understanding of how design techniques can be applied to complement and strengthen existing market research strategies. This is crucial in an era where business competition hinges on a subtle and often intimate understanding of customer needs and behaviours.
Variation of xylem vessel diameters across a climate gradient: insight from a reciprocal transplant experiment with a widespread boreal tree
Authors: Schreiber Stefan G. , Hacke Uwe G. , Hamann Andreas
Published: April 2015

Xylem vessel diameters represent an important plant hydraulic trait to ensure sufficient water supply from the roots to the leaves. The ability to adjust the hydraulic pathway to environmental cues is key in order to satisfy transpirational demands and maximize growth and survival.

We evaluated the variability of vessel diameters in trembling aspen in a reciprocal transplant experiment. We tested six provenances from three ecological regions of North America planted at four test sites in western Canada. All test sites were established at the same time with the same provenances arranged in a randomized complete block design.

Vessel diameter showed a strong interaction of population and test site suggesting a high degree of phenotypic plasticity in this trait. Gaussian kernel density estimates support plastic as well as genetic contributions in vessel diameter control trending from bimodal distributions at the most northern test site towards unimodal distributions at the warmest and mildest test site.

Furthermore, we used test site‐specific climate data in form of a 2‐year, 5‐year and 10‐year average of 21 directly and derived climatic variables and found that average site‐specific vessel diameters correlated strongly with summer moisture availability. A previously found negative relationship with vessel diameter and tree height in central Alberta was also found at two other boreal test sites but reversed at a wetter and milder sub‐boreal test site.

In summary, vessel diameters were highly plastic in response to different environments and varied with summer moisture availability. The variability of vessel diameter and tree height correlations suggests that vessel diameter alone cannot serve as a reliable proxy for long‐term growth performance beyond boreal environments. Instead, selecting aspen populations with a high degree of plasticity in this trait appears to be the safest option for assisted migration and seed transfer programmes under climate change.
What Do We Talk About Now? Reflecting on Publications in AJPA 1970–2015
Authors: Althaus Catherine
Published: April 2015

This article reflects on 45 years of articles published in the Australian Journal of Public Administration (AJPA), providing commentary not only on the journal's status and future but also the state of public administration in Australia. The analysis builds on a first study conducted in 1997, continuing the themes of institutional affiliation, subject matter and research methodology as key categories for AJPA article analysis. The context for the analysis is the advent of the journal's new editorial team. The article concludes that several opportunities present themselves for AJPA's future including performing a strategic stocktake of the discipline and debating its merits as well as marking out what might make for a peculiarly Australian form of public administration (if any) in the contemporary era.