Challenges of recruiting hospice patients with advanced cancer to research : reflections on a delirium screening study

Introduction Delirium research in palliative care, particularly in the dying phase, is possible but is frequently met with ethical and methodological challenges. This paper describes the challenges faced in a previous delirium screening study. Methods Within 72 hours of admission to an acute inpatient specialist palliative care unit one hundred consecutive patients over 18 years of age with advanced cancer were invited to be screened for delirium using validated screening tools. Results Of the 100 consecutive admissions 49 patients were unable to participate including seven who did not meet the inclusion criteria and nine (six families and three patients) who withheld consent. The remaining 33 patients were more unwell and closer to death than those who were recruited. Reasons for non- participation included being too unwell (ten), unresponsive (nine), died (two) or discharged (three) before recruitment and exceeding the 72hour time limit (nine). Conclusion Gate keeping and physical condition of patients were the main obstacles to recruitment and is consistent with barriers faced in previous studies involving palliative care and dying patients. While it is possible and necessary to conduct studies in palliative care, including the terminal phase, as reflective practitioners we must maintain the balance between the demands for evidence-based practice and our compassion and respect for our most vulnerable of patients.

A novel, automated nutrition screening system as a predictor of nutritional risk in an oncology day treatment unit (ODTU)

Purpose Paper-based nutrition screening tools can be challenging to implement in the ambulatory oncology setting. The aim of this study was to determine the validity of the Malnutrition Screening Tool (MST) and a novel, automated nutrition screening system compared to a ‘gold standard’ full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods An observational, cross-sectional study was conducted in an outpatient oncology day treatment unit (ODTU) within an Australian tertiary health service. Eligibility criteria were as follows: ≥18 years, receiving outpatient anticancer treatment and English literate. Patients self-administered the MST. A dietitian assessed nutritional status using the PGSGA, blinded to the MST score. Automated screening system data were extracted from an electronic oncology prescribing system. This system used weight loss over 3 to 6 weeks prior to the most recent weight record or age-categorised body mass index (BMI) to identify nutritional risk. Sensitivity and specificity against PG-SGA (malnutrition) were calculated using contingency tables and receiver operating curves. Results There were a total of 300 oncology outpatients (51.7 % male, 58.6±13.3 years). The area under the curve (AUC) for weight loss alone was 0.69 with a cut-off value of ≥1 % weight loss yielding 63 % sensitivity and 76.7 % specificity. MST (score ≥2) resulted in 70.6 % sensitivity and 69.5 % specificity, AUC 0.77. Conclusions Both the MST and the automated method fell short of the accepted professional standard for sensitivity (~≥80 %) derived from the PG-SGA. Further investigation into other automated nutrition screening options and the most appropriate parameters available electronically is warranted to support targeted service provision.

Whole-genome sequencing reveals untapped genetic potential in Africa’s indigenous cereal crop sorghum

Sorghum is a food and feed cereal crop adapted to heat and drought and a staple for 500 million of the world’s poorest people. Its small diploid genome and phenotypic diversity make it an ideal C4 grass model as a complement to C3 rice. Here we present high coverage (16–45 × ) resequenced genomes of 44 sorghum lines representing the primary gene pool and spanning dimensions of geographic origin, end-use and taxonomic group. We also report the first resequenced genome of S. propinquum, identifying 8 M high-quality SNPs, 1.9 M indels and specific gene loss and gain events in S. bicolor. We observe strong racial structure and a complex domestication history involving at least two distinct domestication events. These assembled genomes enable the leveraging of existing cereal functional genomics data against the novel diversity available in sorghum, providing an unmatched resource for the genetic improvement of sorghum and other grass species.

Mesenchymal stem cells, neural lineage potential, heparan sulfate proteoglycans and the matrix

Along with the tri-lineage of bone, cartilage and fat, human mesenchymal stem cells (hMSCs) retain neural lineage potential. Multiple factors have been described that influence lineage fate of hMSCs including the extracellular microenvironment or niche. The niche includes the extracellular matrix (ECM) providing structural composition, as well as other associated proteins and growth factors, which collectively influence hMSC stemness and lineage specification. As such, lineage specific differentiation of MSCs is mediated through interactions including cell–cell and cell–matrix, as well as through specific signalling pathways triggering downstream events. Proteoglycans (PGs) are ubiquitous within this microenvironment and can be localised to the cell surface or embedded within the ECM. In addition, the heparan sulfate (HS) and chondroitin sulfate (CS) families of PGs interact directly with a number of growth factors, signalling pathways and ECM components including FGFs, Wnts and fibronectin. With evidence supporting a role for HSPGs and CSPGs in the specification of hMSCs down the osteogenic, chondrogenic and adipogenic lineages, along with the localisation of PGs in development and regeneration, it is conceivable that these important proteins may also play a role in the differentiation of hMSCs toward the neuronal lineage. Here we summarise the current literature and highlight the potential for HSPG directed neural lineage fate specification in hMSCs, which may provide a new model for brain damage repair.

Psychological screening and injury among elite athletes

The purpose of the present investigation was to evaluate the effectiveness of the psychological component of the Queensland Academy of Sport (QAS) Health Screening Questionnaire in screening for injury/illness characteristics among elite athletes. In total, 793 scholarship athletes (409 females and 384 males) ranging in age from 11 to 41 years (M = 19, SD = 4.4) across 20 sports at the QAS in Brisbane, Australia, completed the QAS Health Screening Questionnaire. Psychological risk factors examined were life stress and mood, as measured by the Perceived Stress Scale - 10 (PSS-10) and the Brunel Mood Scale (BRUMS) respectively, in addition to disordered eating behaviours and history of diagnosed psychological disorders. Medical risk factors examined included asthma and back pain. Single-factor MANOVAs showed multivaritate effects for injury, second injury, back pain, asthma, anxiety disorder diagnosis, and fasting. Discriminant function analyses demonstrated that life stress and mood scores had significant utility in correctly classifying injury and second injury status, asthma, back pain, anxiety, and eating disorder diagnosis, in addition to the use of fasting and vomiting as weight control methods. The present findings suggest that the psychology component of the QAS Health Screening Questionnaire demonstrates significant utility as a screening tool regarding injury/illness characteristics among elite athletes.

Sulfated glycosaminoglycans mediate the effects of FGF2 on the osteogenic potential of rat calvarial osteoprogenitor cells

Fibroblast growth factor-2 (FGF2) is a powerful promoter of bone growth. We demonstrate here that brief exposure to FGF2 enhances mineralized nodule formation in cultured rat osteoprogenitor cells due to an expansion of cells that subsequently mineralize. This mitogenic effect is mediated via sulfated glycosaminoglycans (GAGs), FGFR1, and the extracellular signal-regulated kinase (ERK) pathway. The GAGs involved in this stimulation are chondroitin sulfates (CS) rather than heparan sulfates (HS). However, continuous FGF2 treatment reduces alkaline phosphatase (ALP) activity, downregulates collagen Ialpha1 (ColIalpha1) and FGFR3 expression, upregulates the expression and secretion of osteopontin (OPN) and inhibits mineralization. The inhibitory effects of FGF2 on FGFR3 expression and ALP activity are also mediated by the ERK pathway, although the effects of FGF2 on ColIalpha1 and OPN expression are mediated by GAGs and PKC activity. Thus short-term activation of FGF2/FGFR1 promotes osteoprogenitor proliferation and subsequent differentiation, while long-term activation of FGF2 signaling disrupts mineralization by modulating osteogenic marker expression. This study thus establishes the central role of sulfated GAGs in the osteogenic progression of osteoprogenitors.

Poly(2-oxazoline) hydrogels as next generation three dimensional cell supports

Synthetic hydrogels selectively decorated with cell adhesion motifs are rapidly emerging as promising substrates for 3D cell culture. When cells are grown in 3D they experience potentially more physiologically relevant cell-cell interactions and physical cues compared with traditional 2D cell culture on stiff surfaces. A newly developed polymer based on poly(2-oxazoline)s has been used for the first time to control attachment of fibroblast cells and is discussed here for its potential use in 3D cell culture with particular focus on cancer cells towards the ultimate aim of high throughput screening of anti-cancer therapies. Advantages and limitations of using poly(2-oxazoline) hydrogels are discussed and compared with more established polymers, especially polyethylene glycol (PEG).

The potential of XML technology as an answer to the data interchange problems of the construction industry

The complex supply chain relations of the construction industry, coupled with the substantial amount of information to be shared on a regular basis between the parties involved, make the traditional paper-based data interchange methods inefficient, error prone and expensive. The successful information technology (IT) applications that enable seamless data interchange, such as the Electronic Data Interchange (EDI) systems, have generally failed to be successfully implemented in the construction industry. An alternative emerging technology, Extensible Markup Language (XML), and its applicability to streamline business processes and to improve data interchange methods within the construction industry are analysed, as is the EDI technology to identify the strategic advantages that XML technology provides to overcome the barriers to implementation. In addition, the successful implementation of XML-based automated data interchange platforms for a large organization, and the proposed benefits thereof, are presented as a case study.

Improving the performance of nutrition screening through a series of quality improvement initiatives

Background Nutrition screening identifies patients at risk of malnutrition to facilitate early nutritional intervention. Studies have reported incompletion and error rates of 30-90% for a range of commonly used screening tools. This study aims to investigate the incompletion and error rates of 3-Minute Nutrition Screening (3-MinNS) and the effect of quality improvement initiatives in improving the overall performance of the screening tool and the referral process for at risk patients. Methods Annual audits were carried out from 2008-2013 on 4467 patients. Value Stream Mapping, Plan-Do-Check-Act cycle and Root Cause Analysis were used in this study to identify gaps and determine the best intervention. The intervention included 1) implementing a nutrition screening protocol, 2) nutrition screening training, 3) nurse empowerment for online dietetics referral of at-risk cases, 4) closed-loop feedback system and 5) removing a component of 3-MinNS that caused the most error without compromising its sensitivity and specificity. Results Nutrition screening error rates were 33% and 31%, with 5% and 8% blank or missing forms, in 2008 and 2009 respectively. For patients at risk of malnutrition, referral to dietetics took up to 7.5 days, with 10% not referred at all. After intervention, the latter decreased to 7% (2010), 4% (2011) and 3% (2012 and 2013), and the mean turnaround time from screening to referral was reduced significantly from 4.3 ± 1.8 days to 0.3 ± 0.4 days (p < 0.001). Error rates were reduced to 25% (2010), 15% (2011), 7% (2012) and 5% (2013) and percentage of blank or missing forms reduced to and remained at 1%. Conclusion Quality improvement initiatives are effective in reducing the incompletion and error rates of nutrition screening, and led to sustainable improvements in the referral process of patients at nutritional risk.

Developing sustainable fish farming in the Western Pacific : a viewpoint on potential reasons for why many attempts failed

Capture fisheries and aquaculture have been a major source of food and providers of economic benefits to many communities around the world for a very long time. While the history of aquaculture or fish farming can be traced back for more than 2000 years in some corners of the globe, notably in China, Japan and the Mediterranean, this is not true everywhere, where in general, fish farming is a relatively new industry. Rapid human population growth and increasing urbanisation over the last 20 to 40 years has meant that while fish consumption has doubled globally, returns from capture fisheries have remained static or have declined due to overexploitation and rising pollution levels, with some fisheries either closing or becoming economically unviable. Data from studies suggest that this trend is unlikely to be reversed unless appropriate fisheries management allows depleted wild stocks to rebuild. This has occurred during a time when demand for fish products has grown, in part due to improved purchasing power in some developing countries and changing dietary habits where fish are now considered to have a positive impact on health. Based on the projected population growth over the next two decades, Food and Agricultural Organization (FAO) estimates that at least an additional 40 million tonnes of aquatic food will be required to maintain the current per capita consumption (FAO 2006).

Understanding the abnormal brain activity in epilepsy as a potential predictor of the onset of an epileptic seizure

The Brain Research Institute (BRI) uses various types of indirect measurements, including EEG and fMRI, to understand and assess brain activity and function. As well as the recovery of generic information about brain function, research also focuses on the utilisation of such data and understanding to study the initiation, dynamics, spread and suppression of epileptic seizures. To assist with the future focussing of this aspect of their research, the BRI asked the MISG 2010 participants to examine how the available EEG and fMRI data and current knowledge about epilepsy should be analysed and interpreted to yield an enhanced understanding about brain activity occurring before, at commencement of, during, and after a seizure. Though the deliberations of the study group were wide ranging in terms of the related matters considered and discussed, considerable progress was made with the following three aspects. (1) The science behind brain activity investigations depends crucially on the quality of the analysis and interpretation of, as well as the recovery of information from, EEG and fMRI measurements. A number of specific methodologies were discussed and formalised, including independent component analysis, principal component analysis, profile monitoring and change point analysis (hidden Markov modelling, time series analysis, discontinuity identification). (2) Even though EEG measurements accurately and very sensitively record the onset of an epileptic event or seizure, they are, from the perspective of understanding the internal initiation and localisation, of limited utility. They only record neuronal activity in the cortical (surface layer) neurons of the brain, which is a direct reflection of the type of electrical activity they have been designed to record. Because fMRI records, through the monitoring of blood flow activity, the location of localised brain activity within the brain, the possibility of combining fMRI measurements with EEG, as a joint inversion activity, was discussed and examined in detail. (3) A major goal for the BRI is to improve understanding about ``when'' (at what time) an epileptic seizure actually commenced before it is identified on an eeg recording, ``where'' the source of this initiation is located in the brain, and ``what'' is the initiator. Because of the general agreement in the literature that, in one way or another, epileptic events and seizures represent abnormal synchronisations of localised and/or global brain activity the modelling of synchronisations was examined in some detail. References C. M. Michel, G. Thut, S. Morand, A. Khateb, A. J. Pegna, R. Grave de Peralta, S. Gonzalez, M. Seeck and T. Landis, Electric source imaging of human brain functions, Brain Res. Rev. , 36 (2--3), 2001, 108--118. doi:10.1016/S0165-0173(01)00086-8 S. Ogawa, R. S. Menon, S. G. Kim and K. Ugurbil, On the characteristics of functional magnetic resonance imaging of the brain, Annu. Rev. Bioph. Biom. , 27 , 1998, 447--474. doi:10.1146/annurev.biophys.27.1.447 C. D. Binnie and H. Stefan, Modern electroencephalography: its role in epilepsy management, Clin. Neurophysiol. , 110 (10), 1999, 1671--1697. doi:10.1016/S1388-2457(99)00125-X J. X. Tao, A. Ray, S. Hawes-Ebersole and J. S. Ebersole, Intracranial eeg substrates of scalp eeg interictal spikes, Epilepsia , 46 (5), 2005, 669--76. doi:10.1111/j.1528-1167.2005.11404.x S. Ogawa, D. W. Tank, R. Menon, J. M. Ellermann, S. G. Kim, H. Merkle and K. Ugurbil, Intrinsic signal changes accompanying sensory stimulation: Functional brain mapping with magnetic resonance imaging, P. Natl. Acad. Sci. USA , 89 (13), 1992, 5951--5955. doi:10.1073/pnas.89.13.5951 J. Engel Jr., Report of the ilae classification core group, Epilepsia , 47 (9), 2006, 1558--1568. doi:10.1111/j.1528-1167.2006.00215.x L. Lemieux, A. Salek-Haddadi, O. Josephs, P. Allen, N. Toms, C. Scott, K. Krakow, R. Turner and D. R. Fish, Event-related fmri with simultaneous and continuous eeg: description of the method and initial case r port, NeuroImage , 14 (3), 2001, 780--7. doi:10.1006/nimg.2001.0853 P. Federico, D. F. Abbott, R. S. Briellmann, A. S. Harvey and G. D. Jackson, Functional mri of the pre-ictal state, Brain , 128 (8), 2005, 1811-7. doi:10.1093/brain/awh533 C. S. Hawco, A. P. Bagshaw, Y. Lu, F. Dubeau and J. Gotman, bold changes occur prior to epileptic spikes seen on scalp eeg, NeuroImage , 35 (4), 2007, 1450--1458. doi:10.1016/j.neuroimage.2006.12.042 F. Moeller, H. R. Siebner, S. Wolff, H. Muhle, R. Boor, O. Granert, O. Jansen, U. Stephani and M. Siniatchkin, Changes in activity of striato-thalamo-cortical network precede generalized spike wave discharges, NeuroImage , 39 (4), 2008, 1839--1849. doi:10.1016/j.neuroimage.2007.10.058 V. Osharina, E. Ponchel, A. Aarabi, R. Grebe and F. Wallois, Local haemodynamic changes preceding interictal spikes: A simultaneous electrocorticography (ecog) and near-infrared spectroscopy (nirs) analysis in rats, NeuroImage , 50 (2), 2010, 600--607. doi:10.1016/j.neuroimage.2010.01.009 R. S. Fisher, W. Boas, W. Blume, C. Elger, P. Genton, P. Lee and J. Engel, Epileptic seizures and epilepsy: Definitions proposed by the international league against epilepsy (ilae) and the international bureau for epilepsy (ibe), Epilepsia , 46 (4), 2005, 470--472. doi:10.1111/j.0013-9580.2005.66104.x H. Berger, Electroencephalogram in humans, Arch. Psychiat. Nerven. , 87 , 1929, 527--570. C. M. Michel, M. M. Murray, G. Lantz, S. Gonzalez, L. Spinelli and R. G. de Peralta, eeg source imaging, Clin. Neurophysiol. , 115 (10), 2004, 2195--2222. doi:10.1016/j.clinph.2004.06.001 P. L. Nunez and R. B. Silberstein, On the relationship of synaptic activity to macroscopic measurements: Does co-registration of eeg with fmri make sense?, Brain Topogr. , 13 (2), 2000, 79--96. doi:10.1023/A:1026683200895 S. Ogawa, T. M. Lee, A. R. Kay and D. W. Tank, Brain magnetic resonance imaging with contrast dependent on blood oxygenation, P. Natl. Acad. Sci. USA , 87 (24), 1990, 9868--9872. doi:10.1073/pnas.87.24.9868 J. S. Gati, R. S. Menon, K. Ugurbil and B. K. Rutt, Experimental determination of the bold field strength dependence in vessels and tissue, Magn. Reson. Med. , 38 (2), 1997, 296--302. doi:10.1002/mrm.1910380220 P. A. Bandettini, E. C. Wong, R. S. Hinks, R. S. Tikofsky and J. S. Hyde, Time course EPI of human brain function during task activation, Magn. Reson. Med. , 25 (2), 1992, 390--397. K. K. Kwong, J. W. Belliveau, D. A. Chesler, I. E. Goldberg, R. M. Weisskoff, B. P. Poncelet, D. N. Kennedy, B. E. Hoppelm, M. S. Cohen and R. Turner, Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation, P. Natl. Acad. Sci. USA , 89 (12), 1992, 5675--5679. doi:10.1073/pnas.89.12.5675 J. Frahm, K. D. Merboldt and W. Hnicke, Functional mri of human brain activation at high spatial resolution, Magn. Reson. Med. , 29 (1), 1993, 139--144. P. A. Bandettini, A. Jesmanowicz, E. C. Wong and J. S. Hyde, Processing strategies for time-course data sets in functional MRI of the human brain, Magn. Reson. Med. , 30 (2), 1993, 161--173. K. J. Friston, P. Jezzard and R. Turner, Analysis of functional MRI time-series, Hum. Brain Mapp. , 1 (2), 1994, 153--171. B. Biswal, F. Z. Yetkin, V. M. Haughton and J. S. Hyde, Functional connectivity in the motor cortex of resting human brain using echo-planar mri, Mag. Reson. Med. , 34 (4), 1995, 537--541. doi:10.1002/mrm.1910340409 K. J. Friston, J. Ashburner, C. D. Frith, J. Poline, J. D. Heather and R. S. J. Frackowiak, Spatial registration and normalization of images, Hum. Brain Mapp. , 3 (3), 1995, 165--189. K. J. Friston, S. Williams, R. Howard, R. S. Frackowiak and R. Turner, Movement-related effects in fmri time-series, Magn. Reson. Med. , 35 (3), 1996, 346--355. G. H. Glover, T. Q. Li and D. Ress, Image-based method for retrospective correction of physiological motion effects in fmri: Retroicor, Magn. Reson. Med. , 44 (1), 2000, 162--167. doi:10.1002/1522-2594(200007)44:13.0.CO;2-E K. J. Friston, O. Josephs, G. Rees and R. Turner, Nonlinear event-related responses in fmri, Magn. Reson. Med. , 39 (1), 1998, 41--52. doi:10.1002/mrm.1910390109 K. Ugurbil, L. Toth and D. Kim, How accurate is magnetic resonance imaging of brain function?, Trends Neurosci. , 26 (2), 2003, 108--114. doi:10.1016/S0166-2236(02)00039-5 D. S. Kim, I. Ronen, C. Olman, S. G. Kim, K. Ugurbil and L. J. Toth, Spatial relationship between neuronal activity and bold functional mri, NeuroImage , 21 (3), 2004, 876--885. doi:10.1016/j.neuroimage.2003.10.018 A. Connelly, G. D. Jackson, R. S. Frackowiak, J. W. Belliveau, F. Vargha-Khadem and D. G. Gadian, Functional mapping of activated human primary cortex with a clinical mr imaging system, Radiology , 188 (1), 1993, 125--130. L. Allison, Hidden Markov Models, Technical Report , School of Computer and Software Engineering, Monash University, 2000. R. J. Elliott, L. Aggoun and J.B. Moore, Hidden Markov Models: Estimation and Control, Appl. Math.-Czech. , 2004. B. Bhavnagri, Discontinuities of plane functions projected from a surface with methods for finding these , Technical Report, 2009. B. Bhavnagri, Computer Vision using Shape Spaces , Technical Report,1996, University of Adelaide. B. Bhavnagri, A method for representing shape based on an equivalence relation on polygons, Pattern Recogn. , 27 (2), 1994, 247--260. doi:10.1016/0031-3203(94)90057-4 D. F. Abbott, A. B. Waites, A. S. Harvey and G. D. Jackson, Exploring epileptic seizure onset with fmri, NeuroImage , 36(S1) (344TH-PM), 2007. M. C. Mackey and L. Glass, Oscillation and chaos in physiological control systems, Science , 197 , 1977, 287--289. S. H. Strogatz, SYNC - The Emerging Science of Spontaneous Order , Theia, New York, 2003. J. W. Kim, J. A. Roberts and P. A. Robinson, Dynamics of epileptic seizures: Evolution, spreading, and suppression, J. Theor. Biol. , 257 (4), 2009, 527--532. doi:10.1016/j.jtbi.2008.12.009 Y. Kuramoto, T. Aoyagi, I. Nishikawa, T. Chawanya T and K. Okuda, Neural network model carrying phase information with application to collective dynamics, J. Theor. Phys. , 87 (5), 1992, 1119--1126. V. B. Mountcastle, The columnar organization of the neocortex, Brain , 120 (4), 1997, 701. doi:10.1093/brain/120.4.701 F. L. Silva, W. Blanes, S. N. Kalitzin, J. Parra, P. Suffczynski and D. N. Velis, Epilepsies as dynamical diseases of brain systems: Basic models of the transition between normal and epileptic activity, Epilepsia , 44 (12), 2003, 72--83. F. H. Lopes da Silva, W. Blanes, S. N. Kalitzin, J. Parra, P. Suffczynski and D. N. Velis, Dynamical diseases of brain systems: different routes to epileptic seizures, ieee T. Bio-Med. Eng. , 50 (5), 2003, 540. L.D. Iasemidis, Epileptic seizure prediction and control, ieee T. Bio-Med. Eng. , 50 (5), 2003, 549--558. L. D. Iasemidis, D. S. Shiau, W. Chaovalitwongse, J. C. Sackellares, P. M. Pardalos, J. C. Principe, P. R. Carney, A. Prasad, B. Veeramani, and K. Tsakalis, Adaptive epileptic seizure prediction system, ieee T. Bio-Med. Eng. , 50 (5), 2003, 616--627. K. Lehnertz, F. Mormann, T. Kreuz, R.G. Andrzejak, C. Rieke, P. David and C. E. Elger, Seizure prediction by nonlinear eeg analysis, ieee Eng. Med. Biol. , 22 (1), 2003, 57--63. doi:10.1109/MEMB.2003.1191451 K. Lehnertz, R. G. Andrzejak, J. Arnhold, T. Kreuz, F. Mormann, C. Rieke, G. Widman and C. E. Elger, Nonlinear eeg analysis in epilepsy: Its possible use for interictal focus localization, seizure anticipation, and prevention, J. Clin. Neurophysiol. , 18 (3), 2001, 209. B. Litt and K. Lehnertz, Seizure prediction and the preseizure period, Curr. Opin. Neurol. , 15 (2), 2002, 173. doi:10.1097/00019052-200204000-00008 B. Litt and J. Echauz, Prediction of epileptic seizures, Lancet Neurol. , 1 (1), 2002, 22--30. doi:10.1016/S1474-4422(02)00003-0 M. M{a}kiranta, J. Ruohonen, K Suominen, J. Niinim{a}ki, E. Sonkaj{a}rvi, V. Kiviniemi, T. Sepp{a}nen, S. Alahuhta, V. J{a}ntti and O. Tervonen, {bold} signal increase preceeds eeg spike activity--a dynamic penicillin induced focal epilepsy in deep anesthesia, NeuroImage , 27 (4), 2005, 715--724. doi:10.1016/j.neuroimage.2005.05.025 K. Lehnertz, F. Mormann, H. Osterhage, A. M{u}ller, J. Prusseit, A. Chernihovskyi, M. Staniek, D. Krug, S. Bialonski and C. E. Elger, State-of-the-art of seizure prediction, J. Clin. Neurophysiol. , 24 (2), 2007, 147. doi:10.1097/WNP.0b013e3180336f16 F. Mormann, T. Kreuz, C. Rieke, R. G. Andrzejak, A. Kraskov, P. David, C. E. Elger and K. Lehnertz, On the predictability of epileptic seizures, Clin. Neurophysiol. , 116 (3), 2005, 569--587. doi:10.1016/j.clinph.2004.08.025 F. Mormann, R. G. Andrzejak, C. E. Elger and K. Lehnertz, Seizure prediction: the long and winding road, Brain , 130 (2), 2007, 314--333. doi:10.1093/brain/awl241 Z. Rogowski, I. Gath and E. Bental, On the prediction of epileptic seizures, Biol. Cybern. , 42 (1), 1981, 9--15. Y. Salant, I. Gath, O. Henriksen, Prediction of epileptic seizures from two-channel eeg, Med. Biol. Eng. Comput. , 36 (5), 1998, 549--556. doi:10.1007/BF02524422 J. Gotman and D.J. Koffler, Interictal spiking increases after seizures but does not after decrease in medication, Evoked Potential , 72 (1), 1989, 7--15. J. Gotman and M. G. Marciani, Electroencephalographic spiking activity, drug levels, and seizure occurence in epileptic patients, Ann. Neurol. , 17 (6), 1985, 59--603. A. Katz, D. A. Marks, G. McCarthy and S. S. Spencer, Does interictal spiking change prior to seizures?, Electroen. Clin. Neuro. , 79 (2), 1991, 153--156. A. Granada, R. M. Hennig, B. Ronacher, A. Kramer and H. Herzel, Phase Response Curves: Elucidating the dynamics of couples oscillators, Method Enzymol. , 454 (A), 2009, 1--27. doi:10.1016/S0076-6879(08)03801-9 doi:10.1016/S0076-6879(08)03801-9 H. Kantz and T. Schreiber, Nonlinear time series analysis , 2004, Cambridge Univ Press. M. V. L. Bennett and R. S Zukin, Electrical coupling and neuronal synchronization in the mammalian brain, Neuron , 41 (4), 2004, 495 --511. doi:10.1016/S0896-6273(04)00043-1 L.D. Iasemidis, J. Chris Sackellares, H. P. Zaveri and W. J. Williams, Phase space topography and the Lyapunov exponent of electrocorticograms in partial seizures, Brain Topogr. , 2 (3), 1990, 187--201. doi:10.1007/BF01140588 M. Le Van Quyen, J. Martinerie, V. Navarro, M. Baulac and F. J. Varela, Characterizing neurodynamic changes before seizures, J. Clin. Neurophysiol. , 18 (3), 2001, 191. J. Martinerie, C. Adam, M. Le Van Quyen, M. Baulac, S. Clemenceau, B. Renault and F. J. Varela, Epileptic seizures can be anticipated by non-linear analysis, Nat. Med. , 4 (10), 1998, 1173--1176. doi:10.1038/2667 A. Pikovsky, M. Rosenblum, J. Kurths and R. C. Hilborn, Synchronization: A universal concept in nonlinear science, Amer. J. Phys. , 70 , 2002, 655. H. R. Wilson and J. D. Cowan, Excitatory and inhibitory interactions in localized populations of model neurons, Biophys. J. , 12 (1), 1972, 1--24. D. Cumin and C. P. Unsworth, Generalising the Kuramoto model for the study of neuronal synchronisation in the brain, Physica D , 226 (2), 2007, 181--196. doi:10.1016/j.physd.2006.12.004 F. K. Skinner, H. Bazzazi and S. A. Campbell, Two-cell to N-cell heterogeneous, inhibitory networks: Precise linking of multistable and coherent properties, J. Comput. Neurosci. , 18 (3), 2005, 343--352. doi:10.1007/s10827-005-0331-1 W. W. Lytton, Computer modelling of epilepsy, Nat. Rev. Neurosci. , 9 (8), 2008, 626--637. doi:10.1038/nrn2416 R. D. Traub, A. Bibbig, F. E. N. LeBeau, E. H. Buhl and M. A. Whittington, Cellular mechanisms of neuronal population oscillations in the hippocampus in vitro, Ann. Rev. , 2004. R. D. Traub, A. Draguhn, M. A. Whittington, T. Baldeweg, A. Bibbig, E. H. Buhl and D. Schmitz, Axonal gap junc ions between principal neurons: A novel source of network oscillations, and perhaps epileptogenesis., Rev. Neuroscience , 13 (1), 2002, 1. doi:10.1146/annurev.neuro.27.070203.144303 M. Scheffer, J. Bascompte, W. A. Brock, V. Brovkin, S. R. Carpenter, V. Dakos, H. Held, E. H. van Nes, M. Rietkerk and G. Sugihara, Early-warning signals for critical transitions, Nature , 461 (7260), 2009, 53--59. doi:10.1038/nature08227 K. Murphy, A Brief Introduction to Graphical Models and Bayesian Networks , 2008, http://www.cs.ubc.ca/murphyk/Bayes/bnintro.html . R. C. Bradley, An elementary

IT governance stability in a political changing environment : exploring potential impacts in the public sector

Public sector organisations (PSOs) operate in information-intensive environments often within operational contexts where efficiency is a goal. What's more, the rapid adoption of IT is expected to facilitate good governance within public sector organisations but it often clashes with the bureaucratic culture of these organisations. Accordingly, models such as IT Governance (ITG) and government reform -in particular the new public management (NPM)- were introduced in PSOs in an effort to address the inefficiencies of bureaucracy and under performance. This work explores the potential effect of change in political direction and policy on the stability of IT governance in Australian public sector organisations. The aim of this paper is to examine implications of a change of government and the resulting political environment on the effectiveness of the audit function of ITG. The empirical data discussed here indicate that a number of aspects of audit functionality were negatively affected by change in political direction and resultant policy changes. The results indicate a perceived decline in capacity and capability which in turn disrupts the stability of IT governance systems in public sector organisations.

Psychological symptoms : a review of screening practices for patients with coronary heart disease (CHD)

Background/Aims: Coronary heart disease (CHD) and coronary events have been strongly linked to psychological symptoms in patients during hospitalisation and post-discharge. Within Australia CHD average length of stay is decreasing and symptoms often do not present until discharge. Early screening and treatment of psychological symptoms has been recommended to reduce mortality and identify anxiety and depression. This literature review was undertaken to evaluate and describe current screening practices to identify psychological symptoms in these patients.

Potential interstellar molecules : Formation of neutral C6CO from C6CO- in the gas phase

Computations at the RCCSD(T)/aug-cc-pVDZ//B3LYP/6-31G* level of theory indicate that neutral C6CO is a stable species. The ground state of this neutral is the singlet cumulene oxide :C=C=C=C=C=C=C=O. The adiabatic electron affinity and dipole moment of singlet C6CO are 2.47 eV and 4.13 D, respectively, at this level of theory. The anion (C6CO)(-.) should be a possible precursor to this neutral. It has been formed by an unequivocal synthesis in the ion source of a mass spectrometer by the S(N)2(Si) reaction between (CH3)(3)Si-C=C-C=C-C=C-CO-CMe3 and F- to form C-=C-C=C-C=C-CO-CMe3 which loses Me3C in the source to form C6CO-.. Charge stripping of this anion by vertical Franck-Condon oxidation forms C6CO, characterised by the neutralisation-reionisation spectrum (-NR+) of C6CO-., which is stable during the timeframe of this experiment (10(-6) s), Copyright (C) 2000 John Wiley & Sons, Ltd.

Navigating the future of roads – considering potential impacts of environmental and social trends on road infrastructure

Providing mobility corridors for communities, enabling freight networks to transport goods and services, and a pathway for emergency services and disaster relief operations, roads are a vital component of our societal system. In the coming decades, a number of modern issues will face road agencies as a result of climate change, resource scarcity and energy related challenges that will have implications for society. To date, these issues have been discussed on a case by case basis, leading to a fragmented approach by state and federal agencies in considering the future of roads – with potentially significant cost and risk implications. Within this context, this paper summarises part of a research project undertaken within the ‘Greening the Built Environment’ program of the Sustainable Built Environment National Research Centre (SBEnrc, Australia), which identified key factors or ‘trends’ affecting the future of roads and key strategies to ensure that road agencies can continue to deliver road infrastructure that meets societal needs in an environmentally appropriate manner. The research was conducted over two years, including a review of academic and state agency literature, four stakeholder workshops in Western Australia and Queensland, and industry consultation. The project was supported financially and through peer review and contribution, by Main Roads Western Australia, QLD Department of Transport and Main Roads, Parsons Brinckerhoff, John Holland Group, and the Australian Green Infrastructure Council (AGIC). The project highlighted several potential trends that are expected to affect road agencies in the future, including predicted resource and materials shortages, increases in energy and natural resources prices, increased costs related to greenhouse gas emissions, changing use and expectations of roads, and changes in the frequency and intensity of weather events. Exploring the implications of these potential futures, the study then developed a number of strategies in order to prepare transport agencies for the associated risks that such trends may present. An unintended outcome of the project was the development of a process for enquiring into future scenarios, which will be explored further in Stage 2 of the project (2013-2014). The study concluded that regardless of the type and scale of response by the agency, strategies must be holistic in approach, and remain dynamic and flexible.