A Comparison of Methodologies from Two Longitudinal Community-Based Randomized Controlled Trials of Similar Interventions in Palliative Care: What Worked and What Did Not

Background: Methodological challenges such as recruitment problems and participant burden make clinical trials in palliative care difficult. In 2001-2004, two community-based randomized controlled trials (RCTs) of case conferences in palliative care settings were independently conducted in Australia-the Queensland Case Conferences trial (QCC) and the Palliative Care Trial (PCT). Design: A structured comparative study of the QCC and PCT was conducted, organized by known practical and organizational barriers to clinical trials in palliative care. Results: Differences in funding dictated study designs and recruitment success; PCT had 6 times the budget of QCC. Sample size attainment. Only PCT achieved the sample size goal. QCC focused on reducing attrition through gatekeeping while PCT maximized participation through detailed recruitment strategies and planned for significant attrition. Testing sustainable interventions. QCC achieved a higher percentage of planned case conferences; the QCC strategy required minimal extra work for clinicians while PCT superimposed conferences on normal work schedules. Minimizing participant burden. Differing strategies of data collection were implemented to reduce participant burden. QCC had short survey instruments. PCT incorporated all data collection into normal clinical nursing encounters. Other. Both studies had acceptable withdrawal rates. Intention-to-treat analyses are planned. Both studies included substudies to validate new outcome measures. Conclusions: Health service interventions in palliative care can be studied using RCTs. Detailed comparative information of strategies, successes and challenges can inform the design of future trials. Key lessons include adequate funding, recruitment focus, sustainable interventions, and mechanisms to minimize participant burden.

Perceptual speed does not cause intelligence, and intelligence does not cause perceptual speed

There is ongoing debate whether the efficiency of local cognitive processes leads to global cognitive ability or whether global ability feeds the efficiency of basic processes. A prominent example is the well-replicated association between inspection time (IT), a measure of perceptual discrimination speed, and intelligence (IQ), where it is not known whether increased speed is a cause or consequence of high IQ. We investigated the direction of causation between IT and IQ in 2012 genetically related subjects from Australia and The Netherlands. Models in which the reliable variance of each observed variable was specified as a latent trait showed IT correlations of -0.44 and -0.33 with respective Performance and Verbal IQ; heritabilities were 57% (IT), 83% (PIQ) and 77% (VIQ). Directional causation models provided poor fits to the data, with covariation best explained by pleiotropic genes (influencing variation in both IT and IQ). This finding of a common genetic factor provides a better target for identifying genes involved in cognition than genes which are unique to specific traits.

Proton conductivity of mesoporous sol-gel zirconium phosphates for fuel cell applications

Zirconium phosphate has been extensively studied as a proton conductor for proton exchange membrane (PEM) fuel cell applications. Here we report the synthesis of mesoporous, templated sol-gel zirconium phosphate for use in PEM applications in an effort to determine its suitability for use as a surface functionalised, solid acid proton conductor in the future. Mesoporous zirconium phosphates were synthesised using an acid-base pair mechanism with surface areas between 78 and 177 m(2) g(-1) and controlled pore sizes in the range of 2-4 nm. TEM characterisation confirmed the presence of a wormhole like pore structure. The conductivity of such materials was up to 4.1 x 10(-6) S cm(-1) at 22degreesC and 84% relative humidity (RH), while humidity reduction resulted in a conductivity decrease by more than an order of magnitude. High temperature testing on the samples confirmed their dependence on hydration for proton conduction and low hydroscopic nature. It was concluded that while the conductivity of these materials is low compared to Nafion, they may be a good candidate as a surface functionalised solid acid proton conductor due to their high surface area, porous structure and inherent ability to conduct protons.

Hindered settling of sand grains

The sedimentation rate of sand grains in the hindered settling regime has been considered to assess particle shape effects. The behaviour of various particulate systems involving sand has been compared with the widely used Richardson-Zaki expression. The general form of the expression is found to hold, in as much as remaining as a suitable means to describe the hindered settling of irregular particles. The sedimentation exponent n in the Richardson-Zaki expression is found to be significantly larger for natural sand grains than for regular particles. The hindered settling effect is therefore greater, leading to lower concentration gradients than expected. The effect becomes more pronounced with increasing particle irregularity. At concentrations around 0.4, the hindered settling velocity of fine and medium natural sands reduces to about 70% of the value predicted using existing empirical expressions for n. Using appropriate expressions for the fluidization velocity and the clear water settling velocity, a simple method is discussed to evaluate the sedimentation exponent and to determine the hindered settling effect for sands of various shapes.

Estimation of water retention curve from mercury intrusion porosimetry and van Genuchten model

The water retention curve (WRC) is a hydraulic characteristic of concrete required for advanced modeling of water (and thus solute) transport in variably saturated, heterogeneous concrete. Unfortunately, determination by a direct experimental method (for example, measuring equilibrium moisture levels of large samples stored in constant humidity cells) is a lengthy process, taking over 2 years for large samples. A surrogate approach is presented in which the WRC is conveniently estimated from mercury intrusion porosimetry (MIP) and validated by water sorption isotherms: The well-known Barrett, Joyner and Halenda (BJH) method of estimating the pore size distribution (PSD) from the water sorption isotherm is shown to complement the PSD derived from conventional MIP. This provides a basis for predicting the complete WRC from MIP data alone. The van Genuchten equation is used to model the combined water sorption and MIP results. It is a convenient tool for describing water retention characteristics over the full moisture content range. The van Genuchten parameter estimation based solely on MIP is shown to give a satisfactory approximation to the WRC, with a simple restriction on one. of the parameters.

Dimensional change behavior of caribbean pine using an environmental scanning electron microscope

Moisture transport and dimensional change during wood drying or wetting processes were analyzed based on pictures from an environmental scanning electron microscope (ESEM). This provides quantitative relationships between dimensional changes of total area, cell wall, and lumen, and moisture content for earlywood and latewood. Earlywood and latewood behave similarly but show some quantitative differences. The overall outcome for sections containing both kinds of wood seems to be dominated by the latewood behavior. The observed strain behavior of wood during drying is anisotropic in ways that are inconsistent with explanations solely related to microfibril orientation or earlywood/latewood interactions and more likely may be influenced by ray tracheids.

Heat and mass transfer during fry-drying of sewage sludge

Deep-frying, which consists of immersing a wet material in a large volume of hot oil, presents a process easily adaptable to dry rather than cook materials. A suitable material for drying is sewage sludge, which may be dried using recycled cooking oils (RCO) as frying oil. One advantage is that this prepares both materials for convenient disposal by incineration. This study examines fry-drying of municipal sewage sludge using recycled cooking oil. The transport processes occurring during fry-drying were monitored through sample weight, temperature, and image analysis. Due to the thicker and wetter samples than the common fried foods, high residual moisture is observed in the sludge when the boiling front has reached the geometric center of the sample, suggesting that the operation is heat transfer controlled only during the first half of the process followed by the addition of other mechanisms that allow complete drying of the sample. A series of mechanisms comprising four stages (i.e., initial heating accompanied by a surface boiling onset, film vapor regime, transitional nucleate boiling, and bound water removal) is proposed. In order to study the effect of the operating conditions on the fry-drying kinetics, different oil temperatures (from 120 to 180 degrees C), diameter (D = 15 to 25 mm), and initial moisture content of the sample (4.8 and 5.6 kg water(.)kg(-1) total dry solids) were investigated.

An analysis of relational complexity in an air traffic control conflict detection task

Theoretical analyses of air traffic complexity were carried out using the Method for the Analysis of Relational Complexity. Twenty-two air traffic controllers examined static air traffic displays and were required to detect and resolve conflicts. Objective measures of performance included conflict detection time and accuracy. Subjective perceptions of mental workload were assessed by a complexity-sorting task and subjective ratings of the difficulty of different aspects of the task. A metric quantifying the complexity of pair-wise relations among aircraft was able to account for a substantial portion of the variance in the perceived complexity and difficulty of conflict detection problems, as well as reaction time. Other variables that influenced performance included the mean minimum separation between aircraft pairs and the amount of time that aircraft spent in conflict.

Degenerate dentition of the dugong (Dugong dugon), or why a grazer does not need teeth: morphology, occlusion and wear of mouthparts

The morphology and functional occlusion of the cheekteeth of 57 dugongs Dugong dugon of both sexes were examined using reflected light and scanning electron microscopy, radiography, hardness testing and skull manipulation. The functional morphology of the horny oral pads was also described. Mouthparts and body size allometry was examined for ontogenetic and gender-related trends. We found that the worn erupted cheekteeth of the dugong are simple flat pegs composed of soft degenerative dentine. During occlusion, the mandible moves in a mainly antero-lingual direction, with the possibility of mandibular retraction in some individuals. Anterior parts of the cheektooth row may become non-functional as a dugong ages. As a function of body size, dugong cheekteeth are extremely small compared with those of other mammalian herbivores, and with other hindgut fermenters in particular. The morphology, small size and occlusal variability of the cheekteeth suggest that there has not been strong selective pressure acting to maintain an effective dentition. In contrast, great development of the horny pads and associated skull parameters and their lower size variability suggest that the horny pads may have assumed the major role in food comminution.

Field observations of instantaneous water slopes and horizontal pressure gradients in the swash-zone

Field observations of instantaneous water surface slopes in the swash zone are presented. For free-surface flows with a hydrostatic pressure distribution the surface slope is equivalent to the horizontal pressure gradient. Observations were made using a novel technique which in its simplest form consists of a horizontal stringline extending seaward from the beach face. Visual observation, still photography or video photography is then sufficient to determine the surface slope where the free-surface cuts the line or between reference points in the image. The method resolves the mean surface gradient over a cross-shore distance of 5 m or more to within +/- 0.001, or 1/20th -1/100th of typical beach gradients. In addition, at selected points and at any instant in time during the swash cycle, the water surface slope can be determined exactly to be dipping either seaward or landward. Close to the location of bore collapse landward dipping water surface slopes of order 0.05-0.1 occur over a very small region (order 0.5 m) at the blunt or convex leading edge of the swash. In the middle and upper swash the water surface slope at this leading edge is usually very close to horizontal or slightly seaward. Behind the leading edge, the water surface slope was observed to be very close to horizontal or dipping seaward at all times throughout the swash uprush. During the backwash the water surface slope was observed to be always dipping seaward, approaching the beach slope, and remained seaward until a new uprush edge or incident bore passed any particular cross-shore location of interest. The observations strongly Suggest that the swash boundary layer is subject to an adverse pressure gradient during uprush and a favourable pressure gradient during the backwash. Furthermore, assuming Euler's equations are a good approximation in the swash, the observations also show that the total fluid acceleration is negative (offshore) for almost the whole of the uprush and for the entire backwash. The observations are contrary to recent work suggesting significant shoreward directed accelerations and pressure gradients occur in the swash (i.e., delta u/delta t > 0 similar to delta p/delta x < 0), but consistent with analytical and numerical solutions for swash uprush and backwash. The results have important implications for sediment transport modelling in the swash zone.

Flight data analysis of the HyShot 2 scramjet flight experiment

The development of scramjet propulsion for alternative launch and payload delivery capabilities has been composed largely of ground experiments for the last 40 years. With the goal of validating the use of short duration ground test facilities, a ballistic reentry vehicle experiment called HyShot was devised to achieve supersonic combustion in flight above Mach 7.5. It consisted of a double wedge intake and two back-to-back constant area combustors; one supplied with hydrogen fuel at an equivalence ratio of 0.34 and the other unfueled. Of the two flights conducted, HyShot 1 failed to reach the desired altitude due to booster failure, whereas HyShot 2 successfully accomplished both the desired trajectory and satisfactory scramjet operation. Postflight data analysis of HyShot 2 confirmed the presence of supersonic combustion during the approximately 3 s test window at altitudes between 35 and 29 km. Reasonable correlation between flight and some preflight shock tunnel tests was observed.

Intra-colonial response to Acroporid "White syndrome" lesions in tabular Acropora spp. (Scleractinia)

'White syndrome' is considered to be the most prevalent coral disease on the Great Barrier Reef, characterised by rapid rates of lesion progression and high levels of colony mortality. This study investigated the production and translocation of photoassimilates towards white syndrome lesions (WSLs) and artificially inflicted lesions in healthy and diseased colonies of tabular Acropora spp. to determine the intra-colonial response to white syndrome using C-14 labelling. Translocation of C-14 labelled photoassimilates was preferentially orientated away from active WSLs, with minimal C-14 activity observed in the lesion borders, whilst artificial lesions (ALs) created directly opposite WSL borders showed significantly higher C-14 activity, suggesting active translocation of photoassimilates for tissue regeneration. Transport of photoassimilates in healthy coral colonies was preferentially oriented towards ALs with a higher perimeter-area ratio, although translocation towards WSL boundaries was minimal even though the lesion perimeter was often the width of the colony (> 200 cm). We suggest that the preferential orientation of photoassimilates away from WSLs may represent a deliberate strategy by the colony to induce a 'shutdown reaction' in order to preserve intra-colonial resources within areas of the colony that are more likely to survive and recover.

Mechanisms influencing levitation and the scaling laws in nanopores: Oscillator model theory

We provide here a detailed theoretical explanation of the floating molecule or levitation effect, for molecules diffusing through nanopores, using the oscillator model theory (Phys. Rev. Lett. 2003, 91, 126102) recently developed in this laboratory. It is shown that on reduction of pore size the effect occurs due to decrease in frequency of wall collision of diffusing particles at a critical pore size. This effect is, however, absent at high temperatures where the ratio of kinetic energy to the solid-fluid interaction strength is sufficiently large. It is shown that the transport diffusivities scale with this ratio. Scaling of transport diffusivities with respect to mass is also observed, even in the presence of interactions.