Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

Raw material supply to shrimp freezing plants: some significant aspects

The shrimp processing plants located at any particular place receive their raw material supplies from local and outside centres. The raw material received, the form in which it was received, the relative contribution by local and outside centres and the seasonal variation in the supplies were studied with respect to the shrimp processing plants located at three places - Cochin, Veraval and Kakinada.

Suitability of commercially available Bacillus probiotics on growth, survival and production of black tiger shrimp (Penaeus monodon Fab.)

Different forms of Bacillus probiotics was assessed in the earthen ponds on tiger shrimp (Penaeus monodon) culture. The experiment was designed with three different treatments depending on the mode of application (T1=oral probiotics; T2=spreading probiotics and T3=oral+ spreading probiotics). The shrimp was cultured for 120 days with the stocking density of 6-PL/m².Oral probiotics in the respective ponds were supplied with feeds. Whereas, spreading probiotics was applied to the pond water during pond preparation at 30, 60 and 90 days of culture period. Results of the experiment revealed that, all forms of Bacillus probiotic had effective role to keep the culture environment friendly in terms of mineralization of organic matter, nitrogen and phosphorus content in bottom sediment; holding of water transparency in a congenial state, increasing the density of planktonic biomass and boosting the THB-Vibrio ratio in water and sediment with insignificance (p>0.05) difference between different treatments. Whilst, spreading form of Bacillus pro biotic showed higher weight gain (27.58±1.18g), survival rate (70.75±8.54%) and production (1167.66±109.62 kg/ha) and expected lower FCR (1.81 ±0.06) values with significant difference (p<0.01) with others methods of application, indicated its superiority in tiger shrimp culture.

Determination of proximate composition, shelf life and fatty acid profiles of breaded kilka (Clupeonella cultriventris) during frozen storage

The present study aimed production of a new product with various texture and sensory properties in chase of the impetus for increasing human consumption considering suitable resources of Kilka fish in Caspian Sea. Following deheading, gutting, and brining, common Kilka were battered in two different formulations, i.e. simple batter and tempura batter, via automated predusting machinery and then, they were fried through flash frying for 30 seconds at 170°C in sunflower oil after they were breaded with bread crumbs flour. The products were subjected to continuous freezing at -40°C and were kept at -18°C in cold storage for four months once they were packed. Chemical composition (protein, fat, moisture, and ash), fatty acid profiles (29 fatty acids), chemical indices of spoilage (peroxide value, thiobarbituric acid, free fatty acids, and volatile nitrogen), and microbial properties (total bacteria count and coliform count) were compared in fresh and breaded Kilka at various times before frying (raw breaded Kilka), after frying (zero-phase), and in various months of frozen storage (phases 1, 2, 3, and 4). Organoleptic properties of breaded Kilka (i.e. odor, taste, texture, crispiness, cohesiveness of batter) and general acceptability in the phases 0, 1, 2, 3, and 4 were evaluated. The results obtained from chemical composition and fatty acid profiles in common Kilka denoted that MUFA, PUFA, and SFA were estimated to be 36.96, 32.85, and 29.12 g / 100g lipid, respectively. Levels of ù-3 and ù-6 were 7.6 and 1.12 g / 100 gr lipid, respectively. Docosahexaonoic acid (20.79%) was the highest fatty acid in PUFA group. ù-3/ù-6 and PUFA/SFA ratios were 7.6 and 1.12, respectively. The high rates of the indices and high percentage of ù-3 fatty acid in common Kilka showed that the fish can be considered as invaluable nutritional and fishery resources and commonsensical consumption of the species may reduce the risk of cardiovascular diseases. Frying breaded Kilka affected overall fat and moisture contents so that moisture content in fried breaded Kilka decreased significantly compared to raw breaded Kilka, while it was absolutely reverse for fat content. Overall fat content in tempura batter treatment was significantly lower than that of simple batter treatment (P≤0.05). Presence of hydrocolloids, namely proteins, starch, gum, and other polysaccharides, in tempura batter may prohibit moisture evaporation and placement with oil during frying process in addition to boosting water holding capacity through confining water molecules. During frying process, fatty acids composition of breaded Kilka with various batters changed so that rates of some fatty acids such as Palmitic acid (C16:0), Stearic acid (C18:0), Oleic acid (C18:1 ù-9cis), and linoleic acid (C18:3 ù-3) increased considerably following frying; however, ù-3/ù-6, PUFA/SFA, and EPA+DHA/C16:0 ratios (Polyan index) decreased significantly after frying. ù-3/ù-6, PUFA/SFA, and EPA+DHA/C16:0 ratios in tempura batter treatment were higher than those of simple batter treatment which is an indicator of higher nutritional value of breaded Kilka with tempura batter. Significant elevations were found in peroxide, thiobarbituric acid, and free fatty acids in fried breaded Kilka samples compared to raw samples which points to fat oxidation during cooking process. Overall microorganism count and coliform count decreased following heating process. Both breaded Kilka samples were of high sanitation quality at zero-phase according to ICMSF Standard. The results acquired from organoleptic evaluation declared that odor, cohesiveness, and general acceptability indices, among others, had significant differences between the treatments (P≤0.05). In all evaluated properties, breaded Kilka with tempura batter in different phases gained higher scores than breaded Kilka with simple batter. During cold storage of various treatments of breaded Kilka, total lipid content, PUFA, MUFA, ù-3, ù- 3/ù-6, PUFA/SFA, Polyen index decreased significantly. The mentioned reductions in addition to significant elevation of spoilage indices, namely peroxide, thiobarbituric acid, and free fatty acids, during frozen storage, indicate to oxidation and enzymatic mechanism activity during frozen storage of breaded Kilka. Considering sensory evaluation at the end of the fourth month and TVB-N contents exceeded eligible rate in the fourth month, shelf life of the products during frozen storage was set to be three months at -18°C. The results obtained from statistical tests indicate to better quality of breaded Kilka processed with tempura batter compared to simple batter in terms of organoleptic evaluation, spoilage indices, and high quality of fat in various sampling phases.

Recognizing of Ichthyophon and investigation of feeding and effects of water temperature, salinity and electrical conductivity on the population dynamic of Barbus grypus in the Dalaki and Helle river

This study was carried out for recognized ichthyophon and investigation of feeding and effects of water temperature, salinity and electrical conductivity on the population dynamic of Barbus grypus in the Dalaki and Helle river. In the study period, 2949 Barbus grypus was cached. The most of total length frequency was 200 to 300 mm and 2 to 3 years old. The oldest fish was8 years old with 756 mm total length. Fecundity was 950 upto 57400 oocyt per fish. Station no. 6 and 7 showed more temperature, fecundity and GSI than other stations. Females adulated before then males. Multiple stepwise regression of fecundity and RE (reproduction effort) showed significant correlation. Fishes of the upper parts of stream was more L than down stream stations. Condition factor of males was more than female, and for down stream stations was better than the other stations. Barbus grypus is omnivorous. Ichthyophon of Dalaki river include 4 family and 9 species that Capoeta capoeta intermadia was more than others species, but in the Helle river was 5 family and 9 species, that Liza abu zarudni was more than others.

Survey of marine turtles ecobiology in north of Persian Gulf

Sea turtles are counted as rare and extincting species. During the last century the population of sea turtles are drastically reducd and the remaining ones are considerd either threatend or endangerd because of some factors as sea pollution, economic benefits, intense fishing effort, beach man-made structures and so on. So, in recent years, more attention to conserving and surviving them is assumed. After a preliminary studies on some of the biological specifications in northern beach of Persian Gulf, three islands ; Hormoz, Hengam and Larak for the biometry of the turtles, a total number of 179, from 1999 to 2002 (4 years) are chosen. Some of the biological attributes as weight, length and their egg-laying are recorded, these items are then analyzed using SPSS software. The observed results are as follows . The lowest weight of the turtles was 35 kg, the highest 59 kg, and the average 45.24 kg. The lowest carapace length was 64 cm. the highest 86 cm and the average 76.79. the lowest number of laying eggs was 73, the highest 126, and the average 86.79. The results are discussed in three following sections: 1-A contrastive analysis of the biometric characteristics during 1999 in the three mentiond islands. 2-A contrastive analysis of the biometric characteristics in Hormoz island from 1999 to 2002. 3-A contrastive analysis of all the biometric characteristics in the three islands and other parts of the world. The results obtained from the turtles biometry in 1999 shows that the average of the turtles weight in Larak is lower than the other mentioned ones, and the heighest average is observed in Hormoz island. The turtles of Hengm have laid more eggs than the others. The results of Hengani turtles biometry during 1999-2002 indicates that the average of their weight in 2002 is more than the other three years in the same place. The least number of eggs laid during these years are 53 and the most are 126. The most number of eggs are laid in Hormoz in 2002, but the average number does not show any significant change.

Significant improvements in optical power budgets of real-time optical OFDM PON systems.

Based on a comprehensive theoretical optical orthogonal frequency division multiplexing (OOFDM) system model rigorously verified by comparing numerical results with end-to-end real-time experimental measurements at 11.25Gb/s, detailed explorations are undertaken, for the first time, of the impacts of various physical factors on the OOFDM system performance over directly modulated DFB laser (DML)-based, intensity modulation and direct detection (IMDD), single-mode fibre (SMF) systems without in-line optical amplification and chromatic dispersion compensation. It is shown that the low extinction ratio (ER) of the DML modulated OOFDM signal is the predominant factor limiting the maximum achievable optical power budget, and the subcarrier intermixing effect associated with square-law photon detection in the receiver reduces the optical power budget by at least 1dB. Results also indicate that, immediately after the DML in the transmitter, the insertion of a 0.02nm bandwidth optical Gaussian bandpass filter with a 0.01nm wavelength offset with respect to the optical carrier wavelength can enhance the OOFDM signal ER by approximately 1.24dB, thus resulting in a 7dB optical power budget improvement at a total channel BER of 1 × 10(-3).

Ferroelectric liquid crystal over silicon devices

Over the past 20 years, ferroelectric liquid crystal over silicon (FLCOS) devices have made a wide impact on applications as diverse as optical correlation and holographic projection. To cover the entire gamut of this technology would be difficult and long winded; hence, this paper describes the significant developments of FLCOS within the Engineering Department at the University of Cambridge.The purpose of this paper is to highlight the key issues in fabricating silicon backplane spatial light modulators (SLMs) and to indicate ways in which the technology can be fabricated using cheap, low-density production and manufacturability. Three main devices have been fabricated as part of several research programmes and are documented in this paper. The fast bitplane SLM and the reconfigurable optical switches for aerospace and telecommunications systems (ROSES) SLM will form the basis of a case study to outline the overall processes involved. There is a great deal of commonality in the fabrication processes for all three devices, which indicates their potential strength and demonstrates that these processes can be made independent of the SLMs that are being assembled. What is described is a generic process that can be applied to any silicon backplane SLM on a die-by-die basis. There are hundreds of factors that can affect the yield in a manufacturing process and the purpose of a good process design procedure is to minimise these factors. One of the most important features in designing a process is fabrication experience, as so many of the lessons in this business can only be learned this way. We are working with the advantage of knowing the mistakes already made in the flat panel display industry, but we are also faced with the fact that those mistakes took many years and many millions of dollars to make.The fabrication process developed here originates and adapts earlier processes from various groups around the world. There are also a few totally new processes that have now been adopted by others in the field. Many, such as the gluing process, are still on-going and have to be worked on more before they will fully suit 'manufacturability'. © 2012 Copyright Taylor and Francis Group, LLC.

Dynamic centrifuge tests on shallow tunnel models in dry sand

In the framework of the Italian research project ReLUIS-DPC, a set of centrifuge tests were carried out at the Schofield Centre in Cambridge (UK) to investigate the seismic behaviour of tunnels. Four samples of dry sand were prepared at different densities, in which a small scale model of circular tunnel was inserted, instrumented with gauges measuring hoop and bending strains. Arrays of accelerometers in the soil and on the box allowed the amplification of ground motion to be evaluated; LVDTs measured the soil surface settlement. This paper describes the main results of this research, showing among others the evolution of the internal forces during the model earthquakes at significant locations along the tunnel lining. © 2010 Taylor & Francis Group, London.

Low-order modelling of ducted flames with temporally varying equivalence ratio in realistic geometries

The interaction between unsteady heat release and acoustic pressure oscillations in gas turbines results in self-excited combustion oscillations which can potentially be strong enough to cause significant structural damage to the combustor. Correctly predicting the interaction of these processes, and anticipating the onset of these oscillations can be difficult. In recent years much research effort has focused on the response of premixed flames to velocity and equivalence ratio perturbations. In this paper, we develop a flame model based on the socalled G-Equation, which captures the kinematic evolution of the flame surfaces, under the assumptions of axisymmetry, and ignoring vorticity and compressibility. This builds on previous work by Dowling [1], Schuller et al. [2], Cho & Lieuwen [3], among many others, and extends the model to a realistic geometry, with two intersecting flame surfaces within a non-uniform velocity field. The inputs to the model are the free-stream velocity perturbations, and the associated equivalence ratio perturbations. The model also proposes a time-delay calculation wherein the time delay for the fuel convection varies both spatially and temporally. The flame response from this model was compared with experiments conducted by Balachandran [4, 5], and found to show promising agreement with experimental forced case. To address the primary industrial interest of predicting self-excited limit cycles, the model has then been linked with an acoustic network model to simulate the closed-loop interaction between the combustion and acoustic processes. This has been done both linearly and nonlinearly. The nonlinear analysis is achieved by applying a describing function analysis in the frequency domain to predict the limit cycle, and also through a time domain simulation. In the latter case, the acoustic field is assumed to remain linear, with the nonlinearity in the response of the combustion to flow and equivalence ratio perturbations. A transfer function from unsteady heat release to unsteady pressure is obtained from a linear acoustic network model, and the corresponding Green function is used to provide the input to the flame model as it evolves in the time domain. The predicted unstable frequency and limit cycle are in good agreement with experiment, demonstrating the potential of this approach to predict instabilities, and as a test bench for developing control strategies. Copyright © 2011 by ASME.

Visual search near threshold: Some features are more equal than others.

While searching for objects, we combine information from multiple visual modalities. Classical theories of visual search assume that features are processed independently prior to an integration stage. Based on this, one would predict that features that are equally discriminable in single feature search should remain so in conjunction search. We test this hypothesis by examining whether search accuracy in feature search predicts accuracy in conjunction search. Subjects searched for objects combining color and orientation or size; eye movements were recorded. Prior to the main experiment, we matched feature discriminability, making sure that in feature search, 70% of saccades were likely to go to the correct target stimulus. In contrast to this symmetric single feature discrimination performance, the conjunction search task showed an asymmetry in feature discrimination performance: In conjunction search, a similar percentage of saccades went to the correct color as in feature search but much less often to correct orientation or size. Therefore, accuracy in feature search is a good predictor of accuracy in conjunction search for color but not for size and orientation. We propose two explanations for the presence of such asymmetries in conjunction search: the use of conjunctively tuned channels and differential crowding effects for different features.

Empathic neural responses are modulated by the perceived fairness of others.

The neural processes underlying empathy are a subject of intense interest within the social neurosciences. However, very little is known about how brain empathic responses are modulated by the affective link between individuals. We show here that empathic responses are modulated by learned preferences, a result consistent with economic models of social preferences. We engaged male and female volunteers in an economic game, in which two confederates played fairly or unfairly, and then measured brain activity with functional magnetic resonance imaging while these same volunteers observed the confederates receiving pain. Both sexes exhibited empathy-related activation in pain-related brain areas (fronto-insular and anterior cingulate cortices) towards fair players. However, these empathy-related responses were significantly reduced in males when observing an unfair person receiving pain. This effect was accompanied by increased activation in reward-related areas, correlated with an expressed desire for revenge. We conclude that in men (at least) empathic responses are shaped by valuation of other people's social behaviour, such that they empathize with fair opponents while favouring the physical punishment of unfair opponents, a finding that echoes recent evidence for altruistic punishment.

Communities of gastrointestinal helminths of fish in historically connected habitats: habitat fragmentation effect in a carnivorous catfish Pelteobagrus fulvidraco from seven lakes in flood plain of the Yangtze River, China

Background: Habitat fragmentation may result in the reduction of diversity of parasite communities by affecting population size and dispersal pattern of species. In the flood plain of the Yangtze River in China, many lakes, which were once connected with the river, have become isolated since the 1950s from the river by the construction of dams and sluices, with many larger lakes subdivided into smaller ones by road embankments. These artificial barriers have inevitably obstructed the migration of fish between the river and lakes and also among lakes. In this study, the gastrointestinal helminth communities were investigated in a carnivorous fish, the yellowhead catfish Pelteobagrus fulvidraco, from two connected and five isolated lakes in the flood plain in order to detect the effect of lake fragmentation on the parasite communities. Results: A total of 11 species of helminths were recorded in the stomach and intestine of P. fulvidraco from seven lakes, including two lakes connected with the Yangtze River, i.e. Poyang and Dongting lakes, and five isolated lakes, i.e. Honghu, Liangzi, Tangxun, Niushan and Baoan lakes. Mean helminth individuals and diversity of helminth communities in Honghu and Dongting lakes was lower than in the other five lakes. The nematode Procamallanus fulvidraconis was the dominant species of communities in all the seven lakes. No significant difference in the Shannon-Wiener index was detected between connected lakes (0.48) and isolated lakes (0.50). The similarity of helminth communities between Niushan and Baoan lakes was the highest (0.6708), and the lowest was between Tangxun and Dongting lakes (0.1807). The similarity was low between Dongting and the other lakes, and the similarity decreased with the geographic distance among these lakes. The helminth community in one connected lake, Poyang Lake was clustered with isolated lakes, but the community in Dongting Lake was separated in the tree. Conclusion: The similarity in the helminth communities of this fish in the flood-plain lakes may be attributed to the historical connection of these habitats and to the completion of the life-cycles of this fish as well as the helminth species within the investigated habitats. The diversity and the digenean majority in the helminth communities can be related to the diet of this fish, and to the lacustrine and macrophytic characters of the habitats. The lake isolation from the river had little detectable effect on the helminth communities of the catfish in flood-plain lakes of the Yangtze River. The low similarities in helminth communities between the Dongting Lake and others may just be a reflection of its unique water environment and anthropogenic alterations or fragmentation in this lake.

Impacts of a small dam on riverine zooplankton

In order to explore the temporal impacts of a small dam on riverine zooplankton, monthly samples were conducted from November 2005 to June 2006 in a reach of Xiangxi River, China, which is affected by a small hydropower plant. A total of 56 taxa of zooplankton were recorded during the study and rotifers were the most abundant group, accounting for 97% of total taxa, while the others were copepod nauplii and copepod adults. This study indicated that: (1) the small dam in the Xiangxi River study area created distinct physical and ecological conditions relative to free-flowing lotic reaches despite the constrained channel and small size of the dam; (2) the existence of the plant's small dam had a significant effect on the zooplankton community. In long periods of drought or dry seasons the effect of the dam on potamoplankton was more pronounced (e.g., November, February, March, and May). But the downfall or the connectivity of channel appeared to decrease the effect of small hydropower plants on riverine zooplankton (e.g., April). The present observation underscores the need for additional studies that provide more basic data on riverine zooplankton communities and quantify ecological responses to dam construction over longer time spans.