Interannual-decadal variability of wintertime mixed layer depths in the North Pacific detected by an ensemble of ocean syntheses

The interannual-decadal variability of the wintertime mixed layer depths (MLDs) over the North Pacific is investigated from an empirical orthogonal function (EOF) analysis of an ensemble of global ocean reanalyses. The first leading EOF mode represents the interannual MLD anomalies centered in the eastern part of the central mode water formation region in phase opposition with those in the eastern subtropics and the central Alaskan Gyre. This first EOF mode is highly correlated with the Pacific decadal oscillation index on both the interannual and decadal time scales. The second leading EOF mode represents the MLD variability in the subtropical mode water (STMW) formation region and has a good correlation with the wintertime West Pacific (WP) index with time lag of 3 years, suggesting the importance of the oceanic dynamical response to the change in the surface wind field associated with the meridional shifts of the Aleutian Low. The above MLD variabilities are in basic agreement with previous observational and modeling findings. Moreover the reanalysis ensemble provides uncertainty estimates. The interannual MLD anomalies in the first and second EOF modes are consistently represented by the individual reanalyses and the amplitudes of the variabilities generally exceed the ensemble spread of the reanalyses. Besides, the resulting MLD variability indices, spanning the 1948–2012 period, should be helpful for characterizing the North Pacific climate variability. In particular, a 6-year oscillation including the WP teleconnection pattern in the atmosphere and the oceanic MLD variability in the STMW formation region is first detected.

Maternity care experiences of Asia ethnic minorities in rural Tasmania, Australia : a mixed methods study

When migrating to Australia Asian women bring with them birthing cultural beliefs and practices, many of which are different from the Australian medical and cultural understanding of reproduction. Such cultural differences may result in conflicts between clients and health care providers especially when the migrants have a poor knowledge of English. The research investigates the maternity care experiences of Asian migrants in Tasmania. The barriers that Asian migrants face in accessing maternity care services and the factors that affect their views towards maternity care were also explored. A mix of quantitative and qualitative methods was employed. Ten women from different ethnic minorities were invited to semi-structured interviews. The qualitative data were analysed using grounded theory. Findings from the interviews were utilized to design a survey questionnaire. Of the 150 survey questionnaires posted, 121 questionnaires were returned. Descriptive statistics and Chi-square tests of independence were used to analyse the quantitative data. Asian migrants followed some traditional practices such as having good rest and eating hot food during the postpartum month. However, they tended to adapt or disregard traditional practices that were no longer applicable in the new environment including the practices of not washing or having a shower. Support is vital for women recovering after childbirth to prevent postnatal depression. Two main barriers migrant women face in accessing health care are language and cultural barriers. Country of origin, partner’s ethnicity, religion and length of stay in Australia are factors that shape the migrants’ views and attitudes towards and experience of maternity care. Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers are recommended to improve available maternal care services. The factors that affect migrants’ view on maternity care should be taken into account when providing maternity care for Asian migrant women.

Retention mechanism divergence of a mixed mode stationary phase for high performance liquid chromatography

Mixed mode stationary phases utilize secondary retention mechanisms to add a dimensionality to the surface of high performance liquid chromatography (HPLC) adsorbents. This approach was used by several authors to improve the separation performance of single dimension separations. We explored the magnitude of these secondary interactions by performing an off-line two-dimensional (2D)-HPLC separation with a Scherzo SM-C18 column of a β-lactoglobulin tryptic digest with a mobile phase pH of 7 in the first dimension and 2 in the second. Mechanism divergence was determined using the peak capacity and a geometric approach to factor analysis, to measure the correlation. This separation was repeated with a C18 stationary phase as a control. It was found that the C18 column had a correlation coefficient of 0.784, smaller than the mixed mode column, 0.884. This indicated that the retention mechanisms of the C18 column were more divergent under these two pH environments than the mixed mode column. However, the SM-C18 still provided alternative selectivity of the peptides to that of the C18 and could be considered as a good alternative for further 2D-HPLC separations.

Factors to drive clinical practice improvement in a Malaysian intensive care unit : assessment of organisational readiness using a mixed method approach

This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identified as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.

Latent patient profile modelling and applications with mixed-variate restricted Boltzmann machine

Efficient management of chronic diseases is critical in modern health care. We consider diabetes mellitus, and our ongoing goal is to examine how machine learning can deliver information for clinical efficiency. The challenge is to aggregate highly heterogeneous sources including demographics, diagnoses, pathologies and treatments, and extract similar groups so that care plans can be designed. To this end, we extend our recent model, the mixed-variate restricted Boltzmann machine (MV.RBM), as it seamlessly integrates multiple data types for each patient aggregated over time and outputs a homogeneous representation called "latent profile" that can be used for patient clustering, visualisation, disease correlation analysis and prediction. We demonstrate that the method outperforms all baselines on these tasks - the primary characteristics of patients in the same groups are able to be identified and the good result can be achieved for the diagnosis codes prediction.

Constitutionalism, good faith and the doctrine of specific performance: rights, duties and equitable discretion

This article will explore the European roots of the doctrine of specific performance and the influence of transformative constitutionalism on these in recent times. The question whether specific performance is available as of right (as in the civil law), or only subject to judicial discretion (as in the common law), will be investigated. The demonstrated impact of constitutional rights on contract law in the mixed system of South Africa will be contrasted with developments in English and Australian contract law, where the common-law rules are more deeply entrenched and the potential scope for human rights-based development of these is arguably smaller, though still important. The article will argue, using comparative rules on specific performance as an example, that the concept of a duty of good faith or contractual fairness is likely to play a greater role in future in all three of the countries under consideration, reducing the common/civil/mixed legal systems divide.

A Modular and digitally programmable interface based on band-pass sigma-delta modulator for mixed-signal systems-on-chip

The focus of this thesis is to discuss the development and modeling of an interface architecture to be employed for interfacing analog signals in mixed-signal SOC. We claim that the approach that is going to be presented is able to achieve wide frequency range, and covers a large range of applications with constant performance, allied to digital configuration compatibility. Our primary assumptions are to use a fixed analog block and to promote application configurability in the digital domain, which leads to a mixed-signal interface. The use of a fixed analog block avoids the performance loss common to configurable analog blocks. The usage of configurability on the digital domain makes possible the use of all existing tools for high level design, simulation and synthesis to implement the target application, with very good performance prediction. The proposed approach utilizes the concept of frequency translation (mixing) of the input signal followed by its conversion to the ΣΔ domain, which makes possible the use of a fairly constant analog block, and also, a uniform treatment of input signal from DC to high frequencies. The programmability is performed in the ΣΔ digital domain where performance can be closely achieved according to application specification. The interface performance theoretical and simulation model are developed for design space exploration and for physical design support. Two prototypes are built and characterized to validate the proposed model and to implement some application examples. The usage of this interface as a multi-band parametric ADC and as a two channels analog multiplier and adder are shown. The multi-channel analog interface architecture is also presented. The characterization measurements support the main advantages of the approach proposed.

Synthesis and thermal characterization of luminescent powers of terbium(III) with mixed ligands

This work deals with the synthesis and thermal decomposition of complexes of general formula: Ln(beta-dik)(3)L (where Ln=Tb(+3), beta-dik=4,4,4-trifluoro-1-phenyl-1,3butanedione(btfa) and L=1,10-fenantroline(phen) or 2,2-bipiridine(bipy). The powders were characterized by melting point, FTIR spectroscopy, LTV-visible, elemental analysis, scanning differential calorimeter(DSC) and thermogravimetry(TG). The TG/DSC curves were obtained simultaneously in a system DSC-TGA, under nitrogen atmosphere. The experimental conditions were: 0.83 ml.s(-1) carrier gas flow, 2.0 +/- 0.5 mg samples and 10 degrees C.min(-1) heating rate. The CHN elemental analysis of the Tb(btfa)(3)bipy and Tb(btfa)(3)phen complexes, are in good agreement with the expected values. The IR spectra evinced that the metal ion is coordinated to the ligands via C=O and C-N groups. The TG/DTG/DSC curves of the complexes show that they decompose before melting. The profiles of the thermal decomposition of the Tb(btfa)3phen and Tb(btfa)3bipy showed six and five decomposition stages, respectively. Our data suggests that the thermal stability of the complexes under investigation followed the order: Tb(btfa)(3)phen < Tb(btfa)(3)bipy.

Y(4260) as a mixed charmonium-tetraquark state

Using the QCD sum rule approach we study the Y(4260) state assuming that it can be described by a mixed charmonium-tetraquark current with J(PC) = 1(--) quantum numbers. For the mixing angle around theta approximate to (53.0 +/- 0.5)degrees, we obtain a value for the mass which is in good agreement with the experimental mass of the Y(4260). For the decay width into the channel Y -> J/psi pi pi we find the value Gamma(Y -> J/psi pi pi) approximate to (4.1 +/- 0.6) MeV, which is much smaller than the total experimental width Gamma approximate to (95 +/- 14) MeV. However, considering the experimental upper limits for the decay of the Y(4260) into open charm, we conclude that we cannot rule out the possibility of describing this state as a mixed charmonium-tetraquark state. DOI: 10.1103/PhysRevD.86.116012

In-situ DRIFT/MS study of the conversion of ethanol on mixed Mg/Si oxides

Due to the high price of natural oil and harmful effects of its usage, as the increase in emission of greenhouse gases, the industry focused in searching of sustainable types of the raw materials for production of chemicals. Ethanol, produced by fermentation of sugars, is one of the more interesting renewable materials for chemical manufacturing. There are numerous applications for the conversion of ethanol into commodity chemicals. In particular, the production of 1,3-butadiene whose primary source is ethanol using multifunctional catalysts is attractive. With the 25% of world rubber manufacturers utilizing 1,3-butadiene, there is an exigent need for its sustainable production. In this research, the conversion of ethanol in one-step process to 1,3-butadiene was studied. According to the literature, the mechanisms which were proposed to explain the way ethanol transforms into butadiene require to have both acid and basic sites. But still, there are a lot of debate on this topic. Thus, the aim of this research work is a better understanding of the reaction pathways with all the possible intermediates and products which lead to the formation of butadiene from ethanol. The particular interests represent the catalysts, based on different ratio Mg/Si in comparison to bare magnesia and silica oxides, in order to identify a good combination of acid/basic sites for the adsorption and conversion of ethanol. Usage of spectroscopictechniques are important to extract information that could be helpful for understanding the processes on the molecular level. The diffuse reflectance infrared spectroscopy coupled to mass spectrometry (DRIFT-MS) was used to study the surface composition of the catalysts during the adsorption of ethanol and its transformation during the temperature program. Whereas, mass spectrometry was used to monitor the desorbed products. The set of studied materials include MgO, Mg/Si=0.1, Mg/Si=2, Mg/Si=3, Mg/Si=9 and SiO2 which were also characterized by means of surface area measurements.

[Sarcomas and mixed mesodermal tumors of the uterus]

Malignant mesodermal tumors of the uterus are an inhomogenous group of uterine malignancies with different pathogenesis, clinical presentation and prognosis. These rare tumors represent approximately 1 % of all uterine malignancies. The aggressive carcinosarcomas or mixed muellerian tumors are defined by mixed malignant epithelial and malignant mesodermal histopathology and are of the same precursor cell origin like endometrial cancer. Thus, carcinosarcomas were reclassified by the FIGO as an aggressive type of endometrial cancer and treated like type II endometrial cancer. Adenosarcomas are also mixed tumors with benign epithelial proliferation and malignant mesodermal cell growth, have a good prognosis and represent less than 5 % of all mesodermal uterine malignancies. Besides carcinosarcomas, the pure mesodermal leiomyosarcomas are the most common mesodermal malignancies. Patients with leiomyosarcamos are usually perimenopausal, and although more than half of the patients present with symptoms, diagnosis occurs incidentally in most cases in final histopathologic workup of an excised putative myoma or uterus. Adequate anamnesis, gynecologic examination and careful imaging by transvaginal ultrasound in the preoperative setting might hint to correct differential diagnosis in many cases. Overall the prognosis of uterine leiomyomas is poor. Malignancies of the endometrial stroma are very rare and divided in two subgroups, the mostly estrogen receptor positive endometrial stromal sarcoma, which occur preferably in premenopausal women and show a favorable prognosis, and the very aggressive undifferentiated endometrial sarcomas. The more rare undifferentiated endometrial sarcomas occur in postmenopausal women and most patients die in the first two years after diagnosis. Risk stratification of preoperative differential diagnosis requires improvements and the correct histopathologic workup of mesodermal uterine malignancies is still a challenge for pathologists.

Mother-Child Spiritual Discourse: A Mixed Methods Study

Parents and children, starting at very young ages, discuss religious and spiritual issues¿where we come from, what happens to us after we die, is there a God, and so on. Unfortunately, few studies have analyzed the content and structure of parent-child conversation about religion and spirituality (Boyatzis & Janicki, 2003; Dollahite & Thatcher, 2009), and most studies have relied on self-report with no direct observation. The current study examined mother-child (M-C) spiritual discourse to learn about its content, structure, and frequency through a survey inventory in combination with direct video observation using a novel structured task. We also analyzed how mothers¿ religiosity along several major dimensions related to their communication behaviors within both methods. Mothers (N = 39, M age = 40) of children aged 3-12 completed a survey packet on M-C spiritual discourse and standard measures of mothers¿ religious fundamentalism, intrinsic religiosity, sanctification of parenting (how much the mother saw herself as doing God¿s work as a parent), and a new measure of parental openness to children¿s spirituality. Then, in a structured task in our lab, mothers (N = 33) and children (M age = 7.33) watched a short film or read a short book that explored death in an age-appropriate manner and then engaged in a videotaped conversation about the movie or book and their religious or spiritual beliefs. Frequency of M-C spiritual discourse was positively related to mothers¿ religious fundamentalism (r = .71, p = .00), intrinsic religiosity (r = .77, p = .00), and sanctification of parenting (r = .79, p = .00), but, surprisingly, was inversely related to mothers¿ v openness to child¿s spirituality (r = -.52, p = .00). Survey data showed that the two most common topics discussed were God (once a week) and religion as it relates to moral issues (once a week). According to mothers their children¿s most common method of initiating spiritual discourse was to repeat what he or she has heard parents or family say about religious issues (M = 2.97; once a week); mothers¿ most common method was to describe their own religious/spiritual beliefs (M = 2.92). Spiritual discourse most commonly occurred either at bedtime or mealtime as reported by 26% of mothers, with the most common triggers reported as daily routine/random thoughts (once a week) and observations of nature (once a week). Mothers¿ most important goals for spiritual discourse were to let their children know that they love them (M = 3.72; very important) and to help them become a good and moral person (M = 3.67; very important). A regression model showed that significant variance in frequency of mother-child spiritual discourse (R2 = .84, p = .00) was predicted by the mothers¿ importance of goals during discourse (ß = 0.46, p = .00), frequency that the mother¿s spirituality was deepened through spiritual discourse (ß = 0.39, p = .00), and the mother¿s fundamentalism (ß = 0.20, p = .05). In a separate regression, the mother¿s comfort in the structured task (ß = 0.70, p = .00), and the number of open-ended questions she asked (ß = -0.26, p = .03) predicted the reciprocity between mother and child (R2 = .62, p = .00). In addition, the mother¿s age (ß = 0.22, p = .059) and comfort during the task (ß = 0.73, p = .00) predicted the child¿s engagement within the structured task. Other findings and theoretical and methodological implications will be discussed.

CHANGE FOR GOOD? AN ASSESSMENT OF THE DISCONNECT BETWEEN PERCEIVED BENEFITS BY ENGOS AND USER SATISFACTION OF SOLAR BOTTLE LIGHTS IN INFORMAL SETTLEMENTS OF DHAKA CITY, BANGLADESH

A major challenge for a developing country such as Bangladesh is to supply basic services to its most marginalized populations, which includes both rural and urban dwellers. The government struggles to provide basic necessities such as water and electricity. In marginalized urban communities in Bangladesh, in particular informal settlements, meeting basic needs is even direr. Most informal settlements are built to respond to a rapid immigration to urban centers, and are thought of as ‘temporary structures’, though many structures have been there for decades. In addition, as the settlements are often squatting on private land, access to formalized services such as electricity or water is largely absent. In some cases, electricity and water connections are brought in - but through informal and non-government sanctioned ways -- these hookups are deemed ‘illegal’ by the state. My research will focus on recent efforts to help ameliorate issues associated with lack of basic services in informal settlements in Bangladesh – in this case lack of light. When the government fails to meet the needs of the general population, different non-government organizations tend to step in to intervene. A new emphasis on solar bottle systems in informal urban settlement areas to help address some energy needs (specifically day-time lighting). One such example is the solar bottle light in Bangladesh, a project introduced by the organization ‘Change’. There has been mixed reactions on this technology among the users. This is where my research intervenes. I have used quantitative method to investigate user satisfactions for the solar bottle lights among the residents of the informal settlements to address the overarching question, is there a disconnect between the perceived benefits of the ENGO and the user satisfaction of the residents of the informal settlements of Dhaka City? This paper uses survey responses to investigate level of user satisfaction and the contributing factors.

Dual dispatch early defibrillation in out-of-hospital cardiac arrest in a mixed urban–rural population

Aims The effects of a system based on minimally trained first responders (FR) dispatched simultaneously with the emergency medical services (EMS) of the local hospital in a mixed urban and rural area in Northwestern Switzerland were examined. Methods and results In this prospective study 500 voluntary fire fighters received a 4-h training in basic-life-support using automated-external-defibrillation (AED). FR and EMS were simultaneously dispatched in a two-tier rescue system. During the years 2001–2008, response times, resuscitation interventions and outcomes were monitored. 1334 emergencies were included. The FR reached the patients (mean age 60.4 ± 19 years; 65% male) within 6 ± 3 min after emergency calls compared to 12 ± 5 min by the EMS (p < 0.0001). Seventy-six percent of the 297 OHCAs occurred at home. Only 3 emergencies with resuscitation attempts occurred at the main railway station equipped with an on-site AED. FR were on the scene before arrival of the EMS in 1166 (87.4%) cases. Of these, the FR used AED in 611 patients for monitoring or defibrillation. CPR was initiated by the FR in 164 (68.9% of 238 resuscitated patients). 124 patients were defibrillated, of whom 93 (75.0%) were defibrillated first by the FR. Eighteen patients (of whom 13 were defibrillated by the FR) were discharged from hospital in good neurological condition. Conclusions Minimally trained fire fighters integrated in an EMS as FR contributed substantially to an increase of the survival rate of OHCAs in a mixed urban and rural area.

Conditions promoting good multiprofessional collaboration practices in Swiss all-day schools

Multiprofessional collaboration in all-day schools refers to teamwork and coordination that takes place between professionals with different vocational backgrounds. In Switzerland, all-day schoolscomprise regular school instruction and school-based extracurricular activities. Nevertheless, multiprofessional collaboration can also refer to collaboration between education professionals in all-day schools and professionals outside the school in a community-based setting of extracurricular activities. A synthesis of the literature shows that collaboration inside and outside the school setting is promoted by conditions in three areas: structural characteristics of the institution, characteristics of the team, and interpersonal processes (Schüpbach, Jutzi & Thomann 2012). In view of these findings, it was the aim of this study to analyze conditions of good collaboration practices in all-day schools in Switzerland. This qualitative study examined 10 all-day schools in five different cantons in the German-speaking part of Switzerland that showed good collaboration practice. In the course of this study, we conducted 18 problem-centered interviews and 10 focus group discussions. In the process of data evaluation, we applied the method of qualitative content analy sis. The findings show that all of the three areas of conditions promoting good collaboration proved to be relevant in the whole sample of all-day schools. Nevertheless, for the three different types of collaboration found? The school- oriented, the mixed/in termediate, and the social environment-oriented type? We identified different conditions of good collaboration practice.