Ultra-fast processing of gigapixel Tissue MicroArray images using high performance computing.

BACKGROUND:
tissue MicroArrays (TMAs) are a valuable platform for tissue based translational research and the discovery of tissue biomarkers. The digitised TMA slides or TMA Virtual Slides, are ultra-large digital images, and can contain several hundred samples. The processing of such slides is time-consuming, bottlenecking a potentially high throughput platform.
METHODS:
a High Performance Computing (HPC) platform for the rapid analysis of TMA virtual slides is presented in this study. Using an HP high performance cluster and a centralised dynamic load balancing approach, the simultaneous analysis of multiple tissue-cores were established. This was evaluated on Non-Small Cell Lung Cancer TMAs for complex analysis of tissue pattern and immunohistochemical positivity.
RESULTS:
the automated processing of a single TMA virtual slide containing 230 patient samples can be significantly speeded up by a factor of circa 22, bringing the analysis time to one minute. Over 90 TMAs could also be analysed simultaneously, speeding up multiplex biomarker experiments enormously.
CONCLUSIONS:
the methodologies developed in this paper provide for the first time a genuine high throughput analysis platform for TMA biomarker discovery that will significantly enhance the reliability and speed for biomarker research. This will have widespread implications in translational tissue based research.

Lest we forget: Remembering the consequences of child neglect - A clarion call to "feisty advocates"

It is widely acknowledged that, across the United Kingdom and the USA, childcare practitioners often struggle with cases of child neglect, because of the difficulties involved in attempting to define the problem at hand, and balancing these cases with others in the caseload that may appear more pressing, such as physical abuse. Consequently, in an attempt to refocus the lens of professional policy and practice, this article will profile a number of research studies that have highlighted the profound developmental deficits that neglect can cause, relative to other forms of child maltreatment, and a range of interventions that have proven to be effective with these types of cases. The article concludes with a discussion of the potential negative impact of the current financial crisis for neglected children.

Current methods and advances in forecasting of wind power generation

Wind power generation differs from conventional thermal generation due to the stochastic nature of wind. Thus wind power forecasting plays a key role in dealing with the challenges of balancing supply and demand in any electricity system, given the uncertainty associated with the wind farm power output. Accurate wind power forecasting reduces the need for additional balancing energy and reserve power to integrate wind power. Wind power forecasting tools enable better dispatch, scheduling and unit commitment of thermal generators, hydro plant and energy storage plant and more competitive market trading as wind power ramps up and down on the grid. This paper presents an in-depth review of the current methods and advances in wind power forecasting and prediction. Firstly, numerical wind prediction methods from global to local scales, ensemble forecasting, upscaling and downscaling processes are discussed. Next the statistical and machine learning approach methods are detailed. Then the techniques used for benchmarking and uncertainty analysis of forecasts are overviewed, and the performance of various approaches over different forecast time horizons is examined. Finally, current research activities, challenges and potential future developments are appraised. (C) 2011 Elsevier Ltd. All rights reserved.

Methods in wind power prediction & forecasting

Globally on-shore wind power has seen considerable growth in all grid systems. In the coming decade off-shore wind power is also expected to expand rapidly. Wind power is variable and intermittent over various time scales because it is weather dependent. Therefore wind power integration into traditional grids needs additional power system and electricity market planning and management for system balancing. This extra system balancing means that there is additional system costs associated with wind power assimilation. Wind power forecasting and prediction methods are used by system operators to plan unit commitment, scheduling and dispatch and by electricity traders and wind farm owners to maximize profit. Accurate wind power forecasting and prediction has numerous challenges. This paper presents a study of the existing and possible future methods used in wind power forecasting and prediction for both on-shore and off-shore wind farms.

Addressing the technical and market challenges to high wind power integration in Ireland

Over the last decade there has been a rapid global increase in wind power stimulated by energy and climate policies. However, as wind power is inherently variable and stochastic over a range of time scales, additional system balancing is required to ensure system reliability and stability. This paper reviews the technical, policy and market challenges to achieving ambitious wind power penetration targets in Ireland’s All-Island Grid and examines a number of measures proposed to address these challenges. Current government policy in Ireland is to address these challenges with additional grid reinforcement, interconnection and open-cycle gas plant. More recently smart grid combined with demand side management and electric vehicles have also been presented as options to mitigate the variability of wind power. In addition, the transmission system operators have developed wind farm specific grid codes requiring improved turbine controls and wind power forecasting techniques.

Design and analysis of dual-rail circuits for security applications

Dual-rail encoding, return-to-spacer protocol, and hazard-free logic can be used to resist power analysis attacks by making energy consumed per clock cycle independent of processed data. Standard dual-rail logic uses a protocol with a single spacer, e.g., all-zeros, which gives rise to energy balancing problems. We address these problems by incorporating two spacers; the spacers alternate between adjacent clock cycles. This guarantees that all gates switch in every clock cycle regardless of the transmitted data values. To generate these dual-rail circuits, an automated tool has been developed. It is capable of converting synchronous netlists into dual-rail circuits and it is interfaced to industry CAD tools. Dual-rail and single-rail benchmarks based upon the advanced encryption standard (AES) have been simulated and compared in order to evaluate the method and the tool.

Government Laws, Regulations and Policies: Small Fish in a Big Pond

Global development has, in recent years, been shaped by the rise of transnational capital. This has implications for the quality and effectiveness of those national laws, regulations and policies in place to monitor transnational capital, ensure that multi national organisations assume responsibility and hold them accountable should they fail to do so. In balancing these objectives, contrasting issues come to the fore, such as the fear of capital flight; an issue especially profound in small open economies where the balance may tip in the favour of retaining, as opposed to regulating, foreign capital.
This paper can be considered in three parts. First, the paper addresses the shift in global leadership from national governments to multinational corporations (with particular reference to the rise of the Transnational Capitalist Class). This shift will incorporate the connotations of the Third Way. In considering this ideology, it will propose the Third Way as a transition phase to a stage when government is more the “third wheel” than an equal partner in governance structures. Second, the implications of the changing nature of governance on the capacity of nation states to develop effective laws, regulations and policies is discussed which leads on to the third aspect of the paper which identifies the challenges for governments, business and society in reimagining the governance structure pertaining to law, regulation and policy and the need to reconsider existing structures in light of global shifts in power structures.
A new leadership structure, both within the national and international governance system has far reaching implications. Boundary constraints no longer an issue, the potential for equality and global democracy is huge. Instead, a post recessionary world faces new governance challenges in the shape of; legitimacy; accountability and responsibility. Capitalism has invaded government and the primary challenge will be in avoiding the same issues that have dogged our financial markets for the last number of years. The challenge then to laws, regulations and public policy is huge, especially considering that the governments regulating are smaller than those dictating agenda on a global level

The influence of culture on home-based family caregiving at end-of-life: A case study of Dutch reformed family care givers in Ontario, Canada

Families are facing increased pressure to provide care to their terminally-ill or dying kin in the home. It is known that balancing care with other personal and social roles can adversely affect family caregivers' (FCGs) health, yet access to supportive services which can mitigate burden is often inadequate. Cultural factors are known to shape the experience of caregiving; however, most research to date tends to neglect the experiences of FCGs from different cultural groups. This understanding is necessary to ensure that supportive services are both meaningful and culturally-appropriate. Using qualitative methods, we undertook longitudinal research with a sample of Dutch Reformed FCGs (n = 5) to understand their experiences of caregiving and bereavement. The results of the study are suggestive of a cultural specificity with respect to caregiving that impacts both responsibilities and reactions to care. Three themes were salient to this group as a cultural entity: cultural attitudes towards care, religious beliefs and coping, and c. ulturally-informed care-seeking behaviours. These three themes were seen to be a function of their religious and ethnic identities and were reinforced by ties to the communities in which they resided. Cultural identity provided a framework through which to understand and make sense of the experience, while group membership provided access to networks of informal support. This research contributes to the geographical literature on care/caregiving by providing insight into the social, cultural and religious context of informal family caregiving with a population who live in close geographic proximity. On a practical level, this case study indicates the importance of considering how these factors may operate in other settings in order to implement timely and appropriate interventions to better support FCGs who are caring for their terminally-ill loved-ones at home.

A direct physiological trade-off between personal and social immunity

1. Recent work shows that organisms possess two strategies of immune response: personal immunity, which defends an individual, and social immunity, which protects other individuals, such as kin. However, it is unclear how individuals divide their limited resources between protecting themselves and protecting others.
2. Here, with experiments on female burying beetles, we challenged the personal immune system and measured subsequent investment in social immunity (antibacterial activity of the anal exudates).
3. Our results show that increased investment in one aspect of personal immunity (wound repair) causes a temporary decrease in one aspect of the social immune response.
4. Our experiments further show that by balancing investment in personal and social immunity in this way during one breeding attempt, females are able to defend their subsequent lifetime reproductive success.
5. We discuss the nature of the physiological trade-off between personal and social immunity in species that differ in the degree of eusociality and coloniality, and suggest that it may also vary within species in relation to age and partner contributions to social immunity.

New challenges faced by carers during their child's hospital admission under segregation

Introduction
This paper presents the results of a qualitative study of CF family carers at the Belfast Paediatric CF Centre. The aim of this study was to describe the carer experience of their child’s admission to hospital under segregated care arrangements, and to highlight the meaning of segregation and cross infection from the carer perspective.

Method
Carers of children with CF who were admitted for two week IV antibiotic treatment during the study period were eligible to participate in this qualitative study. A consecutive series of eligible carers were approached in order of admission and within the time constraints of KR who was present two days each week. Recruitment of carers ended when no new themes emerged. Ten carers, 9 mothers and 1 couple, were interviewed about their experiences (mean age of child: 11.8 years; range: 1-17 years). Interpretative Phenomenological Analysis (IPA) was used to analyse and interpret the interview data.

Results and discussion
Balancing demands and dilemmas was the main contextual theme or experience of being a carer of a child with CF, and particularly so during admission to hospital. Many decisions were required every day that resulted in ‘double binds’ comprising uncertainty and stress. Three secondary themes captured the essence of carers’ experiences specifically related to segregation: managing risk and uncertainty; the burden of admission; and getting through each day. These themes will be described with examples illustrating the challenges faced by carers during their child’s hospitalisation, and the impact of segregation upon carers.

Weaning from mechanical ventilation: a scoping review of qualitative studies

Background; Weaning from mechanical ventilation is influenced by patient, clinician, and organizational factors.

Objective: To identify factors that may influence weaning and adoption of weaning strategies and tools, clinicians’ perceptions of weaning strategies, and weaning experiences of patients and patients’ families.

Method: A scoping review of indexed and nonindexed publications (1990–2012) was done. Qualitative studies of health care providers, patients, and patients’ families involved in weaning were included. Two investigators independently screened 8350 publications and extracted data from 43 studies. Study themes were content analyzed to identify common categories and themes within the categories.

Results: The study sample consisted of nurses in 15 studies, nurses and patients in 1 study, various health care providers in 11, patients in 10, and physicians in 4. Categories identified were as follows: for nurses, role or scope of practice, informing decision making, and influence on weaning outcome; for health care providers, factors influencing weaning decisions or use of protocols, role or scope of practice related to weaning, and organizational structure or practice environment; for patients, experience of mechanical ventilation and weaning, experience of the intensive care environment, psychological phenomena, and enabling success in weaning; and for physicians, tools or factors to facilitate weaning decisions and perceptions of nurses’ role and scope of practice.

Conclusions: Important issues identified were perceived importance of interprofessional collaboration and communication, need to combine subjective knowledge of the patient with objective clinical data, balancing of weaning systematization with individual needs, and appreciation of the physical and psychological work of weaning.

Perceptions of the Nurse Practitioner Role in Facilitating the Implementation of an Onsite Pain Management Team in Long Term Care

Background: One strategy to improve pain management in long term care (LTC) is to optimize the emerging role of the nurse practitioner (NP) in LTC. The purpose of this sub study was to learn about the NP role in implementing an onsite, interdisciplinary Pain Team in the LTC home setting.

Methods: We used a case study design that included two NPs who worked at separate LTC homes. Each of the NPs completed a weekly questionnaire of pain-related activities that they engaged in over a one-year implementation period; and a diary, using critical reflection, about their experiences and strategies used to implement the Pain Team. Descriptive statistics and thematic content analysis were used to analyze the case study data.

Findings: NPs tended to be most engaged in pain assessment and collaborated more with licensed nurses and personal support workers; less with pharmacists. NPs were more involved in organizational level activities, such as participating in committee work or assisting with the development of policies and procedures about pain. NPs created palliative care and pain service protocols; engaged in policy development, in-servicing, quality assurance and advocacy; and encouraged best practices. NPs were challenged with time constraints for pain management and balancing other role priorities and felt that increased scope of practice for them was needed.

Conclusions: The results of this study highlight how NPs implemented a Pain Team in LTC which may be helpful to others interested in implementing a similar strategy to reduce residents’ pain.

Comfort Care Rounds: A Staff Capacity-Building Initiative in Long-Term Care Homes

This article reports a pilot evaluation of Comfort Care Rounds (CCRs)-a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation.

A Smart Grid Information System for Demand Side Participation: Remote Control of Domestic Appliances to Balance Demand

Due to the intermittent nature of renewable generation it is desirable to consider the potential of controlling the demand-side load to smooth overall system demand. The architecture and control methodologies of such a system on a large scale would require careful consideration. Some of these considerations are discussed in this paper; such as communications infrastructure, systems architecture, control methodologies and security. A domestic fridge is used in this paper as an example of a controllable appliance. A layered approach to smart-grid is introduced and it can be observed how each smart-grid component from physical cables, to the end-devices (or smart-applications) can be mapped to these set layers. It is clear how security plays an integral part in each component of the smart-grid so this is also an integral part of each layer. The controllable fridge is described in detail and as one potential smart-grid application which maps to the layered approach. A demonstration system is presented which involves a Raspberry Pi (a low-power, low-cost device representing the appliance controller).

A long-term analysis of pumped hydro storage to firm wind power

Although pumped hydro storage is seen as a strategic key asset by grid operators, financing it is complicated in new liberalised markets. It could be argued that the optimum generation portfolio is now determined by the economic viability of generators based on a short to medium term return on investment. This has meant that capital intensive projects such as pumped hydro storage are less attractive for wholesale electricity companies because the payback periods are too long. In tandem a significant amount of wind power has entered the generation mix, which has resulted in operating and planning integration issues due to wind's inherent uncertain, varying spatial and temporal nature. These integration issues can be overcome using fast acting gas peaking plant or energy storage. Most analysis of wind power integration using storage to date has used stochastic optimisation for power system balancing or arbitrage modelling to examine techno-economic viability. In this research a deterministic dynamic programming long term generation expansion model is employed to optimise the generation mix, total system costs and total carbon dioxide emissions, and unlike other studies calculates reserve to firm wind power. The key finding of this study is that the incentive to build capital-intensive pumped hydro storage to firm wind power is limited unless exogenous market costs come very strongly into play. Furthermore it was demonstrated that reserve increases with increasing wind power showing the importance of ancillary services in future power systems. © 2014 Elsevier Ltd. All rights reserved.