What does “futility” mean? An empirical study of doctors’ perceptions

Objective(s) To describe how doctors define and use the terms “futility” and “futile treatment” in end-of-life care. Design, Setting, Participants A qualitative study using semi-structured interviews with 96 doctors across a range of specialties who treat adults at the end of life. Doctors were recruited from three large Australian teaching hospitals and were interviewed from May to July 2013. Results Doctors’ conceptions of futility focused on the quality and chance of patient benefit. Aspects of benefit included physiological effect, weighing benefits and burdens, and quantity and quality of life. Quality and length of life were linked, but many doctors discussed instances when benefit was determined by quality of life alone. Most doctors described the assessment of chance of success in achieving patient benefit as a subjective exercise. Despite a broad conceptual consensus about what futility means, doctors noted variability in how the concept was applied in clinical decision-making. Over half the doctors also identified treatment that is futile but nevertheless justified, such as short-term treatment as part of supporting the family of a dying person. Conclusions There is an overwhelming preference for a qualitative approach to assessing futility, which brings with it variation in clinical decision-making. “Patient benefit” is at the heart of doctors’ definitions of futility. Determining patient benefit requires discussions with patients and families about their values and goals as well as the burdens and benefits of further treatment.

Length-independent voltage fluctuations in small conductors

The mean-squared voltage fluctuation of a disordered conductor of lengthL smaller than the phase coherence lengthL ϕ, is independent of the distance between the probes. We obtain this result using the voltage additivity and the known results for the conductance fluctuation. Our results complement the recent theoretical and experimental findings.

Probing potential energy surfaces in confined systems: behavior of mean-square displacement in zeolites

Time evolution of mean-squared displacement based on molecular dynamics for a variety of adsorbate-zeolite systems is reported. Transition from ballistic to diffusive behavior is observed for all the systems. The transition times are found to be system dependent and show different types of dependence on temperature. Model calculations on a one-dimensional system are carried out which show that the characteristic length and transition times are dependent on the distance between the barriers, their heights, and temperature. In light of these findings, it is shown that it is possible to obtain valuable information about the average potential energy surface sampled under specific external conditions.

Mean and fluctuating pressure in boat-tail separated flows at transonic speeds

Experiments were carried out investigating the features of mean and unsteady surface pressure fluctuations in boat-tail separated flows relevant to launch vehicle configurations at transonic speeds. The tests were performed on a generic axisymmetric body in the Mach-number range of 0.7-1.2, and the important geometrical parameters, namely, the boat-tail angle and diameter ratio, were varied systematically. The measurements made included primarily the mean and unsteady surface-pressure fluctuations on nine different model configurations. Flow-visualization studies employing a surface oil flow, and schlieren techniques were carried out to infer features like boundary-layer separation, reattachment, and shock waves in the flow. The features of mean and fluctuating surface pressures are discussed in detail including aspects of similarity. It has been observed that, on a generic configuration employed in the present study, the maximum levels of surface-pressure fluctuations in the reattachment zone are appreciably lower than those found on launch vehicle configurations having a bulbous or hammerhead nose shape. A simple correlation is suggested for the maximum value of rms pressure fluctuations in the reattachment zone at different freestream Mach numbers.

Axially homogeneous, zero mean flow buoyancy-driven turbulence in a vertical pipe

We report an experimental study of a new type of turbulent flow that is driven purely by buoyancy. The flow is due to an unstable density difference, created using brine and water, across the ends of a long (length/diameter=9) vertical pipe. The Schmidt number Sc is 670, and the Rayleigh number (Ra) based on the density gradient and diameter is about 108. Under these conditions the convection is turbulent, and the time-averaged velocity at any point is ‘zero’. The Reynolds number based on the Taylor microscale, Reλ, is about 65. The pipe is long enough for there to be an axially homogeneous region, with a linear density gradient, about 6–7 diameters long in the midlength of the pipe. In the absence of a mean flow and, therefore, mean shear, turbulence is sustained just by buoyancy. The flow can be thus considered to be an axially homogeneous turbulent natural convection driven by a constant (unstable) density gradient. We characterize the flow using flow visualization and particle image velocimetry (PIV). Measurements show that the mean velocities and the Reynolds shear stresses are zero across the cross-section; the root mean squared (r.m.s.) of the vertical velocity is larger than those of the lateral velocities (by about one and half times at the pipe axis). We identify some features of the turbulent flow using velocity correlation maps and the probability density functions of velocities and velocity differences. The flow away from the wall, affected mainly by buoyancy, consists of vertically moving fluid masses continually colliding and interacting, while the flow near the wall appears similar to that in wall-bound shear-free turbulence. The turbulence is anisotropic, with the anisotropy increasing to large values as the wall is approached. A mixing length model with the diameter of the pipe as the length scale predicts well the scalings for velocity fluctuations and the flux. This model implies that the Nusselt number would scale as Ra1/2Sc1/2, and the Reynolds number would scale as Ra1/2Sc−1/2. The velocity and the flux measurements appear to be consistent with the Ra1/2 scaling, although it must be pointed out that the Rayleigh number range was less than 10. The Schmidt number was not varied to check the Sc scaling. The fluxes and the Reynolds numbers obtained in the present configuration are much higher compared to what would be obtained in Rayleigh–Bénard (R–B) convection for similar density differences.

Length of near-wall plumes in turbulent convection

We present planforms of line plumes formed on horizontal surfaces in turbulent convection, along with the length of line plumes measured from these planforms, in a six decade range of Rayleigh numbers (10(5) < Ra < 10(11)) and at three Prandtl numbers (Pr = 0.7, 5.2, 602). Using geometric constraints on the relations for the mean plume spacings, we obtain expressions for the total length of near-wall plumes on horizontal surfaces in turbulent convection. The plume length per unit area (L(p)/A), made dimensionless by the near-wall length scale in turbulent convection (Z(w)), remains constant for a given fluid. The Nusselt number is shown to be directly proportional to L(p)H/A for a given fluid layer of height H. The increase in Pr has a weak influence in decreasing L(p)/A. These expressions match the measurements, thereby showing that the assumption of laminar natural convection boundary layers in turbulent convection is consistent with the observed total length of line plumes. We then show that similar relationships are obtained based on the assumption that the line plumes are the outcome of the instability of laminar natural convection boundary layers on the horizontal surfaces.

On the mechanism and the length scales involved in the ductile fracture of a bulk metallic glass

Some bulk metallic glasses (BMGs) exhibit high crack initiation toughness due to shear band mediated plastic flow at the crack tip and yet do not display additional resistance to crack growth due to the lack of a microstructure. Thus, at crack initiation, the fracture behavior of BMGs transits from that of ductile alloys to that of brittle ceramics. In this paper, we attempt to understand the physics behind the characteristic length from the notch root at which this transition occurs, through testing of four-point bend specimens made of a nominally ductile Zr-based BMG in three different structural states. In the as-cast state, both symmetric (mode I) and asymmetric (mixed mode) bend specimens are tested. The process of shear band mediated plastic flow followed by crack initiation at the notch root was monitored through in situ imaging. Results show that stable crack growth occurs inside a dominant shear band through a distance of, similar to 60 mu m, irrespective of the structural state and mode mixity, before attaining criticality. Detailed finite element simulations show that this length corresponds to the distance from the notch root over which a positive hydrostatic stress gradient prevails. The mean ridge heights on fractured surfaces are found to correlate with the toughness of the BMG. The Argon and Salama model, which is based on the meniscus instability phenomenon at the notch root, is modified to explain the experimentally observed physics of fracture in ductile BMGs. (C) 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Length scales in glass-forming liquids and related systems: a review

The central problem in the study of glass-forming liquids and other glassy systems is the understanding of the complex structural relaxation and rapid growth of relaxation times seen on approaching the glass transition. A central conceptual question is whether one can identify one or more growing length scale(s) associated with this behavior. Given the diversity of molecular glass-formers and a vast body of experimental, computational and theoretical work addressing glassy behavior, a number of ideas and observations pertaining to growing length scales have been presented over the past few decades, but there is as yet no consensus view on this question. In this review, we will summarize the salient results and the state of our understanding of length scales associated with dynamical slow down. After a review of slow dynamics and the glass transition, pertinent theories of the glass transition will be summarized and a survey of ideas relating to length scales in glassy systems will be presented. A number of studies have focused on the emergence of preferred packing arrangements and discussed their role in glassy dynamics. More recently, a central object of attention has been the study of spatially correlated, heterogeneous dynamics and the associated length scale, studied in computer simulations and theoretical analysis such as inhomogeneous mode coupling theory. A number of static length scales have been proposed and studied recently, such as the mosaic length scale discussed in the random first-order transition theory and the related point-to-set correlation length. We will discuss these, elaborating on key results, along with a critical appraisal of the state of the art. Finally we will discuss length scales in driven soft matter, granular fluids and amorphous solids, and give a brief description of length scales in aging systems. Possible relations of these length scales with those in glass-forming liquids will be discussed.

Electrothermal stress in conductive body with collinear cracks

The temperature and stress field in a thin plate with collinear cracks interrupting an electric current field are determined. This is accomplished by using a complex function method that allows a direct means of finding the distribution of the electric current, the temperature and stress field. Temperature dependency for the heat-transfer coefficient, coefficient of linear expansion and the elastic modulus are considered. As an example, temperature distribution is calculated for an alloy (No. GH2132) plate with two collinear cracks under high temperature. Relationships between the stress, temperature, electric density and crack length are obtained. Crack trajectories emanating from existing crack are predicted by application of the strain energy density criterion which can also be used for finding the load carrying capacity of the cracked plate. (C) 2003 Elsevier Ltd. All rights reserved.

Some aspects of the ecology of the leatherback turtle Dermochelys coriacea at Laguna Jalova, Costa Rica

The ecology and reproductive biology of the leatherback turtle (Dennochelys coriacea) was studied on a high-energy nesting beach near Laguna Jalova, Costa Rica, between 28 March and 8 June 1985. The peak of nesting was between 15 April and 21 May. Leatherbacks here measured an average 146.6 cm straightline standard carapace length and laid an average 81.57 eggs. The eggs measured a mean 52.12 mm diameter and weighed an average of 85.01 g. Significant positive relationships were found between the carapace lengths of nesters and their clutch sizes and average diameter and weight of eggs. The total clutch weighed between 4.02 and 13.39 kg, and yolkless eggs accounted for an average 12.4% of this weight. The majority of nesters dug shallow (<24 cm) body pits and spent an average 81 minutes at the nest site. A significant number of c1utcbes were laid below the berm crest. In a hatchery 42.2% of the eggs hatched, while in natural nests 70.2% hatched. The average hatchling carapace length was 59.8 mm and weight was 44.6 g. The longevity of leatherback tracks and nests on the beach was affected by weather. One nester was recaptured about one year later off the coast of Mississippi, U.S.A. Egg poaching was intense on some sections of the Costa Rican coast. Four aerial surveys in four different months provided the basis for comparing density of nesting on seven sectors of the Caribbean coast of Costa Rica. The beach at Jalova is heavily used by green turtles (Chelonia mydJJs) after the leatherback nesting season. The role of the Parque Nacional Tortuguero in conserving the leatherback and green turtle is discussed.(PDF file contains 20 pages.)

Studies on the biology of Gymnarchus niloticus in Lake Chad: Age determination and growth; meristic and morphometric characters

The meristic and morphometric characteristics of Gymnarchus niloticus are described and linear equations relating various parts of the body to the head length or total length are given. The age of G. niloticus in Lake Chad (Nigeria) was determined from growth marks on the opercular bones. The mean lengths for age, and mean weights for age obtained for the first five years of life are given. The assymptotic length and the von Betarlanffy growth parameters for the males and females combined are given

An evaluation of length-frequency sampling procedures and subsequent data analysis for purse seine-caught yellowfin tuna in the Eastern Pacific Ocean

ENGLISH: A two-stage sampling design is used to estimate the variances of the numbers of yellowfin in different age groups caught in the eastern Pacific Ocean. For purse seiners, the primary sampling unit (n) is a brine well containing fish from a month-area stratum; the number of fish lengths (m) measured from each well are the secondary units. The fish cannot be selected at random from the wells because of practical limitations. The effects of different sampling methods and other factors on the reliability and precision of statistics derived from the length-frequency data were therefore examined. Modifications are recommended where necessary. Lengths of fish measured during the unloading of six test wells revealed two forms of inherent size stratification: 1) short-term disruptions of existing pattern of sizes, and 2) transition zones between long-term trends in sizes. To some degree, all wells exhibited cyclic changes in mean size and variance during unloading. In half of the wells, it was observed that size selection by the unloaders induced a change in mean size. As a result of stratification, the sequence of sizes removed from all wells was non-random, regardless of whether a well contained fish from a single set or from more than one set. The number of modal sizes in a well was not related to the number of sets. In an additional well composed of fish from several sets, an experiment on vertical mixing indicated that a representative sample of the contents may be restricted to the bottom half of the well. The contents of the test wells were used to generate 25 simulated wells and to compare the results of three sampling methods applied to them. The methods were: (1) random sampling (also used as a standard), (2) protracted sampling, in which the selection process was extended over a large portion of a well, and (3) measuring fish consecutively during removal from the well. Repeated sampling by each method and different combinations indicated that, because the principal source of size variation occurred among primary units, increasing n was the most effective way to reduce the variance estimates of both the age-group sizes and the total number of fish in the landings. Protracted sampling largely circumvented the effects of size stratification, and its performance was essentially comparable to that of random sampling. Sampling by this method is recommended. Consecutive-fish sampling produced more biased estimates with greater variances. Analysis of the 1988 length-frequency samples indicated that, for age groups that appear most frequently in the catch, a minimum sampling frequency of one primary unit in six for each month-area stratum would reduce the coefficients of variation (CV) of their size estimates to approximately 10 percent or less. Additional stratification of samples by set type, rather than month-area alone, further reduced the CV's of scarce age groups, such as the recruits, and potentially improved their accuracy. The CV's of recruitment estimates for completely-fished cohorts during the 198184 period were in the vicinity of 3 to 8 percent. Recruitment estimates and their variances were also relatively insensitive to changes in the individual quarterly catches and variances, respectively, of which they were composed. SPANISH: Se usa un diseño de muestreo de dos etapas para estimar las varianzas de los números de aletas amari11as en distintos grupos de edad capturados en el Océano Pacifico oriental. Para barcos cerqueros, la unidad primaria de muestreo (n) es una bodega de salmuera que contenía peces de un estrato de mes-área; el numero de ta11as de peces (m) medidas de cada bodega es la unidad secundaria. Limitaciones de carácter practico impiden la selección aleatoria de peces de las bodegas. Por 10 tanto, fueron examinados los efectos de distintos métodos de muestreo y otros factores sobre la confiabilidad y precisión de las estadísticas derivadas de los datos de frecuencia de ta11a. Se recomiendan modificaciones donde sean necesarias. Las ta11as de peces medidas durante la descarga de seis bodegas de prueba revelaron dos formas de estratificación inherente por ta11a: 1) perturbaciones a corto plazo en la pauta de ta11as existente, y 2) zonas de transición entre las tendencias a largo plazo en las ta11as. En cierto grado, todas las bodegas mostraron cambios cíclicos en ta11a media y varianza durante la descarga. En la mitad de las bodegas, se observo que selección por ta11a por los descargadores indujo un cambio en la ta11a media. Como resultado de la estratificación, la secuencia de ta11as sacadas de todas las bodegas no fue aleatoria, sin considerar si una bodega contenía peces de un solo lance 0 de mas de uno. El numero de ta11as modales en una bodega no estaba relacionado al numero de lances. En una bodega adicional compuesta de peces de varios lances, un experimento de mezcla vertical indico que una muestra representativa del contenido podría estar limitada a la mitad inferior de la bodega. Se uso el contenido de las bodegas de prueba para generar 25 bodegas simuladas y comparar los resultados de tres métodos de muestreo aplicados a estas. Los métodos fueron: (1) muestreo aleatorio (usado también como norma), (2) muestreo extendido, en el cual el proceso de selección fue extendido sobre una porción grande de una bodega, y (3) medición consecutiva de peces durante la descarga de la bodega. EI muestreo repetido con cada método y distintas combinaciones de n y m indico que, puesto que la fuente principal de variación de ta11a ocurría entre las unidades primarias, aumentar n fue la manera mas eficaz de reducir las estimaciones de la varianza de las ta11as de los grupos de edad y el numero total de peces en los desembarcos. El muestreo extendido evito mayormente los efectos de la estratificación por ta11a, y su desempeño fue esencialmente comparable a aquel del muestreo aleatorio. Se recomienda muestrear con este método. El muestreo de peces consecutivos produjo estimaciones mas sesgadas con mayores varianzas. Un análisis de las muestras de frecuencia de ta11a de 1988 indico que, para los grupos de edad que aparecen con mayor frecuencia en la captura, una frecuencia de muestreo minima de una unidad primaria de cada seis para cada estrato de mes-área reduciría los coeficientes de variación (CV) de las estimaciones de ta11a correspondientes a aproximadamente 10% 0 menos. Una estratificación adicional de las muestras por tipo de lance, y no solamente mes-área, redujo aun mas los CV de los grupos de edad escasos, tales como los reclutas, y mejoró potencialmente su precisión. Los CV de las estimaciones del reclutamiento para las cohortes completamente pescadas durante 1981-1984 fueron alrededor de 3-8%. Las estimaciones del reclutamiento y sus varianzas fueron también relativamente insensibles a cambios en las capturas de trimestres individuales y las varianzas, respectivamente, de las cuales fueron derivadas. (PDF contains 70 pages)

Sexual maturity, fecundity and egg size of wild and cultured samples of Bagrus bayad macropterus

Twenty four matured samples of Bagrus bayad macropterus from the wild (Shiroro Lake, Nigeria) and under captivity, size ranging from 412.69-3300.00 g total body weight, were analysed for sexual maturity,fecundity and egg size. The average fecundity obtained were 53352.59 and 21028.32 eggs for the wild and cultured fish respectively.Positive relationship was observed between fecundity, body size and gonad weight. Fecundity increased as body size increased. A more positive and linear relationship was observed between fecundity and gonad weight than fecundity and total body weight. Egg diameter,length and weight were determined from the egg samples. The mean size range of eggs for cultured fish was 0.74-1.05 mm of diameter; 1.01-1.20 mm of length and 0.25-0.40 mg of weight. Wild samples had mean size range of 0.68-l.09 mm of diameter, 0.85-1.38 mm of length and egg mean weight range was 0.15- 0.40 mg. Sexual maturity is dependent on size (1 kg and above). The egg diameter, egg length and weight bear no relationship with each other. Gonad development study indicated that gonad development was faster under captivity than in wild

Length weight relationship, condition factors and fecundity of Chrysichthys nigrodigitatus and Chrysichthys walkeri in Asejire Lake

Sex ratio and fecundity variations of Chrysichthys nigrodigitatus and Chrysichthys walkeri from Asejire Lake (Nigeria) were examined. The Logarithm transformation of weight (W) against standard length (SL) gave a straight-line graph represented by the following equations: 1) C. nigrodigitatus LogW =-0.66 + 2.13 Log SL; = 0.854; (P < 0.001) n = 209; 2) C. walkeri LogW = -1.23 + 2.63 Log SL; = 0.759; (P < 0.001) n = 237. Males were generally more than females in both species. The ratio of males:females was higher in C. nigrodigitatus (1:0.18) than in C. walkeri (1:0.8). C. walkeri attained sexual maturity at a smaller size of 20.0 g (12.0 cm Standard Length) compared with C. nigrodigitatus maturity size of 45.0 g (14.0 cm Standard Length). Relative fecundity was not dependent on body weight and standard length for C. walkeri but it was significant at P < 0.05 and P < 0.01 respectively for C. nigrodigitatus

Absolute measurement of roughness and lateral-correlation length of random surfaces by use of the simplified model of image-speckle contrast

We present a method of image-speckle contrast for the nonprecalibration measurement of the root-mean-square roughness and the lateral-correlation length of random surfaces with Gaussian correlation. We use the simplified model of the speckle fields produced by the weak scattering object in the theoretical analysis. The explicit mathematical relation shows that the saturation value of the image-speckle contrast at a large aperture radius determines the roughness, while the variation of the contrast with the aperture radius determines the lateral-correlation length. In the experimental performance, we specially fabricate the random surface samples with Gaussian correlation. The square of the image-speckle contrast is measured versus the radius of the aperture in the 4f system, and the roughness and the lateral-correlation length are extracted by fitting the theoretical result to the experimental data. Comparison of the measurement with that by an atomic force microscope shows our method has a satisfying accuracy. (C) 2002 Optical Society of America.