Palliative care team visits. Qualitative study through participant observation

Objectives: To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants. Methods: A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room) were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed. Results: The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients\' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources. Conclusion: Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

Interoperable Resource Brokering with Policy-based Provisioning and Job Allocation

The increasing needs for computational power in areas such as weather simulation, genomics or Internet applications have led to sharing of geographically distributed and heterogeneous resources from commercial data centers and scientific institutions. Research in the areas of utility, grid and cloud computing, together with improvements in network and hardware virtualization has resulted in methods to locate and use resources to rapidly provision virtual environments in a flexible manner, while lowering costs for consumers and providers. However, there is still a lack of methodologies to enable efficient and seamless sharing of resources among institutions. In this work, we concentrate in the problem of executing parallel scientific applications across distributed resources belonging to separate organizations. Our approach can be divided in three main points. First, we define and implement an interoperable grid protocol to distribute job workloads among partners with different middleware and execution resources. Second, we research and implement different policies for virtual resource provisioning and job-to-resource allocation, taking advantage of their cooperation to improve execution cost and performance. Third, we explore the consequences of on-demand provisioning and allocation in the problem of site-selection for the execution of parallel workloads, and propose new strategies to reduce job slowdown and overall cost.

Bionano Electronics: Magneto-Electric Nanoparticles for Drug Delivery, Brain Stimulation and Imaging Applications

Nanoparticles are often considered as efficient drug delivery vehicles for precisely dispensing the therapeutic payloads specifically to the diseased sites in the patient’s body, thereby minimizing the toxic side effects of the payloads on the healthy tissue. However, the fundamental physics that underlies the nanoparticles’ intrinsic interaction with the surrounding cells is inadequately elucidated. The ability of the nanoparticles to precisely control the release of its payloads externally (on-demand) without depending on the physiological conditions of the target sites has the potential to enable patient- and disease-specific nanomedicine, also known as Personalized NanoMedicine (PNM). In this dissertation, magneto-electric nanoparticles (MENs) were utilized for the first time to enable important functions, such as (i) field-controlled high-efficacy dissipation-free targeted drug delivery system and on-demand release at the sub-cellular level, (ii) non-invasive energy-efficient stimulation of deep brain tissue at body temperature, and (iii) a high-sensitivity contrasting agent to map the neuronal activity in the brain non-invasively. First, this dissertation specifically focuses on using MENs as energy-efficient and dissipation-free field-controlled nano-vehicle for targeted delivery and on-demand release of a anti-cancer Paclitaxel (Taxol) drug and a anti-HIV AZT 5’-triphosphate (AZTTP) drug from 30-nm MENs (CoFe2O4-BaTiO3) by applying low-energy DC and low-frequency (below 1000 Hz) AC fields to separate the functions of delivery and release, respectively. Second, this dissertation focuses on the use of MENs to non-invasively stimulate the deep brain neuronal activity via application of a low energy and low frequency external magnetic field to activate intrinsic electric dipoles at the cellular level through numerical simulations. Third, this dissertation describes the use of MENs to track the neuronal activities in the brain (non-invasively) using a magnetic resonance and a magnetic nanoparticle imaging by monitoring the changes in the magnetization of the MENs surrounding the neuronal tissue under different states. The potential therapeutic and diagnostic impact of this innovative and novel study is highly significant not only in HIV-AIDS, Cancer, Parkinson’s and Alzheimer’s disease but also in many CNS and other diseases, where the ability to remotely control targeted drug delivery/release, and diagnostics is the key.

Geospatial Data Indexing Analysis and Visualization via Web Services with Autonomic Resource Management

With the exponential growth of the usage of web-based map services, the web GIS application has become more and more popular. Spatial data index, search, analysis, visualization and the resource management of such services are becoming increasingly important to deliver user-desired Quality of Service. First, spatial indexing is typically time-consuming and is not available to end-users. To address this, we introduce TerraFly sksOpen, an open-sourced an Online Indexing and Querying System for Big Geospatial Data. Integrated with the TerraFly Geospatial database [1-9], sksOpen is an efficient indexing and query engine for processing Top-k Spatial Boolean Queries. Further, we provide ergonomic visualization of query results on interactive maps to facilitate the user’s data analysis. Second, due to the highly complex and dynamic nature of GIS systems, it is quite challenging for the end users to quickly understand and analyze the spatial data, and to efficiently share their own data and analysis results with others. Built on the TerraFly Geo spatial database, TerraFly GeoCloud is an extra layer running upon the TerraFly map and can efficiently support many different visualization functions and spatial data analysis models. Furthermore, users can create unique URLs to visualize and share the analysis results. TerraFly GeoCloud also enables the MapQL technology to customize map visualization using SQL-like statements [10]. Third, map systems often serve dynamic web workloads and involve multiple CPU and I/O intensive tiers, which make it challenging to meet the response time targets of map requests while using the resources efficiently. Virtualization facilitates the deployment of web map services and improves their resource utilization through encapsulation and consolidation. Autonomic resource management allows resources to be automatically provisioned to a map service and its internal tiers on demand. v-TerraFly are techniques to predict the demand of map workloads online and optimize resource allocations, considering both response time and data freshness as the QoS target. The proposed v-TerraFly system is prototyped on TerraFly, a production web map service, and evaluated using real TerraFly workloads. The results show that v-TerraFly can accurately predict the workload demands: 18.91% more accurate; and efficiently allocate resources to meet the QoS target: improves the QoS by 26.19% and saves resource usages by 20.83% compared to traditional peak load-based resource allocation.

The Academic-enterprise experiences framework as a guide for design education

The establishment of support platforms for the development of a new culture in design education, in order to achieve both research exploitation and its results, as an approach to the industrial community, challenges higher education institutions to rethink their functioning, divided between investigation on their own initiative or on demand, and its usefulness / practical application. At the same time, through design education, how can they be the engine that aggregates all these frequently antagonistic interests? Polytechnic institutes are predisposed to collaboration and interdisciplinarity. In our course of Technology and Design of Furniture, the availability of a production unit, testing laboratories, and expertise in engineering, design and marketing, encourage the development of a holistic project. In order to develop such knowledge, we adapt three important ways of thinking in designing interactions influenced by the traditional approach, namely, 1) identifying and understanding a design problem, i.e. a market need, 2) defining the design process and knowing what can be used for design education, i.e. opportunities for design education, and 3) sustainability of this framework and design projects' alignment with education in the same field. We explain our approach by arguing from the academicenterprise experiences perspective. This concept is proposed as a way to achieve those three ways of thinking in design education. Then, a set of interaction attributes is defined to explain how engineering and product design education can enhance meaningful relations with manufacturers, stakeholders and society in general. A final discussion is presented with the implications and benefits of this approach. The results suggest that through academic-enterprise partnerships in design, several goals such as students' motivation, product design innovation and potential for knowledge transfer to industries can be achieved.

Reaction Mechanisms Booster (Self-assessment resources)

This is a set of resources aimed at promoting the development of the skills required to successfully identify and generate organic mechanisms in order to demonstrate a good understanding of the underlying chemical principles. Students complete a task independently, and then mark their own work as they watch talking mark scheme videos where an expert explains how to get to the correct answers. Our research has shown that engagement with these resources is perceived to be highly beneficial by students, and leads to an increase in their confidence to tackle mechanistic problems. If you are a non-UK (or non-A-level) teacher, the terms AS and A2 may be meaningless to you, but the resources should still be useful for anyone studying organic reaction mechanisms. The worksheets are available in Word format, and you should feel free to edit these to meet the needs of your students and the course you are teaching. You can download the files individually by selecting them on the left and clicking download. Please watch the short briefing video on You Tube and read the teachers' notes carefully. Contact me on d.read@soton.ac.uk if you have and questions or comments. Additionally, I would like to thank Henry Pearson for suggesting the format of the alternative self-assessment proformas which you may choose to use with your students.

SC revenue ruling #16-3

Restaurants in South Carolina have begun utilizing electronic tablet table top ordering and bill payment devices. The purpose and intended use of these devices is to streamline the ordering and bill payment processes by allowing restaurant patrons the ability to order food and beverages through a mobile menu and to pay for meals on demand. This advisory opinion reflects the Department’s official position regarding electronic “table top ordering devices” used by restaurants.

Revêtement intelligent à base des silices mésoporeuses fonctionnalisées pour le relargage stimulé d’agents antimicrobiens

Les biofilms bactériens sont composés d’organismes unicellulaires vivants au sein d’une matrice protectrice, formée de macromolécules naturelles. Des biofilms non désirés peuvent avoir un certain nombre de conséquences néfastes, par exemple la diminution du transfert de chaleur dans les échangeurs de chaleurs, l’obstruction de membranes poreuses, la contamination des surfaces coques de navires, etc. Par ailleurs, les bactéries pathogènes qui prolifèrent dans un biofilm posent également un danger pour la santé s’ils croissent sur des surfaces médicales synthétiques comme des implants biomédicaux, cathéters ou des lentilles de vue. De plus, la croissance sur le tissu naturel par certaines souches des bactéries peut être fatale, comme Pseudomonas aeruginosa dans les poumons. Cependant, la présence de biofilms reste difficile à traiter, car les bactéries sont protégées par une matrice extracellulaire. Pour tenter de remédier à ces problèmes, nous proposons de développer une surface antisalissure (antifouling) qui libère sur demande des agents antimicrobiens. La proximité et la disposition du système de relargage placé sous le biofilm, assureront une utilisation plus efficace des molécules antimicrobiennes et minimiseront les effets secondaires de ces dernières. Pour ce faire, nous envisageons l’utilisation d’une couche de particules de silice mésoporeuses comme agents de livraison d’agents antimicrobiens. Les nanoparticules de silice mésoporeuses (MSNs) ont démontré un fort potentiel pour la livraison ciblée d’agents thérapeutiques et bioactifs. Leur utilisation en nano médecine découle de leurs propriétés de porosité intéressantes, de la taille et de la forme ajustable de ces particules, de la chimie de leur surface et leur biocompatibilité. Ces propriétés offrent une flexibilité pour diverses applications. De plus, il est possible de les charger avec différentes molécules ou biomolécules (de tailles variées, allant de l’ibuprofène à l’ARN) et d’exercer un contrôle précis des paramètres d’adsorption et des cinétiques de relargage (désorption). Mots Clés : biofilms, nanoparticules de silice mésoporeuses, microfluidique, surface antisalissure.

Evaluación de costo efectividad de la profilaxis versus tratamiento a demanda en pacientes con Hemofilia A moderada y severa para prevenir sangrado articular de una aseguradora en Colombia

Introducción: En Colombia existe un protocolo de manejo para pacientes con hemofilia A severa sin inhibidores que recomienda el manejo de profilaxis primaria y secundaria con FVIII. Objetivos: Estimar la relación incremental de costo-efectividad (RICE) de la profilaxis con Factor VIII vs tratamiento a demanda para prevenir sangrados articulares en pacientes con hemofilia A moderada y severa de una aseguradora en Colombia. Materiales y Métodos: Se adaptó un modelo de Markov desde la perspectiva del tercer pagador. Las probabilidades de transición se ajustaron mediante un modelo de regresión logística multinomial explicadas por la edad y el peso. Las tasas de eventos son anuales. Las efectividades se extrajeron de la cohorte de la aseguradora y de la literatura. Los costos incluyeron el FVIII, medicamentos, hospitalización, procedimientos quirúrgicos, apoyo diagnóstico y consultas médicas. La tasa de descuento fue del 3%. Resultados: En pacientes con hemofilia A moderada y severa la profilaxis con FVIII evitará en promedio 7 sangrados articulares, el RICE para el sangrado articular es de $303.457. Conclusiones: La profilaxis con Factor VIII es una estrategia costo-efectiva en el manejo de pacientes con hemofilia A moderada y severa para la aseguradora, disminuyendo el número de sangrados articulares al año.

Non-Equilibrium Atmospheric Plasma As A Novel Route To Nanomaterial Synthesis And Processing For Biomedical Applications

Since last century, the rising interest of value-added and advanced functional materials has spurred a ceaseless development in terms of industrial processes and applications. Among the emerging technologies, thanks to their unique features and versatility in terms of supported processes, non-equilibrium plasma discharges appear as a key solvent-free, high-throughput and cost-efficient technique. Nevertheless, applied research studies are needed with the aim of addressing plasma potentialities optimizing devices and processes for future industrial applications. In this framework, the aim of this dissertation is to report on the activities carried out and the results achieved concerning the development and optimization of plasma techniques for nanomaterial synthesis and processing to be applied in the biomedical field. In the first section, the design and investigation of a plasma assisted process for the production of silver (Ag) nanostructured multilayer coatings exhibiting anti-biofilm and anti-clot properties is described. With the aim on enabling in-situ and on-demand deposition of Ag nanoparticles (NPs), the optimization of a continuous in-flight aerosol process for particle synthesis is reported. The stability and promising biological performances of deposited coatings spurred further investigation through in-vitro and in-vivo tests which results are reported and discussed. With the aim of addressing the unanswered questions and tuning NPs functionalities, the second section concerns the study of silver containing droplet conversion in a flow-through plasma reactor. The presented results, obtained combining different analysis techniques, support a formation mechanism based on droplet to particle conversion driven by plasma induced precursor reduction. Finally, the third section deals with the development of a simulative and experimental approach used to investigate the in-situ droplet evaporation inside the plasma discharge addressing the main contributions to liquid evaporation in the perspective of process industrial scale up.

The Role of B5G UAV-Aided Mobile Networks

With the advent of 5G, several novel network paradigms and technologies have been proposed to fulfil the key requirements imposed. Flexibility, efficiency and scalability, along with sustainability and convenience for expenditure have to be addressed in targeting these brand new needs. Among novel paradigms introduced in the scientific literature in recent years, a constant and increasing interest lies in the use of unmanned aerial vehicles (UAVs) as network nodes supporting the legacy terrestrial network for service provision. Their inherent features of moving nodes make them able to be deployed on-demand in real-time. Which, in practical terms, means having them acting as a base station (BS) when and where there is the highest need. This thesis investigates then the potential role of UAV-aided mobile radio networks, in order to validate the concept of adding an aerial network component and assess the system performance, from early to later stages of its deployment. This study is intended for 5G and beyond systems, to allow time for the technology to mature. Since advantages can be manyfold, the aerial network component is considered at the network layer under several aspects, from connectivity to radio resource management. A particular emphasis is given to trajectory design, because of the efficiency and flexibility it potentially adds to the infrastructure. Two different frameworks have been proposed, to take into account both a re-adaptable heuristic and an optimal solution. Moreover, diverse use cases are taken under analysis, from mobile broadband to machine and vehicular communications. The thesis aim is thus to discuss the potential and advantages of UAV-aided systems from a broad perspective. Results demonstrate that the technology has good prospects for diverse scenarios with a few arrangements.

Sensori elettrochimici a base di PEDOT:PSS stampati a getto di inchiostro

Conductive polymers (CPS) are a class of carbon-based materials, capable of conducting electric current, characterized by metallic properties in combination with the intrinsic properties of conventional polymers. The structural model of the CP consists of a system of double π-conjugated on the backbone (polyene structure) which can easily undergo reversible doping reaching a wide range of conductivity. Thanks to their versatility and peculiar properties (mechanical flexibility, biocompatibility, transparency, ease of chemical functionalization, high thermal stability), CPS have revolutionized the science of materials giving rise to Organic Bioelectronics, the discipline resulting from the convergence between biology and electronics. The Poly (3,4-ethylenedioxythiophene) : poly (styrenesulfonate) (PEDOT: PSS), complex polyelectrolyte, in the form of a thin film, currently represents the reference standard in applications concerning Bioelectronics. In this project, two types of electrochemical sensors ink-jet printed on a flexible polymeric substrate, the polyethylene terephthalate, have been developed and characterized. The Drop on Demand (DOD) inkjet technology has allowed to control the positioning of fluid volumes of the order of picoliters with an accuracy of ± 25μm. This resulted in the creation of amperometric sensors and organic electrochemical transistors (OECT) all-PEDOT: PSS with high reproducibility. The sensors have been used for the determination of Ascorbic Acid (AA) which is currently considered an important benchmark in the field of sensors. In Cyclic Voltammetry, the amperometric sensor has detected AA at potentials less than 0.2 V vs. SCE thanks to the electrocatalytic properties of the PEDOT: PSS. On the other hand, the OECT detected AA concentrations equal to 10 nanomolar in Chronoamperometry. Furthermore, a promising new generation of all-printed OECTS, consisting of silver metal contacts, has been created. Preliminary results are presented.

Multi-organ support device for combined extracorporeal carbon dioxide removal and hemofiltration treatments with pump-free solution for ultrafiltration

The use of extracorporeal organ support (ECOS) devices is increasingly widespread, to temporarily sustain or replace the functions of impaired organs in critically ill patients. Among ECOS, respiratory functions are supplied by extracorporeal life support (ECLS) therapies like extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R), and renal replacement therapies (RRT) are used to support kidney functions. However, the leading cause of mortality in critically ill patients is multi-organ dysfunction syndrome (MODS), which requires a complex therapeutic strategy where extracorporeal treatments are often integrated to pharmacological approach. Recently, the concept of multi-organ support therapy (MOST) has been introduced, and several forms of isolated ECOS devices are sequentially connected to provide simultaneous support to different organ systems. The future of critical illness goes towards the development of extracorporeal devices offering multiple organ support therapies on demand by a single hardware platform, where treatment lines can be used alternately or in conjunction. The aim of this industrial PhD project is to design and validate a device for multi-organ support, developing an auxiliary line for renal replacement therapy (hemofiltration) to be integrated on a platform for ECCO2R. The intended purpose of the ancillary line, which can be connected on demand, is to remove excess fluids by ultrafiltration and achieve volume control by the infusion of a replacement solution, as patients undergoing respiratory support are particularly prone to develop fluid overload. Furthermore, an ultrafiltration regulation system shall be developed using a powered and software-modulated pinch-valve on the effluent line of the hemofilter, proposed as an alternative to the state-of-the-art solution with peristaltic pump.

Ricerca delle vulnerabilità e Penetration Test per Architetture Serverless

Il lavoro di tesi proposto è volto allo studio delle architetture Serverless, strutture che permettono agli sviluppatori di comporre facilmente applicazioni distribuite su molti servizi all’interno di un cloud, senza la necessità di gestire il server. Più nello specifico sono state studiate le FaaS (Function-as-a-Service), un modello di elaborazione cloud basato su eventi in cui il codice viene distribuito in container gestiti dalla piattaforma, e successivamente eseguito on-demand. A seguito di una prima parte di ricerca dello stato dell'arte, l'attenzione si è spostata sulla ricerca di vulnerabilità nel contesto del servizio OpenFaaS, un framework open-source che permette agli sviluppatori di distribuire facilmente funzioni e microservizi. Il deployment è stato fatto faasd, quest’ultimo è una semplificazione di OpenFaaS, usa le stesse componenti e lo stesso ecosistema di OpenFaaS ma usa Containerd al posto di Kubernetes. Dopo una prima fase di installazione e log-in il lavoro si è concentrato nelle varie metodologie di penetration test, nonché di ricerca delle vulnerabilità di sicurezza associate a tale paradigma. In informatica, il penetration test è il processo operativo di analisi o valutazione della sicurezza di un sistema o di una rete, simulando l'attacco di un potenziale utente malintenzionato. Nell'ultima fase sono stati condotti vari tentativi di attacco al sistema OpenFaaS tramite l'ausilio di alcuni tool. Inizialmente è stata fatta un'analisi della rete e del traffico tramite tool quali NMAP e Wireshark, per comprenderne meglio la struttura e come faasd creasse le funzioni a partire dai container. Infine, tramite OpenFaaS sono state create delle funzioni per testare la sicurezza e l'affidabilità di quest'ultima. In particolare, le funzioni indagano all'interno dei container al fine di comprendere la possibilità di eseguire code injection e rilevare possibili dati sensibili nel filesystem dell'immagine Docker così come nelle variabili d'ambiente.

The elasticity of demand is about occupancy, not prices: building European demand curves based on occupancy elasticity

The peak congestion of the European grid may create significant impacts on system costs because of the need for higher marginal cost generation, higher cost system balancing and increasing grid reinforcement investment. The use of time of use rates, incentives, real time pricing and other programmes, usually defined as Demand Side Management (DSM), could bring about significant reductions in prices, limit carbon emissions from dirty power plants, and improve the integration of renewable sources of energy. Unlike previous studies on elasticity of residential electricity demand under flat tariffs, the aim of this study is not to investigate the known relatively inelastic relationship between demand and prices. Rather, the aim is to assess how occupancy levels vary in different European countries. This reflects the reality of demand loads, which are predominantly determined by the timing of human activities (e.g. travelling to work, taking children to school) rather than prices. To this end, two types of occupancy elasticity are estimated: baseline occupancy elasticity and peak occupancy elasticity. These represent the intrinsic elasticity associated with human activities of single residential end-users in 15 European countries. This study makes use of occupancy time-series data from the Harmonised European Time Use Survey database to build European occupancy curves; identify peak occupancy periods; draw time use demand curves for video and TV watching activity; and estimate national occupancy elasticity levels of single-occupant households. Findings on occupancy elasticities provide an indication of possible DSM strategies based on occupancy levels and not prices.