Doctors’ perspectives on law and life-sustaining treatment: Survey design and recruitment strategies for a challenging cohort

- Background Palliative medicine and other specialists play significant legal roles in decisions to withhold and withdraw life-sustaining treatment at the end of life. Yet little is known about their knowledge of or attitudes to the law, and the role they think it should play in medical practice. Consideration of doctors’ views is critical to optimizing patient outcomes at the end of life. However, doctors are difficult to engage as participants in empirical research, presenting challenges for researchers seeking to understand doctors’ experiences and perspectives. - Aims To determine how to engage doctors involved in end-of-life care in empirical research about knowledge of the law and the role it plays in medical practice at the end of life. - Methods Postal survey of all specialists in palliative medicine, emergency medicine, geriatric medicine, intensive care, medical oncology, renal medicine, and respiratory medicine in three Australian states: New South Wales, Victoria, and Queensland. The survey was sent in hard copy with two reminders and a follow up reminder letter was also sent to the directors of hospital emergency departments. Awareness was further promoted through engagement with the relevant medical colleges and publications in professional journals; various incentives to respond were also used. The key measure is the response rate of doctors to the survey. - Results Thirty-two percent of doctors in the main study completed their survey with response rate by specialty ranging from 52% (palliative care) to 24% (medical oncology). This overall response rate was twice that of the reweighted pilot study (16%). - Conclusions Doctors remain a difficult cohort to engage in survey research but strategic recruitment efforts can be effective in increasing response rate. Collaboration with doctors and their professional bodies in both the development of the survey instrument and recruitment of participants is essential.

Quarantine and surveillance strategies for plant pathogen detection and control

Incursions of plant pests and diseases pose serious threats to food security, agricultural productivity and the natural environment. One of the challenges in confidently delimiting and eradicating incursions is how to choose from an arsenal of surveillance and quarantine approaches in order to best control multiple dispersal pathways. Anthropogenic spread (propagules carried on humans or transported on produce or equipment) can be controlled with quarantine measures, which in turn can vary in intensity. In contrast, environmental spread processes are more difficult to control, but often have a temporal signal (e.g. seasonality) which can introduce both challenges and opportunities for surveillance and control. This leads to complex decisions regarding when, where and how to search. Recent modelling investigations of surveillance performance have optimised the output of simulation models, and found that a risk-weighted randomised search can perform close to optimally. However, exactly how quarantine and surveillance strategies should change to reflect different dispersal modes remains largely unaddressed. Here we develop a spatial simulation model of a plant fungal-pathogen incursion into an agricultural region, and its subsequent surveillance and control. We include structural differences in dispersal via the interplay of biological, environmental and anthropogenic connectivity between host sites (farms). Our objective was to gain broad insights into the relative roles played by different spread modes in propagating an invasion, and how incorporating knowledge of these spread risks may improve approaches to quarantine restrictions and surveillance. We find that broad heuristic rules for quarantine restrictions fail to contain the pathogen due to residual connectivity between sites, but surveillance measures enable early detection and successfully lead to suppression of the pathogen in all farms. Alternative surveillance strategies attain similar levels of performance by incorporating environmental or anthropogenic dispersal risk in the prioritisation of sites. Our model provides the basis to develop essential insights into the effectiveness of different surveillance and quarantine decisions for fungal pathogen control. Parameterised for authentic settings it will aid our understanding of how the extent and resolution of interventions should suitably reflect the spatial structure of dispersal processes.

Mahanadi streamflow: climate change impact assessment and adaptive strategies

Impacts of climate change on hydrology are assessed by downscaling large scale general circulation model (GCM) outputs of climate variables to local scale hydrologic variables. This modelling approach is characterized by uncertainties resulting from the use of different models, different scenarios, etc. Modelling uncertainty in climate change impact assessment includes assigning weights to GCMs and scenarios, based on their performances, and providing weighted mean projection for the future. This projection is further used for water resources planning and adaptation to combat the adverse impacts of climate change. The present article summarizes the recent published work of the authors on uncertainty modelling and development of adaptation strategies to climate change for the Mahanadi river in India.

Over-expression and purification strategies for recombinant multi-protein oligomers: A case study of Mycobacterium tuberculosis sigma/anti-sigma factor protein complexes

The function of a protein in a cell often involves coordinated interactions with one or several regulatory partners. It is thus imperative to characterize a protein both in isolation as well as in the context of its complex with an interacting partner. High resolution structural information determined by X-ray crystallography and Nuclear Magnetic Resonance offer the best route to characterize protein complexes. These techniques, however, require highly purified and homogenous protein samples at high concentration. This requirement often presents a major hurdle for structural studies. Here we present a strategy based on co-expression and co-purification to obtain recombinant multi-protein complexes in the quantity and concentration range that can enable hitherto intractable structural projects. The feasibility of this strategy was examined using the sigma factor/anti-sigma factor protein complexes from Mycobacterium tuberculosis. The approach was successful across a wide range of sigma factors and their cognate interacting partners. It thus appears likely that the analysis of these complexes based on variations in expression constructs and procedures for the purification and characterization of these recombinant protein samples would be widely applicable for other multi-protein systems. (C) 2010 Elsevier Inc. All rights reserved.

Design issues and caching strategies for CD-ROM based multimedia storage

CD-ROMs have proliferated as a distribution media for desktop machines for a large variety of multimedia applications (targeted for a single-user environment) like encyclopedias, magazines and games. With CD-ROM capacities up to 3 GB being available in the near future, they will form an integral part of Video on Demand (VoD) servers to store full-length movies and multimedia. In the first section of this paper we look at issues related to the single- user desktop environment. Since these multimedia applications are highly interactive in nature, we take a pragmatic approach, and have made a detailed study of the multimedia application behavior in terms of the I/O request patterns generated to the CD-ROM subsystem by tracing these patterns. We discuss prefetch buffer design and seek time characteristics in the context of the analysis of these traces. We also propose an adaptive main-memory hosted cache that receives caching hints from the application to reduce the latency when the user moves from one node of the hyper graph to another. In the second section we look at the use of CD-ROM in a VoD server and discuss the problem of scheduling multiple request streams and buffer management in this scenario. We adapt the C-SCAN (Circular SCAN) algorithm to suit the CD-ROM drive characteristics and prove that it is optimal in terms of buffer size management. We provide computationally inexpensive relations by which this algorithm can be implemented. We then propose an admission control algorithm which admits new request streams without disrupting the continuity of playback of the previous request streams. The algorithm also supports operations such as fast forward and replay. Finally, we discuss the problem of optimal placement of MPEG streams on CD-ROMs in the third section.

Fusion of Complementary Online and Offline Strategies for Recognition of Handwritten Kannada Characters

This work describes an online handwritten character recognition system working in combination with an offline recognition system. The online input data is also converted into an offline image, and parallely recognized by both online and offline strategies. Features are proposed for offline recognition and a disambiguation step is employed in the offline system for the samples for which the confidence level of the classifier is low. The outputs are then combined probabilistically resulting in a classifier out-performing both individual systems. Experiments are performed for Kannada, a South Indian Language, over a database of 295 classes. The accuracy of the online recognizer improves by 11% when the combination with offline system is used.

Novel materials, materials design and synthetic strategies: recent advances and new directions

There have been major advances in solid state and materials chemistry in the last two decades and the subject is growing rapidly. In this account, a few of the important aspects of materials chemistry of interest to the author are presented. Accordingly, transition metal oxides, which constitute the most fascinating class of inorganic materials, receive greater attention, Metal-insulator transitions in oxides, high temperature superconductivity in cuprates and colossal magnetoresistance in manganates are discussed at some length and the outstanding problems indicated, We then discuss certain other important classes of materials which include molecular materials, biomolecular materials and porous solids. Recent developments in synthetic strategies for inorganic materials are reviewed. Some results on metal nanoparticles and nanotubes are briefly presented. The overview, which is essentially intended to provide a flavour of the subject and show how it works, lists references to many crucial reviews in the recent literature.

Existing and emerging strategies for the synthesis of nanoscale heterostructures

Development of new multifunctional nanostructures relies on the ability to make new materials at the nanoscale with control over size, shape and composition. While this control is extremely important to tune several properties, an alternative strategy is to create active interfaces between two or more nanostructures to form nanoscale heterostructures. In these heterostructures, the interfaces play a key role in stabilizing and enhancing the efficiency of the individual components for various applications. In this article, we discuss synthesis methods of different types of nanoscale heterostructures and the role of interfaces in various applications. We present the current state-of-the-art in designing heterostructures and possible upcoming synthetic strategies with their advantages and disadvantages. We present how such heterostructures are highly efficient for catalytic, photovoltaic and nanoelectronic applications drawing several examples from our own studies and from the literature.

Performance of a class of multi-robot deploy and search strategies based on centroidal voronoi configurations

This article considers a class of deploy and search strategies for multi-robot systems and evaluates their performance. The application framework used is deployment of a system of autonomous mobile robots equipped with required sensors in a search space to gather information. The lack of information about the search space is modelled as an uncertainty density distribution. The agents are deployed to maximise single-step search effectiveness. The centroidal Voronoi configuration, which achieves a locally optimal deployment, forms the basis for sequential deploy and search (SDS) and combined deploy and search (CDS) strategies. Completeness results are provided for both search strategies. The deployment strategy is analysed in the presence of constraints on robot speed and limit on sensor range for the convergence of trajectories with corresponding control laws responsible for the motion of robots. SDS and CDS strategies are compared with standard greedy and random search strategies on the basis of time taken to achieve reduction in the uncertainty density below a desired level. The simulation experiments reveal several important issues related to the dependence of the relative performances of the search strategies on parameters such as the number of robots, speed of robots and their sensor range limits.

Cell Reprogramming, IPS Limitations, and Overcoming Strategies in Dental Bioengineering

8 p.