Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

Panulirus versicolor (Latrielle), a new record from the central Andhra coast (Bay of Bengal)

Details are given of the finding of Panulirus versicolor from the central Andhra coast of India for the first time, including also a brief description of the specimen, which was found in 1983.

A new distributional record of Astropecten polyacanthus Muller and Troschel, 1842 (Echinodermata: Asteroidea) from the coastal waters of Pakistan

Previously an asteroid starfish Astropecten indicus has been described by Tahera (1996), and another species of the genus Astropecten i.e. A. polyacanthus Muller and Troschel, 1842 has been collected from the subtidal region of a sandy shore of Clifton (24°47'42"N 66°59'6"E), Karachi. The latter species is here reported for the first time from the Pakistan coast of the northern Arabian Sea and fills the gap in the known distribution. The species is briefly described and illustrated.

First record of a spindle cowry Crenovolva (Ovulidae, Gastropoda) from Bulleji, Karachi, on the gorgonian coral Muricella sp. and with a note on their association

Attached to hard substrata on our shores occur the branching colonies of gorgonian corals of the genus Muricella (Fig. 1A, Pl. 1B, C, D). Since there is no report on this genus from Pakistan this report be taken as the first record from here. The family Ovulidae comprises several hundred species of marine gastropods, all of which appear to be obligate associates of cnidarians as stated by Robertson (1970) and Hadfield (1976); the present ovulid gastropod genus Crenovolva lives exclusively on the gorgonians (Morton, 1989). Tirmizi and Zehra (1984) recorded thirty-two families of gastropods from Pakistan, but not any representative of the Ovulidae, so the material at hand may be the first record from Pakistan. Since we are unable to reach to specific level the material is being reported as unspecified.

Bunga rus bunga roides , A Record New to China ( Xizang AR) with a Note on Trimeresurus tibeta nus( Plate Ⅵ, lower)

1998 年在西藏墨脱县海拔1000 m 左右地方采到成年雌性环蛇1 号, 系我国新纪录。该蛇全长/ 尾长(mm) 1095/ 112 (尾尖断) 。通身背面黑褐色, 后3/ 4 有由背鳞白色点斑缀成的窄横纹约40 个; 腹面浅黑 色, 每隔3 或4 枚腹鳞有不规则的黄白色横斑。尾背有少数不完整的白色纹, 但尾腹面有7 条很明显的横斑。头 部斑纹与M. Smith (1943 : 410) 描述一致, 可能由于蛇龄较老而不清晰。背鳞通身15 行, 脊鳞略扩大; 腹鳞 233 , 尾下鳞35 (略低于文献记载的44～51 , 可能与尾尖断有关) , 除前端第三、四两枚成单外, 其余均成对。 没有颊鳞; 眶前鳞1 , 眶后鳞2 ; 颞鳞1 + 2 ; 上唇鳞7 (22223 式) ; 下唇鳞7 , 第一对在颏鳞后彼此相接, 前4 对 接前颔片; 前颔片大于后颔片, 后者后半介一小鳞。检查一侧, 除前沟牙及其预备牙外, 没有发现其他上颌齿。

Microrasbora Annandale, a new genus record in China, with description of a new species (Teleostei: Cyprinidae)

A new species of genus Microrasbora Annandale (1918), M. microphthalma, is described from the Nanwan River, a tributary of the Ruili River, Irrawaddy drainage, in southwest Yunnan province, China. This new species is the first record of the genus Microras

Two new species and a new record of the genus Sinogastromyzon (Teleostei: Balitoridae) from Yunnan, China

Two new species and a new record of Sinogastromyzon are described from Lixianjiang River of Yunnan province, China. Sinogastromyzon lixianjiangensis, new species, can be distinguished from its congeners by the following characters: pectoral fin with XIII-XIV, 15-17 rays; pelvic fin with X-XI, 10-12 rays; 60-65 lateral-line scales; no scales on the dorsum of paired fins or the region between axilla of pectoral fin and pelvic-fin origin; tip of pelvic fin close to anus; tip of anal fin close to caudal-fin base; anal-fin origin nearer to the caudal-fin base than to the posterior pelvic-fin base; anus nearer to anal-fin origin than to the posterior pelvic-fin base; dorsal side of the body with 9-11 black blotches. Sinogastromyzon macrostoma, new species can be distinguished from its congeners by the following characters: pectoral fin with XII-XIV, 12-15 rays; pelvic fin with VII-IX, 11-13 rays; 48-56 lateral-line scales; mouth extremely big, slightly arched; no scales on the dorsum of paired fins or the region between axilla of pectoral fin and pelvic-fin origin; tip of pelvic fin far beyond anus; tip of anal fin far from caudal-fin base; anal-fin origin about midway between the posterior pelvic-fin base and caudal-fin base; anus nearer to posterior pelvic-fin base than to anal-fin origin; dorsal side of the body uniformly gray, without regular blotches in formalin preserved specimen. Sinogastromyzon cf. multiocellum is firstly recorded in China.

Experimental demonstration of a record high 11.25Gb/s real-time optical OFDM transceiver supporting 25km SMF end-to-end transmission in simple IMDD systems.

The fastest ever 11.25Gb/s real-time FPGA-based optical orthogonal frequency division multiplexing (OOFDM) transceivers utilizing 64-QAM encoding/decoding and significantly improved variable power loading are experimentally demonstrated, for the first time, incorporating advanced functionalities of on-line performance monitoring, live system parameter optimization and channel estimation. Real-time end-to-end transmission of an 11.25Gb/s 64-QAM-encoded OOFDM signal with a high electrical spectral efficiency of 5.625bit/s/Hz over 25km of standard and MetroCor single-mode fibres is successfully achieved with respective power penalties of 0.3dB and -0.2dB at a BER of 1.0 x 10(-3) in a directly modulated DFB laser-based intensity modulation and direct detection system without in-line optical amplification and chromatic dispersion compensation. The impacts of variable power loading as well as electrical and optical components on the transmission performance of the demonstrated transceivers are experimentally explored in detail. In addition, numerical simulations also show that variable power loading is an extremely effective means of escalating system performance to its maximum potential.

Agyrius watanabeorum Ishikawa, a New Record Genus and Species from China and Vietnam(Hemiptera: Reduviidae)

瓦氏阿猎蝽Agyrius watanabeorum 为日本半翅目学者石川忠2002 年根据采自泰国北部的标本所命 名，其描记较为详细，配有正模的整体黑白照片和部分特征图，但对该种的阳茎结构没有提及。在研 究中国和越南的猎蝽时，我们发现了该种。本文中我们重新描述了瓦氏阿猎蝽，绘制了较详细的整体 图和局部特征图。阿猎蝽属Agyrius Stål, 1863 为中国和越南的新记录属，瓦氏阿猎蝽Agyrius watanabeorum Ishikawa, 2002 为中国和越南的新记录种；其在中国和越南的分布也是该属种最北的分布 记录。

Redescription of Trypanosoma ophiocephali Chen 1964 (Kinetoplastida : Trypanosomatina : Trypanosomatidae) and first record from the blood of dark sleeper (Odontobutis obscura Temminck and Schlegel) in China

During the parasite fauna investigation within 2004 and 2005, the freshwater fish trypanosomes were isolated from the blood of dark sleeper (Odontobutis obscura Temminck and Schlegel) and snakehead fish (Ophiocephalus argus Cantor) from Niushan Lake, Hubei Province, China. Blood trypomastigotes were used for light microscopy investigations. The detailed descriptions of three morphological groups of the genus Trypanosoma: Trypanosoma sp. I and Trypanosoma sp. II found in blood of O. obscura, and Trypanosoma sp. III found in blood of O. argus were provided. Morphological features and host species show Trypanosoma sp. III belong to Trypanosoma ophiocephali Chen 1964, an incompletely described species. Infection with trypanosomes of O. obscura was recorded for the first time. According to the size and appearance, the trypanosomes in O. obscura were also tentatively identified as T. ophiocephali Chen 1964.

Sediment sources and the flood record from Wanghu lake, in the middle reaches of the Yangtze River

A sediment core was collected from the centre of Wanghu Lake, in the Middle Reaches of the Yangtze River. The recent part of the core was dated using a combination of Pb-210 and spheroidal carbonaceous particle (SCP) techniques. Extrapolating this chronology dated the laminated section of the core, between 723 and 881 mm, to the first half of the 18th century and this section was selected for detailed study. The thicknesses of the laminae were measured using reflecting and polarizing microscopes whilst geochemistry was determined by an electron probe. The thickness of the dark layers was found to be positively correlated with titanium concentrations, and negatively correlated with aluminium and potassium concentrations. The thickness of the light layers was found to be negatively correlated with the concentrations of titanium. It is concluded that the dark layers were deposited from the Fushui River, a tributary of the Yangtze River, under periods of normal flow whilst the light Layers were mainly deposited from the Yangtze River itself during flood periods. Documentary evidence for floods occurring in the take catchment corresponded with thick laminations of high titanium concentration. Further, two of the three thickest, light laminations with low titanium concentrations were found to be synchronous with recorded flood dates of the main Yangtze River in its Middle Reaches, but one was synchronous with a local drought. These data suggest that the Lake sediment provides an archive of the relative water levels of the Yangtze and Wanghu including floods of both the main Yangtze River and the local hydrological regime. (c) 2006 Elsevier B.V. All rights reserved.

Redescription of Camallanus hypophthalmichthys Dogel and Akhmerov, 1959 (Nematoda : Camallanidae) and its first record from fishes in China

The nematode Camallanus hypophthalmichthys Dogel and Akhmerov, 1959 is redescribed from specimens collected from the intestine of the bighead carp Aristichthys nobilis, from Liangzihu Lake (Yangtze River basin), Hubei Province, central China. The light and scanning electron microscopical examination made it possible to study in detail the morphology of this so far little-known species and to confirm its validity. The main specific features of C. hypophthalmichthys distinguishing it from the most similar Camallanus spp. is the presence of 3 small caudal processes on the male tail tip, 13-16 longitudinal ridges on the inner surface of the valve of the buccal capsule, and the arrangement of preanal and postanal genital papillae in the male. This finding represents a new host record, the first record of this parasite in the Yangtze River basin, and the first documented record of C. hypophthalmichthys from China. Camallanus hypophthalmichthys is considered a specific intestinal parasite of fishes of the cyprinid Hypophthalmichthyinae.