Community Conversation: Outpatient Palliative Care

In 2014, a community task force wrote a Blueprint that outlines steps to make Whatcom County a community of excellence for those with serious illness or facing death and their families. Th e Blueprint has five pillars: Advance Care Planning, Clinical Care, Provider Training , Community Culture and Activation and Financial Sustainability

Community Conversation: Advance Care Planning - NOTES

Commitment #1 - to educate our community about the importance of Advance Care Planning Commitment #2 - to provide assistance in the development and completion of Advance Care Plans Commitment #3 - to assure that Advance Care Plans are complete and clearly understood by both you and any provider Commitment #4 - to develop and maintain a system to store Advance Care Plans until necessary Commitment #5 - to appropriately follow your Advance Care Pla

Handout: Everyone Needs an Advance Directive! Not Everyone Needs a POLST!

The Advance Directive and Physician Orders for Life Sustaining Treatments (POLST) are both important tools for documenting your wishes for care. They are each designed to accomplish specific goals - it is important to understand who they are intended for and what they do

Passages in Graphs

Directed graphs can be partitioned in so-called passages. A passage P is a set of edges such that any two edges sharing the same initial vertex or sharing the same terminal vertex are both inside $P$ or are both outside of P. Passages were first identified in the context of process mining where they are used to successfully decompose process discovery and conformance checking problems. In this article, we examine the properties of passages. We will show that passages are closed under set operators such as union, intersection and difference. Moreover, any passage is composed of so-called minimal passages. These properties can be exploited when decomposing graph-based analysis and computation problems.Comment: 8 page

Non-adiabatic Fast Control of Mixed States based on Lewis-Riesenfeld Invariant

We apply the inversely-engineered control method based on Lewis-Riesenfeld invariants to control mixed states of a two-level quantum system. We show that the inversely-engineered control passages of mixed states - and pure states as special cases - can be made significantly faster than the conventional adiabatic control passages, which renders the method applicable to quantum computation. We devise a new type of inversely-engineered control passages, to be coined the antedated control passages, which further speed up the control significantly. We also demonstrate that by carefully tuning the control parameters, the inversely-engineered control passages can be optimized in terms of speed and energy cost.Comment: 9 pages, 9 figures, version to appear in J. Phys. Soc. Jp

Wind and solar powered turbine

A power generating station having a generator driven by solar heat assisted ambient wind is described. A first plurality of radially extendng air passages direct ambient wind to a radial flow wind turbine disposed in a centrally located opening in a substantially disc-shaped structure. A solar radiation collecting surface having black bodies is disposed above the fist plurality of air passages and in communication with a second plurality of radial air passages. A cover plate enclosing the second plurality of radial air passages is transparent so as to permit solar radiation to effectively reach the black bodies. The second plurality of air passages direct ambient wind and thermal updrafts generated by the black bodies to an axial flow turbine. The rotating shaft of the turbines drive the generator. The solar and wind drien power generating system operates in electrical cogeneration mode with a fuel powered prime mover

Evaluation of the cell viability of human Wharton's jelly stem cells for use in cell therapy

Human umbilical cord Wharton's jelly stem cells (HWJSCs) are gaining attention as a possible clinical source of mesenchymal stem cells for cell therapy and tissue engineering due to their high accessibility, expansion potential, and plasticity. We employed a combination of highly sensitive techniques to determine the average cell viability levels and proliferation capabilities of 10 consecutive cell passages of cultured HWJSCs and then used RNA microarrays to identify genes associated with changes in cell viability levels. We found an initial decrease in cell viability from the first to the third cell passage followed by an increase until the sixth passage and a final decrease from the sixth to tenth cell passages. The highest cell viability levels corresponded to the fifth and sixth passages. The intracellular ionic contents of potassium, sodium, and chlorine suggest that the lower cell viability levels at passages 2, 3, and 8-10 may be associated with apoptotic cell death. In fact, gene expression analysis revealed that the average cell viability was significantly associated with genes with a function in apoptotic cell death, especially pro-apoptotic FASTKD2, BNIP3L genes and anti-apoptotic TNFAIP8 and BCL2L2 genes. This correlation with both pro-apoptotic and anti-apoptotic genes suggests that there may be a complex live-death equilibrium in cultured HWJSCs kept in culture for multiple cell passages. In this study, the highest cell viability levels corresponded to the fifth and sixth HWJSC passages, suggesting that these passages should be preferentially employed in cell therapy or tissue engineering protocols using this cell type

Effects of simultaneous speech and sign on infants’ attention to spoken language

Objectives: To examine the hypothesis that infants receiving a degraded auditory signal have more difficulty segmenting words from fluent speech if familiarized with the words presented in both speech and sign compared to familiarization with the words presented in speech only. Study Design: Experiment utilizing an infant-controlled visual preference procedure. Methods: Twenty 8.5-month-old normal-hearing infants completed testing. Infants were familiarized with repetitions of words in either the speech + sign (n = 10) or the speech only (n = 10) condition. Results: Infants were then presented with four six-sentence passages using an infant-controlled visual preference procedure. Every sentence in two of the passages contained the words presented in the familiarization phase, whereas none of the sentences in the other two passages contained familiar words.Infants exposed to the speech + sign condition looked at familiar word passages for 15.3 seconds and at nonfamiliar word passages for 15.6 seconds, t (9) = -0.130, p = .45. Infants exposed to the speech only condition looked at familiar word passages for 20.9 seconds and to nonfamiliar word passages for 15.9 seconds. This difference was statistically significant, t (9) = 2.076, p = .03. Conclusions: Infants\u27 ability to segment words from degraded speech is negatively affected when these words are initially presented in simultaneous speech and sign. The current study suggests that a decreased ability to segment words from fluent speech may contribute towards the poorer performance of pediatric cochlear implant recipients in total communication settings on a wide range of spoken language outcome measures

Hydraulic calipers

Hydraulic calipers determine area of annular openings in irregular or concealed passages. With modifications the device could be adapted to investigations of cross-sectional changes in heat flow passages, ducts, conduits, and heat exchanger elements

A method for measuring cooling air flow in base coolant passages of rotating turbine blades

Method accurately determines actual coolant mass flow rate in cooling passages of rotating turbine blades. Total and static pressures are measured in blade base coolant passages. Mass flow rates are calculated from these measurements of pressure, measured temperature and known area