Cepheid Color-Temperature Relations

Using our 1997 work in spectroscopic temperatures, as well as published Cepheid photometry, we derive color-temperature relations for a set of 13 Cepheids in Galactic clusters. The colors and temperatures used are individual values taken at different phases, rather than mean values averaged over the pulsational cycle. The observed colors are corrected for both reddening and metallicity. The effect of gravity on the colors is small. We find that B-V and V-R are the best colors to use to determine a Cepheid photometric temperature scale. These color-temperature relations will be useful for future Cepheid Baade-Wesselink studies and for abundance analyses of more Galactic and extragalactic Cepheids

Producing Flexible Nurses: How Institutional Texts Organize Nurses’ Experiences of Learning to Work on Redesigned Nursing Teams (Préparer des infirmières polyvalentes : comment des documents officiels orientent les expériences d’apprentissage des infirmières en fonction du travail au sein d’équipes reconfigurées)

The purpose of this qualitative research was to utilize an Institutional Ethnographic (IE) lens to trace how various institutional (regulatory, educational, union, governmental, or health authority) texts and resources organize baccalaureate (RN) and diploma (vocational or practical) nurses’ experiences of learning to practice on acute care teams. Functional care models have been introduced in acute care, creating RN-LPN-health care aide (HCA) teams in conjunction with expanded practice scopes for LPNs. Questions arise as to how nurses (RNs and LPNs) learn to work together on these intra-professional teams. Beginning from the standpoint of front-line workers provides an entry-point into understanding how institutional priorities organize the everyday work of people. Ten RNs and ten LPNs were interviewed in two small community acute care hospitals on Vancouver Island. More specifically, in observations and interviews we looked for ways in which textually mediated work processes (such as regulatory, governmental, health authority, and educational documents) and other conceptual resources influenced nurses’ understandings of nursing education and professional practice. This analysis focused on how RNs and LPNs learn to work on re-designed nursing teams and traced the textually mediated discourses that are organizing this learning in the context of recent changes to LPN education and nursing teams. Our findings highlight unarticulated nursing knowledge/thinking, and the textual insertion of functional, skilled and flexible worker discourses, which organize to blur practice between RN and LPNs making them [potentially] interchangeable in complex acute care contexts. This study, situated as one analysis among a larger study, shows the invisibility of nursing disciplinary and professional goals and knowledge in nurses’ talk, as RNs and LPNs re-learn and sustain nursing practice in ways that fulfill other institutional and organizational goals. This re-alignment has significant implications for educators in nursing programs, who participate in teaching within educational silos. This research has shown that the absence of clarity in functional roles (perpetuating role confusion and ambiguity) is purposeful, with the goal of creating flexible workers. Résumé Cette étude qualitative selon une perspective d’ethnographie institutionnelle, visait à examiner comment divers documents institutionnels (réglementaires, académiques, syndicaux, gouvernementaux ou d’autorité régionale) orientent les expériences d’apprentissage des infirmières formées au baccalauréat (IB, en anglais RN) et des infirmières diplômées de formation professionnelle ou pratique (ID, en anglais LPN), en fonction de la pratique au sein d’équipes de soins aigus . L’intégration de modèles fonctionnels dans les soins aigus a entraîné la création d’équipes d’IBs-IDs- aides-soignantes et élargi la portée de la pratique des IDs. De cette situation surgissent des questions, à savoir comment les infirmières (IBs et IDs) apprennent à collaborer dans ces équipes intraprofessionnelles. Aborder la question du point de vue des travailleuses de première ligne offre une ouverture vers la compréhension de la manière dont les priorités institutionnelles organisent le travail quotidien de ces personnes. Nous nous sommes entretenues avec dix IB et dix ID de deux petits hôpitaux communautaires de soins aigus, sur l’île de Vancouver. Plus spécifiquement, à travers les observations et les entrevues, nous avons cherché les moyens par lesquels les processus de travail inscrits dans des textes institutionnels (documentation réglementaire, gouvernementale, d’autorité régionale et académique), ainsi que d’autres ressources conceptuelles, ont influencé la compréhension des infirmières quant à la formation et à la pratique professionnelle en sciences infirmières. Cette analyse était centrée sur la manière dont les IB et les ID apprennent à travailler au sein d’équipes infirmières reconfigurées et ciblait les énoncés de textes qui orientent cet apprentissage, dans le contexte des récents changements dans la formation des ID et au sein des équipes dont elles font partie. Nos résultats soulignent un savoir/ une pensée infirmière inexprimée et l’intégration textuelle d’un discours de travail fonctionnel, compétent et polyvalent qui contribuent à brouiller les pratiques entre les IB et les ID, les rendant [potentiellement] interchangeables en contexte de soins aigus complexes. Cette étude, qui ne représente qu’une analyse d’une étude plus large, démontre l’invisibilité de la discipline infirmière et des objectifs et savoirs professionnels dans le discours des infirmières, alors que les IB et les ID réapprennent et maintiennent une pratique infirmière qui répond à d’autres objectifs institutionnels et organisationnels. Cet ajustement a d’importantes répercussions pour les enseignantes des programmes de soins et sciences infirmières, qui évoluent de manière parallèle dans des établissements d’enseignement. Cette recherche démontre que l’absence de clarté dans les rôles fonctionnels (qui maintient la confusion de rôle et l’ambiguïté) est délibérée et vise à former des travailleuses polyvalentes

Lithium and r-Process Abundances in the Population II Cepheid M5 V42

We report the results of an abundance analysis of the 25.7 day Population II Cepheid V42 in the globular cluster M5. V42 is probably a post–asymptotic giant branch (AGB) star, in its final crossing of the H-R diagram. We find [Fe/H] = -1.22, in excellent agreement with a similar analysis of this star by Gonzalez & Lambert, and of red giants in M5 by Sneden et al. The analysis is based on six spectra obtained during three different phases of the star's pulsational cycle. Oxygen is depleted, and sodium is enhanced, while the "α" elements Mg, Si, Ca, and Ti are enhanced by about 0.3 dex. Most interesting, lithium is detected, with log (Li) ≈ +1.8, suggesting the production of lithium and its rapid transport to the surface. Zinc and silicon abundances are normal with respect to iron and calcium, suggesting that depletion onto dust grains during the AGB stage has not affected the star's abundances. The neutron-capture elements show ratios consistent with a nearly pure r-process origin. This r-process dominance is probably unrelated to the production of lithium, since the cluster's red giant branch stars show a similar pattern. Nonetheless, it appears that some low-mass, metal-poor stars do not solely destroy lithium in the course of their normal evolution

Development and Validation of a Clinical Scoring System to Differentiate Patients with Inflammatory Bowel Disease and Diarrhea-Predominant Irritable Bowel Disease

Background: There is no validated scoring system for differentiating inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS). Studies variably report clinical measures such as radiology, endoscopy, inflammatory markers, and symptoms to separate IBS from IBD. Our study seeks to create a system to IBD patients from IBS. The “REBISS” score incorporates various clinical criteria used commonly for diagnosis. We also studied a second system called “REBISS-PCP” focusing on a subset of criteria that are available to PCPs when faced with this challenge. Methods: This study was approved by the UMass IRB. Two cohorts were identified: 24 IBD patients (Group1) and 24 IBS patients (Group2). Subjects in Group1 were patients with Crohn’s or ulcerative colitis. Subjects in Group2 were identified as having IBS based on ROME III criteria. Retrospective analysis was performed and a score was calculated. One point is assigned for having: radiological findings consistent with IBD, endoscopic findings of inflammation or ulceration, biopsy findings consistent with IBD, elevated inflammatory markers, weight loss, hematochezia, extra-intestinal signs/symptoms, palpable mass on exam, and perianal disease. The maximum score is 10 points. For the REBISS-PCP score, the same clinical criteria were studied with the exclusion of endoscopic and biopsy findings. Maximum score for that system is 8 points. A likelihood ratio chi-square test was performed for both cohorts and scoring systems. Results: The REBISS scoring system showed a significant differentiation of the two cohorts in regards to scoring distribution (chi-square value = 59.8; p\u3c0.0001). The REBISS-PCP scoring system also found a significant differentiation of the two cohorts (chi-square value = 35.7;p\u3c 0.0001). Discussion: The REBISS scoring system could be used to standardize IBD and IBSd populations in an academic research setting, while both the REBISS and REBISS-PCP scoring system could be used as a screening tool in clinical practice

Exploratory analysis of methods for automated classification of laboratory test orders into syndromic groups in veterinary medicine

Background: Recent focus on earlier detection of pathogen introduction in human and animal populations has led to the development of surveillance systems based on automated monitoring of health data. Real- or near real-time monitoring of pre-diagnostic data requires automated classification of records into syndromes-syndromic surveillance-using algorithms that incorporate medical knowledge in a reliable and efficient way, while remaining comprehensible to end users. Methods: This paper describes the application of two of machine learning (Naïve Bayes and Decision Trees) and rule-based methods to extract syndromic information from laboratory test requests submitted to a veterinary diagnostic laboratory. Results: High performance (F1-macro = 0.9995) was achieved through the use of a rule-based syndrome classifier, based on rule induction followed by manual modification during the construction phase, which also resulted in clear interpretability of the resulting classification process. An unmodified rule induction algorithm achieved an F1-micro score of 0.979 though this fell to 0.677 when performance for individual classes was averaged in an unweighted manner (F1-macro), due to the fact that the algorithm failed to learn 3 of the 16 classes from the training set. Decision Trees showed equal interpretability to the rule-based approaches, but achieved an F1-micro score of 0.923 (falling to 0.311 when classes are given equal weight). A Naïve Bayes classifier learned all classes and achieved high performance (F1-micro = 0.994 and F1-macro =. 955), however the classification process is not transparent to the domain experts. Conclusion: The use of a manually customised rule set allowed for the development of a system for classification of laboratory tests into syndromic groups with very high performance, and high interpretability by the domain experts. Further research is required to develop internal validation rules in order to establish automated methods to update model rules without user input

Who cares for the bereaved? A national survey of family caregivers of people with motor neurone disease

Background: Although Motor Neurone Disease (MND) caregivers are most challenged physically and psychologically, there is a paucity of population-based research to investigate the impact of bereavement, unmet needs, range of supports, and their helpfulness as perceived by bereaved MND caregivers. Methods: An anonymous national population-based cross-sectional postal and online survey of bereavement experiences of family caregivers who lost a relative/friend to MND in 2016, 2017, and 2018. Recruitment was through all MND Associations in Australia. Results: 393 valid responses were received (31% response rate). Bereaved caregiver deterioration in physical (31%) and mental health (42%) were common. Approximately 40% did not feel their support needs were met. Perceived insufficiency of support was higher for caregivers at high bereavement risk (63%) and was associated with a significant worsening of their mental and physical health. The majority accessed support from family and friends followed by MND Associations, GPs, and funeral providers. Informal supports were reported to be the most helpful. Sources of professional help were the least used and they were perceived to be the least helpful. Conclusions: This study highlights the need for a new and enhanced approach to MND bereavement care involving a caregiver risk and needs assessment as a basis for a tailored “goodness of fit” support plan. This approach requires continuity of care, more resources, formal plans, and enhanced training for professionals, as well as optimizing community capacity. MND Associations are well-positioned to support affected families before and after bereavement but may require additional training and resources to fulfill this role

Estimation of species divergence times in presence of cross-species gene flow

Cross-species introgression can have significant impacts on phylogenomic reconstruction of species divergence events. Here, we used simulations to show how the presence of even a small amount of introgression can bias divergence time estimates when gene flow is ignored in the analysis. Using advances in analytical methods under the multispecies coalescent (MSC) model, we demonstrate that by accounting for incomplete lineage sorting and introgression using large phylogenomic data sets this problem can be avoided. The multispecies-coalescent-with-introgression (MSci) model is capable of accurately estimating both divergence times and ancestral effective population sizes, even when only a single diploid individual per species is sampled. We characterize some general expectations for biases in divergence time estimation under three different scenarios: 1) introgression between sister species, 2) introgression between non-sister species, and 3) introgression from an unsampled (i.e., ghost) outgroup lineage. We also conducted simulations under the isolation-with-migration (IM) model, and found that the MSci model assuming episodic gene flow was able to accurately estimate species divergence times despite high levels of continuous gene flow. We estimated divergence times under the MSC and MSci models from two published empirical datasets with previous evidence of introgression, one of 372 target-enrichment loci from baobabs (Adansonia), and another of 1,000 transcriptome loci from fourteen species of the tomato relative, Jaltomata. The empirical analyses not only confirm our findings from simulations, demonstrating that the MSci model can reliably estimate divergence times, but also show that divergence time estimation under the MSC can be robust to the presence of small amounts of introgression in empirical datasets with extensive taxon sampling

Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia

Acknowledgements We wish to dedicate this work to the memory of Christian Osmer, a dedicated, caring doctor who was committed to achieving the best care for his patients and their relatives. He saw his contribution to this project as a way of advancing best care for surgical patients. We are very grateful for his valuable input to this work and the pleasure we had in working with him. We are grateful to Karen Hovhanisyan (former Trials Search Co-ordinator, Cochrane Anaesthesia, Critical and Emergency Care Group (ACE)) for carrying out the electronic database searches and to Jane Cracknell (Managing Editor, ACE) for her support throughout the review process. We would also like to thank W Alastair Chambers and Manjeet Shehmar for clinical advice relating to judgements about general anaesthesia usage, and Yvonne Cooper and Louise Pike who retrieved documents and screened papers as research assistants in earlier stages of the review. We are grateful to the following colleagues who helped us with foreign language papers - either by screening papers or by providing translation: Stefano Carrubba, Chuan Gao, Chen Ji, Kate Rhie, Reza Roudsari and Alena Vasianovich. We would like to thank Andy Smith (content editor), Nathan Pace (statistical editor), Michael Donnelly, Allan Cyna and Michael Wang (peer reviewers), and Shunjie Chua (consumer referee) for their help and editorial advice during the preparation of this systematic review. We would also like to thank Andrew Smith (content editor), Nathan Pace (statistical editor), Michael Wang and Allan Cyna (peer reviewers), and Lynda Lane (Cochrane Consumer Network representative) for their help and editorial advice during the preparation of the protocol (Powell 2010). Sources of support Internal sources Manchester Centre for Health Psychology, University of Manchester, UK. An award of £2000 was received to support research assistant costs. External sources British Academy, UK. We received a small research grant of £7480 to support research assistant costs.Peer reviewedPublisher PD