Optimizing anesthesia techniques in the ambulatory setting

Ambulatory surgery refers to the process of admitting patients, administering anesthesia and surgical care, and discharging patients home following an appropriate level of recovery on the same day. The word ambulatory is derived from the latin word ambulare, which means ''to walk''. This means that patients treated on an ambulatory basis do not require hospitalisation and achieve a level of postoperative 'home readiness' that allows them to go home within hours of procedure completion

Differences in the Experience of Caregiving Between Spouse and Adult Child Caregivers in Dementia With Lewy Bodies.

Background and objectivesDementia caregiving has been associated with increased burden, depression, grief, a decreased sense of well-being and quality of life, and a weakening of social support. Little is known about the experience of caregiving in Dementia with Lewy Bodies (DLB). The present study examines differences in the caregiving experience of spouse versus adult child caregivers of individuals with DLB.Research design and methodsIn this cross-sectional analytic study of spouses (n = 255) and adult children (n = 160) caregivers of individuals with DLB, participants completed an online survey of burden, grief, depression, well-being, quality of life, and social support.ResultsAdult child caregivers were more likely to care for women (p < .001) and see the care recipient less often (p < .001) than spouses. Adult child caregivers reported lower quality of life (p < .001) and more caregiver burden (p < .009), but also greater social support (p < .001) than spouses. Between group analyses of caregiver type by disease severity demonstrated that spousal caregivers experience greater grief with advancing disease (p = .005), while adult child caregivers increase social support with advancing disease (p < .001).Discussion and implicationsSpouses and adult children experience DLB caregiving differently. This was explained by the younger age of the adult child caregiver, frequency of contact with the care recipient, and differences in the care recipient's characteristics, frequency of neuropsychiatric symptoms, and disease severity. DLB caregiver support for this population should target psychoeducation for complicated neuropsychiatric symptoms in the care recipient. Screening all DLB caregivers for burden, grief, and depression is suggested to identify those that may benefit most from intervention. Spouses specifically may benefit from interventions that target increasing social support, while adult child caregivers may benefit from interventions aimed at mitigating burden and improving quality of life

Inclusive leadership : realizing positive outcomes through belongingness and being valued for uniqueness

We introduce a theoretically-grounded conceptualization of inclusive leadership and present a framework for understanding factors that contribute to and follow from inclusive leadership within work groups. We conceptualize inclusive leadership as a set of positive leader behaviors that facilitate group members perceiving belongingness in the work group while maintaining their uniqueness within the group as they fully contribute to group processes and outcomes. We propose that leader pro-diversity beliefs, humility, and cognitive complexity increase the propensity of inclusive leader behaviors. We identify five categories of inclusive leadership behaviors that facilitate group members' perceptions of inclusion, which in turn lead to member work group identification, psychological empowerment, and behavioral outcomes (creativity, job performance, and reduced turnover) in the pursuit of group goals. This framework provides theoretical grounding for the construct of inclusive leadership while advancing our understanding of how leaders can increase diverse work group effectiveness

20 cm VLA Radio-Continuum Study of M31 - Images and Point Source Catalogues

We present a series of new high-sensitivity and high-resolution radio-continuum images of M31 at \lambda=20 cm (\nu=1.4 GHz). These new images were produced by merging archived 20 cm radio-continuum observations from the Very Large Array (VLA) telescope. Images presented here are sensitive to rms=60 \mu Jy and feature high angular resolution (<10"). A complete sample of discrete radio sources have been catalogued and analysed across 17 individual VLA projects. We identified a total of 864 unique discrete radio sources across the field of M31. One of the most prominent regions in M31 is the ring feature for which we estimated total integrated flux of 706 mJy at \lambda=20 cm. We compare here, detected sources to those listed in Gelfand et al. (2004) at \lambda=92 cm and find 118 sources in common to both surveys. The majority (61%) of these sources exhibit a spectral index of \alpha <-0.6 indicating that their emission is predominantly non-thermal in nature. That is more typical for background objects.Comment: 28 pages, 25 figures, accepted for publication in the Serbian Astronomical Journa

On the role of the Knudsen layer in rapid granular flows

A combination of molecular-dynamics simulations, theoretical predictions, and previous experiments are used in a two-part study to determine the role of the Knudsen layer in rapid granular flows. First, a robust criterion for the identification of the thickness of the Knudsen layer is established: a rapid deterioration in Navier-Stokes-order prediction of the heat flux is found to occur in the Knudsen layer. For (experimental) systems in which heat flux measurements are not easily obtained, a rule-of-thumb for estimating the Knudsen layer thickness follows, namely that such effects are evident within 2.5 (local) mean free paths of a given boundary. Second, comparisons of simulation and experimental data with Navier-Stokes order theory are used to provide a measure as to when Knudsen layer effects become non-negligible. Specifically, predictions that do not account for the presence of a Knudsen layer appear reliable for Knudsen layers collectively composing up to 20% of the domain, whereas deterioration of such predictions becomes apparent when the domain is fully comprised of the Knudsen layer.Comment: 9 figures, accepted to Journal of Fluid Mechanic

Cortical–subcortical interactions in hypersomnia disorders: Mechanisms underlying cognitive and behavioral aspects of the sleep–wake cycle

Subcortical circuits mediating sleep–wake functions have been well characterized in animal models, and corroborated by more recent human studies. Disruptions in these circuits have been identified in hypersomnia disorders (HDs) such as narcolepsy and Kleine–Levin Syndrome, as well as in neurodegenerative disorders expressing excessive daytime sleepiness. However, the behavioral expression of sleep–wake functions is not a simple on-or-off state determined by subcortical circuits, but encompasses a complex range of behaviors determined by the interaction between cortical networks and subcortical circuits. While conceived as disorders of sleep, HDs are equally disorders of wake, representing a fundamental instability in neural state characterized by lapses of alertness during wake. These episodic lapses in alertness and wakefulness are also frequently seen in neurodegenerative disorders where electroencephalogram demonstrates abnormal function in cortical regions associated with cognitive fluctuations (CFs). Moreover, functional connectivity MRI shows instability of cortical networks in individuals with CFs. We propose that the inability to stabilize neural state due to disruptions in the sleep–wake control networks is common to the sleep and cognitive dysfunctions seen in hypersomnia and neurodegenerative disorders

Radio Galaxy Zoo: Knowledge Transfer Using Rotationally Invariant Self-Organising Maps

With the advent of large scale surveys the manual analysis and classification of individual radio source morphologies is rendered impossible as existing approaches do not scale. The analysis of complex morphological features in the spatial domain is a particularly important task. Here we discuss the challenges of transferring crowdsourced labels obtained from the Radio Galaxy Zoo project and introduce a proper transfer mechanism via quantile random forest regression. By using parallelized rotation and flipping invariant Kohonen-maps, image cubes of Radio Galaxy Zoo selected galaxies formed from the FIRST radio continuum and WISE infrared all sky surveys are first projected down to a two-dimensional embedding in an unsupervised way. This embedding can be seen as a discretised space of shapes with the coordinates reflecting morphological features as expressed by the automatically derived prototypes. We find that these prototypes have reconstructed physically meaningful processes across two channel images at radio and infrared wavelengths in an unsupervised manner. In the second step, images are compared with those prototypes to create a heat-map, which is the morphological fingerprint of each object and the basis for transferring the user generated labels. These heat-maps have reduced the feature space by a factor of 248 and are able to be used as the basis for subsequent ML methods. Using an ensemble of decision trees we achieve upwards of 85.7% and 80.7% accuracy when predicting the number of components and peaks in an image, respectively, using these heat-maps. We also question the currently used discrete classification schema and introduce a continuous scale that better reflects the uncertainty in transition between two classes, caused by sensitivity and resolution limits

Conceptual Design of the Coronagraphic High Angular Resolution Imaging Spectrograph (CHARIS) for the Subaru Telescope

Recent developments in high-contrast imaging techniques now make possible both imaging and spectroscopy of planets around nearby stars. We present the conceptual design of the Coronagraphic High Angular Resolution Imaging Spectrograph (CHARIS), a lenslet-based, cryogenic integral field spectrograph (IFS) for imaging exoplanets on the Subaru telescope. The IFS will provide spectral information for 140x140 spatial elements over a 1.75 arcsecs x 1.75 arcsecs field of view (FOV). CHARIS will operate in the near infrared (lambda = 0.9 - 2.5 microns) and provide a spectral resolution of R = 14, 33, and 65 in three separate observing modes. Taking advantage of the adaptive optics systems and advanced coronagraphs (AO188 and SCExAO) on the Subaru telescope, CHARIS will provide sufficient contrast to obtain spectra of young self-luminous Jupiter-mass exoplanets. CHARIS is in the early design phases and is projected to have first light by the end of 2015. We report here on the current conceptual design of CHARIS and the design challenges

Statistics of counter-streaming solar wind suprathermal electrons at solar minimum : STEREO observations

Previous work has shown that solar wind suprathermal electrons can display a number of features in terms of their anisotropy. Of importance is the occurrence of counter-streaming electron patterns, i.e., with "beams" both parallel and anti-parallel to the local magnetic field, which is believed to shed light on the heliospheric magnetic field topology. In the present study, we use STEREO data to obtain the statistical properties of counter-streaming suprathermal electrons (CSEs) in the vicinity of corotating interaction regions (CIRs) during the period March–December 2007. Because this period corresponds to a minimum of solar activity, the results are unrelated to the sampling of large-scale coronal mass ejections, which can lead to CSE owing to their closed magnetic field topology. The present study statistically confirms that CSEs are primarily the result of suprathermal electron leakage from the compressed CIR into the upstream regions with the combined occurrence of halo depletion at 90° pitch angle. The occurrence rate of CSE is found to be about 15–20% on average during the period analyzed (depending on the criteria used), but superposed epoch analysis demonstrates that CSEs are preferentially observed both before and after the passage of the stream interface (with peak occurrence rate >35% in the trailing high speed stream), as well as both inside and outside CIRs. The results quantitatively show that CSEs are common in the solar wind during solar minimum, but yet they suggest that such distributions would be much more common if pitch angle scattering were absent. We further argue that (1) the formation of shocks contributes to the occurrence of enhanced counter-streaming sunward-directed fluxes, but does not appear to be a necessary condition, and (2) that the presence of small-scale transients with closed-field topologies likely also contributes to the occurrence of counter-streaming patterns, but only in the slow solar wind prior to CIRs