Reply to the comment by Carmelo Anile on the paper "Complexity analysis of the cerebrospinal fluid pulse waveform during infusion studies"

Veterinary technology is an emerging profession within the veterinary and allied animal health fields in Australia and affords graduates the opportunity to contribute to the small but growing body of literature within this discipline. This study describes the introduction of a contextualised assessment task to develop students’ research capability, competence and confidence in professional writing, and to engage them with the academic publishing process. Students worked in self-selected dyads to author a scientific case report, of publishable standard, based on authentic cases from their clinical practicum. Intrinsic to the task, students attended a series of workshops that explored topics such as critiquing the literature, professional writing styles and oral presentation skills. Assessment was multi-staged with progressive feedback, including peer review, and culminated with students presenting their abstracts at a mock conference. Students reported the task to be an enjoyable and valuable learning experience which improved their competence and confidence in scientific writing; supported by a comparison of previously submitted work. Linking scientific writing skills to clinical practice experiences enhanced learning outcomes and may foster the professionalisation of students within this emerging discipline

Physical interpretation of the correlation between multi-angle spectral data and canopy height

Recent empirical studies have shown that multi-angle spectral data can be useful for predicting canopy height, but the physical reason for this correlation was not understood. We follow the concept of canopy spectral invariants, specifically escape probability, to gain insight into the observed correlation. Airborne Multi-Angle Imaging Spectrometer (AirMISR) and airborne Laser Vegetation Imaging Sensor (LVIS) data acquired during a NASA Terrestrial Ecology Program aircraft campaign underlie our analysis. Two multivariate linear regression models were developed to estimate LVIS height measures from 28 AirMISR multi-angle spectral reflectances and from the spectrally invariant escape probability at 7 AirMISR view angles. Both models achieved nearly the same accuracy, suggesting that canopy spectral invariant theory can explain the observed correlation. We hypothesize that the escape probability is sensitive to the aspect ratio (crown diameter to crown height). The multi-angle spectral data alone therefore may not provide enough information to retrieve canopy height globally

Mitochondrial uncoupling as a regulator of life-history trajectories in birds: an experimental study in the zebra finch.

Mitochondria have a fundamental role in the transduction of energy from food into ATP. The coupling between food oxidation and ATP production is never perfect, but may nevertheless be of evolutionary significance. The 'uncoupling to survive' hypothesis suggests that 'mild' mitochondrial uncoupling evolved as a protective mechanism against the excessive production of damaging reactive oxygen species (ROS). Because resource allocation and ROS production are thought to shape animal life histories, alternative life-history trajectories might be driven by individual variation in the degree of mitochondrial uncoupling. We tested this hypothesis in a small bird species, the zebra finch (Taeniopygia guttata), by treating adults with the artificial mitochondrial uncoupler 2,4-dinitrophenol (DNP) over a 32-month period. In agreement with our expectations, the uncoupling treatment increased metabolic rate. However, we found no evidence that treated birds enjoyed lower oxidative stress levels or greater survival rates, in contrast to previous results in other taxa. In vitro experiments revealed lower sensitivity of ROS production to DNP in mitochondria isolated from skeletal muscles of zebra finch than mouse. In addition, we found significant reductions in the number of eggs laid and in the inflammatory immune response in treated birds. Altogether, our data suggest that the 'uncoupling to survive' hypothesis may not be applicable for zebra finches, presumably because of lower effects of mitochondrial uncoupling on mitochondrial ROS production in birds than in mammals. Nevertheless, mitochondrial uncoupling appeared to be a potential life-history regulator of traits such as fecundity and immunity at adulthood, even with food supplied ad libitum

Offspring sex ratio and gonadal irradiation in the British Childhood Cancer Survivor Study

We investigated offspring sex ratio among 6232 offspring born to 3218 survivors of childhood cancer in relation to therapeutic irradiation, and pooled our data with those from two other large-scale studies giving a total of 9685 offspring. Exposure to high-dose gonadal irradiation was not associated with a significant alteration in offspring sex ratio compared to low doses (men: P=0.58, women: P=0.66). There was also no evidence that the ratio varied with time since cancer diagnosis when comparing survivors treated with radiotherapy vs those without (men: P=0.51; women: P=0.46). This, the largest study to date, finds no evidence that exposure to radiation affects the offspring sex ratio among survivors of childhood cancer

Interoception and Respiratory Sinus Arrhythmia in Gambling Disorder

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordGambling has long-standing links with excitement and physiological arousal, but prior research has not considered i) gamblers’ ability to detect internal physiological signals, or ii) markers of parasympathetic functioning. The present study measured interoception in individuals with gambling disorder, using selfreport measures and a heart beat counting task administered at rest. Resting state Respiratory Sinus Arrhythmia (RSA), an index of heart rate variability, was measured as a proxy for parasympathetic control and emotional regulation capacity. In a case-control design, 50 individuals with gambling disorder were compared against 35 controls without gambling problems. Participants completed two self-report measures of bodily awareness and a behavioural test of heart beat counting. A resting state electrocardiogram (five minutes) was used to calculate RSA. There were no significant differences on the self-report or behavioral interoception probes. The group with gambling disorder displayed significantly reduced RSA, which at face value is consistent with reduced parasympathetic control. However, the group difference in RSA did not survive controlling for age and smoking status, as established predictors of heart rate variability. Our findings do not support any changes in interoceptive processing in people with gambling disorder, at least under resting conditions. Our observation that group differences in RSA are partly explained by smoking behavior highlights the importance of controlling for nicotine use in future research characterizing physiological functioning and emotional regulation in disordered gambling.Centre for Gambling Research at UBCProvince of British Columbia governmentBritish Columbia Lottery CorporationNatural Sciences and Engineering Research Council (Canada

Oxidative stress and mitochondrial responses to stress exposure suggest that king penguins are naturally equipped to resist stress

Exposure to unpredictable environmental stressors could influence animal health and fitness by inducing oxidative stress, potentially through downstream effects of glucocorticoid stress hormones (e.g. corticosterone) on mitochondrial function. Yet, it remains unclear whether species that have evolved in stochastic and challenging environments may present adaptations to alleviate the effects of stress exposure on oxidative stress. We tested this hypothesis in wild king penguins by investigating mitochondrial and oxidative stress responses to acute restraint-stress, and their relationships with baseline (potentially mirroring exposure to chronic stress) and stress-induced increase in corticosterone levels. Acute restraint-stress did not significantly influence mitochondrial function. However, acute restraint-stress led to a significant increase in endogenous antioxidant defences, while oxidative damage levels were mostly not affected or even decreased. High baseline corticosterone levels were associated with an up-regulation of the glutathione antioxidant system and a decrease in mitochondrial efficiency. Both processes might contribute to prevent oxidative damage, potentially explaining the negative relationship observed between baseline corticosterone and plasma oxidative damage to proteins. While stress exposure can represent an oxidative challenge for animals, protective mechanisms like up-regulating antioxidant defences and decreasing mitochondrial efficiency seem to occur in king penguins, allowing them to cope with their stochastic and challenging environment

Simulation methods in the healthcare systems

International audienceHealthcare systems can be considered as large-scale complex systems. They need to be well managed in order to create the desired values for its stakeholders as the patients, the medical staff and the industrials working for healthcare. Many simulation methods coming from other sectors have already proved their added value for healthcare. However, based on our experience in the French heath sector (Jean et al. 2012), we found these methods are not widely used in comparison with other areas as manufacturing and logistic. This paper presents a literature review of the healthcare issue and major simulations methods used to address them. This work is design to suggest how more systematic creation of solutions may be performed using complementary methods to resolve a common issue. We believe that this first work can help to better understand the simulation approaches used for health workers, deciders or researchers of any responsibility level

The Impact of Inpatient Boarding on ED Efficiency: A Discrete-Event Simulation Study

In this study, a discrete-event simulation approach was used to model Emergency Department’s (ED) patient flow to investigate the effect of inpatient boarding on the ED efficiency in terms of the National Emergency Department Crowding Scale (NEDOCS) score and the rate of patients who leave without being seen (LWBS). The decision variable in this model was the boarder-released-ratio defined as the ratio of admitted patients whose boarding time is zero to all admitted patients. Our analysis shows that the Overcrowded+ (a NEDOCS score over 100) ratio decreased from 88.4% to 50.4%, and the rate of LWBS patients decreased from 10.8% to 8.4% when the boarder-released-ratio changed from 0% to 100%. These results show that inpatient boarding significantly impacts both the NEDOCS score and the rate of LWBS patient and this analysis provides a quantification of the impact of boarding on emergency department patient crowding

Atomic-scale confinement of optical fields

In the presence of matter there is no fundamental limit preventing confinement of visible light even down to atomic scales. Achieving such confinement and the corresponding intensity enhancement inevitably requires simultaneous control over atomic-scale details of material structures and over the optical modes that such structures support. By means of self-assembly we have obtained side-by-side aligned gold nanorod dimers with robust atomically-defined gaps reaching below 0.5 nm. The existence of atomically-confined light fields in these gaps is demonstrated by observing extreme Coulomb splitting of corresponding symmetric and anti-symmetric dimer eigenmodes of more than 800 meV in white-light scattering experiments. Our results open new perspectives for atomically-resolved spectroscopic imaging, deeply nonlinear optics, ultra-sensing, cavity optomechanics as well as for the realization of novel quantum-optical devices

The impact of delays to admission from the emergency department on inpatient outcomes

<p>Abstract</p> <p>Background</p> <p>We sought to determine the impact of delays to admission from the Emergency Department (ED) on inpatient length of stay (LOS), and IP cost.</p> <p>Methods</p> <p>We conducted a retrospective analysis of 13,460 adult (≥ 18 yrs) ED visits between April 1 2006 and March 30 2007 at a tertiary care teaching hospital with two ED sites in which the mode of disposition was admission to ICU, surgery or inpatient wards. We defined ED Admission Delay as ED time to decision to admit > 12 hours. The primary outcomes were IP LOS, and total IP cost.</p> <p>Results</p> <p>Approximately 11.6% (n = 1558) of admitted patients experienced admission delay. In multivariate analysis we found that admission delay was associated with 12.4% longer IP LOS (95% CI 6.6% - 18.5%) and 11.0% greater total IP cost (6.0% - 16.4%). We estimated the cumulative impact of delay on all delayed patients as an additional 2,183 inpatient days and an increase in IP cost of $2,109,173 at the study institution.</p> <p>Conclusions</p> <p>Delays to admission from the ED are associated with increased IP LOS and IP cost. Improving patient flow through the ED may reduce hospital costs and improve quality of care. There may be a business case for investments to reduce emergency department admission delays.</p