Service evaluation of community based palliative care and a hospice at home service

Background: Hospices and other palliative and end-of-life care providers are now required to develop services that aim to improve the quality of end-of-life care and choice in terms of place of care and death for those living with or dying from a life-threatening illness. In 2010, an NHS clinical commissioning group in South Yorkshire, UK, produced a strategic plan that aimed to improve the quality and choice of end-of-life care locally. To that end, it established a project team to review the services already provided by the local hospice and to extend the hospice’s already existing services, including expansion of the hospice-at-home service. Aims: To explore the views of key stakeholders, including healthcare staff and service users, with regard to the quality of care provided by the expanded hospice-at-home service and the choice and quality of palliative care available in the community. Four priorities for exploration were identified: the use of electronic records, advance care planning, communication and care co-ordination, and 24-hour access to end-of-life care services. Method: A policy-applied qualitative methodology was used to explore stakeholder views. Four focus groups, using a semi-structured interview schedule, were conducted with four stakeholder groups: patients/carers; community nursing staff; palliative care nurse specialists; and GPs/senior managers. Data analysis used a framework approach to categorise the stakeholder responses according to the four priority areas identified. Findings: A total of 30 participants were recruited from the four stakeholder groups; patients and carers (n=5); community nursing staff (n=6); palliative care nurse specialists (n=9); and GPs and senior managers (n=10). Participants perceived that important aspects of end-of-life care needs were being met. These included quick access to hospice-at-home services particularly over bank holidays, and the prevention of admission to hospital for patients who received visits and treatment at home from this service. These aspects were highly valued by all the participants who took part in the focus groups. Issues that needed improvement were identified and included communication problems between hospital and community services, education and training needs for some staff regarding the use of technology and the limitations of the current service in relation to home visits from the hospice-at-home service. Conclusions: Recommendations for developing end-of-life care services included 24-hour access to home visits over 7 days each week, the provision of training and education for staff in the use of technology, talking to families about advance care planning, and improved communication between and timely transfer of information from hospital to community services when patients are discharged

Parallel HOP: A Scalable Halo Finder for Massive Cosmological Data Sets

Modern N-body cosmological simulations contain billions ($10^9$) of dark matter particles. These simulations require hundreds to thousands of gigabytes of memory, and employ hundreds to tens of thousands of processing cores on many compute nodes. In order to study the distribution of dark matter in a cosmological simulation, the dark matter halos must be identified using a halo finder, which establishes the halo membership of every particle in the simulation. The resources required for halo finding are similar to the requirements for the simulation itself. In particular, simulations have become too extensive to use commonly-employed halo finders, such that the computational requirements to identify halos must now be spread across multiple nodes and cores. Here we present a scalable-parallel halo finding method called Parallel HOP for large-scale cosmological simulation data. Based on the halo finder HOP, it utilizes MPI and domain decomposition to distribute the halo finding workload across multiple compute nodes, enabling analysis of much larger datasets than is possible with the strictly serial or previous parallel implementations of HOP. We provide a reference implementation of this method as a part of the toolkit yt, an analysis toolkit for Adaptive Mesh Refinement (AMR) data that includes complementary analysis modules. Additionally, we discuss a suite of benchmarks that demonstrate that this method scales well up to several hundred tasks and datasets in excess of $2000^3$ particles. The Parallel HOP method and our implementation can be readily applied to any kind of N-body simulation data and is therefore widely applicable.Comment: 29 pages, 11 figures, 2 table

Implementing within‐cross genomic prediction to reduce oat breeding costs

A barrier to the adoption of genomic prediction in small breeding programs is the initial cost of genotyping material. Although decreasing, marker costs are usually higher than field trial costs. In this study we demonstrate the utility of stratifying a narrow‐base biparental oat population genotyped with a modest number of markers to employ genomic prediction at early and later generations. We also show that early generation genotyping data can reduce the number of lines for later phenotyping based on selections of siblings to progress. Using sets of small families selected at an early generation could enable the use of genomic prediction for adaptation to multiple target environments at an early stage in the breeding program. In addition, we demonstrate that mixed marker data can be effectively integrated to combine cheap dominant marker data (including legacy data) with more expensive but higher density codominant marker data in order to make within generation and between lineage predictions based on genotypic information. Taken together, our results indicate that small programs can test and initiate genomic predictions using sets of stratified, narrow‐base populations and incorporating low density legacy genotyping data. This can then be scaled to include higher density markers and a broadened population base

Hypoxia Promotes Atrial Tachyarrhythmias via Opening of ATP-Sensitive Potassium Channels

BACKGROUND: Hypoxia-ischemia predisposes to atrial arrhythmia. Atrial ATP-sensitive potassium channel (KATP) modulation during hypoxia has not been explored. We investigated the effects of hypoxia on atrial electrophysiology in mice with global deletion of KATP pore-forming subunits. METHODS: Whole heart KATP RNA expression was probed. Whole-cell KATP current and action potentials were recorded in isolated wild-type (WT), Kir6.1 global knockout (6.1-gKO), and Kir6.2 global knockout murine atrial myocytes. Langendorff-perfused hearts were assessed for atrial effective refractory period (ERP), conduction velocity, wavefront path length (WFPL), and arrhymogenicity under normoxia/hypoxia using a microelectrode array and programmed electrical stimulation. Heart histology was assessed. RESULTS: Expression patterns were essentially identical for all KATP subunit RNA across human heart, whereas in mouse, Kir6.1 and SUR2 (sulphonylurea receptor) were higher in ventricle than atrium, and Kir6.2 and SUR1 were higher in atrium. Compared with WT, Kir6.2 global knockout atrial myocytes had reduced tolbutamide-sensitive current and action potentials were more depolarized with slower upstroke and reduced peak amplitude. Action potential duration was prolonged in 6.1-gKO atrial myocytes, absent of changes in other ion channel gene expression or atrial myocyte hypertrophy. In Langendorff-perfused hearts, baseline atrial ERP was prolonged and conduction velocity reduced in both KATP knockout mice compared with WT, without histological fibrosis. Compared with baseline, hypoxia led to conduction velocity slowing, stable ERP, and WFPL shortening in WT and 6.1-gKO hearts, whereas WFPL was stable in Kir6.2 global knockout hearts due to ERP prolongation with conduction velocity slowing. Tolbutamide reversed hypoxia-induced WFPL shortening in WT and 6.1-gKO hearts through ERP prolongation. Atrial tachyarrhythmias inducible with programmed electrical stimulation during hypoxia in WT and 6.1-gKO mice correlated with WFPL shortening. Spontaneous arrhythmia was not seen. CONCLUSIONS: KATP block/absence leads to cellular and tissue level atrial electrophysiological modification. Kir6.2 global knockout prevents hypoxia-induced atrial WFPL shortening and atrial arrhythmogenicity to programmed electrical stimulation. This mechanism could be explored translationally to treat ischemically driven atrial arrhythmia

The Spatial Clustering of ROSAT All-Sky Survey AGNs II. Halo Occupation Distribution Modeling of the Cross Correlation Function

This is the second paper of a series that reports on our investigation of the clustering properties of AGNs in the ROSAT All-Sky Survey (RASS) through cross-correlation functions (CCFs) with Sloan Digital Sky Survey (SDSS) galaxies. In this paper, we apply the Halo Occupation Distribution (HOD) model to the CCFs between the RASS Broad-line AGNs with SDSS Luminous Red Galaxies (LRGs) in the redshift range 0.16<z<0.36 that was calculated in paper I. In our HOD modeling approach, we use the known HOD of LRGs and constrain the HOD of the AGNs by a model fit to the CCF. For the first time, we are able to go beyond quoting merely a `typical' AGN host halo mass, M_h, and model the full distribution function of AGN host dark matter halos. In addition, we are able to determine the large-scale bias and the mean M_h more accurately. We explore the behavior of three simple HOD models. Our first model (Model A) is a truncated power-law HOD model in which all AGNs are satellites. With this model, we find an upper limit to the slope (\alpha) of the AGN HOD that is far below unity. The other two models have a central component, which has a step function form, where the HOD is constant above a minimum mass, without (Model B) or with (Model C) an upper mass cutoff, in addition to the truncated power-law satellite component, similar to the HOD that is found for galaxies. In these two models we find the upper limits of \alpha < 0.95 and \alpha < 0.84 for Model B and C respectively. Our analysis suggests that the satellite AGN occupation increases slower than, or may even decrease with, M_h, in contrast to the satellite's HODs of luminosity-threshold samples of galaxies, which, in contrast, grow approximately as \propto M_h^\alpha with \alpha\approx 1. These results are consistent with observations that the AGN fraction in groups and clusters decreases with richness.Comment: 15 pages, 9 figures. ApJ in pres

The Dark Matter Haloes and Host Galaxies of MgII Absorbers at z~1

Strong foreground absorption features from singly-ionized Magnesium (Mg II) are commonly observed in the spectra of quasars and are presumed to probe a wide range of galactic environments. To date, measurements of the average dark matter halo masses of intervening Mg II absorbers by way of large-scale cross-correlations with luminous galaxies have been limited to z<0.7. In this work we cross-correlate 21 strong (W{\lambda}2796>0.6 {\deg}A) Mg II absorption systems detected in quasar spectra from the Sloan Digital Sky Survey Data Release 7 with ~32,000 spectroscopically confirmed galaxies at 0.7<z<1.45 from the DEEP2 galaxy redshift survey. We measure dark matter (DM) halo biases of b_G=1.44\pm0.02 and b_A=1.49\pm0.45 for the DEEP2 galaxies and Mg II absorbers, respectively, indicating that their clustering amplitudes are roughly consistent. Haloes with the bias we measure for the Mg II absorbers have a corresponding mass of 1.8(+4.2/-1.6) \times 10^12h-1M_sun, although the actual mean absorber halo mass will depend on the precise distribution of absorbers within DM haloes. This mass estimate is consistent with observations at z=0.6, suggesting that the halo masses of typical Mg II absorbers do not significantly evolve from z~1. We additionally measure the average W{\lambda}2796>0.6 \AA gas covering fraction to be f =0.5 within 60 h-1kpc around the DEEP2 galaxies, and we find an absence of coincident strong Mg II absorption beyond a projected separation of ~40 h-1kpc. Although the star-forming z>1 DEEP2 galaxies are known to exhibit ubiquitous blueshifted Mg II absorption, we find no direct evidence in our small sample linking W{\lambda}2796>0.6 \AA absorbers to galaxies with ongoing star formation.Comment: 12 pages, 5 figures, Accepted to MNRA

The DEEP2 Galaxy Redshift Survey: The Voronoi-Delaunay Method Catalog of Galaxy Groups

We present a public catalog of galaxy groups constructed from the spectroscopic sample of galaxies in the fourth data release from the Deep Extragalactic Evolutionary Probe 2 (DEEP2) Galaxy Redshift Survey, including the Extended Groth Strip (EGS). The catalog contains 1165 groups with two or more members in the EGS over the redshift range 0 0.6 in the rest of DEEP2. Twenty-five percent of EGS galaxies and fourteen percent of high-z DEEP2 galaxies are assigned to galaxy groups. The groups were detected using the Voronoi-Delaunay method (VDM) after it has been optimized on mock DEEP2 catalogs following similar methods to those employed in Gerke et al. In the optimization effort, we have taken particular care to ensure that the mock catalogs resemble the data as closely as possible, and we have fine-tuned our methods separately on mocks constructed for the EGS and the rest of DEEP2. We have also probed the effect of the assumed cosmology on our inferred group-finding efficiency by performing our optimization on three different mock catalogs with different background cosmologies, finding large differences in the group-finding success we can achieve for these different mocks. Using the mock catalog whose background cosmology is most consistent with current data, we estimate that the DEEP2 group catalog is 72% complete and 61% pure (74% and 67% for the EGS) and that the group finder correctly classifies 70% of galaxies that truly belong to groups, with an additional 46% of interloper galaxies contaminating the catalog (66% and 43% for the EGS). We also confirm that the VDM catalog reconstructs the abundance of galaxy groups with velocity dispersions above ~300 km s^(–1) to an accuracy better than the sample variance, and this successful reconstruction is not strongly dependent on cosmology. This makes the DEEP2 group catalog a promising probe of the growth of cosmic structure that can potentially be used for cosmological tests

The Persistence of Cool Galactic Winds in High Stellar Mass Galaxies Between z~1.4 and ~1

We present an analysis of the MgII 2796, 2803 and FeII 2586, 2600 absorption line profiles in coadded spectra of 468 galaxies at 0.7 < z < 1.5. The galaxy sample, drawn from the Team Keck Treasury Redshift Survey of the GOODS-N field, has a range in stellar mass (M_*) comparable to that of the sample at z~1.4 analyzed in a similar manner by Weiner et al. (2009; W09), but extends to lower redshifts and has specific star formation rates which are lower by ~0.6 dex. We identify outflows of cool gas from the Doppler shift of the MgII absorption lines and find that the equivalent width (EW) of absorption due to outflowing gas increases on average with M_* and star formation rate (SFR). We attribute the large EWs measured in spectra of the more massive, higher-SFR galaxies to optically thick absorbing clouds having large velocity widths. The outflows have hydrogen column densities N(H) > 10^19.3 cm^-2, and extend to velocities of ~500 km/s. While galaxies with SFR > 10 Msun/yr host strong outflows in both this and the W09 sample, we do not detect outflows in lower-SFR (i.e., log M_*/Msun < 10.5) galaxies at lower redshifts. Using a simple galaxy evolution model which assumes exponentially declining SFRs, we infer that strong outflows persist in galaxies with log M_*/Msun > 10.5 as they age between z=1.4 and z~1, presumably because of their high absolute SFRs. Finally, using high resolution HST/ACS imaging in tandem with our spectral analysis, we find evidence for a weak trend (at 1 sigma significance) of increasing outflow absorption strength with increasing galaxy SFR surface density.Comment: Submitted to ApJ. 25 pages, 19 figures, Figure 2 reduced in resolution. Uses emulateapj forma

An Online Database for Informing Ecological Network Models: http://kelpforest.ucsc.edu

Ecological network models and analyses are recognized as valuable tools for understanding the dynamics and resiliency of ecosystems, and for informing ecosystem-based approaches to management. However, few databases exist that can provide the life history, demographic and species interaction information necessary to parameterize ecological network models. Faced with the difficulty of synthesizing the information required to construct models for kelp forest ecosystems along the West Coast of North America, we developed an online database (http://kelpforest.ucsc.edu/) to facilitate the collation and dissemination of such information. Many of the database’s attributes are novel yet the structure is applicable and adaptable to other ecosystem modeling efforts. Information for each taxonomic unit includes stage-specific life history, demography, and body-size allometries. Species interactions include trophic, competitive, facilitative, and parasitic forms. Each data entry is temporally and spatially explicit. The online data entry interface allows researchers anywhere to contribute and access information. Quality control is facilitated by attributing each entry to unique contributor identities and source citations. The database has proven useful as an archive of species and ecosystem-specific information in the development of several ecological network models, for informing management actions, and for education purposes (e.g., undergraduate and graduate training). To facilitate adaptation of the database by other researches for other ecosystems, the code and technical details on how to customize this database and apply it to other ecosystems are freely available and located at the following link (https://github.com/kelpforest-cameo/databaseui)

Ubiquitous outflows in DEEP2 spectra of star-forming galaxies at z=1.4

Galactic winds are a prime suspect for the metal enrichment of the intergalactic medium and may have a strong influence on the chemical evolution of galaxies and the nature of QSO absorption line systems. We use a sample of 1406 galaxy spectra at z~1.4 from the DEEP2 redshift survey to show that blueshifted Mg II 2796, 2803 A absorption is ubiquitous in starforming galaxies at this epoch. This is the first detection of frequent outflowing galactic winds at z~1. The presence and depth of absorption are independent of AGN spectral signatures or galaxy morphology; major mergers are not a prerequisite for driving a galactic wind from massive galaxies. Outflows are found in coadded spectra of galaxies spanning a range of 30x in stellar mass and 10x in star formation rate (SFR), calibrated from K-band and from MIPS IR fluxes. The outflows have column densities of order N_H ~ 10^20 cm^-2 and characteristic velocities of ~ 300-500 km/sec, with absorption seen out to 1000 km/sec in the most massive, highest SFR galaxies. The velocities suggest that the outflowing gas can escape into the IGM and that massive galaxies can produce cosmologically and chemically significant outflows. Both the Mg II equivalent width and the outflow velocity are larger for galaxies of higher stellar mass and SFR, with V_wind ~ SFR^0.3, similar to the scaling in low redshift IR-luminous galaxies. The high frequency of outflows in the star-forming galaxy population at z~1 indicates that galactic winds occur in the progenitors of massive spirals as well as those of ellipticals. The increase of outflow velocity with mass and SFR constrains theoretical models of galaxy evolution that include feedback from galactic winds, and may favor momentum-driven models for the wind physics.Comment: Accepted by ApJ. 25 pages, 17 figures. Revised to add discussions of intervening absorbers and AGN-driven outflows; conclusions unchange