Patient History Elicitation and Diagnostic Decision Making

Technology has changed the way people communicate, and communication between patients and medical professionals has not been exempt from these developments. Clinicians are now text messaging, emailing, and video conferencing patient. Understanding the impact of the new modalities on communication patterns is imperative to ensure quality care. Thirty-two medical professionals of varying experience conducted a patient interview with two confederate patients over an instant messaging system. The first interview was 15 minutes and the second 7 minutes, the latter condition inducing time pressure. The results demonstrated that time pressure has an adverse impact on the medical professionals’ communication patterns. The experience level of the medical professional was a mediating factor with strategies exhibited paralleling those outlined by stages of medical expertise

GROTESQUE AND GOTHIC CHILDREN'S LITERATURE: FROM NINETEENTH-CENTURY PICTUREBOOKS UP TO TIM BURTON

The aim of the present dissertation is to show that Tim Burton\u2019s imaginative universe can be considered as a remediation of a past tradition of grotesque and Gothic children\u2019s book illustration which I have identified with the picturebooks realised by some illustrators who lived between the nineteenth and the twenty-first century. The first two chapters are meant to provide a historical and theoretical background to the development of the works specifically discussed in the last two chapters. At the beginning of Alice\u2019s Adventures in Wonderland, the young protagonist asks what is the use of a book without pictures or conversations. Turning Alice\u2019s question upside down, in the first chapter I investigate what is the use of picturebooks. I start by tracing a brief history of picturebooks showing that it is strongly connected with the changes and improvements undergone by children\u2019s literature and by book illustrations. Subsequently, I identify in the interaction between words and images the distinguishing feature of picturebooks. Text-picture interaction is what makes picturebooks original and unique, and what explains their usefulness in the development of both verbal and visual literacy and especially of the literacy of the imagination. The second chapter deals with the grotesque and the Gothic. Despite the fact that they are examined separately, I do not conceive the grotesque and the Gothic as two distinct entities and in this chapter I show that they share many elements and they can be considered as complementary. I especially pinpoint that in the beginning both the terms grotesque and Gothic are used in the artistic field and only later start to be applied also in literature. As far as the grotesque is concerned, I examine the etymology of the word and all its changes and developments over the centuries in order to identify its main features. The same procedure is then applied also to the analysis of the Gothic. This study is useful to make some remarks about the grotesque and the Gothic in children\u2019s literature, thus introducing the examination of some grotesque and Gothic picturebooks. As a matter of fact, in the third chapter I take into consideration the following illustrators lived between the nineteenth and the twenty-first century: Alfred Crowquill, Heinrich Hoffmann, Edward Lear, Richard Dadd, John Tenniel, Wilhelm Busch, Arthur Burdett Frost, Charles Addams, Ronald Searle, Edward Gorey. These artists are examined in chronological order, according to their date of birth. For each of them I provide some biographical information and I analyse the most significant works. Both the illustrators and their picturebooks have been chosen according to the following criteria: - Their style is strongly characterised by the presence of grotesque and Gothic elements - Their imaginative universes may have influenced the Burtonesque style Tim Burton is the protagonist of the fourth and last chapter, where I examine his figure of \u201cvisual storyteller\u201d in order to show that his whole artistic production can be considered as a remediation of the picturebooks analysed in the previous chapter in particular, and of the children\u2019s literature in general. Taking into consideration his movies, his picturebooks and his drawings and sketches, which are the basis of his creative process, I identify the main features of the so-called "Burtonesque", providing evidence of its being at the same time an appropriation and a remediation. This is the reason why Burton\u2019s imaginative universe succeeds in exploring the limitless possibilities of grotesque and Gothic picturebooks, respecting its main feature, that is the imaginative activity and the development of the literacy of imagination

Electrical properties of growing porous anodic aluminum oxide films

Electrochemical oxidation of aluminum and aluminum alloys in acid electrolytes results in a coating with ordered structure on the nano-scale. Although this highly functional nano-material is available commercially for a diverse range of applications, the driving forces responsible for structure development are not well understood. Two electrical properties, the resistance and capacitance, contain information about the current, space charge and electric field distribution during structure development. The electrical properties of porous oxide films were extracted in situ during growth on three base materials at varying temperatures and current densities. In this work, a single frequency electrochemical impedance spectroscopy technique and an experimental apparatus designed for in situ measurement of cell potential and current were used. The electrical properties calculated during structure development in sulfuric acid at current densities between 5 and 35 mA·cm--2 support the hypothesis that structure originates from competition between electrostatic forces and viscous dissipation

The Scientific Method as a Scaffold to Enhance Communication Skills in Chemistry

Scientific success in the field of chemistry depends upon the mastery of a wide range of soft skills, most notably scientific writing and speaking. However, training for scientific communication is typically limited at the undergraduate level, where students struggle to express themselves in a clear and logical manner. The underlying issue is deeper than basic technical skills; rather, it is a problem of students’ unawareness of a fundamental and strategic framework for writing and speaking with a purpose. The methodology has been implemented for individual mentorship and in our regional summer research program to deliver a blueprint of thought and reasoning that endows students with the confidence and skills to become more effective communicators. Our didactic process intertwines undergraduate research with the scientific method and is partitioned into six steps, referred to as “phases”, to allow for focused and deep thinking on the essential components of the scientific method. The phases are designed to challenge the student in their zone of proximal development so they learn to extract and ultimately comprehend the elements of the scientific method through focused written and oral assignments. Students then compile their newly acquired knowledge to create a compelling and logical story, using their persuasive written and oral presentations to complete a research proposal, final report, and formal 20 min presentation. We find that such an approach delivers the necessary guidance to promote the logical framework that improves writing and speaking skills. Over the past decade, we have witnessed both qualitative and quantitative gains in the students’ confidence in their abilities and skills (developed by this process), preparing them for future careers as young scientists

2012 Haida Gwaii Mw 7.7 Earthquake Response - Ocean Bottom Seismometer Relocation and Geophone Orientation Analysis and Quality Control of Wide-Angle P-wave Refraction Data

Canada's second largest instrumentally recorded earthquake occurred on October 27th, 2012, off the west coast of Moresby Island, Haida Gwaii. Analysis of seismic waveforms and the pattern of aftershocks indicate that it was a thrust earthquake with a magnitude of Mw = 7.7. To accurately locate earthquakes, recording stations need to be positioned such that they surround the epicenter and the sound speed at which seismic waves travel through the earth's crust must be known. The land stations on Haida Gwaii are all to the east of the aftershock sequence, thus making these offshore earthquake locations uncertain and making depths for those events almost impossible to calculate accurately. Only sparse information from seismic refraction work conducted in the early 1980ies on the offshore velocity structure around the epicenter is known. Therefore, a series of 14 ocean bottom seismometers (OBS) were deployed for the duration of 1 month between December 6, 2012 and January 5, 2013 to record a portion of the aftershock sequence. An active source seismic program was conducted in January 2013 prior to the OBS recovery to acquire information on the sediment- and crustal structures to aid in the earthquake location analyses. However, the initial refraction data were not recorded on any of the 14 OBS as the batteries on all of the OBS stations had drained by the time of the survey. An extra set of six OBS was re-deployed and a total of four single-channel seismic profiles were acquired across these six OBS stations for a smaller-scale detailed refraction velocity experiment. Using the active source seismic data, each of the six OBS of the second deployment were re-located on the ocean floor, which is a critical pre-requisite for any velocity analysis. The OBS instruments drifted on average by 200m to the NW of the deployment drop-position. New offset information for the relocated OBS stations were calculated, and used for an initial exemplary but non-ray-tracing based 1D refraction velocity analysis on selected OBS stations to demonstrate the general utility of the OBS refraction data. Additional particle motion analyses were conducted for five of the six OBS stations of the second refraction survey to define the geophone orientation. One of these six stations (OBS-5) appeared to have identical horizontal components and therefore could not be used for a geophone-orientation determination. Long-range refraction seismic arrivals from the active-source experiment with a single 520 cubic inch G-gun were identified on some of the Haida Gwaii land-stations with offset ranges of up to 58 km. This information can potentially be used for a deep-crustal refraction velocity analysis. At this stage, only basic information on these land-station data is documented for potential future analyses

Inducible Caspase9-mediated suicide gene for MSC-based cancer gene therapy

Cellular therapies based on mesenchymal stromal/stem cells (MSC) are promising strategies in regenerative medicine and oncology. Despite encouraging results, there is still some level of concerns on inoculating MSC in cancer patients. To face this issue, one possibility resides in engineering MSC by incorporating a suicide gene in order to control their fate once infused. Strategies based on Herpes Simplex Virus Thymidine Kinase (HSV-TK) and the Cytosine Deaminase genes have been developed and more recently a novel suicide gene, namely, iCasp9, has been proposed. This approach is based on a variant of human Caspase9 that binds with high affinity to a synthetic, bioinert small molecule (AP20187) leading to cell death. Based on this technology so far marginally applied to MSC, we tested the suitability of iCasp9 suicide strategy in MSC to further increase their safety. MSC have been transfected by a lentiviral vector carrying iCasp9 gene and then tested for viability after AP20187 treatment in comparison with mock-transfected cells. Moreover, accounting our anti-tumor approaches based on MSC expressing potent anti-cancer ligand TNF-Related Apoptosis-Inducing Ligand (TRAIL), we generated adipose MSC co-expressing iCasp9 and TRAIL successfully targeting an aggressive sarcoma type. These data show that anti-cancer and suicide mechanisms can coexist without affecting cells performance and hampering the tumoricidal activity mediated by TRAIL. In conclusion, this study originally indicates the suitability of combining a MSC-based anti-cancer gene approach with iCasp9 demonstrating efficiency and specificity

Conditional Transgenesis Using Dimerizable Cre (DiCre)

Cre recombinase is extensively used to engineer the genome of experimental animals. However, its usefulness is still limited by the lack of an efficient temporal control over its activity. We have recently developed a conceptually new approach to regulate Cre recombinase, that we have called Dimerizable Cre or DiCre. It is based on splitting Cre into two inactive moieties and fusing them to FKBP12 (FK506-binding protein) and FRB (binding domain of the FKBP12-rapamycin associated protein), respectively. These latter can be efficiently hetero-dimerized by rapamycin, leading to the reinstatement of Cre activity. We have been able to show, using in vitro approaches, that this ligand-induced dimerization is an efficient way to regulate Cre activity, and presents a low background activity together with a high efficiency of recombination following dimerization. To test the in vivo performance of this system, we have, in the present work, knocked-in DiCre into the Rosa26 locus of mice. To evaluate the performance of the DiCre system, mice have been mated with indicator mice (Z/EG or R26R) and Cre-induced recombination was examined following activation of DiCre by rapamycin during embryonic development or after birth of progenies. No recombination could be observed in the absence of treatment of the animals, indicating a lack of background activity of DiCre in the absence of rapamycin. Postnatal rapamycin treatment (one to five daily injection, 10 mg/kg i.p) induced recombination in a number of different tissues of progenies such as liver, heart, kidney, muscle, etc. On the other hand, recombination was at a very low level following in utero treatment of DiCre×R26R mice. In conclusion, DiCre has indeed the potentiality to be used to establish conditional Cre-deleter mice. An added advantage of this system is that, contrary to other modulatable Cre systems, it offers the possibility of obtaining regulated recombination in a combinatorial manner, i.e. induce recombination at any desired time-point specifically in cells characterized by the simultaneous expression of two different promoters

Do not simply call them alphabet books

The paper deals with alphabet books, referring especially to the complexity of modes of signification in such discourses. "Lyrics Pathetic and Humorous, from A to Z", an alphabet book written and illustrated by Edmund Dulac in 1908, offers the addresses (bearing in mind Roman Jakobson's model of communication) the possibility of observing, analysing and interpreting diachronic differences and of valuing synchronic artistic productions