Energy Versus Throughput Optimisation for Machine-to-Machine Communication.

We investigate the trade-off between energy usage and (packet) throughput in wireless mesh networks performing machine-to-machine communication. For this we provide a novel mixed-integer programming formulation to maximise the throughput while maintaining minimal energy usage, together with an effective price-and-branch solution algorithm based on column generation. The resulting optimisation model is the main original contribution of the presented paper. We conducted a numerical study using network examples from 10 to 40 nodes, in which periodic sensor measurements are aggregated and disseminated to actuators. In almost all cases, we were able to achieve maximum throughput and minimum energy usage simultaneously, and in those cases where this was not possible, the costs incurred in one objective in order to achieve the other were typically low. The solution times for all network sizes were of the order of seconds, showing that our optimisation model is feasible to use in practice.

Deresuscitation of Patients With Iatrogenic Fluid Overload Is Associated With Reduced Mortality in Critical Illness.

OBJECTIVES: To characterize current practice in fluid administration and deresuscitation (removal of fluid using diuretics or renal replacement therapy), the relationship between fluid balance, deresuscitative measures, and outcomes and to identify risk factors for positive fluid balance in critical illness. DESIGN: Retrospective cohort study. SETTING: Ten ICUs in the United Kingdom and Canada. PATIENTS: Adults receiving invasive mechanical ventilation for a minimum of 24 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Four-hundred patients were included. Positive cumulative fluid balance (fluid input greater than output) occurred in 87.3%: the largest contributions to fluid input were from medications and maintenance fluids rather than resuscitative IV fluids. In a multivariate logistic regression model, fluid balance on day 3 was an independent risk factor for 30-day mortality (odds ratio 1.26/L [95% CI, 1.07-1.46]), whereas negative fluid balance achieved in the context of deresuscitative measures was associated with lower mortality. Independent predictors of greater fluid balance included treatment in a Canadian site. CONCLUSIONS: Fluid balance is a practice-dependent and potentially modifiable risk factor for adverse outcomes in critical illness. Negative fluid balance achieved with deresuscitation on day 3 of ICU stay is associated with improved patient outcomes. Minimization of day 3 fluid balance by limiting maintenance fluid intake and drug diluents, and using deresuscitative measures, represents a potentially beneficial therapeutic strategy which merits investigation in randomized trials.

Tripodal thiols as ligands for molecular magnets: very strong antiferromagnetic exchange interactions in vanadium(III) clusters.

The synthesis, structural and magnetic characterisation of [V(III)(3)O(tmme)(2)(diimine)(2)Cl] [diimine=2,2'-bipyridine (1) or 1,10-phenanthroline (2)] and (HNEt(3))(2)[V(III)(4)O(tmme)(4)] (3) is reported, in which H(3)tmme is tris(mercaptomethyl)ethane, MeC(CH(2)SH)(3), the thiol analogue of the famous tripodal alcohol ligands typified by H(3)thme [tris(hydroxymethyl)ethane, MeC(CH(2)OH)(3)]. Complexes 1 and 3 have "T-shaped" and square topologies, respectively, and the latter is centred on a rare example of a square-planar oxide. The tri-thiolate ligands bind the periphery of the clusters and provide such strong antiferromagnetic exchange pathways that in both cases only a single total spin state is occupied up to room temperature, in the absence of metal-metal bonding. Magnetic data, electronic structure calculations and electrochemical data are reported.

Through the eyes of children: engaging primary school-aged children in creating supportive school environments for physical activity and nutrition.

ISSUES ADDRESSED: This paper presents a qualitative study of physical activity, eating and drinking experiences of children at Wellington Public School, NSW. The study was designed and implemented to inform school programs and policies with a goal of fostering a supportive and healthy environment at the school. METHODS: The study involved use of focus groups, drawings and photovoice with 37 students from Kindergarten to Year 6 to determine problems, underlying causes and possible student-led interventions to enhance the school physical activity and nutritional environment. RESULTS: Students considered play as related to fun games with friends. Sport was associated with structured, competitive types of physical activity. Infants class students preferred play, while primary students reported a preference for semi-structured and structured activities. Suggestions to improve school playing areas mirrored these preferences. The children suggested strategies for increasing fruit, vegetable and water consumption during the school day. CONCLUSION: The students were keen to explore ways to increase physical activity opportunities and develop a supportive nutritional environment at school. Simple, easy to implement suggestions were among the outcomes of the study, reinforcing the importance of including students' views in healthy school program and policy development.

An analytic model for Throughput Optimal Distributed Coordination Function (TO-DCF).

TO-DCF, a new backoff scheme for 802.11, has the potential to significantly increase throughput in dense wireless LANs while also opportunistically favouring nodes with heavier traffic loads and/or better channel conditions. In this paper we present an analytical model to investigate the behaviour and performance of the TO-DCF protocol with regards to operating parameters such as the number of nodes, the contention window size and the backoff countdown probabilities. We then compare numerical results from an implementation of our model with simulations. Our model shows a high level of accuracy, even when the model assumptions are relaxed, and provides guidance for network operators to correctly configure the weight functions for nodes running TO-DCF given the network's operating conditions.

Impact of tumour bed boost integration on acute and late toxicity in patients with breast cancer: A systematic review.

The purpose of this systematic review was to summarise the evidence from studies investigating the integration of tumour bed boosts into whole breast irradiation for patients with Stage 0-III breast cancer, with a focus on its impact on acute and late toxicities. A comprehensive systematic electronic search through the Ovid MEDLINE, EMBASE and PubMed databases from January 2000 to January 2015 was conducted. Studies were considered eligible if they investigated the efficacy of hypo- or normofractionated whole breast irradiation with the inclusion of a daily concurrent boost. The primary outcomes of interest were the degree of observed acute and late toxicity following radiotherapy treatment. Methodological quality assessment was performed on all included studies using either the Newcastle-Ottawa Scale or a previously published investigator-derived quality instrument. The search identified 35 articles, of which 17 satisfied our eligibility criteria. Thirteen and eleven studies reported on acute and late toxicities respectively. Grade 3 acute skin toxicity ranged from 1 to 7% whilst moderate to severe fibrosis and telangiectasia were both limited to 9%. Reported toxicity profiles were comparable to historical data at similar time-points. Studies investigating the delivery of concurrent boosts with whole breast radiotherapy courses report safe short to medium-term toxicity profiles and cosmesis rates. Whilst the quality of evidence and length of follow-up supporting these findings is low, sufficient evidence has been generated to consider concurrent boost techniques as an alternative to conventional sequential techniques.

Clinician perspectives on protocols designed to minimize sedation.

PURPOSE: Within a multicenter randomized trial comparing protocolized sedation with protocolized sedation plus daily interruption (DI), we sought perspectives of intensive care unit (ICU) clinicians regarding each strategy. METHODS: At 5 ICUs, we administered a questionnaire daily to nurses and physicians, asking whether they liked using the assigned strategy, reasons for their responses, and concerns regarding DI. RESULTS: A total of 301 questionnaires were completed, for 31 patients (15 protocol only and 16 DI); 117 (59 physicians and 58 nurses) were the first questionnaire completed by that health care provider for that patient and were included in analyses. Most respondents liked using the assigned strategy (81% protocol only and 81% DI); more physicians than nurses liked DI (100% vs 61%; P < .001). Most common reasons for liking the assigned sedation strategy were better neurologic assessment (70% DI), ease of use (58% protocol only), and improved patient outcomes (51% protocol only and 44% DI). Only 19% of clinicians disliked the assigned sedation strategy (equal numbers for protocol only and DI). Respondents' concerns during DI were respiratory compromise (61%), pain (48%), agitation (45%), and device removal (26%). More questionnaires from nurses than physicians expressed concerns about DI. CONCLUSIONS: Most respondents liked both sedation strategies. Nurses and physicians had different preferences and rationales for liking or disliking each strategy.

Intensity-modulated radiation therapy to bilateral lower limb extremities concurrently: a planning case study.

Non-melanomatous skin cancers represent 80% of all newly diagnosed cancers in Australia with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most common. A previously healthy 71-year-old woman presented with widespread and tender superficial skin cancers on the lower bilateral limbs. External beam radiation therapy through the use of intensity-modulated radiation therapy (IMRT) was employed as the treatment modality of choice as this technique provides conformal dose distribution to a three-dimensional treatment volume while reducing toxicity to surrounding tissues. The patient was prescribed a dose of 60 Gy to the planning target volume (PTV) with 1.0 cm bolus over the ventral surface of each limb. The beam arrangement consisted of six treatment fields that avoided entry and exit through the contralateral limb. The treatment plans met the International Commission on Radiation Units and Measurements (ICRU) guidelines and produced highly conformal dosimetric results. Skin toxicity was measured against the National Cancer Institute: Common Terminology Criteria for Adverse Events (NCI: CTCAE) version 3. A well-tolerated treatment was delivered with excellent results given the initial extent of the disease. This case study has demonstrated the feasibility and effectiveness of IMRT for skin cancers as an alternative to surgery and traditional superficial radiation therapy, utilising a complex PTV of the extremities for patients with similar presentations.

Synthesis, spectroscopy and electronic structure of the vinylidene and alkynyl complexes [W(C=CHR)(dppe)(η-C7H7)](+) and [W(C≡CR)(dppe)(η-C7H7](n+) (n = 0 or 1).

The first examples of vinylidene complexes of the cycloheptatrienyl tungsten system [W(C=CHR)(dppe)(η-C7H7)](+) (dppe = Ph2PCH2CH2PPh2; R = H, 3; Ph, 4; C6H4-4-Me, 5) have been synthesised by reaction of [WBr(dppe)(η-C7H7)], 1, with terminal alkynes HC≡CR; a one-pot synthesis of 1 from [WBr(CO)2(η-C7H7)] facilitates its use as a precursor. The X-ray structure of 4[PF6] reveals that the vinylidene ligand substituents lie in the pseudo mirror plane of the W(dppe)(η-C7H7) auxiliary (vertical orientation) with the phenyl group located syn to the cycloheptatrienyl ring. Variable temperature ¹H NMR investigations on [W(C=CH2)(dppe)(η-C7H7)][PF6], 3, estimate the energy barrier to rotation about the W=C(α) bond as 62.5 ± 2 kJ mol⁻¹; approximately 10 kJ mol⁻¹ greater than for the molybdenum analogue. Deprotonation of 4 and 5 with KOBu(t) yields the alkynyls [W(C≡CR)(dppe)(η-C7H7)] (R = Ph, 6; C6H4-4-Me, 7) which undergo a reversible one-electron oxidation at a glassy carbon electrode in CH2Cl2 with E(½) values approximately 0.12 V negative of Mo analogues. The 17-electron radicals [6](+) and [7](+) have been investigated by spectroelectrochemical IR, UV-visible and EPR methods. The electronic structures of representative vinylidene (3) and alkynyl (6) complexes have been investigated at the B3LYP/Def2-SVP level. In both cases, electronic structure is characterised by a frontier orbital with significant metal d(z²)character and this dominates the structural and spectroscopic properties of the system.

Caregiver psychoeducation for first-episode psychosis.

INTRODUCTION: International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes. METHODS: Caregivers of people with first-episode psychosis completed a 23-item adapted version of the self-report Family Questionnaire (KQ) and a 17-item adapted version of the self-report Drug Attitudes Inventory (DAI) before and after the six-week DETECT Information and Support Course (DISC). Using a Generalised Linear Repeated Measures Model, we analyzed the differences in proportions of correct answers before and after the programme. RESULTS: Over a 24-month study period, 31 caregivers (13 higher socioeconomic; 13 lower socioeconomic; five unspecified socioeconomic; 19 female; 12 male) participated in the DISC programme and completed inventories before and after the course. Knowledge of psychosis and specific knowledge of medication treatment improved among caregivers overall (p<.01; effect sizes 0.78 and 0.94 respectively). There were no significant gender or socioeconomic differences in any improvement. DISCUSSION: This study confirms that caregiver psychoeducation specifically for first-episode psychosis directly improves knowledge of the illness overall and, in particular, knowledge of medication. Gender is not a factor in this, while the lack of any socioeconomic differences dispels the myth that patients in lower socioeconomic groups are disadvantaged because their caregivers know less.

Experimental observation of spin delocalisation onto the aryl-alkynyl ligand in the complexes [Mo(C≡CAr)(Ph2PCH2CH2PPh2)(η-C7H7)]+ (Ar = C6H5, C6H4-4-F; C7H7 = cycloheptatrienyl): an EPR and ENDOR investigation.

The paramagnetic aryl-alkynyl complexes [Mo(C≡CAr)(dppe)(η-C(7)H(7))](+) (dppe = Ph(2)PCH(2)CH(2)PPh(2); Ar = C(6)H(5), [1](+); C(6)D(5), [2](+); C(6)H(4)-4-F, [3](+); C(6)H(4)-4-Me, [5](+)) and [Mo(C≡CBu(t))(dppe)(η-C(7)H(7))](+) [4](+), have been investigated in a combined EPR and ENDOR study. Direct experimental evidence for the delocalisation of unpaired spin density over the framework of an aryl-alkynyl ligand has been obtained. The X-band solution EPR spectrum of the 4-fluoro derivative, [3](+), exhibits resolved hyperfine coupling to the remote para position of the aryl group [a(iso)((19)F) = 4.5 MHz, (1.6 G)] in addition to couplings attributable to (95/97)Mo, (31)P and (1)H of the C(7)H(7) ring. A full analysis of the (1)H ENDOR spectra is restricted by the low g anisotropy of the system which prevents the use of orientation selection. However, inter-comparison of the (1)H cw-ENDOR frozen solution spectra of [1](+), [2](+), [4](+) and [5](+), combined with spectral simulation informed by calculated values derived from DFT investigations, has facilitated estimation of the experimental a(iso)((1)H) hyperfine couplings of [1](+) including the ortho, ±3.7 MHz (±1.3 G) and para, ±3.9 MHz (±1.4 G) positions of the C(6)H(5) substituent of the aryl-alkynyl ligand.

Metal-stabilised diynyl radicals: structure and reactivity of [Mo(C[triple bond]C-C[triple bond]CSiMe3)L2(eta-C7H7)]*+ (L2 = 2,2'-bipyridine or dppe).

The unprecedented spectroscopic and structural characterisation of a series of 17-electron, monometallic diynyl radicals, [Mo(C[triple bond]C-C[triple bond]CR)L(2)(eta-C(7)H(7))]*(+) (L(2) = bipy, R = SiMe(3); L(2) = dppe, R = SiMe(3) or H), are reported; the (L(2) = dppe, R = SiMe(3)) derivative is reactive to chain-centred C(beta)-C(beta') dimerisation.