The Development of the ATLAS SCT as a Luminometer and the Search for SUSY Decays with Compressed Mass Spectra

The formulation of the Standard Model of particle physics (SM) is one of the greatest scientific achievements of the 20th century. It is, however, incomplete (for example, it lacks a dark matter candidate) as well as the fact that the hierarchy problem violates naturalness arguments. This has motivated the construction of particle accelerators to probe fundamental particles at increasingly high center-of-mass energies and luminosities, the LHC at CERN being the latest to continue this legacy. This thesis covers both the enhancement of luminosity measurements of pp collisions at ATLAS, underpinning the accuracy of all measurements made by the detector, and a search for one of the most theoretically viable extensions to the SM: supersymmetry. ATLAS uses mainly event-counting algorithms to measure luminosity, which break down at higher luminosities. If the ATLAS SemiConductor Tracker (SCT) can be employed as a luminometer using hit-counting algorithms, this issue may be mitigated. It is established here that the SCT can feasibly operate as a luminometer when recording two-or-more strip clusters with the standard binary readout mode (01X). Thus, the SCT can measure the luminosity with an accuracy within 10% of two of ATLAS’s existing luminometers: LUCID and TileCal. The discovery of the supersymmetric top (stop) would be fundamental for solving the hierarchy problem. An analysis of an experimentally challenging region of phase space, where stop decays have a compressed mass spectrum, complements the ATLAS one-lepton stop search using 13 TeV pp collisions at 139 fb−1 is presented. The aMT2 kinematic variable, designed to give a lower limit on pair-produced particle masses, is found to be effective at differentiating SUSY decays from the SM background, when used as an upper bound. No significant excess was observed above the Standard Model background and limits at 95% confidence level are set. Stop quarks are found to be excluded up to 500 GeV and mass splittings between the stop and the neutralino are found to be excluded up to 130 GeV, complimenting the exclusion limits found by other ATLAS searches for stop decays with one-lepton final states

Student-industry co-creation for innovation and skills development

The chapter aims to explore an ongoing approach towards enhancing student’ employability skills and building confidence. This approach draws on literature related to soft skills development and issues surrounding student confidence. It provides an innovative approach involving students, academic faculty and external organisations in a collaborative problem-solving activity known as ‘Innovation and Global Growth week’ (IGG).The outcome of this week of events is realigned with the factual needs of participating businesses and aims at generating creative ideas and innovation in order to address challenges faced by the participating businesses.This approach stimulates contextual skills and knowledge learning for students, faculty and the enterprises involved

A pragmatic cluster randomised trial evaluating three implementation interventions

Background Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. Methods A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients' experiences, and stakeholders' experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Results Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. Conclusions This was a large, complex study and one of the first national randomised controlled trials conducted within acute care in implementation research. The evidence base for fasting practice was accepted by those participating in this study and the messages from it simple; however, implementation and practical challenges influenced the interventions' impact. A set of conditions for implementation emerges from the findings of this study, which are presented as theoretically transferable propositions that have international relevance. Trial registration ISRCTN18046709 - Peri-operative Implementation Study Evaluation (POISE

Urinary ATP and visualization of intracellular bacteria: a superior diagnostic marker for recurrent UTI in renal transplant recipients?

Renal transplant recipients (RTR) are highly susceptible to urinary tract infections (UTIs) with over 50% of patients having at least one UTI within the first year. Yet it is generally acknowledged that there is considerable insensitivity and inaccuracy in routine urinalysis when screening for UTIs. Thus a large number of transplant patients with genuine urine infections may go undiagnosed and develop chronic recalcitrant infections, which can be associated with graft loss and morbidity. Given a recent study demonstrating ATP is released by urothelial cells in response to bacteria exposure, possibly acting at metabotropic P2Y receptors mediating a proinflammatory response, we have investigated alternative, and possibly more appropriate, urinalysis techniques in a cohort of RTRs.Mid-stream urine (MSU) samples were collected from 53 outpatient RTRs. Conventional leukocyte esterase and nitrite dipstick tests, and microscopic pyuria counts (in 1 ?l), ATP concentration measurements, and identification of intracellular bacteria in shed urothelial cells, were performed on fresh unspun samples and compared to ‘gold-standard’ bacterial culture results.Of the 53 RTRs, 22% were deemed to have a UTI by ‘gold-standard’ conventional bacteria culture, whereas 87%, 8% and 4% showed evidence of UTIs according to leukocyte esterase dipstick, nitrite dipstick, and a combination of both dipsticks, respectively. Intracellular bacteria were visualized in shed urothelial cells of 44% of RTRs, however only 1 of the 23 RTRs (44%) was deemed to have a UTI by conventional bacteria culture. A significant association of the ‘gold-standard’ test with urinary ATP concentration combined with visualization of intracellular bacteria in shed urothelial cells was determined using the Fisher’s exact test.It is apparent that standard bedside tests for UTIs give variable results and that seemingly quiescent bacteria in urothelial cells are very common in RTRs and may represent a focus of subclinical infection. Furthermore, our results suggest urinary ATP concentration combined with detection of intracellular bacteria in shed urinary epithelial cells may be a sensitive means by which to detect ‘occult’ infection in RTRs

FIRE (facilitating implementation of research evidence) : a study protocol

Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids

Advancements in left ventricular assist devices to prevent pump thrombosis and blood coagulopathy

Mechanical circulatory support (MCS) devices, such as left ventricular assist devices (LVADs) are very useful in improving outcomes in patients with advanced-stage heart failure. Despite recent advances in LVAD development, pump thrombosis is one of the most severe adverse events caused by LVADs. The contact of blood with artificial materials of LVAD pumps and cannulas triggers the coagulation cascade. Heat spots, for example, produced by mechanical bearings are often subjected to thrombus build-up when low-flow situations impair washout and thus the necessary cooling does not happen. The formation of thrombus in an LVAD may compromise its function, causing a drop in flow and pumping power leading to failure of the LVAD, if left unattended. If a clot becomes dislodged and circulates in the bloodstream, it may disturb the flow or occlude the blood vessels in vital organs and cause internal damage that could be fatal, for example, ischemic stroke. That is why patients with LVADs are on anti-coagulant medication. However, the anti-coagulants can cause a set of issues for the patient-an example of gastrointestinal (GI) bleeding is given in illustration. On account of this, these devices are only used as a last resort in clinical practice. It is, therefore, necessary to develop devices with better mechanics of blood flow, performance and hemocompatibility. This paper discusses the development of LVADs through landmark clinical trials in detail and describes the evolution of device design to reduce the risk of pump thrombosis and achieve better hemocompatibility. Whilst driveline infection, right heart failure and arrhythmias have been recognised as LVAD-related complications, this paper focuses on complications related to pump thrombosis, especially blood coagulopathy in detail and potential strategies to mitigate this complication. Furthermore, it also discusses the LVAD implantation techniques and their anatomical challenges

Simultaneous quantification of 12 different nucleotides and nucleosides released from renal epithelium and in human urine samples using ion-pair reversed-phase HPLC

Nucleotides and nucleosides are not only involved in cellular metabolism but also act extracellularly via P1 and P2 receptors, to elicit a wide variety of physiological and pathophysiological responses through paracrine and autocrine signalling pathways. For the first time, we have used an ion-pair reversed-phase high-performance liquid chromatography ultraviolet (UV)-coupled method to rapidly and simultaneously quantify 12 different nucleotides and nucleosides (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, adenosine, uridine triphosphate, uridine diphosphate, uridine monophosphate, uridine, guanosine triphosphate, guanosine diphosphate, guanosine monophosphate, guanosine): (1) released from a mouse renal cell line (M1 cortical collecting duct) and (2) in human biological samples (i.e., urine). To facilitate analysis of urine samples, a solid-phase extraction step was incorporated (overall recovery rate ? 98 %). All samples were analyzed following injection (100 ?l) into a Synergi Polar-RP 80 Å (250 × 4.6 mm) reversed-phase column with a particle size of 10 ?m, protected with a guard column. A gradient elution profile was run with a mobile phase (phosphate buffer plus ion-pairing agent tetrabutylammonium hydrogen sulfate; pH 6) in 2-30 % acetonitrile (v/v) for 35 min (including equilibration time) at 1 ml min(-1) flow rate. Eluted compounds were detected by UV absorbance at 254 nm and quantified using standard curves for nucleotide and nucleoside mixtures of known concentration. Following validation (specificity, linearity, limits of detection and quantitation, system precision, accuracy, and intermediate precision parameters), this protocol was successfully and reproducibly used to quantify picomolar to nanomolar concentrations of nucleosides and nucleotides in isotonic and hypotonic cell buffers that transiently bathed M1 cells, and urine samples from normal subjects and overactive bladder patients

Managing diabetes in people with dementia: protocol for a realist review

Background Worldwide, the prevalences of diabetes and dementia are both increasing, particularly in older people. Rates of diabetes in people with dementia are between 13 and 20 %. Diabetes management and diabetic self-care may be adversely affected by the presence of dementia. There is a need to know what interventions work best in the management of diabetes in people living with dementia (PLWD) in different settings and at different stages of the dementia trajectory. The overall aim is to develop an explanatory account or programme theory about ‘what works’ in the management of diabetes in people in what context and to identify promising interventions that merit further evaluation. Methods/design This study uses a realist approach including studies on the management of diabetes in older people, medication management, diabetes-related self-care, workforce issues and assessment and treatment. We will use an iterative, stakeholder driven, four-stage approach. Phase 1: development of initial programme theory/ies through a first scoping of the literature and consultation with key stakeholder groups (user/patient representatives, dementia-care providers, clinicians, diabetes and dementia researchers and diabetes specialists). Phase 2: systematic searches of the evidence to test and develop the theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. Phase 4: actionable recommendations for the management of diabetes in PLWD. Discussion A realist synthesis of the evidence will provide a theoretical framework (i.e. an explanation of how interventions work, for whom, in what context and why) for practice and future research work that articulates the barriers and facilitators to effective management of diabetes in people with dementia. By providing possible explanations for the way in which interventions are thought to work and how change is achieved, it will demonstrate how to tailor an intervention to the setting and patient group. The propositions arising from the review will also inform the design of future intervention studies. Systematic review registration PROSPERO registration number CRD42015020625

Lessons in Leadership

Lessons in Leadership: The Betty Irene Moore Speaker Series embodies Betty Irene Moore\u27s vision and hope for nurses to lead within their teams, organizations and communities, with the ultimate goal of improving the experience and outcomes of patient care. Through personal experience, Betty recognized that nurses play a critical role in providing safe, high-quality patient care and outcomes. They are caregivers, mentors, teachers and researchers; and they provide 95 percent of direct patient care in hospitals. This recognition gave rise to the Betty Irene Moore Nursing Initiative, with building leadership skills in nurses as one of its main strategies. This video is one of a collection of 13 short videos featuring nationally-recognized nurse leaders whose leadership spans nursing, health care, government and other sectors. This video features the following nurse leaders (in order of appearance): Claire Fagin, RN, PhD, FAAN Angela Barron McBride, RN, PhD, FAAN Marla Salmon, RN, ScD, FAAN Patricia Benner, RN, PhD, FAAN Peter Buerhaus, RN, PhD, FAAN Linda Aiken, RN, PhD, FAAN, FRCN Martha Hill, RN, PhD, FAAN Sheila Burke, RN, MPA, FAAN Jennie Chin Hansen, RN, MS, FAAN Shirley S. Chater, RN, PhD, FAAN Mary Naylor, RN, PhD, FAAN Beverly Malone, RN, PhD, FAAN To quickly locate the individual leader videos in this collection, please click on the publisher link below. To learn more about this series, or to request a copy of the video collection, please click here

Engaging underrepresented people in a regional transformation project:Co-production of a framework

This report summarises the activities from the Engaging Underrepresented People in a Regional Transformation Project, a collaboration with the Lancashire and South Cumbria New Hospitals Programme (LSCNHP). The project was awarded project funding from Research England through the Lancaster University Vice-Chancellor’s Prize for Participatory Research. The project ran from the beginning of March to the end of July 2022. The Lancashire and South Cumbria New Hospitals Programme is part of the Government’s commitment to building 40 new hospitals by 2030. Together with eight existing schemes, this will mean 48 hospitals built in England over the next decade, the biggest hospital building programme in a generation. Find out more on the ‘Improving NHS infrastructure’ website. Discussions with the New Hospitals Programme team identified that, whilst there has been engagement with regional stakeholders, local people, patients, staff, and some health inclusion groups, there was still a gap in the engagement of those who were routinely underrepresented. The project team were open to further insight and suggestions on how to address the gap. This project aimed to: Fill a gap in knowledge on good practice engagement with underrepresented people, Produce a framework for future engagement practice, Provide evidence to inform the New Hospitals Programme’s engagement practice, Inform engagement approaches for future transformation projects