An identification and brief advice programme for low-risk alcohol consumption in an acute medical setting: an implementation study.

OBJECTIVES: To implement an identification and brief advice (IBA) intervention to detect low-risk/hazardous alcohol consumption. DESIGN: Implementation was guided through the use of quality improvement tools and training. SETTING: This study was conducted over an 18-month period from April 2010 to September 2011 on a 42-bed acute medical unit at a central London acute hospital. PARTICIPANTS: All medical patients over the age of 18 admitted to the acute assessment unit were eligible; any patient unable to provide a medical history either through language barriers or due to illness was excluded. MAIN OUTCOME MEASURES: Percentage of medical patients admitted each week to the acute assessment unit who were screened for low-risk/hazardous alcohol consumption. RESULTS: Weekly data were analysed in time series run charts and cross-referenced to the date of educational sessions and their effect on the uptake of screening monitored. A demonstrable change in the mean percentage number of patients screened was observed in different time periods, 67.3-80.1%, following targeted teaching on the AAU. CONCLUSIONS: Our study demonstrates the successful use of quality improvement methodology to guide the implementation of Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), an IBA intervention, in the acute medical setting. The incorporation of the AUDIT-C into an admission document has been well accepted by the junior doctors, attaining an average (mean) of 80% of patients being screened using the tool. Targeted teaching of clinical staff involved in admitting patients appears to be the most effective method in improving uptake of IBA by junior doctors

Minimal symmetric Darlington synthesis

We consider the symmetric Darlington synthesis of a p x p rational symmetric Schur function S with the constraint that the extension is of size 2p x 2p. Under the assumption that S is strictly contractive in at least one point of the imaginary axis, we determine the minimal McMillan degree of the extension. In particular, we show that it is generically given by the number of zeros of odd multiplicity of I-SS*. A constructive characterization of all such extensions is provided in terms of a symmetric realization of S and of the outer spectral factor of I-SS*. The authors's motivation for the problem stems from Surface Acoustic Wave filters where physical constraints on the electro-acoustic scattering matrix naturally raise this mathematical issue

The nature and fate of natural resins in the geosphere XIII: a probable pinaceous resin from the early Cretaceous (Barremian), Isle of Wight

Terpenoid resin is produced by all families and most genera of the order Coniferales (the conifers), and the distribution of terpenes present in most conifer resins is characteristic of the originating family. Analyses of early Cretaceous (Barremian) amber (fossil resin) from the English Wealden, Isle of Wight, southern England, by pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS), indicate a terpene distribution dominated by abietane- and labdane-type terpenes. Similar distributions are observed in some species of the extant family Pinaceae. The Pinaceae are well represented within the Wealden deposits of southern England, by only one (known) species, Pityites solmsii (Seward) Seward, whereas the macro-fossil record of these deposits is dominated by the extinct conifer family Cheirolepidiaceae, for which no resin chemistry has been reported. By analogy with modern materials, it is probable that the ambers found in these deposits are derived from an extinct member of the Pinaceae, but given the absence of evidence concerning the chemotaxonomy of the Cheirolepidiaceae, this family cannot be excluded a priori as a possible paleobotanical source. These ambers may therefore be assigned to either the Pinaceae or to the Cheirolepidiaceae. These samples are the oldest ambers to date to yield useful chemotaxonomic data

The Potential for Bonding Titanium Restorations

: The use of titanium for implants has shown the biological acceptance of the metal. Recently, methods of using titanium for restorations, crowns, and bridges have been introduced using both cast and spark erosion systems for fabrication. A potential also exists for using titanium for bonded (Maryland) bridges. Materials and Methods : In this study, the potential for bonding titanium was investigated by cementing with various adhesives: (A) metal to metal, (B) metal to enamel, and (C) comparing with a known procedure of bonding nickel-chromium. Truncated cones of pure titanium were fabricated with a 5-mm circular face for bonding to a larger titanium disc embedded in a plastic ring. A special jig was used to pull the bonded cone from the disc on an Instron tensile testing machine (Instron Corporation, Canton, MA). The resin-metal adhesives used were: (1) Infinity, (2) Metabond, (3) All-Bond 2, and (4) Panavia. These were compared with (5) nickel-chromium cones sandblasted and bonded to nickel-chromium with Panavia. Titanium cones were also bonded to human enamel with (6) Panavia and (7) Metabond. The 10 samples in each group were subjected to tensile force, and point of fracture was recorded. The data were subjected to an analysis of variance with a Scheffe F test at the 95% level of significance. Results : The results of tensile forces in MPa were (1) Infinity, 28.1 ± 3.6; (2) Metabond, 28.1 ± 1; (3) All-Bond 2, 49.5 ± 4.3; (4) Panavia, 57.9 ± 3.1; (5) Panavia to nickel-chromium, 42.9 ± 6.6; (6) Panavia to enamel, 18.5 ± 4.7; and (7) Metabond to enamel, 19.3 ± 3.5. Titanium was most effectively bonded with All-Bond 2 and Panavia, with Panavia samples significantly better than Panavia to nickel-chromium samples. Conclusions : It was concluded that titanium bonded restorations with certain adhesive cements were a definite possibility.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74888/1/j.1532-849X.1993.tb00399.x.pd

The interplay of intrinsic and extrinsic bounded noises in genetic networks

After being considered as a nuisance to be filtered out, it became recently clear that biochemical noise plays a complex role, often fully functional, for a genetic network. The influence of intrinsic and extrinsic noises on genetic networks has intensively been investigated in last ten years, though contributions on the co-presence of both are sparse. Extrinsic noise is usually modeled as an unbounded white or colored gaussian stochastic process, even though realistic stochastic perturbations are clearly bounded. In this paper we consider Gillespie-like stochastic models of nonlinear networks, i.e. the intrinsic noise, where the model jump rates are affected by colored bounded extrinsic noises synthesized by a suitable biochemical state-dependent Langevin system. These systems are described by a master equation, and a simulation algorithm to analyze them is derived. This new modeling paradigm should enlarge the class of systems amenable at modeling. We investigated the influence of both amplitude and autocorrelation time of a extrinsic Sine-Wiener noise on: $(i)$ the Michaelis-Menten approximation of noisy enzymatic reactions, which we show to be applicable also in co-presence of both intrinsic and extrinsic noise, $(ii)$ a model of enzymatic futile cycle and $(iii)$ a genetic toggle switch. In $(ii)$ and $(iii)$ we show that the presence of a bounded extrinsic noise induces qualitative modifications in the probability densities of the involved chemicals, where new modes emerge, thus suggesting the possibile functional role of bounded noises

A Variational Method in Out of Equilibrium Physical Systems

A variational principle is further developed for out of equilibrium dynamical systems by using the concept of maximum entropy. With this new formulation it is obtained a set of two first-order differential equations, revealing the same formal symplectic structure shared by classical mechanics, fluid mechanics and thermodynamics. In particular, it is obtained an extended equation of motion for a rotating dynamical system, from where it emerges a kind of topological torsion current of the form $\epsilon_{ijk} A_j \omega_k$, with $A_j$ and $\omega_k$ denoting components of the vector potential (gravitational or/and electromagnetic) and $\omega$ is the angular velocity of the accelerated frame. In addition, it is derived a special form of Umov-Poynting's theorem for rotating gravito-electromagnetic systems, and obtained a general condition of equilibrium for a rotating plasma. The variational method is then applied to clarify the working mechanism of some particular devices, such as the Bennett pinch and vacuum arcs, to calculate the power extraction from an hurricane, and to discuss the effect of transport angular momentum on the radiactive heating of planetary atmospheres. This development is seen to be advantageous and opens options for systematic improvements.Comment: 22 pages, 1 figure, submitted to review, added one referenc

Non-supersymmetric heterotic model building

We investigate orbifold and smooth Calabi-Yau compactifications of the non-supersymmetric heterotic SO(16)xSO(16) string. We focus on such Calabi-Yau backgrounds in order to recycle commonly employed techniques, like index theorems and cohomology theory, to determine both the fermionic and bosonic 4D spectra. We argue that the N=0 theory never leads to tachyons on smooth Calabi-Yaus in the large volume approximation. As twisted tachyons may arise on certain singular orbifolds, we conjecture that such tachyonic states are lifted in the full blow-up. We perform model searches on selected orbifold geometries. In particular, we construct an explicit example of a Standard Model-like theory with three generations and a single Higgs field.Comment: 1+30 pages latex, 11 tables; v2: references and minor revisions added, matches version published in JHE

The Explosion Mechanism of Core-Collapse Supernovae and Its Observational Signatures

The death of massive stars is shrouded in many mysteries. One of them is the mechanism that overturns the collapse of the degenerate iron core into an explosion, a process that determines the supernova explosion energy, properties of the surviving compact remnant, and the nucleosynthetic yields. The number of core-collapse supernova observations has been growing with an accelerating pace thanks to modern time-domain astronomical surveys and new tests of the explosion mechanism are becoming possible. We review predictions of parameterized supernova explosion models and compare them with explosion properties inferred from observed light curves, spectra, and neutron star masses.Comment: Reviews in Frontiers of Modern Astrophysics; From Space Debris to Cosmology, edited by Kab\'ath, Petr; Jones, David; Skarka, Marek. ISBN: 978-3-030-38509-5. Cham: Springer International Publishing, 2020, pp. 189-21

Stochastic Gravity: Theory and Applications

Whereas semiclassical gravity is based on the semiclassical Einstein equation with sources given by the expectation value of the stress-energy tensor of quantum fields, stochastic semiclassical gravity is based on the Einstein-Langevin equation, which has in addition sources due to the noise kernel.In the first part, we describe the fundamentals of this new theory via two approaches: the axiomatic and the functional. In the second part, we describe three applications of stochastic gravity theory. First, we consider metric perturbations in a Minkowski spacetime: we compute the two-point correlation functions for the linearized Einstein tensor and for the metric perturbations. Second, we discuss structure formation from the stochastic gravity viewpoint. Third, we discuss the backreaction of Hawking radiation in the gravitational background of a quasi-static black hole.Comment: 75 pages, no figures, submitted to Living Reviews in Relativit