Incorporating patient preferences in the management of multiple long-term conditions: is this a role for clinical practice guidelines?

Background: Clinical practice guidelines provide an evidence-based approach to managing single chronic conditions, but their applicability to multiple conditions has been actively debated. Incorporating patient-preference recommendations and involving consumers in guideline development may enhance their applicability, but further understanding is needed. Objectives: To assess guidelines that include recommendations for comorbid conditions to determine the extent to which they incorporate patient-preference recommendations; use consumer-engagement processes during development, and, if so, whether these processes produce more patient-preference recommendations; and meet standard quality criteria, particularly in relation to stakeholder involvement. Design: A review of Australian guidelines published from 2006 to 2014 that incorporated recommendations for managing comorbid conditions in primary care. Document analysis of guidelines examined the presence of patient-preference recommendations and the consumer-engagement processes used. The Appraisal of Guidelines for Research and Evaluation instrument was used to assess guideline quality. Results: Thirteen guidelines were reviewed. Twelve included at least one core patient-preference recommendation. Ten used consumer-engagement processes, including participation in development groups (seven guidelines) and reviewing drafts (ten guidelines). More extensive consumer engagement was generally linked to greater incorporation of patient-preference recommendations. Overall quality of guidelines was mixed, particularly in relation to stakeholder involvement. Conclusions: Guidelines do incorporate some patient-preference recommendations, but more explicit acknowledgement is required. Consumer-engagement processes used during guideline development have the potential to assist in identifying patient preferences, but further research is needed. Clarification of the consumer role and investment in consumer training may strengthen these processes.Journal of Comorbidity 2015;5(1):122–13

The Evolution of Radio Galaxies at Intermediate Redshift

We describe a new estimate of the radio galaxy 1.4 GHz luminosity function and its evolution at intermediate redshifts (z~0.4). Photometric redshifts and color selection have been used to select Bj<23.5 early-type galaxies from the Panoramic Deep Fields, a multicolor survey of two 25 sq deg fields. Approximately 230 radio galaxies have then been selected by matching early-type galaxies with NVSS radio sources brighter than 5 mJy. Estimates of the 1.4 GHz luminosity function of radio galaxies measure significant evolution over the observed redshift range. For an Omega_M=1 cosmology the evolution of the radio power is consistent with luminosity evolution where P(z)=P(0)(1+z)^{k_L} and 3<k_L<5. The observed evolution is similar to that observed for UVX and X-ray selected AGN and is consistent with the same physical process being responsible for the optical and radio luminosity evolution of AGN.Comment: 26 pages, 9 Figures, Accepted for Publication in A

Finding Gravitational Lenses With X-rays

There are $\sim 1$, 0.1 and 0.01 gravitationally lensed X-ray sources per square degree with soft X-ray fluxes exceeding $10^{-15}, 10^{-14}$ and $10^{-13} ergs/s cm^{-2}$ respectively. These sources will be detected serendipitously with the Chandra X-ray Observatory at a rate of 1--3 lenses per year of high resolution imaging. The low detection rate is due to the small area over which the HRC and ACIS cameras have the <1\farcs5 FWHM resolution necessary to find gravitational lenses produced by galaxies. Deep images of rich clusters at intermediate redshifts should yield one wide separation (\Delta\theta \gtorder 5\farcs0) multiply-imaged background X-ray source for every $\sim 10$, 30 and 300 clusters imaged to the same flux limits.Comment: 13 pages, including 5 figures, submitted to ApJ Letter

Localizing gravitational wave sources with optical telescopes and combining electromagnetic and gravitational wave data

Neutron star binaries, which are among the most promising sources for the direct detection of gravitational waves (GW) by ground based detectors, are also potential electromagnetic (EM) emitters. Gravitational waves will provide a new window to observe these events and hopefully give us glimpses of new astrophysics. In this paper, we discuss how EM information of these events can considerably improve GW parameter estimation both in terms of accuracy and computational power requirement. And then in return how GW sky localization can help EM astronomers in follow-up studies of sources which did not yield any prompt emission. We discuss how both EM source information and GW source localization can be used in a framework of multi-messenger astronomy. We illustrate how the large error regions in GW sky localizations can be handled in conducting optical astronomy in the advance detector era. We show some preliminary results in the context of an array of optical telescopes called BlackGEM, dedicated for optical follow-up of GW triggers, that is being constructed in La Silla, Chile and is expected to operate concurrent to the advanced GW detectors.Comment: 8 pages, 8 figures, Proceeding for Sant Cugat Forum for Astrophysic

QSO clustering and the AAT 2dF redshift survey

We review previous results on the clustering and environments of QSOs. We show that the correlation length for QSOs derived from existing surveys is r~5/h Mpc, similar to the observed correlation length for field galaxies at the present epoch. The galaxy environment for z<1 radio-quiet QSOs is also consistent with field galaxies. The evolution of the QSO correlation length with redshift is currently uncertain, largely due to the small numbers of QSOs (~2000) in surveys suitable for clustering analysis. We report on intial progress with the AAT 2dF QSO redshift survey, which, once completed will comprise almost 30000 QSOs. With over 1000 QSOs already observed, it is already the largest single homogeneous QSO survey. We discuss prospects for deriving limits on cosmological parameters from this survey, and on the evolution of large-scale structure in the Universe.Comment: Invited talk at RS meeting on 'Large Scale Structure in the Universe' held at the Royal Society on 25-26 March 1998 14 pages, 11 figre

Can Survey-based Scenarios Measure Consumer Values for Improved Food Safety?

Demand and Price Analysis, Food Consumption/Nutrition/Food Safety,

F-Seq: a feature density estimator for high-throughput sequence tags

Summary: Tag sequencing using high-throughput sequencing technologies are now regularly employed to identify specific sequence features, such as transcription factor binding sites (ChIP-seq) or regions of open chromatin (DNase-seq). To intuitively summarize and display individual sequence data as an accurate and interpretable signal, we developed F-Seq, a software package that generates a continuous tag sequence density estimation allowing identification of biologically meaningful sites whose output can be displayed directly in the UCSC Genome Browser

Acoustic power delivery to pipeline monitoring wireless sensors

The use of energy harvesting for powering wireless sensors is made more challenging in most applications by the requirement for customi zation to each specific application environment because of specificities of the availab le energy form, such as precise location, direction and motion frequency, as well a s the temporal variation and unpredictability of the energy source. Wireless pow er transfer from dedicated sources can overcome these difficulties, and in this work, the use of targeted ultrasonic power transfer as a possible method for remote powering o f sensor nodes is investigated. A powering system for pipeline monitoring sensors is described and studied experimentally, with a pair of identical, non6inert ial piezoelectric transducers used at the transmitter and receiver. Power transmission of 18 mW (Root6Mean6Square) through 1 m of a 118 mm diameter cast iron pipe, wi th 8 mm wall thickness is demonstrated. By analysis of the delay between tran smission and reception, including reflections from the pipeline edges, a transmission speed of 1000 m/s is observed, corresponding to the phase velocity of the L(0,1) a xial and F(1,1) radial modes of the pipe structure. A reduction of power delivery with water6filling is observed, yet over 4 mW of delivered power through a fully6filled pipe i s demonstrated. The transmitted power and voltage levels exceed the requirements fo r efficient power management, including rectification at cold6starting conditions , and for the operation of low6power sensor nodes. The proposed powering technique may a llow the implementation of energy autonomous wireless sensor systems for monit oring industrial and network pipeline infrastructure

Phonon-Induced Rabi-Frequency Renormalization of Optically Driven Single InGaAs/GaAs Quantum Dots

The authors thank the EPSRC (U.K.) EP/G001642, and the QIPIRC U.K. for financial support. A. N. is supported by the EPSRC and B.W. L. by the Royal Society.We study optically driven Rabi rotations of a quantum dot exciton transition between 5 and 50 K, and for pulse areas of up to 14 pi. In a high driving field regime, the decay of the Rabi rotations is nonmonotonic, and the period decreases with pulse area and increases with temperature. By comparing the experiments to a weak-coupling model of the exciton-phonon interaction, we demonstrate that the observed renormalization of the Rabi frequency is induced by fluctuations in the bath of longitudinal acoustic phonons, an effect that is a phonon analogy of the Lamb shift.Peer reviewe

High-accuracy waveforms for binary black hole inspiral, merger, and ringdown

The first spectral numerical simulations of 16 orbits, merger, and ringdown of an equal-mass non-spinning binary black hole system are presented. Gravitational waveforms from these simulations have accumulated numerical phase errors through ringdown of ~0.1 radian when measured from the beginning of the simulation, and ~0.02 radian when waveforms are time and phase shifted to agree at the peak amplitude. The waveform seen by an observer at infinity is determined from waveforms computed at finite radii by an extrapolation process accurate to ~0.01 radian in phase. The phase difference between this waveform at infinity and the waveform measured at a finite radius of r=100M is about half a radian. The ratio of final mass to initial mass is M_f/M = 0.95162 +- 0.00002, and the final black hole spin is S_f/M_f^2=0.68646 +- 0.00004.Comment: 15 pages, 11 figures; New figure added, text edited to improve clarity, waveform made availabl