Development of Prognosis in Palliative care Study (PiPS) predictor models to improve prognostication in advanced cancer: prospective cohort study

OBJECTIVE: To develop a novel prognostic indicator for use in patients with advanced cancer that is significantly better than clinicians' estimates of survival. DESIGN: Prospective multicentre observational cohort study. SETTING: 18 palliative care services in the UK (including hospices, hospital support teams, and community teams). PARTICIPANTS: 1018 patients with locally advanced or metastatic cancer, no longer being treated for cancer, and recently referred to palliative care services. MAIN OUTCOME MEASURES: Performance of a composite model to predict whether patients were likely to survive for "days" (0-13 days), "weeks" (14-55 days), or "months+" (>55 days), compared with actual survival and clinicians' predictions. RESULTS: On multivariate analysis, 11 core variables (pulse rate, general health status, mental test score, performance status, presence of anorexia, presence of any site of metastatic disease, presence of liver metastases, C reactive protein, white blood count, platelet count, and urea) independently predicted both two week and two month survival. Four variables had prognostic significance only for two week survival (dyspnoea, dysphagia, bone metastases, and alanine transaminase), and eight variables had prognostic significance only for two month survival (primary breast cancer, male genital cancer, tiredness, loss of weight, lymphocyte count, neutrophil count, alkaline phosphatase, and albumin). Separate prognostic models were created for patients without (PiPS-A) or with (PiPS-B) blood results. The area under the curve for all models varied between 0.79 and 0.86. Absolute agreement between actual survival and PiPS predictions was 57.3% (after correction for over-optimism). The median survival across the PiPS-A categories was 5, 33, and 92 days and survival across PiPS-B categories was 7, 32, and 100.5 days. All models performed as well as, or better than, clinicians' estimates of survival. CONCLUSIONS: In patients with advanced cancer no longer being treated, a combination of clinical and laboratory variables can reliably predict two week and two month survival

Properties of implanted and CVD incorporated nitrogen-vacancy centers: preferential charge state and preferential orientation

The combination of the long electron state spin coherence time and the optical coupling of the ground electronic states to an excited state manifold makes the nitrogen-vacancy (NV) center in diamond an attractive candidate for quantum information processing. To date the best spin and optical properties have been found in centers deep within the diamond crystal. For useful devices it will be necessary to engineer NVs with similar properties close to the diamond surface. We report on properties including charge state control and preferential orientation for near surface NVs formed either in CVD growth or through implantation and annealing

Understanding non-vaccinating parents' views to inform and improve clinical encounters: A qualitative study in an Australian community

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objectives To explain vaccination refusal in a sample of Australian parents. Design Qualitative design, purposive sampling in a defined population. Setting A geographically bounded community of approximately 30 000 people in regional Australia with high prevalence of vaccination refusal. Participants Semi structured interviews with 32 non-vaccinating parents: 9 fathers, 22 mothers and 1 pregnant woman. Purposive sampling of parents who had decided to discontinue or decline all vaccinations for their children. Recruitment via local advertising then snowballing. Results Thematic analysis focused on explaining decision-making pathways of parents who refuse vaccination. Common patterns in parents' accounts included: perceived deterioration in health in Western societies; a personal experience introducing doubt about vaccine safety; concerns regarding consent; varied encounters with health professionals (dismissive, hindering and helpful); a quest for the real truth'; reactance to system inflexibilities and ongoing risk assessment. Conclusions We suggest responses tailored to the perspectives of non-vaccinating parents to assist professionals in understanding and maintaining empathic clinical relationships with this important patient group

Polymorphisms in the circadian expressed genes PER3 and ARNTL2 are associated with diurnal preference and GNβ3 with sleep measures

Sleep and circadian rhythms are intrinsically linked, with several sleep traits, including sleep timing and duration, influenced by both sleep homeostasis and the circadian phase. Genetic variation in several circadian genes has been associated with diurnal preference (preference in timing of sleep), although there has been limited research on whether they are associated with other sleep measurements. We investigated whether these genetic variations were associated with diurnal preference (Morningness-Eveningness Questionnaire) and various sleep measures, including: the global Pittsburgh Sleep Quality index score; sleep duration; and sleep latency and sleep quality. We genotyped 10 polymorphisms in genes with circadian expression in participants from the G1219 sample (n = 966), a British longitudinal population sample of young adults. We conducted linear regressions using dominant, additive and recessive models of inheritance to test for associations between these polymorphisms and the sleep measures. We found a significant association between diurnal preference and a polymorphism in period homologue 3 (PER3) (P < 0.005, recessive model) and a novel nominally significant association between diurnal preference and a polymorphism in aryl hydrocarbon receptor nuclear translocator-like 2 (ARNTL2) (P < 0.05, additive model). We found that a polymorphism in guanine nucleotide binding protein beta 3 (GNβ3) was associated significantly with global sleep quality (P < 0.005, recessive model), and that a rare polymorphism in period homologue 2 (PER2) was associated significantly with both sleep duration and quality (P < 0.0005, recessive model). These findings suggest that genes with circadian expression may play a role in regulating both the circadian clock and sleep homeostasis, and highlight the importance of further studies aimed at dissecting the specific roles that circadian genes play in these two interrelated but unique behaviours

Modification of the spontaneous emission rate of nitrogen-vacancy centers in diamond by coupling to plasmons

Nitrogen-vacancy centers in diamond are widely studied both as a testbed for solid state quantum optics and for their applications in quantum information processing and magnetometry. Here we demonstrate coupling of the nitrogen-vacancy centers to gap plasmons in metal nano-slits. We use diamond samples where nitrogen-vacancy centers are implanted tens of nanometers under the surface. Silver nano-slits are patterned on the sample such that diamond ridges tens of nanometers wide fill the slit gap. We measure enhancement of the spontaneous emission rate of the zero photon line by a factor of 3 at a temperature of 8K

Associations between diurnal preference, sleep quality and externalizing behaviours: a behavioural genetic analysis

Background - Certain aspects of sleep co-occur with externalizing behaviours in youth, yet little is known about these associations in adults. The present study: (1) examines the associations between diurnal preference (morningness versus eveningness), sleep quality and externalizing behaviours; (2) explores the extent to which genetic and environmental influences are shared between or are unique to these phenotypes; (3) examines the extent to which genetic and environmental influences account for these associations. Method - Questionnaires assessing diurnal preference, sleep quality and externalizing behaviours were completed by 1556 young adult twins and siblings. Results - A preference for eveningness and poor sleep quality were associated with greater externalizing symptoms [r=0.28 (95% CI 0.23–0.33) and 0.34 (95% CI 0.28–0.39), respectively]. A total of 18% of the genetic influences on externalizing behaviours were shared with diurnal preference and sleep quality and an additional 14% were shared with sleep quality alone. Non-shared environmental influences common to the phenotypes were small (2%). The association between diurnal preference and externalizing behaviours was mostly explained by genetic influences [additive genetic influence (A)=80% (95% CI 0.56–1.01)], as was the association between sleep quality and externalizing behaviours [A=81% (95% CI 0.62–0.99)]. Non-shared environmental (E) influences accounted for the remaining variance for both associations [E=20% (95% CI −0.01 to 0.44) and 19% (95% CI 0.01–0.38), respectively]. Conclusions - A preference for eveningness and poor sleep quality are moderately associated with externalizing behaviours in young adults. There is a moderate amount of shared genetic influences between the phenotypes and genetic influences account for a large proportion of the association between sleep and externalizing behaviours. Further research could focus on identifying specific genetic polymorphisms common to both sleep and externalizing behaviours

Resonant enhancement of the zero-phonon emission from a color center in a diamond cavity

We demonstrate coupling of the zero-phonon line of individual nitrogen-vacancy centers and the modes of microring resonators fabricated in single-crystal diamond. A zero-phonon line enhancement exceeding ten-fold is estimated from lifetime measurements at cryogenic temperatures. The devices are fabricated using standard semiconductor techniques and off-the-shelf materials, thus enabling integrated diamond photonics.Comment: 5 pages, 4 figure

Mapping of shape invariant potentials by the point canonical transformation

In this paper by using the method of point canonical transformation we find that the Coulomb and Kratzer potentials can be mapped to the Morse potential. Then we show that the P\"{o}schl-Teller potential type I belongs to the same subclass of shape invariant potentials as Hulth\'{e}n potential. Also we show that the shape-invariant algebra for Coulomb, Kratzer, and Morse potentials is SU(1,1), while the shape-invariant algebra for P\"{o}schl-Teller type I and Hulth\'{e}n is SU(2)

New Shape Invariant Potentials in Supersymmetric Quantum Mechanics

Quantum mechanical potentials satisfying the property of shape invariance are well known to be algebraically solvable. Using a scaling ansatz for the change of parameters, we obtain a large class of new shape invariant potentials which are reflectionless and possess an infinite number of bound states. They can be viewed as q-deformations of the single soliton solution corresponding to the Rosen-Morse potential. Explicit expressions for energy eigenvalues, eigenfunctions and transmission coefficients are given. Included in our potentials as a special case is the self-similar potential recently discussed by Shabat and Spiridonov.Comment: 8pages, Te