Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy

Purpose of the Review: Pathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges. Recent Findings: Evidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care. Summary: More emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it

Current status of NLTE analysis of stellar atmospheres

Various available codes for NLTE modeling and analysis of hot star spectra are reviewed. Generalizations of standard equations of kinetic equilibrium and their consequences are discussed.Comment: in Determination of Atmospheric Parameters of B-, A-, F- and G-Type Stars, E. Niemczura et al. eds., Springer, in pres

The complete mitochondrial genome of the foodborne parasitic pathogen Cyclospora cayetanensis

Cyclospora cayetanensis is a human-specific coccidian parasite responsible for several food and water-related outbreaks around the world, including the most recent ones involving over 900 persons in 2013 and 2014 outbreaks in the USA. Multicopy organellar DNA such as mitochondrion genomes have been particularly informative for detection and genetic traceback analysis in other parasites. We sequenced the C. cayetanensis genomic DNA obtained from stool samples from patients infected with Cyclospora in Nepal using the Illumina MiSeq platform. By bioinformatically filtering out the metagenomic reads of non-coccidian origin sequences and concentrating the reads by targeted alignment, we were able to obtain contigs containing Eimeria-like mitochondrial, apicoplastic and some chromosomal genomic fragments. A mitochondrial genomic sequence was assembled and confirmed by cloning and sequencing targeted PCR products amplified from Cyclospora DNA using primers based on our draft assembly sequence. The results show that the C. cayetanensis mitochondrion genome is 6274 bp in length, with 33% GC content, and likely exists in concatemeric arrays as in Eimeria mitochondrial genomes. Phylogenetic analysis of the C. cayetanensis mitochondrial genome places this organism in a tight cluster with Eimeria species. The mitochondrial genome of C. cayetanensis contains three protein coding genes, cytochrome (cytb), cytochrome C oxidase subunit 1 (cox1), and cytochrome C oxidase subunit 3 (cox3), in addition to 14 large subunit (LSU) and nine small subunit (SSU) fragmented rRNA genes

Search for new phenomena in high-mass final states with a photon and a jet from pp collisions at √s = 13 TeV with the ATLAS detector

A search is performed for new phenomena in events having a photon with high transverse momentum and a jet collected in 36.7fb-1 of proton–proton collisions at a centre-of-mass energy of s = 13 TeV recorded with the ATLAS detector at the Large Hadron Collider. The invariant mass distribution of the leading photon and jet is examined to look for the resonant production of new particles or the presence of new high-mass states beyond the Standard Model. No significant deviation from the background-only hypothesis is observed and cross-section limits for generic Gaussian-shaped resonances are extracted. Excited quarks hypothesized in quark compositeness models and high-mass states predicted in quantum black hole models with extra dimensions are also examined in the analysis. The observed data exclude, at 95% confidence level, the mass range below 5.3 TeV for excited quarks and 7.1 TeV (4.4 TeV) for quantum black holes in the Arkani-Hamed–Dimopoulos–Dvali (Randall–Sundrum) model with six (one) extra dimensions

Search for new phenomena in dijet events using 37 fb−1 of pp collision data collected at √s=13 TeV with the ATLAS detector

Dijet events are studied in the proton-proton collision data set recorded at s=13 TeV with the ATLAS detector at the Large Hadron Collider in 2015 and 2016, corresponding to integrated luminosities of 3.5 fb-1 and 33.5 fb-1 respectively. Invariant mass and angular distributions are compared to background predictions and no significant deviation is observed. For resonance searches, a new method for fitting the background component of the invariant mass distribution is employed. The data set is then used to set upper limits at a 95% confidence level on a range of new physics scenarios. Excited quarks with masses below 6.0 TeV are excluded, and limits are set on quantum black holes, heavy W′ bosons, W∗ bosons, and a range of masses and couplings in a Z′ dark matter mediator model. Model-independent limits on signals with a Gaussian shape are also set, using a new approach allowing factorization of physics and detector effects. From the angular distributions, a scale of new physics in contact interaction models is excluded for scenarios with either constructive or destructive interference. These results represent a substantial improvement over those obtained previously with lower integrated luminosity

Search for supersymmetry in final states with missing transverse momentum and multiple b-jets in proton-proton collisions at √s=13 TeV with the ATLAS detector

A search for supersymmetry involving the pair production of gluinos decaying via third-generation squarks into the lightest neutralino χ˜10 $$\left({\tilde{\chi}}_1^0\right)$$ is reported. It uses LHC proton-proton collision data at a centre-of-mass energy s=13 $$\sqrt{s}=13$$ TeV with an integrated luminosity of 36.1 fb−1 collected with the ATLAS detector in 2015 and 2016. The search is performed in events containing large missing transverse momentum and several energetic jets, at least three of which must be identified as originating from b-quarks. To increase the sensitivity, the sample is divided into subsamples based on the presence or absence of electrons or muons. No excess is found above the predicted background. For χ˜10 $${\tilde{\chi}}_1^0$$ masses below approximately 300 GeV, gluino masses of less than 1.97 (1.92) TeV are excluded at 95% confidence level in simplified models involving the pair production of gluinos that decay via top (bottom) squarks. An interpretation of the limits in terms of the branching ratios of the gluinos into third-generation squarks is also provided. These results improve upon the exclusion limits obtained with the 3.2 fb−1 of data collected in 2015

Search for heavy resonances decaying to a W or Z boson and a Higgs boson in the qq¯(′)bb¯ final state in pp collisions at √s = 13 TeV with the ATLAS detector

A search for heavy resonances decaying to a W or Z boson and a Higgs boson in the qq¯(′)bb¯ final state is described. The search uses 36.1 fb−1 of proton–proton collision data at s=13 TeV collected by the ATLAS detector at the CERN Large Hadron Collider in 2015 and 2016. The data are in agreement with the Standard Model expectations, with the largest excess found at a resonance mass of 3.0 TeV with a local (global) significance of 3.3 (2.1) σ. The results are presented in terms of constraints on a simplified model with a heavy vector triplet. Upper limits are set on the production cross-section times branching ratio for resonances decaying to a W (Z) boson and a Higgs boson, itself decaying to bb¯, in the mass range between 1.1 and 3.8 TeV at 95% confidence level; the limits range between 83 and 1.6 fb (77 and 1.1 fb) at 95% confidence level

Strong and Tunable Nonlinear Optomechanical Coupling in a Low-Loss System

A major goal in optomechanics is to observe and control quantum behavior in a system consisting of a mechanical resonator coupled to an optical cavity. Work towards this goal has focused on increasing the strength of the coupling between the mechanical and optical degrees of freedom; however, the form of this coupling is crucial in determining which phenomena can be observed in such a system. Here we demonstrate that avoided crossings in the spectrum of an optical cavity containing a flexible dielectric membrane allow us to realize several different forms of the optomechanical coupling. These include cavity detunings that are (to lowest order) linear, quadratic, or quartic in the membrane's displacement, and a cavity finesse that is linear in (or independent of) the membrane's displacement. All these couplings are realized in a single device with extremely low optical loss and can be tuned over a wide range in situ; in particular, we find that the quadratic coupling can be increased three orders of magnitude beyond previous devices. As a result of these advances, the device presented here should be capable of demonstrating the quantization of the membrane's mechanical energy.Comment: 12 pages, 4 figures, 1 tabl

Emergence d’une spécialité scientifique dans l’espace - La réparation de l’ADN

International audienceIn the study of science, the specialty is seen as the ideal level of analysis to understand the genesis and development of scientific communities. This article uses bibliometric data to analyze the emergence of DNA repair by testing a hybrid method to identify the specialty’s appearance in geographical space by focusing on the geographical trajectories of the pioneers in this field. We try to identify the professional mobility of researchers using these bibliometric data, and if possible to highlight the structural networks of places during the emergence stage of the specialty. These networks determine places as much as they are built by individual trajectories. In this way, we try to make a place for the geography of science in the field of social studies of science.Dans l’étude des sciences, la spécialité est perçue comme le niveau d’analyse idéal pour comprendre la genèse et le développement des collectifs scientifiques. Cet article utilise des données bibliométriques pour analyser l’émergence de la Réparation de l’ADN en expérimentant une méthode mixte pour repérer son apparition dans l’espace géographique. En nous concentrant sur les trajectoires géographiques de pionniers dans cedomaine, nous tâchons de repérer leur mobilité professionnelle à l’aide de données bibliométriques dans la perspective de mettre en évidence les réseaux de lieux structurants dans la phase d’émergence de la spécialité. Ces réseaux de lieux déterminent autant qu’ils sont construits par les trajectoires individuelles. Nous essayons ainsi de faire une place à la géographie des sciences dans le domaine des études sociales des sciences