Prioritising patients in hyperemesis gravidarum research

We aimed to identify the extent to which hyperemesis gravidarum (HG) effects people’s lives during pregnancy and in future pregnancies and then to establish future research priorities in collaboration with patients and clinicians, and to map the evidence currently addressing those priorities. Methods used to identify the effects of HG on people include a qualitative systematic review and a large-scale, mixed methods survey of over 5,000 participants. Recurrence rate was assessed with a quantitative systematic review of prospective studies and a prospective follow-up study of a well-defined cohort from a previous RCT. To establish research priorities the established James Lind Alliance methodology was followed, and the evidence map was created with software from the EPPI Centre following emerging systematic methods. Profound physical and psychological effects of HG were identified, including suicidal ideation and termination of wanted pregnancy. Recurrence was high in subsequent pregnancy which can substantially alter people’s family plans and curtail future pregnancy completely. Patients/clinicians from 32 countries took part in submitting potential research questions which were then prioritised, and a map produced of the current literature addressing them. Most require original research to begin to address them, while some would benefit from systematic review to reduce research waste from repetitive, inconclusive studies. Taken together this thesis presents a significant stride in improving the relevance and quality of HG research, places the patient voice centrally within it and advances progress on obtaining answers to questions that will help to improve the lives of those with HG in the future

Resistively Detected NMR in Quantum Hall States: Investigation of the anomalous lineshape near ν=1\nu=1

A study of the resistively detected nuclear magnetic resonance (RDNMR) lineshape in the vicinity of $\nu=1$ was performed on a high-mobility 2D electron gas formed in GaAs/AlGaAs. In higher Landau levels, application of an RF field at the nuclear magnetic resonance frequency coincides with an observed minimum in the longitudinal resistance, as predicted by the simple hyperfine interaction picture. Near $\nu=1$ however, an anomalous dispersive lineshape is observed where a resistance peak follows the usual minimum. In an effort to understand the origin of this anomalous peak we have studied the resonance under various RF and sample conditions. Interestingly, we show that the lineshape can be completely inverted by simply applying a DC current. We interpret this as evidence that the minima and maxima in the lineshape originate from two distinct mechanisms.Comment: 5 pages, 3 figures, EP2DS 17, to be published in Physica

A Tale of Two Fractals: The Hofstadter Butterfly and The Integral Apollonian Gaskets

This paper unveils a mapping between a quantum fractal that describes a physical phenomena, and an abstract geometrical fractal. The quantum fractal is the Hofstadter butterfly discovered in 1976 in an iconic condensed matter problem of electrons moving in a two-dimensional lattice in a transverse magnetic field. The geometric fractal is the integer Apollonian gasket characterized in terms of a 300 BC problem of mutually tangent circles. Both of these fractals are made up of integers. In the Hofstadter butterfly, these integers encode the topological quantum numbers of quantum Hall conductivity. In the Apollonian gaskets an infinite number of mutually tangent circles are nested inside each other, where each circle has integer curvature. The mapping between these two fractals reveals a hidden threefold symmetry embedded in the kaleidoscopic images that describe the asymptotic scaling properties of the butterfly. This paper also serves as a mini review of these fractals, emphasizing their hierarchical aspects in terms of Farey fractions

The Morphometric Synthesis for landmarks and edge-elements in images

Over the last decade, techniques from mathematical statistics, multivariate biometrics, non-Euclidean geometry, and computer graphics have been combined in a coherent new system of tools for the biometric analysis of landmarks , or labelled points, along with the biological images in which they are seen. Multivariate analyses of samples for all the usual scientific purposes - description of mean shapes, of shape variation, and of the covariation of shape with size, group, or other causes or effects - may be carried out very effectively in the tangent space to David Kendall's shape space at the Procrustes average shape. For biometric interpretation of such analyses, we need a basis for the tangent space that is Procrustes-orthonormal, and we need graphics for visualizing mean shape differences and other segments and vectors there; both of these needs are managed by the thin-plate spline. The spline also links the biometrics of landmarks to deformation analysis of curves in the images from which the landmarks originally arose. This article reviews the principal tools of this synthesis in a typical study design involving landmarks and edge information from a microfossil.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75091/1/j.1365-3121.1995.tb00535.x.pd

Chiral three-nucleon forces and bound excited states in neutron-rich oxygen isotopes

We study the spectra of neutron-rich oxygen isotopes based on chiral two- and three-nucleon interactions. First, we benchmark our many-body approach by comparing ground-state energies to coupled-cluster results for the same two-nucleon interaction, with overall good agreement. We then calculate bound excited states in 21,22,23O, focusing on the role of three-nucleon forces, in the standard sd shell and an extended sdf7/2p3/2 valence space. Chiral three-nucleon forces provide important one- and two-body contributions between valence neutrons. We find that both these contributions and an extended valence space are necessary to reproduce key signatures of novel shell evolution, such as the N = 14 magic number and the low-lying states in 21O and 23O, which are too compressed with two-nucleon interactions only. For the extended space calculations, this presents first work based on nuclear forces without adjustments. Future work is needed and open questions are discussed.Comment: 6 pages, 4 figures, published versio

A terminal assessment of stages theory : introducing a dynamic states approach to entrepreneurship

Stages of Growth models were the most frequent theoretical approach to understanding entrepreneurial business growth from 1962 to 2006; they built on the growth imperative and developmental models of that time. An analysis of the universe of such models (N=104) published in the management literature shows no consensus on basic constructs of the approach, nor is there any empirical confirmations of stages theory. However, by changing two propositions of the stages models, a new dynamic states approach is derived. The dynamic states approach has far greater explanatory power than its precursor, and is compatible with leading edge research in entrepreneurship

Abelian gauge potentials on cubic lattices

The study of the properties of quantum particles in a periodic potential subject to a magnetic field is an active area of research both in physics and mathematics; it has been and it is still deeply investigated. In this review we discuss how to implement and describe tunable Abelian magnetic fields in a system of ultracold atoms in optical lattices. After discussing two of the main experimental schemes for the physical realization of synthetic gauge potentials in ultracold set-ups, we study cubic lattice tight-binding models with commensurate flux. We finally examine applications of gauge potentials in one-dimensional rings.Comment: To appear on: "Advances in Quantum Mechanics: Contemporary Trends and Open Problems", G. Dell'Antonio and A. Michelangeli eds., Springer-INdAM series 201

'To live and die [for] Dixie': Irish civilians and the Confederate States of America

Around 20,000 Irishmen served in the Confederate army in the Civil War. As a result, they left behind, in various Southern towns and cities, large numbers of friends, family, and community leaders. As with native-born Confederates, Irish civilian support was crucial to Irish participation in the Confederate military effort. Also, Irish civilians served in various supporting roles: in factories and hospitals, on railroads and diplomatic missions, and as boosters for the cause. They also, however, suffered in bombardments, sieges, and the blockade. Usually poorer than their native neighbours, they could not afford to become 'refugees' and move away from the centres of conflict. This essay, based on research from manuscript collections, contemporary newspapers, British Consular records, and Federal military records, will examine the role of Irish civilians in the Confederacy, and assess the role this activity had on their integration into Southern communities. It will also look at Irish civilians in the defeat of the Confederacy, particularly when they came under Union occupation. Initial research shows that Irish civilians were not as upset as other whites in the South about Union victory. They welcomed a return to normalcy, and often 'collaborated' with Union authorities. Also, Irish desertion rates in the Confederate army were particularly high, and I will attempt to gauge whether Irish civilians played a role in this. All of the research in this paper will thus be put in the context of the Drew Gilpin Faust/Gary Gallagher debate on the influence of the Confederate homefront on military performance. By studying the Irish civilian experience one can assess how strong the Confederate national experiment was. Was it a nation without a nationalism

Prioritising research areas for antibiotic stewardship programmes in hospitals: a behavioural perspective consensus paper

SCOPE: Antibiotic stewardship programmes (ASPs) are necessary in hospitals to improve the judicious use of antibiotics. While ASPs require complex change of key behaviours on individual, team, organisation and policy levels, evidence from the behavioural sciences is underutilised in antibiotic stewardship studies across the world, including high-income countries (HICs). A consensus procedure was performed to propose research priority areas for optimising effective implementation of ASPs in hospital settings, using a behavioural perspective. METHODS: A workgroup for behavioural approaches to ASPs was convened in response to the fourth call for leading expert network proposals by the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR). Eighteen clinical and academic specialists in antibiotic stewardship, implementation science and behaviour change from four high-income countries with publicly-funded health care systems (that is Canada, Germany, Norway and the UK), met face-to-face to agree on broad research priority areas using a structured consensus method. QUESTION ADDRESSED AND RECOMMENDATIONS: The consensus process on the 10 identified research priority areas resulted in recommendations that need urgent scientific interest and funding to optimise effective implementation of antibiotic stewardship programmes for hospital inpatients in HICs with publicly-funded health care systems. We suggest and detail, behavioural science evidence-guided research efforts in the following areas: 1) Comprehensively identifying barriers and facilitators to implementing antibiotic stewardship programmes and clinical recommendations intended to optimise antibiotic prescribing; 2) Identifying actors ('who') and actions ('what needs to be done') of antibiotic stewardship programmes and clinical teams; 3) Synthesising available evidence to support future research and planning for antibiotic stewardship programmes; 4) Specifying the activities in current antibiotic stewardship programmes with the purpose of defining a 'control group' for comparison with new initiatives; 5) Defining a balanced set of outcomes and measures to evaluate the effects of interventions focused on reducing unnecessary exposure to antibiotics; 6) Conducting robust evaluations of antibiotic stewardship programmes with built-in process evaluations and fidelity assessments; 7) Defining and designing antibiotic stewardship programmes; 8) Establishing the evidence base for impact of antibiotic stewardship programmes on resistance; 9) Investigating the role and impact of government and policy contexts on antibiotic stewardship programmes; and 10) Understanding what matters to patients in antibiotic stewardship programmes in hospitals. Assessment, revisions and updates of our priority-setting exercise should be considered, at intervals of 2 years. To propose research priority areas in low- and medium income countries (LIMCs), the methodology reported here could be applied