Effectiveness of interventions to support the early detection of skin cancer through skin self-examination: a systematic review and meta-analysis.

BACKGROUND: As skin cancer incidence rises, there is a need to evaluate early detection interventions by the public using skin self-examination (SSE); however, the literature focuses on primary prevention. No systematic reviews have evaluated the effectiveness of such SSE interventions. OBJECTIVES: To systematically examine, map, appraise and synthesize, qualitatively and quantitatively, studies evaluating the early detection of skin cancer, using SSE interventions. METHODS: This is a systematic review (narrative synthesis and meta-analysis) examining randomized controlled trials (RCTs) and quasiexperimental, observational and qualitative studies, published in English, using PRISMA and National Institute for Health and Care Excellence guidance. The MEDLINE, Embase and PsycINFO databases were searched through to April 2015 (updated in April 2018 using MEDLINE). Risk-of-bias assessment was conducted. RESULTS: Included studies (n = 18), totalling 6836 participants, were derived from 22 papers; these included 12 RCTs and five quasiexperiments and one complex-intervention development. More studies (n = 10) focused on targeting high-risk groups (surveillance) than those at no higher risk (screening) (n = 8). Ten (45%) study interventions were theoretically underpinned. All of the study outcomes were self-reported, behaviour related and nonclinical in nature. Meta-analysis demonstrated the impact of the intervention on the degree of SSE activity from five studies, especially in the short term (up to 4 months) (odds ratio 2·31, 95% confidence interval 1·90-2·82), but with small effect sizes. Risk-of-bias assessment indicated that 61% of the studies (n = 11) were of weak quality. CONCLUSIONS: Four RCTs and a quasiexperimental study indicate that some interventions can enhance SSE activity and so are more likely to aid early detection of skin cancer. However, the actual clinical impact remains unclear, and this is based on overall weak study (evidence) quality

Tall tales from de Sitter space II: Field theory dualities

We consider the evolution of massive scalar fields in (asymptotically) de Sitter spacetimes of arbitrary dimension. Through the proposed dS/CFT correspondence, our analysis points to the existence of new nonlocal dualities for the Euclidean conformal field theory. A massless conformally coupled scalar field provides an example where the analysis is easily explicitly extended to 'tall' background spacetimes.Comment: 31 pages, 2 figure

Out of equilibrium: understanding cosmological evolution to lower-entropy states

Despite the importance of the Second Law of Thermodynamics, it is not absolute. Statistical mechanics implies that, given sufficient time, systems near equilibrium will spontaneously fluctuate into lower-entropy states, locally reversing the thermodynamic arrow of time. We study the time development of such fluctuations, especially the very large fluctuations relevant to cosmology. Under fairly general assumptions, the most likely history of a fluctuation out of equilibrium is simply the CPT conjugate of the most likely way a system relaxes back to equilibrium. We use this idea to elucidate the spacetime structure of various fluctuations in (stable and metastable) de Sitter space and thermal anti-de Sitter space.Comment: 27 pages, 11 figure

Bosonic Excitations in Random Media

We consider classical normal modes and non-interacting bosonic excitations in disordered systems. We emphasise generic aspects of such problems and parallels with disordered, non-interacting systems of fermions, and discuss in particular the relevance for bosonic excitations of symmetry classes known in the fermionic context. We also stress important differences between bosonic and fermionic problems. One of these follows from the fact that ground state stability of a system requires all bosonic excitation energy levels to be positive, while stability in systems of non-interacting fermions is ensured by the exclusion principle, whatever the single-particle energies. As a consequence, simple models of uncorrelated disorder are less useful for bosonic systems than for fermionic ones, and it is generally important to study the excitation spectrum in conjunction with the problem of constructing a disorder-dependent ground state: we show how a mapping to an operator with chiral symmetry provides a useful tool for doing this. A second difference involves the distinction for bosonic systems between excitations which are Goldstone modes and those which are not. In the case of Goldstone modes we review established results illustrating the fact that disorder decouples from excitations in the low frequency limit, above a critical dimension $d_c$, which in different circumstances takes the values $d_c=2$ and $d_c=0$. For bosonic excitations which are not Goldstone modes, we argue that an excitation density varying with frequency as $\rho(\omega) \propto \omega^4$ is a universal feature in systems with ground states that depend on the disorder realisation. We illustrate our conclusions with extensive analytical and some numerical calculations for a variety of models in one dimension

Criticality of the Mean-Field Spin-Boson Model: Boson State Truncation and Its Scaling Analysis

The spin-boson model has nontrivial quantum phase transitions at zero temperature induced by the spin-boson coupling. The bosonic numerical renormalization group (BNRG) study of the critical exponents $\beta$ and $\delta$ of this model is hampered by the effects of boson Hilbert space truncation. Here we analyze the mean-field spin boson model to figure out the scaling behavior of magnetization under the cutoff of boson states $N_{b}$. We find that the truncation is a strong relevant operator with respect to the Gaussian fixed point in $0<s<1/2$ and incurs the deviation of the exponents from the classical values. The magnetization at zero bias near the critical point is described by a generalized homogeneous function (GHF) of two variables $\tau=\alpha-\alpha_{c}$ and $x=1/N_{b}$. The universal function has a double-power form and the powers are obtained analytically as well as numerically. Similarly, $m(\alpha=\alpha_{c})$ is found to be a GHF of $\epsilon$ and $x$. In the regime $s>1/2$, the truncation produces no effect. Implications of these findings to the BNRG study are discussed.Comment: 9 pages, 7 figure

Quantum Griffiths effects and smeared phase transitions in metals: theory and experiment

In this paper, we review theoretical and experimental research on rare region effects at quantum phase transitions in disordered itinerant electron systems. After summarizing a few basic concepts about phase transitions in the presence of quenched randomness, we introduce the idea of rare regions and discuss their importance. We then analyze in detail the different phenomena that can arise at magnetic quantum phase transitions in disordered metals, including quantum Griffiths singularities, smeared phase transitions, and cluster-glass formation. For each scenario, we discuss the resulting phase diagram and summarize the behavior of various observables. We then review several recent experiments that provide examples of these rare region phenomena. We conclude by discussing limitations of current approaches and open questions.Comment: 31 pages, 7 eps figures included, v2: discussion of the dissipative Ising chain fixed, references added, v3: final version as publishe

Vicious walk with a wall, noncolliding meanders, and chiral and Bogoliubov-deGennes random matrices

Spatially and temporally inhomogeneous evolution of one-dimensional vicious walkers with wall restriction is studied. We show that its continuum version is equivalent with a noncolliding system of stochastic processes called Brownian meanders. Here the Brownian meander is a temporally inhomogeneous process introduced by Yor as a transform of the Bessel process that is a motion of radial coordinate of the three-dimensional Brownian motion represented in the spherical coordinates. It is proved that the spatial distribution of vicious walkers with a wall at the origin can be described by the eigenvalue-statistics of Gaussian ensembles of Bogoliubov-deGennes Hamiltonians of the mean-field theory of superconductivity, which have the particle-hole symmetry. We report that the time evolution of the present stochastic process is fully characterized by the change of symmetry classes from the type $C$ to the type $C$I in the nonstandard classes of random matrix theory of Altland and Zirnbauer. The relation between the non-colliding systems of the generalized meanders of Yor, which are associated with the even-dimensional Bessel processes, and the chiral random matrix theory is also clarified.Comment: REVTeX4, 16 pages, 4 figures. v2: some additions and correction

A Unified Algebraic Approach to Few and Many-Body Correlated Systems

The present article is an extended version of the paper {\it Phys. Rev.} {\bf B 59}, R2490 (1999), where, we have established the equivalence of the Calogero-Sutherland model to decoupled oscillators. Here, we first employ the same approach for finding the eigenstates of a large class of Hamiltonians, dealing with correlated systems. A number of few and many-body interacting models are studied and the relationship between their respective Hilbert spaces, with that of oscillators, is found. This connection is then used to obtain the spectrum generating algebras for these systems and make an algebraic statement about correlated systems. The procedure to generate new solvable interacting models is outlined. We then point out the inadequacies of the present technique and make use of a novel method for solving linear differential equations to diagonalize the Sutherland model and establish a precise connection between this correlated system's wave functions, with those of the free particles on a circle. In the process, we obtain a new expression for the Jack polynomials. In two dimensions, we analyze the Hamiltonian having Laughlin wave function as the ground-state and point out the natural emergence of the underlying linear $W_{1+\infty}$ symmetry in this approach.Comment: 18 pages, Revtex format, To appear in Physical Review

Random Mass Dirac Fermions in Doped Spin-Peierls and Spin-Ladder systems: One-Particle Properties and Boundary Effects

Quasi-one-dimensional spin-Peierls and spin-ladder systems are characterized by a gap in the spin-excitation spectrum, which can be modeled at low energies by that of Dirac fermions with a mass. In the presence of disorder these systems can still be described by a Dirac fermion model, but with a random mass. Some peculiar properties, like the Dyson singularity in the density of states, are well known and attributed to creation of low-energy states due to the disorder. We take one step further and study single-particle correlations by means of Berezinskii's diagram technique. We find that, at low energy $\epsilon$, the single-particle Green function decays in real space like $G(x,\epsilon) \propto (1/x)^{3/2}$. It follows that at these energies the correlations in the disordered system are strong -- even stronger than in the pure system without the gap. Additionally, we study the effects of boundaries on the local density of states. We find that the latter is logarithmically (in the energy) enhanced close to the boundary. This enhancement decays into the bulk as $1/\sqrt{x}$ and the density of states saturates to its bulk value on the scale $L_\epsilon \propto \ln^2 (1/\epsilon)$. This scale is different from the Thouless localization length $\lambda_\epsilon\propto\ln (1/\epsilon)$. We also discuss some implications of these results for the spin systems and their relation to the investigations based on real-space renormalization group approach.Comment: 26 pages, LaTex, 9 PS figures include

Persistence in a Stationary Time-series

We study the persistence in a class of continuous stochastic processes that are stationary only under integer shifts of time. We show that under certain conditions, the persistence of such a continuous process reduces to the persistence of a corresponding discrete sequence obtained from the measurement of the process only at integer times. We then construct a specific sequence for which the persistence can be computed even though the sequence is non-Markovian. We show that this may be considered as a limiting case of persistence in the diffusion process on a hierarchical lattice.Comment: 8 pages revte