7,236 research outputs found

    PMH60 A PHARMACOECONOMIC COMPARISON OF ESCITALOPRAM AND DULOXETINE IN TREATMENT OF MAJOR DEPRESSIVE DISORDER (MDD) IN THE UNITED KINGDOM

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    Classical and Quantum Solitons in the Symmetric Space Sine-Gordon Theories

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    We construct the soliton solutions in the symmetric space sine-Gordon theories. The latter are a series of integrable field theories in 1+1-dimensions which are associated to a symmetric space F/G, and are related via the Pohlmeyer reduction to theories of strings moving on symmetric spaces. We show that the solitons are kinks that carry an internal moduli space that can be identified with a particular co-adjoint orbit of the unbroken subgroup H of G. Classically the solitons come in a continuous spectrum which encompasses the perturbative fluctuations of the theory as the kink charge becomes small. We show that the solitons can be quantized by allowing the collective coordinates to be time-dependent to yield a form of quantum mechanics on the co-adjoint orbit. The quantum states correspond to symmetric tensor representations of the symmetry group H and have the interpretation of a fuzzy geometric version of the co-adjoint orbit. The quantized finite tower of soliton states includes the perturbative modes at the base.Comment: 53 pages, additional comments and small errors corrected, final journal versio

    Prevalence of rheumatoid arthritis in South America: a systematic review and meta-analysis

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    Rheumatoid arthritis (RA) is among the most prevalent chronic autoimmune and inflammatory diseases worldwide. The aim of this study was to establish a pooled estimate of the RA prevalence in South America by means of a meta-analysis of the available epidemiologic studies. Systematic searches in PubMed, Lilacs, SciELO, Scopus, and Web of Science databases (updated May 2019) were done followed by a systematic grey literature search to identify original research articles and reports, published after 2000, providing data of RA prevalence in any South American country. Proportion meta-analysis of weighted pooled was performed, with between-trial heterogeneity assessed by the inconsistency relative index. Sensitivity analyses and sub-group analyses were also done. A total of 25 articles, representing 27 population-based studies were included. Pooled prevalence of RA resulted in 0.48% with 591,981 cases in a population of 114,537,812 individuals (I2=99%). Brazil and Colombia presented the lowest rates of RA prevalence 0.22%, and 0.24%, respectively. RA prevalence in indigenous population was higher 1.45%, and studies using COPCORD method reported also the highest rates 1.07%

    On the perturbative S-matrix of generalized sine-Gordon models

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    Motivated by its relation to the Pohlmeyer reduction of AdS_5 x S^5 superstring theory we continue the investigation of the generalized sine-Gordon model defined by SO(N+1)/SO(N) gauged WZW theory with an integrable potential. Extending our previous work (arXiv:0912.2958) we compute the one-loop two-particle S-matrix for the elementary massive excitations. In the N = 2 case corresponding to the complex sine-Gordon theory it agrees with the charge-one sector of the quantum soliton S-matrix proposed in hep-th/9410140. In the case of N > 2 when the gauge group SO(N) is non-abelian we find a curious anomaly in the Yang-Baxter equation which we interpret as a gauge artifact related to the fact that the scattered particles are not singlets under the residual global subgroup of the gauge group

    Comparing open and minimally invasive surgical procedures for oesophagectomy in the treatment of cancer: the ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) feasibility study and pilot trial

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    Localised oesophageal cancer can be curatively treated with surgery (oesophagectomy) but the procedure is complex with a risk of complications, negative effects on quality of life and a recovery period of 6-9 months. Minimal-access surgery may accelerate recovery.The ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) study aimed to establish the feasibility of, and methodology for, a definitive trial comparing minimally invasive and open surgery for oesophagectomy. Objectives were to quantify the number of eligible patients in a pilot trial; develop surgical manuals as the basis for quality assurance; standardise pathological processing; establish a method to blind patients to their allocation in the first week post surgery; identify measures of postsurgical outcome of importance to patients and clinicians; and establish the main cost differences between the surgical approaches.Pilot parallel three-arm randomised controlled trial nested within feasibility work.Two UK NHS departments of upper gastrointestinal surgery.Patients aged ≥ 18 years with histopathological evidence of oesophageal or oesophagogastric junctional adenocarcinoma, squamous cell cancer or high-grade dysplasia, referred for oesophagectomy or oesophagectomy following neoadjuvant chemo(radio)therapy.Oesophagectomy, with patients randomised to open surgery, a hybrid open chest and minimally invasive abdomen or totally minimally invasive access.The primary outcome measure for the pilot trial was the number of patients recruited per month, with the main trial considered feasible if at least 2.5 patients per month were recruited.During 21 months of recruitment, 263 patients were assessed for eligibility; of these, 135 (51%) were found to be eligible and 104 (77%) agreed to participate, an average of five patients per month. In total, 41 patients were allocated to open surgery, 43 to the hybrid procedure and 20 to totally minimally invasive surgery. Recruitment is continuing, allowing a seamless transition into the definitive trial. Consequently, the database is unlocked at the time of writing and data presented here are for patients recruited by 31 August 2014. Random allocation achieved a good balance between the arms of the study, which, as a high proportion of patients underwent their allocated surgery (69/79, 87%), ensured a fair comparison between the interventions. Dressing patients with large bandages, covering all possible incisions, was successful in keeping patients blind while pain was assessed during the first week post surgery. Postsurgical length of stay and risk of adverse events were within the typical range for this group of patients, with one death occurring within 30 days among 76 patients. There were good completion rates for the assessment of pain at 6 days post surgery (88%) and of the patient-reported outcomes at 6 weeks post randomisation (74%).Rapid recruitment to the pilot trial and the successful refinement of methodology indicated the feasibility of a definitive trial comparing different approaches to oesophagectomy. Although we have shown a full trial of open compared with minimally invasive oesophagectomy to be feasible, this is necessarily based on our findings from the two clinical centres that we could include in this small preliminary study.Current Controlled Trials ISRCTN59036820.This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 48. See the NIHR Journals Library website for further project information

    How do child and adolescent mental health problems influence public sector costs? Interindividual variations in a nationally representative British sample.

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    Author's manuscript version. The final published version of the article is available from the publisher as an open access article via: DOI: 10.1111/jcpp.12327BACKGROUND: Policy and practice guidelines emphasize that responses to children and young people with poor mental health should be tailored to needs, but little is known about the impact on costs. We investigated variations in service-related public sector costs for a nationally representative sample of children in Britain, focusing on the impact of mental health problems. METHODS: Analysis of service uses data and associated costs for 2461 children aged 5-15 from the British Child and Adolescent Mental Health Surveys. Multivariate statistical analyses, including two-part models, examined factors potentially associated with interindividual differences in service use related to emotional or behavioural problems and cost. We categorized service use into primary care, specialist mental health services, frontline education, special education and social care. RESULTS: Marked interindividual variations in utilization and costs were observed. Impairment, reading attainment, child age, gender and ethnicity, maternal age, parental anxiety and depression, social class, family size and functioning were significantly associated with utilization and/or costs. CONCLUSIONS: Unexplained variation in costs could indicate poor targeting, inequality and inefficiency in the way that mental health, education and social care systems respond to emotional and behavioural problems.Department of Health (England)Wellcome Trus

    Non-technical skills and students' overconfidence in accounting

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    Purpose: Despite the institutional calls to include the development of non-technical skills as objectives in accounting curriculum and the attempts to do so, a gap between the level of skills exhibited by graduates and those needed to succeed as a professional is still perceived. One of the possible causes could be students' overconfidence, defined as a very optimistic assessment of their own abilities. The main objective of the paper is to assess the existence of overconfidence. Design/methodology/approach: Two samples, students and employers were surveyed regarding the exhibited level of accounting graduates in a set of 22 non-technical skills, highlighted as relevant in the literature. This enabled a comparison of the opinions of employers with the perceptions of students concerning the demonstrated level of such skills. Findings: The results of this study support the existence of students' overconfidence. In all the skills students score their ability higher than employers do with those differences being statistically significant in 21 out of 22 skills. Employers who are in closer contact with entry level accountants perceive even lower exhibited skills levels in graduates. Research limitations/implications: Overconfident students would be less motivated to actively participate in activities designed to improve skills resulting in underachievement and in lower performance. This low performance in highly valued skills could potentially harm their employability. Originality/value: Although the literature focussing on non-technical skills in accounting is prolific there are few papers comparing the views of employers and students, and there are no previous studies focussing on overconfidence
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