General Practitioners' perceptions of the route to evidence-based medicine: a questionnaire survey

Objectives: To determine the attitude of general practitioners towards evidence based medicine and their related educational needs. Design: A questionnaire study of general practitioners. Setting: General practice in the former Wessex region, England. Subjects: Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied. Main outcome measures: Respondents' attitude towards evidence based medicine, ability to access and interpret evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine. Results: Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases and 17% to the world wide web. Most had some understanding of the technical terms used. The major perceived barrier to practising evidence based medicine was lack of personal time. Respondents thought the most appropriate way to move towards evidence based general practice was by using evidence based guidelines or proposals developed by colleagues. Conclusion: Promoting and improving access to summaries of evidence, rather than teaching all general practitioners literature searching and critical appraisal, would be the more appropriate method of encouraging evidence based general practice. General practitioners who are skilled in accessing and interpreting evidence should be encouraged to develop local evidence based guidelines and advice

A Surrogate Model of Gravitational Waveforms from Numerical Relativity Simulations of Precessing Binary Black Hole Mergers

We present the first surrogate model for gravitational waveforms from the coalescence of precessing binary black holes. We call this surrogate model NRSur4d2s. Our methodology significantly extends recently introduced reduced-order and surrogate modeling techniques, and is capable of directly modeling numerical relativity waveforms without introducing phenomenological assumptions or approximations to general relativity. Motivated by GW150914, LIGO's first detection of gravitational waves from merging black holes, the model is built from a set of $276$ numerical relativity (NR) simulations with mass ratios $q \leq 2$, dimensionless spin magnitudes up to $0.8$, and the restriction that the initial spin of the smaller black hole lies along the axis of orbital angular momentum. It produces waveforms which begin $\sim 30$ gravitational wave cycles before merger and continue through ringdown, and which contain the effects of precession as well as all $\ell \in \{2, 3\}$ spin-weighted spherical-harmonic modes. We perform cross-validation studies to compare the model to NR waveforms \emph{not} used to build the model, and find a better agreement within the parameter range of the model than other, state-of-the-art precessing waveform models, with typical mismatches of $10^{-3}$. We also construct a frequency domain surrogate model (called NRSur4d2s_FDROM) which can be evaluated in $50\, \mathrm{ms}$ and is suitable for performing parameter estimation studies on gravitational wave detections similar to GW150914.Comment: 34 pages, 26 figure

Inhibition of vicariously learned fear in children using positive modeling and prior exposure

One of the challenges to conditioning models of fear acquisition is to explain how different individuals can experience similar learning events and only some of them subsequently develop fear. Understanding factors moderating the impact of learning events on fear acquisition is key to understanding the etiology and prevention of fear in childhood. This study investigates these moderators in the context of vicarious (observational) learning. Two experiments tested predictions that the acquisition or inhibition of fear via vicarious learning is driven by associative learning mechanisms similar to direct conditioning. In Experiment 1, 3 groups of children aged 7 to 9 years received 1 of 3 inhibitive information interventions psychoeducation, factual information, or no information (control)—prior to taking part in a vicarious fear learning procedure. In Experiment 2, 3 groups of children aged 7 to 10 years received 1 of 3 observational learning interventions—positive modeling (immunization), observational familiarity (latent inhibition), or no prevention (control)— before vicarious fear learning. Results indicated that observationally delivered manipulations inhibited vicarious fear learning, while preventions presented via written information did not. These findings confirm that vicarious learning shares some of the characteristics of direct conditioning and can explain why not all individuals will develop fear following a vicarious learning event. They also suggest that the modality of inhibitive learning is important and should match the fear learning pathway for increased chances of inhibition. Finally, the results demonstrate that positive modeling is likely to be a particularly effective method for preventing fear-related observational learning in children

NLO corrections to differential cross sections for pseudo-scalar Higgs boson production

We have computed the full next-to-leading (NLO) QCD corrections to the differential distributions $d^2\sigma/(dp_T~dy)$ for pseudo-scalar Higgs (A) production at large hadron colliders. This calculation has been carried out using the effective Lagrangian approach which is valid as long as the mass of the pseudo-scalar Higgs boson $m_{\rm A}$ and its transverse momentum $p_T$ do not exceed the top-quark mass $m_t$. The shape of the distributions hardly differ from those obtained for scalar Higgs (H) production because, apart from the overall coupling constant and mass, there are only small differences between the partonic differential distributions for scalar and pseudo-scalar production. Therefore there are only differences in the magnitudes of the hadronic differential distributions which can be mainly attributed to the unknown mixing angle $\beta$ describing the pseudo-scalar Higgs coupling to the top quarks.Comment: 9 pages, LaTeX, 3 Postscript figures In the previous version we have forgotten to include contributions which arrise from interferences between graphs containing vertices corresponding to the operator $O_2(x)$ in Eq. (3) with graphs originating from the operator $O_1(x)$. These interferences occur because of the prescription for the Levi-Civita tensor given in our paper. These extra contributions are added to Eqs. (19) and (20). Numerically they are completely negligible so that the figures are not altere

Public Health Surveillance for Australian bat lyssavirus in Queensland, Australia, 2000–2001

From February 1, 2000, to December 4, 2001, a total of 119 bats (85 Megachiroptera and 34 Microchiroptera) were tested for Australian bat lyssavirus (ABLV) infection. Eight Megachiroptera were positive by immunofluorescence assay that used cross-reactive antibodies to rabies nucleocapsid protein. A case study of cross-species transmission of ABLV supports the conclusion that a bat reservoir exists for ABLV in which the virus circulates across Megachiroptera species within mixed communities

The Spin-Resolved Atomic Velocity Distribution and 21-cm Line Profile of Dark-Age Gas

The 21-cm hyperfine line of atomic hydrogen (HI) is a promising probe of the cosmic dark ages. In past treatments of 21-cm radiation it was assumed the hyperfine level populations of HI could be characterized by a velocity-independent ``spin temperature'' T_s determined by a competition between 21-cm radiative transitions, spin-changing collisions, and (at lower redshifts) Lyman-alpha scattering. However we show here that, if the collisional time is comparable to the radiative time, the spin temperature will depend on atomic velocity, T_s=T_s(v), and one must replace the usual hyperfine level rate equations with a Boltzmann equation describing the spin and velocity dependence of the HI distribution function. We construct here the Boltzmann equation relevant to the cosmic dark ages and solve it using a basis-function method. Accounting for the actual spin-resolved atomic velocity distribution results in up to a 2 per cent suppression of the 21-cm emissivity, and a redshift and angular-projection dependent suppression or enhancement of the linear power spectrum of 21-cm fluctuations of up to 5 per cent. The effect on the 21-cm line profile is more dramatic -- its full-width at half maximum (FWHM) can be enhanced by up to 60 per cent relative to the velocity-independent calculation. We discuss the implications for 21-cm tomography of the dark ages.Comment: 25 pages, 6 figures, submitted to Mon. Not. Roy. Astron. So

Life and times:synthesis, trafficking, and evolution of VSG

Evasion of the acquired immune response in African trypanosomes is principally mediated by antigenic variation, the sequential expression of distinct variant surface glycoproteins (VSGs) at extremely high density on the cell surface. Sequence diversity between VSGs facilitates escape of a subpopulation of trypanosomes from antibody-mediated killing. Significant advances have increased understanding of the mechanisms underpinning synthesis and maintenance of the VSG coat. In this review, we discuss the biosynthesis, trafficking, and turnover of VSG, emphasising those unusual mechanisms that act to maintain coat integrity and to protect against immunological attack. We also highlight new findings that suggest the presence of unique or highly divergent proteins that may offer therapeutic opportunities, as well as considering aspects of VSG biology that remain to be fully explored

Inhibition of vicariously learned fear in children using positive modeling and prior exposure

One of the challenges to conditioning models of fear acquisition is to explain how different individuals can experience similar learning events and only some of them subsequently develop fear. Understanding factors moderating the impact of learning events on fear acquisition is key to understanding the etiology and prevention of fear in childhood. This study investigates these moderators in the context of vicarious (observational) learning. Two experiments tested predictions that the acquisition or inhibition of fear via vicarious learning is driven by associative learning mechanisms similar to direct conditioning. In Experiment 1, 3 groups of children aged 7 to 9 years received 1 of 3 inhibitive information interventions—psychoeducation, factual information, or no information (control)—prior to taking part in a vicarious fear learning procedure. In Experiment 2, 3 groups of children aged 7 to 10 years received 1 of 3 observational learning interventions—positive modeling (immunization), observational familiarity (latent inhibition), or no prevention (control)—before vicarious fear learning. Results indicated that observationally delivered manipulations inhibited vicarious fear learning, while preventions presented via written information did not. These findings confirm that vicarious learning shares some of the characteristics of direct conditioning and can explain why not all individuals will develop fear following a vicarious learning event. They also suggest that the modality of inhibitive learning is important and should match the fear learning pathway for increased chances of inhibition. Finally, the results demonstrate that positive modeling is likely to be a particularly effective method for preventing fear-related observational learning in childre

Self-Organized Criticality in a Fibre-Bundle type model

The dynamics of a fibre-bundle type model with equal load sharing rule is numerically studied. The system, formed by N elements, is driven by a slow increase of the load upon it which is removed in a novel way through internal transfers to the elements broken during avalanches. When an avalanche ends, failed elements are regenerated with strengths taken from a probability distribution. For a large enough N and certain restrictions on the distribution of individual strengths, the system reaches a self-organized critical state where the spectrum of avalanche sizes is a power law with an exponent $\tau\simeq 1.5$.Comment: 10 pages, 6 figures. To be published in Physica