Rare top decay t-> c l+l- as a probe of new physics

The rare top decay t-> c l+l-, which involves flavor violation, is studied as a possible probe of new physics. This decay is analyzed with the simplest Standard Model extensions with additional gauge symmetry formalism. The considered extension is the Left-Right Symmetric Model, including a new neutral gauge boson Z' that allows to obtain the decay at tree level through Flavor Changing Neutral Currents (FCNC) couplings. The neutral gauge boson couplings are considered diagonal but family non-universal in order to induce these FCNC. We find the $BR(t-> c l+l-)~10^{-13} for a range 1 TeV < M_{Z'} < 3 TeV.Comment: 9 pages, 6 figure

Effect of Preventive Primary Care Outreach on Health Related Quality of Life Among Older Adults at Risk of Functional Decline: Randomised Controlled Trial

Objective: To evaluate the impact of a provider initiated primary care outreach intervention compared with usual care among older adults at risk of functional decline. Design: Randomised controlled trial. Setting: Patients enrolled with 35 family physicians in five primary care networks in Hamilton, Ontario, Canada. Participants: Patients were eligible if they were 75 years of age or older and were not receiving home care services. Of 3166 potentially eligible patients, 2662 (84%) completed the validated postal questionnaire used to determine risk of functional decline. Of 1724 patients who met the risk criteria, 769 (45%) agreed to participate and 719 were randomised. Intervention: The 12 month intervention, provided by experienced home care nurses in 2004-6, consisted of a comprehensive initial assessment using the resident assessment instrument for home care; collaborative care planning with patients, their families, and family physicians; health promotion; and referral to community health and social support services. Main outcome measures: Quality adjusted life years (QALYs), use and costs of health and social services, functional status, self rated health, and mortality. Results: The mean difference in QALYs between intervention and control patients during the study period was not statistically significant (0.017, 95% confidence interval ?0.022 to 0.056; P=0.388). The mean difference in overall cost of prescription drugs and services between the intervention and control groups was not statistically significant, (-$C165 (£107; 118;$162), 95% confidence interval -$C16 545 to$$16 214; P=0.984). Changes over 12 months in functional status and self rated health were not significantly different between the intervention and control groups. Ten patients died in each group. Conclusions: The results of this study do not support adoption of this preventive primary care intervention for this target population of high risk older adults

The introduction of an acute physiological support service for surgical patients is an effective error reduction strategy

AbstractIntroductionAcute surgical patients are particularly vulnerable to human error. The Acute Physiological Support Team (APST) was created with the twin objectives of identifying high-risk acute surgical patients in the general wards and reducing both the incidence of error and impact of error on these patients. A number of error taxonomies were used to understand the causes of human error and a simple risk stratification system was adopted to identify patients who are particularly at risk of error.ResultsDuring the period November 2012–January 2013 a total of 101 surgical patients were cared for by the APST at Edendale Hospital. The average age was forty years. There were 36 females and 65 males. There were 66 general surgical patients and 35 trauma patients. Fifty-six patients were referred on the day of their admission. The average length of stay in the APST was four days. Eleven patients were haemo-dynamically unstable on presentation and twelve were clinically septic. The reasons for referral were sepsis,4 respiratory distress,3 acute kidney injury AKI (38), post-operative monitoring (39), pancreatitis,3 ICU down-referral,7 hypoxia,5 low GCS,1 coagulopathy.1 The mortality rate was 13%. A total of thirty-six patients experienced 56 errors. A total of 143 interventions were initiated by the APST. These included institution or adjustment of intravenous fluids (101), blood transfusion,12 antibiotics,9 the management of neutropenic sepsis,1 central line insertion,3 optimization of oxygen therapy,7 correction of electrolyte abnormality,8 correction of coagulopathy.2ConclusionOur intervention combined current taxonomies of error with a simple risk stratification system and is a variant of the defence in depth strategy of error reduction. We effectively identified and corrected a significant number of human errors in high-risk acute surgical patients. This audit has helped understand the common sources of error in the general surgical wards and will inform on-going error reduction initiatives

DOUBLE KNEE BEND IN THE POWER CLEAN

The power clean is well established as the “gold standard” exercise for the development of lower extremity propulsive forces (Garhammer, 1982). The power clean has become a sprint specific strength and conditioning exercise, which is incorporated into periodised training programmes (Siff, 1992). Specifically the occurrence of a double knee bend (DKB) provides a mechanism to elicit a sprint specific stretch shortening cycle (SSC), maximising power output (Enoka, 1979). The aim of this exploratory study was to investigate whether the DKB occurred in power cleans as relative load increased

In good company: risk, security and choice in young people's drug decisions

This article draws on original empirical research with young people to question the degree to which 'individualisation of risk', as developed in the work of Beck and Giddens, adequately explains the risks young people bear and take. It draws on alternative understandings and critiques of 'risk' not to refute the notion of the reflexive individual upon which 'individualisation of risk' is based but to re-read that reflexivity in a more hermeneutic way. It explores specific risk-laden moments – young people's drug use decisions – in their natural social and cultural context of the friendship group. Studying these decisions in context, it suggests, reveals the meaning of 'risk' to be not given, but constructed through group discussion, disagreement and consensus and decisions taken to be rooted in emotional relations of trust, mutual accountability and common security. The article concludes that 'the individualisation of risk' fails to take adequate account of the significance of intersubjectivity in risk-decisions. It argues also that addressing the theoretical overemphasis on the individual bearer of risk requires not only further empirical testing of the theory but appropriate methodological reflection

Ação larvicida de derivados arilsulfonilicos da (+)-canfora e da (+)-isopinocanfona sobre o carrapato Boophilus microplus.

Testou-se a atividade larvicida de 33 derivados arilsulfonílicos da (+)-cânfora e da (+)-isopinocanfona no carrapato B. microplus, na busca de princípios ativos menos tóxicos para o seu controle. Os produtos foram obtidos por clorossulfonação da (+)-cânfora e da (+)-isopinocanfona. Eles foram submetidos à solubilização e testados separadamente e em conjunto contra larvas de carrapato encerradas em envelopes contendo papéis impregnados e acondicionadas em estufa climatizada. A mortalidade média não atingiu 5% em todos os testes realizados, indicando que a clorossulfonação não é a rota de síntese mais adequada para a obtenção de derivados sintéticos com efeito larvicida sobre B. microplus. Os 33 produtos testados sob a forma de triagem biológica não podem ser considerados como potenciais acaricidas

An immunohistochemical assessment of cellular proliferation markers in head and neck squamous cell cancers.

Prognostic information is essential for the evaluation, judgement and optimal treatment of patients with squamous cell cancers (SCCs) of the upper aerodigestive tract. Using immunohistochemical and flow cytometric techniques, we have studied the significance of cellular expression of the Ki-67 antigen, epidermal growth factor receptor (EGFR), the transferrin receptor (TFR) and DNA ploidy status in a prospective analysis of patients with SCCs of the head and neck region. All 42 fresh tumour samples (five well differentiated; 28 moderately differentiated; nine poorly differentiated) expressed both EGFR and TFR to varying degrees. Receptor expression was most marked on the peripheral invading margin of cancer cell islands although staining was also demonstrated in a random fashion within cellular islands and consistently along the basal cell layer of overlying stratified squamous epithelium. The percentage of cancer cells that reacted with the Ki-67 monoclonal antibody was assessed as low (less than 10%) in 15 samples (35.8%), intermediate (10-30%) in 19 samples (45.2%) and high (greater than 30%) in eight samples (19.0%). Eleven of 15 samples (73%) with a low percentage reactivity were DNA diploid, whereas seven of eight samples (87.5%) with a high percentage reactivity were DNA aneuploid. Poorly differentiated SCCs were significantly more often aneuploid than were either moderately or well differentiated tumours. Our results suggest that EGFR and TFR are widely distributed on SCCs, especially on proliferating cells at the invading tumour margin. In addition, there is a close spatial correlation between cells expressing EGFR, TFR and those expressing the Ki-67 antigen. Tumours in which the staining intensity for both EGFR and TFR was intense invariably expressed the Ki-67 antigen in a high proportion of cells. Further patient follow-up will be important in determining whether intense EGFR and TFR staining, combined with a high percentage reactivity with Ki-67 antibody and DNA aneuploidy, will ultimately define a subset of head and neck cancer patients with a poor clinical outcome

Professionalism, golf coaching and a master of science degree

A distinction can be made between 'professionalisation', which is concerned with occupational status and standing, and 'professionalism,' which refers to matters of quality and standards of practice (especially specialized knowledge, ethics and altruism). The purpose of this stimulus article is to present key features of contemporary medical professionalism as a basis for critically reflecting on discourse associated with Tiger Woods' current coach, Sean Foley. It is suggested that that provision of a Master of Science degree in golf teaching/coaching would facilitate the development of 'professionalism' in golf coaches