Observation of opto-mechanical multistability in a high Q torsion balance oscillator

We observe the opto-mechanical multistability of a macroscopic torsion balance oscillator. The torsion oscillator forms the moving mirror of a hemi-spherical laser light cavity. When a laser beam is coupled into this cavity, the radiation pressure force of the intra-cavity beam adds to the torsion wire's restoring force, forming an opto-mechanical potential. In the absence of optical damping, up to 23 stable trapping regions were observed due to local light potential minima over a range of 4 micrometer oscillator displacement. Each of these trapping positions exhibits optical spring properties. Hysteresis behavior between neighboring trapping positions is also observed. We discuss the prospect of observing opto-mechanical stochastic resonance, aiming at enhancing the signal-to-noise ratio (SNR) in gravity experiments.Comment: 4 pages, 5 figure

Sex differences in incidence, mortality, and survival in individuals with stroke in Scotland, 1986 to 2005

<p><b>Background and Purpose:</b> The aim of this study was to examine the effect of sex across different age groups and over time for stroke incidence, 30-day case-fatality, and mortality.</p> <p><b>Methods:</b> All first hospitalizations for stroke in Scotland (1986 to 2005) were identified using linked morbidity and mortality data. Age-specific rate ratios (RRs) for comparing women with men for both incidence and mortality were modeled with adjustment for study year and socioeconomic deprivation. Logistic regression was used to model 30-day case-fatality.</p> <p><b>Results:</b> Women had a lower incidence of first hospitalization than men and size of effect varied with age (55 to 64 years, RR=0.65, 95% CI 0.63 to 0.66; 85 years, RR=0.94, 95% CI 0.91 to 0.96). Women aged 55 to 84 years had lower mortality than men and again size of effect varied with age (65 to 74 years, RR=0.79, 95% CI 0.76 to 0.81); 75 to 84 years, RR=0.94, 95% CI 0.92 to 0.95). Conversely, women aged 85 years had 15% higher stroke mortality than men (RR=1.15, 95% CI 1.12 to 1.18). Adjusted risk of death within 30 days was significantly higher in women than men, and this difference increased over the 20-year period in all age groups (adjusted OR in 55 to 64 year olds 1.23, 95% CI 1.14 to 1.33 in 1986 and 1.51, 95% CI 1.39 to 1.63 in 2005).</p> <p><b>Conclusions:</b> We observed lower rates of incidence and mortality in younger women than men. However, higher numbers of older women in the population mean that the absolute burden of stroke is greater in women. Short-term case-fatality is greater in women of all ages and, worryingly, these differences have increased from 1986 to 2005.</p&gt

Introduction. Human perspectives on the quest for knowledge

We firstly introduce the new Springer series Human Perspectives in Health Sciences and Technology (HPHST), and then we move on to illustrate the topic this volume deals with, namely whether machines will replace scientists in scientific development. We then explain the decision of having this volume to be the first volume of the HPHST series. Finally, we describe the organization of this book and give a brief presentation of each chapter

Strategic toolkits: seniority, usage and performance in the German SME machinery and equipment sector

This paper examines the strategic tool kit, from a human resource management (HRM) perspective, in terms of usage and impact. Research to date has tended to consider usage, assuming to a certain extent that knowledge and understanding of particular tools suggest that practitioners value them. The research on which this paper is based builds upon the idea that usage indicates satisfaction, but develops the usage theme to investigate which decision-makers are actually engaged in both tool appliance and the strategic process. Of particular interest to the researchers are the educational background, age and seniority of the decision-makers. In addition, potential links with HRM and organizational performance are also explored. The context of the research, the German machinery and equipment sector, provides an insight into the industry's ability to sustain growth in face of increasing international competition. The paper calls for a greater awareness, from a human resource perspective, and utilization of strategic management practice and associated decision-making aids

Effect of pragmatic versus explanatory interventions on medication adherence in people with cardiometabolic conditions: a systematic review and meta-analysis

Objective To synthesise findings from randomised controlled trials (RCTs) of interventions aimed at increasing medication adherence in individuals with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD). And, in a novel approach, to compare the intervention effect of studies which were categorised as being more pragmatic or more explanatory using the Pragmatic-Explanatory Continuum Indicator Summary-2 (PRECIS-2) tool, to identify whether study design affects outcomes. As explanatory trials are typically held under controlled conditions, findings from such trials may not be relatable to real-world clinical practice. In comparison, pragmatic trials are designed to replicate real-world conditions and therefore findings are more likely to represent those found if the intervention were to be implemented in routine care. Design Systematic review and meta-analysis. Data sources Ovid Medline, Ovid Embase, Web of Science and CINAHL from 1 January 2013 to 31 December 2018. Eligibility criteria for selecting studies RCTs lasting ≥3 months (90 days), involving ≥200 patients in the analysis, with either established CVD and/or T2DM and which measured medication adherence. From 4403 citations, 103 proceeded to full text review. Studies published in any language other than English and conference abstracts were excluded. Main outcome measure Change in medication adherence. Results Of 4403 records identified, 34 studies were considered eligible, of which 28, including 30 861 participants, contained comparable outcome data for inclusion in the meta-analysis. Overall interventions were associated with an increase in medication adherence (OR 1.57 (95% CI: 1.33 to 1.84), p<0.001; standardised mean difference 0.24 (95% CI: −0.10 to 0.59) p=0.101). The effectiveness of interventions did not differ significantly between studies considered pragmatic versus explanatory (p=0.598), but did differ by intervention type, with studies that included a multifaceted rather than a single-faceted intervention having a more significant effect (p=0.010). The analysis used random effect models and used the revised Cochrane Risk of Bias Tool to assess study quality. Conclusions In this meta-analysis, interventions were associated with a significant increase in medication adherence. Overall multifaceted interventions which included an element of education alongside regular patient contact or follow-up showed the most promise. Effectiveness of interventions between pragmatic and explanatory trials was comparable, suggesting that findings can be transferred from idealised to real-word conditions. PROSPERO registration number CRD42017059460

Quintessence, the Gravitational Constant, and Gravity

Dynamical vacuum energy or quintessence, a slowly varying and spatially inhomogeneous component of the energy density with negative pressure, is currently consistent with the observational data. One potential difficulty with the idea of quintessence is that couplings to ordinary matter should be strongly suppressed so as not to lead to observable time variations of the constants of nature. We further explore the possibility of an explicit coupling between the quintessence field and the curvature. Since such a scalar field gives rise to another gravity force of long range (\simg H^{-1}_0), the solar system experiments put a constraint on the non-minimal coupling: |\xi| \siml 10^{-2}.Comment: 9 pages, a version to be published in Phys.Rev.

Estimating the furrow infiltration characteristic from a single advance point

Management and control of surface irrigation, in particular furrow irrigation, is limited by spatio-temporal soil infiltration variability as well as the high cost and time associated with collecting intensive field data for estimation of the infiltration characteristics. Recent work has proposed scaling the commonly used infiltration function by using a model infiltration curve and a single advance point for every other furrow in an irrigation event. Scaling factors were calculated for a series of furrows at two sites and at four points down the length of the field (0.25 L, 0.5 L, 0.75 L and L). Differences in the value of the scaling factor with distance were found to be a function of the shape of the advance curves. It is concluded that use of points early in the advance results in a substantial loss of accuracy and should be avoided. The scaling factor was also strongly correlated with the furrow-wetted perimeter suggesting that the scaling is an appropriate way of both predicting and accommodating the effect of the hydraulic variability

Patient information leaflets (PILs) for UK randomised controlled trials : a feasibility study exploring whether they contain information to support decision making about trial participation

Peer reviewedPublisher PD

Predicting the safety and efficacy of butter therapy to raise tumour pHe: an integrative modelling study

Background: Clinical positron emission tomography imaging has demonstrated the vast majority of human cancers exhibit significantly increased glucose metabolism when compared with adjacent normal tissue, resulting in an acidic tumour microenvironment. Recent studies demonstrated reducing this acidity through systemic buffers significantly inhibits development and growth of metastases in mouse xenografts.\ud \ud Methods: We apply and extend a previously developed mathematical model of blood and tumour buffering to examine the impact of oral administration of bicarbonate buffer in mice, and the potential impact in humans. We recapitulate the experimentally observed tumour pHe effect of buffer therapy, testing a model prediction in vivo in mice. We parameterise the model to humans to determine the translational safety and efficacy, and predict patient subgroups who could have enhanced treatment response, and the most promising combination or alternative buffer therapies.\ud \ud Results: The model predicts a previously unseen potentially dangerous elevation in blood pHe resulting from bicarbonate therapy in mice, which is confirmed by our in vivo experiments. Simulations predict limited efficacy of bicarbonate, especially in humans with more aggressive cancers. We predict buffer therapy would be most effectual: in elderly patients or individuals with renal impairments; in combination with proton production inhibitors (such as dichloroacetate), renal glomular filtration rate inhibitors (such as non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitors), or with an alternative buffer reagent possessing an optimal pK of 7.1–7.2.\ud \ud Conclusion: Our mathematical model confirms bicarbonate acts as an effective agent to raise tumour pHe, but potentially induces metabolic alkalosis at the high doses necessary for tumour pHe normalisation. We predict use in elderly patients or in combination with proton production inhibitors or buffers with a pK of 7.1–7.2 is most promising

Comparative efficacy and acceptability of psychotherapies for post-traumatic stress disorder in children and adolescents: Study protocol for a systematic review and network meta-analysis

Introduction Post-traumatic stress disorder (PTSD) is common among children and adolescents who are exposed to trauma, and it is often associated with significant negative impacts on their psychosocial functioning and quality of life. Many types of psychotherapies have been found to be effective for PTSD in children and adolescents. However, due to the lack of direct comparisons between different psychotherapies, the hierarchy of treatment efficacy is still unclear. Therefore, we plan to conduct a systematic review and network meta-analysis to evaluate the efficacy and acceptability of various types of psychotherapies for PTSD in children and adolescents. Methods and analysis A systematic search will be conducted among eight electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, Cumulative Index of Nursing and Allied Health, Published International Literature on Traumatic Stress (PILOTS) and ProQuest Dissertations, from inception to October 2017. Randomised controlled trials, regardless of language, publication year and publication type, comparing any psychotherapies for PTSD to any control condition or alternative treatment in children and adolescents (18 years old or less) diagnosed with full or subclinical PTSD will be included. Study duration and the number of treatment sessions will not be limited. The primary outcome will be PTSD symptom severity at post-treatment as measured by a rating scale reported by the child, parent or a clinician. The secondary outcomes will include: (1) efficacy at follow-up; (2) acceptability (all-cause discontinuation); (3) anxiety symptom severity; (4) depressive symptom severity and (5) quality of life and functional improvement. Bayesian network meta-analyses for all relative outcome measures will be performed. We will conduct subgroup and sensitivity network meta-analyses to determine whether the findings are affected by study characteristics. The quality of the evidence contributing to network estimates of the primary outcome will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluations framework. Ethics and dissemination No ethical issues are foreseen. The results will be published in a peer-reviewed journal, which will be disseminated electronically and in print. This network meta-analysis may be updated to inform and guide the clinical management of PTSD in children and adolescents. PROSPERO registration number CRD42016051786