604 research outputs found
Lensing Properties of Lightlike Current Carrying Cosmic Strings
The lensing properties of superconducting cosmic strings endowed with a time
dependent pulse of lightlike current are investigated. The metric outside the
core of the string belongs to the --wave class, with a deficit angle. We
study the field theoretic bosonic Witten model coupled to gravity, and we show
that the full metric (both outside and inside the core) is a Taub-Kerr-Shild
generalization of that for the static string with no current. It is shown that
the double image due to the deficit angle evolves in an unambiguous way as a
pulse of lightlike current passes between the source and the observer.
Observational consequences of this signature of the existence of cosmic strings
are briefly discussed.Comment: 21 pages, LaTeX-REVTeX, 7 figures available upon request, preprint #
DAMTP-R94/1
Are the singularities stable?
The spacetime singularities play a useful role in gravitational theories by
distinguishing physical solutions from non-physical ones. The problem, we
studying in this paper is: are these singularities stable? To answer this
question, we have analyzed the general problem of stability of the family of
the static spherically symmetric solutions of the standard Einstein-Maxwell
model coupled to an extra free massless scalar field. We have obtained the
equations for the axial and polar perturbations. The stability against axial
perturbations has been proven.Comment: 13 pages, LaTeX, no figure
Anisotropic intrinsic lattice thermal conductivity of phosphorene from first principles
Phosphorene, the single layer counterpart of black phosphorus, is a novel
two-dimensional semiconductor with high carrier mobility and a large
fundamental direct band gap, which has attracted tremendous interest recently.
Its potential applications in nano-electronics and thermoelectrics call for a
fundamental study of the phonon transport. Here, we calculate the intrinsic
lattice thermal conductivity of phosphorene by solving the phonon Boltzmann
transport equation (BTE) based on first-principles calculations. The thermal
conductivity of phosphorene at is
(zigzag) and
(armchair), showing an obvious anisotropy along different directions. The
calculated thermal conductivity fits perfectly to the inverse relation with
temperature when the temperature is higher than Debye temperature (). In comparison to graphene, the minor contribution around
of the ZA mode is responsible for the low thermal conductivity of
phosphorene. In addition, the representative mean free path (MFP), a critical
size for phonon transport, is also obtained.Comment: 5 pages and 6 figures, Supplemental Material available as
http://www.rsc.org/suppdata/cp/c4/c4cp04858j/c4cp04858j1.pd
An empirical assessment and comparison of species-based and habitat-based surrogates: a case study of forest vertebrates and large old trees
A holy grail of conservation is to find simple but reliable measures of environmental change to guide management. For example, particular species or particular habitat attributes are often used as proxies for the abundance or diversity of a subset of other taxa. However, the efficacy of such kinds of species-based surrogates and habitat-based surrogates is rarely assessed, nor are different kinds of surrogates compared in terms of their relative effectiveness. We use 30-year datasets on arboreal marsupials and vegetation structure to quantify the effectiveness of: (1) the abundance of a particular species of arboreal marsupial as a species-based surrogate for other arboreal marsupial taxa, (2) hollow-bearing tree abundance as a habitat-based surrogate for arboreal marsupial abundance, and (3) a combination of species- and habitat-based surrogates. We also quantify the robustness of species-based and habitat-based surrogates over time. We then use the same approach to model overall species richness of arboreal marsupials. We show that a species-based surrogate can appear to be a valid surrogate until a habitat-based surrogate is co-examined, after which the effectiveness of the former is lost. The addition of a species-based surrogate to a habitat-based surrogate made little difference in explaining arboreal marsupial abundance, but altered the co-occurrence relationship between species. Hence, there was limited value in simultaneously using a combination of kinds of surrogates. The habitat-based surrogate also generally performed significantly better and was easier and less costly to gather than the species-based surrogate. We found that over 30 years of study, the relationships which underpinned the habitat-based surrogate generally remained positive but variable over time. Our work highlights why it is important to compare the effectiveness of different broad classes of surrogates and identify situations when either species- or habitat-based surrogates are likely to be superior.This study has been funded by the Australian Research Council, Parks Victoria, the Department of Sustainability and Environment (and its predecessor
departments), Melbourne Water, the Earthwatch Institute, the Thomas Foundation and Lindenmayer’s personal funds
The use of arm vein in lower-extremity revascularization: Results of 520 procedures performed in eight years
AbstractPurpose: The absence of an adequate ipsilateral saphenous vein in patients requiring lower-extremity revascularization poses a difficult clinical dilemma. This study examined the results of the use of autogenous arm vein bypass grafts in these patients. Methods: Five hundred twenty lower-extremity revascularization procedures performed between 1990 and 1998 were followed prospectively with a computerized vascular registry. The arm vein conduit was prepared by using intraoperative angioscopy for valve lysis and identification of luminal abnormalities in 44.8% of cases. Results: Seventy-two (13.8%) femoropopliteal, 174 (33.5%) femorotibial, 29 (5.6%) femoropedal, 101 (19.4%) popliteo-tibial/pedal, and 144 (27.7%) extension “jump” graft bypass procedures were performed for limb salvage (98.2%) or disabling claudication (1.8%). The average age of patients was 68.5 years (range, 32 to 91 years); 63.1% of patients were men, and 36.9% of patients were women. Eighty-five percent of patients had diabetes mellitus, and 77% of patients had a recent history of smoking. The grafts were composed of a single arm vein segment in 363 cases (69.8%) and of spliced composite vein with venovenostomy in 157 cases (30.2%). The mean follow-up period was 24.9 months (range, 1 month to 7.4 years). Overall patency and limb salvage rates for all graft types were: primary patency, 30-day = 97.0% ± 0.7%, 1-year = 80.2% ± 2.1%, 3-year = 68.9% ± 3.6%, 5-year = 54.5% ± 6.6%; secondary patency, 30-day = 97.0% ± 0.7%, 1-year = 80.7% ± 2.1%, 3-year = 70.3% ± 3.4%, 5-year = 57.5% ± 6.2%; limb salvage, 30-day = 97.6% ± 0.7%, 1-year = 89.8% ± 1.7%, 3-year = 82.1% ± 3.3%, 5-year = 71.5% ± 6.9%. Secondary patency and limb salvage rates were greatest at 5 years for femoropopliteal grafts (69.8% ± 12.8%, 80.7% ± 11.8%), as compared with femorotibial (59.6% ± 10.3%, 72.7% ± 10.5%), femoropedal (54.9% ± 25.7%, 56.8% ± 26.9%,) and popliteo-tibial/pedal grafts (39.0% ± 7.3%, 47.6% ± 15.4%). The patency rate of composite vein grafts was equal to that of single-vein conduits. The overall survival rate was 54% at 4 years. Conclusion: Autogenous arm vein has been used successfully in a wide variety of lower-extremity revascularization procedures and has achieved excellent long- and short-term patency and limb salvage rates, higher than those generally reported for prosthetic or cryopreserved grafts. Its durability and easy accessibility make it an alternative conduit of choice when an adequate saphenous vein is not available. (J Vasc Surg 2000;31:50-9.
Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease
PublishedOpen Access ArticleObjective To test the effectiveness of an integrated collaborative care model for people with depression and long term physical conditions.
Design Cluster randomised controlled trial.
Setting 36 general practices in the north west of England.
Participants 387 patients with a record of diabetes or heart disease, or both, who had depressive symptoms (≥10 on patient health questionaire-9 (PHQ-9)) for at least two weeks. Mean age was 58.5 (SD 11.7). Participants reported a mean of 6.2 (SD 3.0) long term conditions other than diabetes or heart disease; 240 (62%) were men; 360 (90%) completed the trial.
Interventions Collaborative care included patient preference for behavioural activation, cognitive restructuring, graded exposure, and/or lifestyle advice, management of drug treatment, and prevention of relapse. Up to eight sessions of psychological treatment were delivered by specially trained psychological wellbeing practitioners employed by Improving Access to Psychological Therapy services in the English National Health Service; integration of care was enhanced by two treatment sessions delivered jointly with the practice nurse. Usual care was standard clinical practice provided by general practitioners and practice nurses.
Main outcome measures The primary outcome was reduction in symptoms of depression on the self reported symptom checklist-13 depression scale (SCL-D13) at four months after baseline assessment. Secondary outcomes included anxiety symptoms (generalised anxiety disorder 7), self management (health education impact questionnaire), disability (Sheehan disability scale), and global quality of life (WHOQOL-BREF).
Results 19 general practices were randomised to collaborative care and 20 to usual care; three practices withdrew from the trial before patients were recruited. 191 patients were recruited from practices allocated to collaborative care, and 196 from practices allocated to usual care. After adjustment for baseline depression score, mean depressive scores were 0.23 SCL-D13 points lower (95% confidence interval −0.41 to −0.05) in the collaborative care arm, equal to an adjusted standardised effect size of 0.30. Patients in the intervention arm also reported being better self managers, rated their care as more patient centred, and were more satisfied with their care. There were no significant differences between groups in quality of life, disease specific quality of life, self efficacy, disability, and social support.
Conclusions Collaborative care that incorporates brief low intensity psychological therapy delivered in partnership with practice nurses in primary care can reduce depression and improve self management of chronic disease in people with mental and physical multimorbidity. The size of the treatment effects were modest and were less than the prespecified effect but were achieved in a trial run in routine settings with a deprived population with high levels of mental and physical multimorbidity.
Trial registration ISRCTN80309252.National Institute for Health ResearchCollaboration for Leadership in Applied Health ResearchCare for Greater Mancheste
Finding Apparent Horizons in Dynamic 3D Numerical Spacetimes
We have developed a general method for finding apparent horizons in 3D
numerical relativity. Instead of solving for the partial differential equation
describing the location of the apparent horizons, we expand the closed 2D
surfaces in terms of symmetric trace--free tensors and solve for the expansion
coefficients using a minimization procedure. Our method is applied to a number
of different spacetimes, including numerically constructed spacetimes
containing highly distorted axisymmetric black holes in spherical coordinates,
and 3D rotating, and colliding black holes in Cartesian coordinates.Comment: 19 pages, 13 figures, LaTex, to appear in Phys. Rev. D. Minor changes
mad
Supersymmetric Electroweak Cosmic Strings
We study the connection between supersymmetry and a topological bound
in a two-Higgs-doublet system with an gauge group. We derive the Bogomol'nyi equations from
supersymmetry considerations showing that they hold provided certain conditions
on the coupling constants, which are a consequence of the huge symmetry of the
theory, are satisfied. Their solutions, which can be interpreted as electroweak
cosmic strings breaking one half of the supersymmetries of the theory, are
studied. Certain interesting limiting cases of our model which have recently
been considered in the literature are finally analyzed.Comment: 20 pages, RevTe
Update on the collaborative interventions for circulation and depression (COINCIDE) trial: changes to planned methodology of a cluster randomized controlled trial of collaborative care for depression in people with diabetes and/or coronary heart disease.
Published onlineJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tBACKGROUND: The COINCIDE trial aims to evaluate the effectiveness and cost-effectiveness of a collaborative care intervention for depression in people with diabetes and/or coronary heart disease attending English general practices. DESIGN: This update details changes to the cluster and patient recruitment strategy for the COINCIDE study. The original protocol was published in Trials (http://www.trialsjournal.com/content/pdf/1745-6215-13-139.pdf). Modifications were made to the recruitment targets in response to lower-than-expected patient recruitment at the first ten general practices recruited into the study. In order to boost patient numbers and retain statistical power, the number of general practices recruited was increased from 30 to 36. Follow-up period was shortened from 6 months to 4 months to ensure that patients recruited to the trial could be followed up by the end of the study. RESULTS: Patient recruitment began on the 01/05/2012 and is planned to be completed by the 30/04/2013. Recruitment for general practices was completed on 31/10/2012, by which time the target of 36 practices had been recruited. The main trial results will be published in a peer-reviewed journal. CONCLUSION: The data from the trial will provide evidence on the effectiveness and cost-effectiveness of collaborative care for depression in people with diabetes and/or coronary heart disease. TRIAL REGISTRATION: TRIAL REGISTRATION NUMBER: ISRCTN80309252.NIHR Collaboration for Leadership in Applied Health Research and Care for Greater Mancheste
Collaborative Interventions for Circulation and Depression (COINCIDE): study protocol for a cluster randomized controlled trial of collaborative care for depression in people with diabetes and/or coronary heart disease.
Published onlineJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tBACKGROUND: Depression is up to two to three times as common in people with long-term conditions. It negatively affects medical management of disease and self-care behaviors, and leads to poorer quality of life and high costs in primary care. Screening and treatment of depression is increasingly prioritized, but despite initiatives to improve access and quality of care, depression remains under-detected and under-treated, especially in people with long-term conditions. Collaborative care is known to positively affect the process and outcome of care for people with depression and long-term conditions, but its effectiveness outside the USA is still relatively unknown. Furthermore, collaborative care has yet to be tested in settings that resemble more naturalistic settings that include patient choice and the usual care providers. The aim of this study was to test the effectiveness of a collaborative-care intervention, for people with depression and diabetes/coronary heart disease in National Health Service (NHS) primary care, in which low-intensity psychological treatment services are delivered by the usual care provider - Increasing Access to Psychological Therapies (IAPT) services. The study also aimed to evaluate the cost-effectiveness of the intervention over 6 months, and to assess qualitatively the extent to which collaborative care was implemented in the intervention general practices. METHODS: This is a cluster randomized controlled trial of 30 general practices allocated to either collaborative care or usual care. Fifteen patients per practice will be recruited after a screening exercise to detect patients with recognized depression (≥10 on the nine-symptom Patient Health Questionnaire; PHQ-9). Patients in the collaborative-care arm with recognized depression will be offered a choice of evidence-based low-intensity psychological treatments based on cognitive and behavioral approaches. Patients will be case managed by psychological well-being practitioners employed by IAPT in partnership with a practice nurse and/or general practitioner. The primary outcome will be change in depressive symptoms at 6 months on the 90-item Symptoms Checklist (SCL-90). Secondary outcomes include change in health status, self-care behaviors, and self-efficacy. A qualitative process evaluation will be undertaken with patients and health practitioners to gauge the extent to which the collaborative-care model is implemented, and to explore sustainability beyond the clinical trial. DISCUSSION: COINCIDE will assess whether collaborative care can improve patient-centered outcomes, and evaluate access to and quality of care of co-morbid depression of varying intensity in people with diabetes/coronary heart disease. Additionally, by working with usual care providers such as IAPT, and by identifying and evaluating interventions that are effective and appropriate for routine use in the NHS, the COINCIDE trial offers opportunities to address translational gaps between research and implementation. TRIAL REGISTRATION NUMBER: ISRCTN80309252 TRIAL STATUS: Open.NIHR Collaboration for Leadership in Applied Health Research and Care for Greater Mancheste
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