An overview of systematic reviews in medical education and a focused review in prescribing

Background: Tertiary reviews (review of reviews) in medical education tend to focus on doctors, continuing education and professional practice. This paper provides a tertiary review of all areas of medical education at all levels. An in-depth focus on prescribing is included. Methods and results: A systematic search using the keywords ‘medical education’ AND (‘systematic review’ OR ‘meta-analysis’) yielded 187 reviews. Reviews were coded by intervention, curriculum/theme, participants and outcomes, creating a systematic map. The most popular interventions and curriculum were simulation (9%) and prescribing (7%), respectively. Most reviews included multiple participant types (68%) and sought patient/health outcomes (64%). Twelve prescribing reviews included in the in-depth review found active educational strategies more effective than passive strategies. Discussion: The systematic map highlights topics and interventions, but further research should explore the cost-effectiveness of the reviews themselves. Prescribing reviews tend to focus on doctors; more research into the acquisition of prescribing skills by students/junior doctors is required

Measurement Near Threshold of 9-Be(3-He, Pi) to the A = 12 Isobaric Triplet by Recoil Detection

This work was supported by the National Science Foundation Grant NSF PHY 81-14339 and by Indiana Universit

Moduli Stabilization with Long Winding Strings

Stabilizing all of the modulus fields coming from compactifications of string theory on internal manifolds is one of the outstanding challenges for string cosmology. Here, in a simple example of toroidal compactification, we study the dynamics of the moduli fields corresponding to the size and shape of the torus along with the ambient flux and long strings winding both internal directions. It is known that a string gas containing states with non-vanishing winding and momentum number in one internal direction can stabilize the radius of this internal circle to be at self-dual radius. We show that a gas of long strings winding all internal directions can stabilize all moduli, except the dilaton which is stabilized by hand, in this simple example.Comment: title changed, improved presentation; reference added. 18 pages, JHEP styl

LOCV calculation for Beta-stable matter at finite temperature

The method of lowest-order constrained variational, which predicts reasonably the nuclear matter semi-empirical data is used to calculate the equation of state of beta-stable matter at finite temperature. The Reid soft-core with and without the N-$\Delta$ interactions which fits the N-N scattering data as well as the $UV_{14}$ potential plus the three-nucleon interaction are considered in the nuclear many-body Hamiltonian. The electron and muon are treated relativistically in the total Hamiltonian at given temperature, to make the fluid electrically neutral and stable against beta decay. The calculation is performed for a wide range of baryon density and temperature which are of interest in the astrophysics. The free energy, entropy, proton abundance, etc. of nuclear beta-stable matter are calculated. It is shown that by increasing the temperature, the maximum proton abundance is pushed to the lower density while the maximum itself increases as we increase the temperature. The proton fraction is not enough to see any gas-liquid phase transition. Finally we get an overall agreement with other many-body techniques, which are available only at zero temperature.Comment: LaTex, 20 page

Acceptability of aspirin for cancer preventive therapy: a survey and qualitative study exploring the views of the UK general population

Objectives Aspirin could be offered for colorectal cancer prevention for the UK general population. To ensure the views of the general population are considered in future guidance, we explored public perceptions of aspirin for preventive therapy. Design We conducted an online survey to investigate aspirin use, and awareness of aspirin for cancer prevention among the UK general population. We conducted semistructured interviews with a subsample of survey respondents to explore participants’ acceptability towards aspirin for cancer preventive therapy. We analysed the interview data using reflexive thematic analysis and mapped the themes onto the Theoretical Domains Framework, and the Necessity and Concerns Framework. Setting Online survey and remote interviews. Participants We recruited 400 UK respondents aged 50–70 years through a market research company to the survey. We purposefully sampled, recruited and interviewed 20 survey respondents. Results In the survey, 19.0% (76/400) of respondents were aware that aspirin can be used to prevent cancer. Among those who had previously taken aspirin, 1.9% (4/216) had taken it for cancer prevention. The interviews generated three themes: (1) perceived necessity of aspirin; (2) concerns about side effects; and (3) preferred information sources. Participants with a personal or family history of cancer were more likely to perceive aspirin as necessary for cancer prevention. Concerns about taking aspirin at higher doses and its side effects, such as gastrointestinal bleeding, were common. Many described wanting guidance and advice on aspirin to be communicated from sources perceived as trustworthy, such as healthcare professionals. Conclusions Among the general population, those with a personal or family history of cancer may be more receptive towards taking aspirin for preventive therapy. Future policies and campaigns recommending aspirin may be of particular interest to these groups. Multiple considerations about the benefits and risks of aspirin highlight the need to support informed decisions on the medication

Segregation by Racial and Demographic Group: Evidence from the San Francisco Bay Area

This paper considers residential segregation by race and by type of household in 1970 and 1980. The paper presents entropy indices of segregation for the San Francisco Bay Area and its five metropolitan areas. The methodology permits an investigation of the effects of group definition upon segregation measures, and an analysis of the degree of independence in the segregation of households by race and demographic group. The results indicate that the levels of segregation by race and by household type have declined modestly during the 1970s, at least in this region. More importantly, however, the results indicate a remarkable independence in the spatial distribution of households by race and demographic group. Only a very small fraction of the observed levels of segregation by race could be ’explained’ by the prior partitioning of households by demographic group. The principal results of the analysis are invariant to changes in the definition of racial or household groups

Massively-parallel electrical-conductivity imaging of hydrocarbonsusing the Blue Gene/L supercomputer

Large-scale controlled source electromagnetic (CSEM)three-dimensional (3D) geophysical imaging is now receiving considerableattention for electrical conductivity mapping of potential offshore oiland gas reservoirs. To cope with the typically large computationalrequirements of the 3D CSEM imaging problem, our strategies exploitcomputational parallelism and optimized finite-difference meshing. Wereport on an imaging experiment, utilizing 32,768 tasks/processors on theIBM Watson Research Blue Gene/L (BG/L) supercomputer. Over a 24-hourperiod, we were able to image a large scale marine CSEM field data setthat previously required over four months of computing time ondistributed clusters utilizing 1024 tasks on an Infiniband fabric. Thetotal initial data misfit could be decreased by 67 percent within 72completed inversion iterations, indicating an electrically resistiveregion in the southern survey area below a depth of 1500 m below theseafloor. The major part of the residual misfit stems from transmitterparallel receiver components that have an offset from the transmittersail line (broadside configuration). Modeling confirms that improvedbroadside data fits can be achieved by considering anisotropic electricalconductivities. While delivering a satisfactory gross scale image for thedepths of interest, the experiment provides important evidence for thenecessity of discriminating between horizontal and verticalconductivities for maximally consistent 3D CSEM inversions

Cumulative socioeconomic status and incident type 2 diabetes among African American adults from the Jackson heart study

Background: The cumulative socioeconomic status (SES) model posits that childhood and adult experiences accumulate to influence disease risk. While individual SES indicators such as education and income are independently associated with incident type 2 diabetes (T2D), the association of cumulative SES and incident T2D is unclear, especially in African American adults. Methods: We utilized cohort data of African American participants (n = 3681, mean age 52.6 years) enrolled in the Jackson Heart Study from 2000 to 2013 free of T2D or cardiovascular disease at baseline (2000–2004). Cumulative SES scores at baseline were derived using six SES indicators (education, wealth, income, occupation, employment status, and mother's education) categorized as low, middle, and high. Incident T2D was defined at exam 2 (2005–2008) or exam 3 (2009–2013) based on fasting glucose ≥126 mg/dL, HbA1c ≥ 6.5, reported diabetic medication use, or self-reported physician diagnosis. Proportional hazards regression, allowing for interval censoring, was used to estimate the association between cumulative SES and incident T2D (hazard ratio(HR), 95% confidence interval (CI)) after adjustment for covariates. Sex and age differences were tested using interaction terms. Results: There were 544 incident T2D cases. The association between low (versus high) cumulative SES and incident T2D was not significant (HR 1.04 [95% CI 0.85, 1.28]) and did not differ by sex (p value for interaction>0.05). However, there were differences by (age p value for interaction = 0.0052 for middle-aged adults and 0.0186 for older adults). Low (versus high) cumulative SES was associated a greater hazard of incident T2D among those 20–46 years (HR 1.12 [95% CI 1.03, 1.21]), 47–59 years (HR 1.25 [95% CI 1.06, 1.47]) and those 60–93 years (HR 1.39 [95% CI 1.09, 1.78]) after adjustment for sex and family history of diabetes. Associations attenuated after adding behavioral and lifestyle risk factors. Conclusion: The association of low cumulative SES and incident T2D differed by age, which may suggest interventionist should consider impacts of SES on T2D by age

Ramond-Ramond Fields, Fractional Branes and Orbifold Differential K-Theory

We study D-branes and Ramond-Ramond fields on global orbifolds of Type II string theory with vanishing H-flux using methods of equivariant K-theory and K-homology. We illustrate how Bredon equivariant cohomology naturally realizes stringy orbifold cohomology. We emphasize its role as the correct cohomological tool which captures known features of the low-energy effective field theory, and which provides new consistency conditions for fractional D-branes and Ramond-Ramond fields on orbifolds. We use an equivariant Chern character from equivariant K-theory to Bredon cohomology to define new Ramond-Ramond couplings of D-branes which generalize previous examples. We propose a definition for groups of differential characters associated to equivariant K-theory. We derive a Dirac quantization rule for Ramond-Ramond fluxes, and study flat Ramond-Ramond potentials on orbifolds.Comment: 46 pages; v2: typos correcte

Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012

Coronaviruses have the potential to cause severe transmissible human disease, as demonstrated by the severe acute respiratory syndrome (SARS) outbreak of 2003. We describe here the clinical and virological features of a novel coronavirus infection causing severe respiratory illness in a patient transferred to London, United Kingdom, from the Gulf region of the Middle East